This thesis explores the lived experience of those with Bipolar Disorder type I or type II condition. The aim is to delineate how individuals cope following the diagnosis of this chronic, recurrent mental illness. Twenty participants were interviewed in depth, producing 18 hours of recordings and 480 pages of transcript. Narrative data were thematically analysed to reveal themes common to the process of adaptation. The exploratory framework identified key elements of the lived experience of bipolar disorder, including: the phenomenology of highs and lows, the role of anxiety in triggering episodes, reactions to diagnosis, and issues with prescribed medications. Analyses highlighted how difficult it is for individuals to reconcile themselves to the symptoms and consequences of the illness, and also illustrated the extent of subjective distress and reduced quality of life incurred. The psychosocial burden, particularly the difficulties developing a sense of authenticity and coherent identity, and having to adjust life goals, were examined in detail. Negative coping behaviours, specifically the use of alcohol and drugs, as well as the influence of shame and guilt on peoples??? coping repertoires were also explored. Finally, the importance of psychosocial interventions, collaborative health care strategies and necessity for long-term, follow-up care were emphasised.

<p><strong>Syfte:</strong> Syftet med litteraturstudien var att beskriva brännskadade personers upplevelser av livet efter en brännskada. <strong>Bakgrund:</strong> En brännskada är ett trauma för både kropp och själ och ett stort lidande för den drabbade. Fysiska förändringar och psykologisk kris gör vägen tillbaka svår. Genom medicinskt kunnande och genom att vara ett medmänskligt stöd har sjuksköterskan en viktig roll under både den fysiska och psykiska läkningsprocessen. <strong>Metod: </strong>Studien är en allmän litteraturstudie baserad på fem kvalitativa vetenskapliga artiklar samt en självbiografi, publicerade mellan år 2003-2008. Analysen innebar att meningsbärande enheter togs ut och sammanfördes till tre huvudkategorier med tillhörande underkategorier. <strong>Resultat:</strong> De brännskadade upplevde att livet efter brännskadan innebar stort lidande och gjorde att de inte längre kunde vara självständiga. De upplevde bristande tillit till sin egen kropp vilket ledde till ett försämrat självförtroende. För att kunna gå vidare i livet var det viktigt att finna vägar för att acceptera och hantera det som hänt. Efter hand kunde livet ses positivt och värderas högre. Flera olika faktorer hade stor betydelse för att de skulle kunna känna trygghet i sitt förändrade liv. <strong>Slutsats: </strong>För att sjuksköterskan ska finnas där som stöd för den brännskadade behövs djupare kunskap inom området, vilket gör att ytterligare forskning är betydelsefull. Kunskapen skulle kunna spridas vidare genom att brännskadade föreläser om sina upplevelser och att de som är insatta i ämnet handleder personal inom hälso- och sjukvård utifrån casemetodik.</p> / <p><strong>Aim:</strong> The purpose was to describe how people with burn injuries experience their life after a burn injury. <strong>Background:</strong> A burn injury is a trauma for both body and soul and a big suffering for the person who is affected. Physical changes and psychological crisis makes it hard to recover. By medical knowledge and through human support nurses have an important role during the physical and psychological healing process. <strong>Method:</strong> This study is a literature overview, based on five qualitative scientific articles and one biography, published between the years 2003-2008. In the analysis meaning units were identified and brought together into main categories and sub categories. <strong>Result:</strong> People with burn injuries experiences that life after the injuries meant a great deal of suffering as well as a loss of independence. They experienced lacking trust in their own body, which lead to impaired self-confidence. To be able to move on in life, they had to find ways to accept and deal with what had happened. Several different factors were of importance to make them feel safety in their changed life. <strong>Conclusions: </strong>For the nurse to be able to be there for people with burn injuries, more knowledge of the subject is needed, which makes further research important. The knowledge could spread by the burn injured holding lectures about his or hers experiences, and by the well-informed tutoring health care staff and students using case methodology.</p>

<p> </p><p><strong>Bakgrund</strong>: Vårdpersonal möter i arbetet patienter som upplever rädsla. Inom omvårdnad är förståelse för människors upplevelser och erfarenheter central. Genom att försöka förstå fenomen som påverkar människans livsvärld gynnas relationen mellan vårdtagare och sjuksköterska. <strong>Syfte</strong>: Syftet var att beskriva fenomenet rädsla ur ett livsvärldsperspektiv. <strong>Metod</strong>: Studien baserades på 74 berättelser om rädsla skrivna av sjuksköterskestudenter. Kvalitativ innehållsanalys användes. <strong>Resultat</strong>: Situationer av ovisshet, maktlöshet eller hot utlöste rädsla. Under rädsleupplevelsen gjorde den tysta kroppen sig påmind, kroppen upplevdes okontrollerbar, informanterna blev tillfälligt förvirrade och fick förändrad verklighetsuppfattning. Kamp- och flyktbeteende och upplevelser av att rädslan födde nya känslor beskrevs också. När rädslan släppte tystnade kroppen, situationen upplevdes overklig och ibland genant och händelsen lämnade spår. <strong>Diskussion</strong>: Eftersom människor riktar medvetandet olika är det individuellt vad människor blir rädda för. Rädslan finns i levd kropp och påverkar samt påverkas av levd tid. Att gå till sig själv och förstå sin egen rädsla underlättar för att känna igen och förstå upplevelsen av rädsla hos andra. <strong>Slutsats</strong>: Att förstå och kunna möta rädsla hos andra är centralt i omvårdnad liksom i alla människovårdande yrken. Då upplevelsen av rädsla är central är det viktigt att förhålla sig fördomsfri till vad som utlöser rädsla hos andra människor och undvika att värdera rädslan.</p><p> </p> / <p> </p><p><strong>Background</strong>: Nursing staff often meet with patients that experience fear. An understanding of humans„ lived experiences is central in nursing. Attempts to understand phenomena that influence daily life of humans might contribute to a positive interaction between patient and nurse. <strong>Purpose</strong>: The aim was to describe fear from a life-world perspective. <strong>Method</strong>: The study was based on 74 narratives about fear, written by nursing students and a qualitative content analysis was used. <strong>Results</strong>: Situations that led to uncertainty and powerlessness triggered fear. When experiencing fear the usually silent body became "loud", the body was felt as uncontrollable and the informants were temporally confused and had an altered perception of reality. The fear arouses more and new emotions and wishes to fight and flee. When the fear faded away, the body became silent, the informants perceived the situation unreal and embarrassing and felt that the experience left marks on their bodies and minds. <strong>Discussion</strong>: What frightens humans is individual as different people direct their consciousness differently. Fear exists in the lived body. It influences and is influenced by the lived time. Attempts to make one‟s own fear consciousness contribute to an ability to recognize and understand other‟s fear as well.<strong> Conclusion</strong>: To see and understand other‟s fear is central in nursing, as well as in other caring services. Since lived experience of fear is central it is important not to be prejudiced about what situations that trigger fear and to avoid judging other peoples fear.</p><p> </p>

The number of men and women suffering from alcohol dependency is increasing.Today there are shortcomings in knowledge about the lived experiences of being a woman or a man with alcohol dependency; knowledge which might be of importance for meeting these individual’s specific care needs. The overall aim of the study was to obtain a deeper understanding of women and men's experience of living with alcohol dependency and being professionally cared for. The qualitative investigation design was exploratory and founded in a life world perspective. Data were collected from fourteen women and fifteen men with alcohol dependency by means of open in-depth interviews and subjected to a phenomenological-hermeneutic analysis. It was found that living with alcohol dependency encompasses a complex but limited life situation in which both women and men strive for social acceptance and adjustment. Women turned out to live a more introverted life than men and presented false facades. Men turned out to live a life in action, risk taking and control. Professional caring was shown to mean availability and confirmation of needs. For men with alcohol dependency professional caring meant support and gentle guidance in their active struggle against their alcohol dependency. For women, professional caring meant having an active caregiver who cherished them and enabled them to rest. Professional caring reduced senses of shame in both women and men. It may be concluded that in order to offer care for men and women with alcohol dependency professional carers have to consider gender specific needs of support and guidance. In addition, in order to alleviate suffering, professional caregivers have to be accessible, supportive and directed toward the alcohol dependent women's and men’s everyday world.

Bakgrund: Vårdpersonal möter i arbetet patienter som upplever rädsla. Inom omvårdnad är förståelse för människors upplevelser och erfarenheter central. Genom att försöka förstå fenomen som påverkar människans livsvärld gynnas relationen mellan vårdtagare och sjuksköterska. Syfte: Syftet var att beskriva fenomenet rädsla ur ett livsvärldsperspektiv. Metod: Studien baserades på 74 berättelser om rädsla skrivna av sjuksköterskestudenter. Kvalitativ innehållsanalys användes. Resultat: Situationer av ovisshet, maktlöshet eller hot utlöste rädsla. Under rädsleupplevelsen gjorde den tysta kroppen sig påmind, kroppen upplevdes okontrollerbar, informanterna blev tillfälligt förvirrade och fick förändrad verklighetsuppfattning. Kamp- och flyktbeteende och upplevelser av att rädslan födde nya känslor beskrevs också. När rädslan släppte tystnade kroppen, situationen upplevdes overklig och ibland genant och händelsen lämnade spår. Diskussion: Eftersom människor riktar medvetandet olika är det individuellt vad människor blir rädda för. Rädslan finns i levd kropp och påverkar samt påverkas av levd tid. Att gå till sig själv och förstå sin egen rädsla underlättar för att känna igen och förstå upplevelsen av rädsla hos andra. Slutsats: Att förstå och kunna möta rädsla hos andra är centralt i omvårdnad liksom i alla människovårdande yrken. Då upplevelsen av rädsla är central är det viktigt att förhålla sig fördomsfri till vad som utlöser rädsla hos andra människor och undvika att värdera rädslan. / Background: Nursing staff often meet with patients that experience fear. An understanding of humans„ lived experiences is central in nursing. Attempts to understand phenomena that influence daily life of humans might contribute to a positive interaction between patient and nurse. Purpose: The aim was to describe fear from a life-world perspective. Method: The study was based on 74 narratives about fear, written by nursing students and a qualitative content analysis was used. Results: Situations that led to uncertainty and powerlessness triggered fear. When experiencing fear the usually silent body became "loud", the body was felt as uncontrollable and the informants were temporally confused and had an altered perception of reality. The fear arouses more and new emotions and wishes to fight and flee. When the fear faded away, the body became silent, the informants perceived the situation unreal and embarrassing and felt that the experience left marks on their bodies and minds. Discussion: What frightens humans is individual as different people direct their consciousness differently. Fear exists in the lived body. It influences and is influenced by the lived time. Attempts to make one‟s own fear consciousness contribute to an ability to recognize and understand other‟s fear as well. Conclusion: To see and understand other‟s fear is central in nursing, as well as in other caring services. Since lived experience of fear is central it is important not to be prejudiced about what situations that trigger fear and to avoid judging other peoples fear.

Why, and what does it involve for an individual to perform Arts and Crafts, are the questions studied in this thesis. The purpose of this thesis is to examine the pedagogical conditions of Arts and Crafts objects, through studying the processes that take place where people give form to personal expressions and to understand the meanings these processes have for them. Phenomenological theory, especially the theory of the lived body, which presents the body as a unity not separated into body and thought, with object and subject in an inter-relationship, is used as a theoretical standpoint throughout the thesis. A phenomenological and a semiotic approach have been used to analyse and describe the empirical data. This thesis consists of three different studies, the examination of a place where Arts and Crafts are performed, the study of people's experiences of creating Arts and Crafts objects, and finally how people relate to their chosen Art and Craft materials. This contributes to an understanding of the pedagogical conditions and processes present in their relationship to work materials. The analysis illustrates that an opportunity for a new level of understanding is reached when particular pedagogical processes are carried out whilst working with various forms of Arts and Crafts materials. These processes understood as pedagogical conditions consist of: time and pace, physical and mental environment, materialization, the object and experience. Another finding is that there are different ways of relating to the Arts and Crafts materials, a bodily relation or a cognitive relation. These ways of relating exist in one person, but one of these relating attitudes is often more salient than the other. Making Arts and Crafts is in this thesis seen as an activity of both bodily and cognitive meaning making.

The overall aim of this thesis was to identify factors that early in a sick leave period could illuminate people’s resources and obstacles for returning to work; factors that could predict need for professional support in the sick leave process leading to a positive outcome for the individual. This thesis consists of four studies. The studied population was living in a rural part of a northern county in Sweden, and had been on sick leave for 28 days irrespective of diagnosis. The participants have been followed for five years with different investigation methods and subgroups of participants. The thesis was initiated by sending a questionnaire to the participants; the responses were compared to groups of healthy controls. The aim was to find predictors of the likelihood of a return to work that can be identified early in a sick leave period. The main focus was on individual mental resources (Study I). The next phase involved studies of sick leave statistics obtained from the Swedish Social Insurance Office, for the study population two years before and two years after the start of the research project. The material from the sick leave statistics was analysed together with responses from the questionnaire study with Partial Least Square (PLS). This was done to search for connections between the participants and factors of concern for sick leave and returning to work in different subgroups (Study II). In-depth interviews also were conducted to explore what the participants experienced as important in their sick leave process as they progressed back to work, or to long term sick leave or disability pension (Study III). Another study investigated client files in the Swedish Social Insurance Office to describe what information that was possible to find: in terms of medical and vocational rehabilitation including assessments, predictors for the outcome of the sick leave process, and the quality of the information in the files (Study IV). The findings showed significantly lower life satisfaction and psychosocial resources in the study-group compared to the healthy controls. The PLS analysis showed that it was the impact of multiple factors that influenced the study group, and the PLS analysis could help with early prediction of the outcome. Important factors were: personal belief in an ability to work in the future, number of sick leave days in the past, diagnosis, self-evaluated symptoms, life satisfaction and sense of coherence, length of education and sector of employment, and many different consequences in daily life caused by activity limitations. The interview study confirmed these results and added the following important resources: confirmation and support, structural and contextual factors, and participation in the sick leave process. Ideal-types were crystallized that can be identified in the early phases of the sick leave process. The client file study showed that some information was possible to find but a majority of the wanted information was limited why an improvement on the quality of documentation is suggested to give better basis for the files.

Avhandlingens övergripande syfte är att tolka och beskriva innebörder av stöd, utifrån att vara förälder till barn med funktionsnedsättning och att vara professionella stödjare. Datainsamling har skett i form av berättande intervjuer med 39 föräldrar (23 mödrar och 16 fäder) och 9 professionella (7 kvinnor, 2 män) från olika verksamheter. Samtliga intervjuer har analyserats med hjälp av fenomenologisk hermeneutisk metod. Innebörder av att vara förälder till barn med funktionsnedsättning (studie I) har tolkats som en medvetenhet om viktiga värden i livet. Barnet har ett inneboende värde som en unik person och föräldrarna strävar efter att göra sitt bästa för barnet. Denna strävan innebär att konfrontera oro, osäkerhet och rädsla i vården av barnet och andra personers nedvärdering av barnet. I föräldrarnas strävan att tillmötesgå barnets olika behov, ingår också att anpassa egna behov efter barnets. Den fördjupade förståelsen av studiens resultat är, att det handlar om en strävan att möjliggöra för barnet att leva ett gott liv. Innebörder av att få stöd av professionella (studie II) har tolkats som att föräldrar och barn blir bekräftade som värdefulla personer och att föräldrarna uppnår trygghet och kompetens i föräldraskapet och får ett hopp för barnets framtid. Erfarenheter av att inte få stöd, medför en kamp mot de professionella, för att kräva det stöd som föräldrarna anser att de och barnet behöver. Innebörder av att vara professionell stödjare (studie III), består av att ha personlig filosofi, som är integrerat i sättet att vara och handla som stödjare. Det innebär att vara trygg i hoppet om att det alltid går att göra något för att hjälpa, genom att söka unika lösningar i den aktuella situationen. Tillit till föräldrar som partners och att få deras tillit, samt att möjliggöra för föräldrarna att uppnå kompetens och trygghet i vården av sina barn är andra innebörder. Detta har tolkats som en frihet från att vara bunden av byråkrati och prestige och en möjlighet att vara äkta, följa sin filosofi och att vara i samklang med barn och föräldrar. Innebörder av informellt stöd (studie IV) har tolkats som en livsberikande gemenskap, där barnet, innefattas i kärleksfulla relationer med närstående och har en naturlig plats i samhället. Att som föräldrar kunna dela glädje, oro och sorg med andra personer och att få möjlighet att uppleva lättnad och spontanitet i det dagliga livet, är andra innebörder av informellt stöd. Helhetsförståelsen av de fyra studierna är, att stöd av professionella i sin tur är ett stöd i föräldrars etiska förpliktelse i deras strävan att möjliggöra för barnet att leva ett gott liv. Informellt stöd betyder att föräldrar och barn är inneslutna i trofasta och berikande relationer med andra. / The overarching aim of this thesis is to interpret and describe the meanings of support for parents from the context of being a parent of a child with disability. The data collection is based on narrative interviews with 39 parents (23 mothers and 16 fathers) and nine professionals (seven women and two men) from various areas in the health care system and local authority. A phenomenological hermeneutic method guided the text analyses. The meanings of being a parent of a child affected by disability (study I) have been interpreted as awareness about important values in life. The child has an intrinsic value as a unique person and the parents are striving to do their best for their child. This striving means confronting worries, unsafeness and fear in the care of the child and confronting other persons’ devaluation of the child. Adjusting the parents’ own needs to those of the child and orchestrating the child’s various needs are other meanings. The deepened understanding of the result of the study is that the parents are striving to enable the child a good life. Being supported by professionals (study II) means experiences of the child and oneself as being confirmed as valuable persons. Moreover, it enables parents to gain confidence and competence in their parenthood and hope for the child’s future. Experiences of lack of support give rise to a struggle against the professionals, aimed at getting the support the parents regard as necessary for their own and their child’s needs. The meanings of being a supporter (study III) were interpreted as being and acting according to a personal philosophy, which is integrated in the professional task, and believing that it is always possible to help by searching for unique solutions in the current situation. Trusting the parents as partners and enabling the parents to gain competence and confidence in the care of their children are further meanings. The deepened understanding of being a professional supporter is to be in tune with one’s philosophy and the child’s and parents’ needs. The meanings of informal support (study IV) were interpreted as experiences of being involved in true relationships with other persons. This enables the child and the parents to be in a life enriching togetherness. The interpreted whole of the studies is that being a parent of a child affected by disability means to strive for the fulfilment of the ethical obligation to enable the child to have a good life. To be supported by professionals means receiving help to fulfil the ethical obligation. Being a professional supporter means to be and act in accordance to the unique child and parent and the present situation. Informal support means to be involved in a natural human togetherness.

The purpose of this thesis is to describe what it is like to suffer from malignant lymphoma and to highlight the care given to these patients. A reflective lifeworld approach, founded in phenomenological philosophy, has been used. Data have been collected using interviews and have been analyzed using essence-seeking analysis. The results are founded upon three empirical studies and a philosophical excursus. The results are presented in four sections. The thesis describes how patients with malignant lymphoma live in limbo characterized by existential uncertainties, partly caused by the mortal threat of the disease and by failings in the actions of the healthcare staff. Patients fear dying when suffering from malignant lymphoma, regardless of whether the disease is a genuine medical threat to their life. Thus, there is a substantial need for existential support for these patients. However, the results show that deficiencies in existential support can lead to patients feeling objectified, which in turn increases their existential uncertainties. Care that is solely directed towards the physiological body and excludes the human as a subject can be experienced as a disparagement. Care that includes the patients’ lifeworld provides alleviated suffering and a possibility for the patients themselves to take an active part in the health process. Despite the healthcare staff’s genuine ambition to alleviate the suffering, patients’ existential questions are met with a degree of conflict; on the one hand they are a natural part of healthcare, and on the other the questions are of such character that they are not part of professional healthcare. A healthcare culture that does not fully acknowledge the importance of existential questions appears to be one of the greatest obstacles to a holistic healthcare approach. Furthermore, there appears to be a lack of shared strategies among the healthcare staff when meeting the patients’ existential questions. A conflict arises in an unnecessary battle between biology and existence, which in turn increases the patients’ existential insecurities. Medical knowledge is insufficient in caring for patients with malignant lymphoma. An understanding of caring science is needed in order for the care to become caring and able to meet the needs as described by patients with malignant lymphoma. Healthcare staff most be provided with sufficient support to meet the patients’ existential questions. The organization of healthcare is characterised by being a culture in which existential questions are not given sufficient attention. It seems that healthcare staff give priority to medical/technical tasks rather than conversations of existential character.

This thesis is focusing on the lived experience of dementia. Both living with a partner as well as living alone. There is no unequivocal picture of how it is to live with dementia and few studies have been carried out in homes of afflicted persons. A deeper understanding of how it is to live with dementia can be a good starting-point for caring and the organisation of care.    The aim of this thesis is to describe, clarify and explain the lived experience of dementia from a lifeworld theoretical point of view. Another aim is to illuminate how decision makers look upon persons with dementia, their life and their care. Interviews and observations have been used to collect data. Participating informants have been couples with one partner suffering from dementia, persons with dementia living alone, politicians, administrators and social workers. Data was analysed with a phenomenological and a hermeneutical approach.   To live as a couple where one part has dementia (study 1) implies to live in a heteronomous existence where both the person with dementia and the partner become strangers in a world that should be the most well-known and familiar. The couple’s existence is narrowed and controlled by the impact of the dementia disease and the existence  is characterised of hopelessness and homelessness.   To live alone with dementia (study 2) means to live with a broken identity when the person with dementia gradually loses the memory of himself and his life. It becomes a life where the world of the individual is reduced to a quiet background that does not demand attention. The person with dementia does not longer know how he or she should relate to the world. The existence is characterised by a strong sense of loneliness and only a vague knowledge of the situation. The person with dementia longs for other people and gets a sense of boredom in the existence.   The comprehensive interpretation (study 3) shows that life with dementia is characterised by a gradual loss of meaning in life due to a disturbed intentionality. With disturbed intentionality the person with dementia gets increasingly more difficulties in understanding the meaning of the use of everyday objects. The person with dementia fights this and tries to create meaningfulness in the existence – something which gets very difficult and strenuous in time, since even the easiest everyday chores have to be thought through to make sense and even to be accomplished. The effort can in time become overpowering for the person with dementia who then stops doing the chores and becomes passive.   Politicians, administrators and social workers (study 4) are well aware that dementia gives suffering to the afflicted and the partner. The care is not designed to meet their needs for home care, and the decision makers don’t know how to change this. The person with dementia becomes like an object when the social workers don’t includes them in a dialogue about their needs and care. The partner is left alone in solving difficult problems and in making difficult decisions.   The theory of intentionality can help the professionals in the care of persons with dementia. By helping the cared-for-person to ‘stretch the intentional threads’ the caregivers can give the person a possibility to be rooted in the world. A care that supports intentionality and identity and reaches all the way in to the homes of the person with dementia would improve their situation and increase their well-being. This is possible when engaging the person in every-day chores that promote meaning. This kind of care contributes to the possibility for the person with dementia to be rooted in language, time and space.