This thesis explores the phenomenon of touch and describes its meaning in the healthcare context. Caring science theory based on a lifeworld approach forms the theoretical perspective of the dissertation and consequently the patient perspective is guiding the research. The ontological, epistemological and methodological framework of the thesis is phenomenology. The overall aim was to describe the phenomenon of touch in the healthcare context. Touch showed to be a phenomenon with several diverse aspects being differentially explicit in different contexts. Four empirical studies were therefore conducted in different contexts. Further, a synthesis of the empirical results was carried out to show the invariant meanings and structure of the phenomenon. Furthermore, a philosophical illumination of the results was carried out to further deepen and expand the understanding of touch related to healthcare. The phenomenon of touch is described as a complex caring movement, as an interplay between lived bodies forming a foundation to understand health, suffering, well-being, and care. The results show how touch has the power to both alleviate the patients’ suffering and to experience joy and deep connectedness, as well as how touch can frighten and cause or worsen suffering. In order to take advantage of the caring potential, the person who touches must be fully present in all senses of the word. Caring touch of different kinds can never be reduced to a “method”. It is much more than a mechanical and static act or a treatment. Moreover, touch that is objectifying may be understood as an obstacle or detrimental for the caring relationship and well-being since it lacks the necessary pliable interpersonal room. Such touch creates distance and alienation rather than closeness, trust and togetherness. If the potential of touch for caring is to be used and the threat of non-caring warded off, then the intentionality of touch must be balanced visavi the existential vulnerability of the individual. Therefore carers need to be open and attentive to the lifeworld of the patients to enhance their health-processes and avoid hurting them.

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 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.

Bakgrund: Bröstcancer är vanligt i Sverige. Behandlingar vid bröstcancer leder till biverkningar som påverkar kvinnors levda kropp och sexualitet vilket skapar ett stort lidande. Det är sjuksköterskan ansvar att förebygga och lindra lidande. Det behövs en djupgående förståelse av patienters upplevelser vid bröstcancer för att sjuksköterska ska kunna bedriva en adekvat omvårdnad. Syfte: Att belysa kvinnors upplevelse av förändring i sin levda kropp vid bröstcancer. Metod: En beskrivande innebördsanalys av självbiografier. Resultat: Det framkom en upplevelse av stympning efter mastektomi och en rädsla för håravfall. Det fanns en förlust av den kvinnliga identiteten. Orkeslöshet var vanligt efter behandlingarna vilket påverkade vardagen. Oro fanns över vad andra tyckte om den nya kroppen. Sexualiteten försämrades och påverkade den levda kroppen. Rörelseförmågan upplevdes sämre efter behandlingarna. Trots alla biverkningar fanns en acceptans hos kvinnorna för den nya kroppen. Konklusion: Den levda kroppen och sexualiteten förändras vid bröstcancer och både den mentala och fysiska hälsan påverkas. Sjuksköterskan behöver prata och lyssna på patienten för att kunna ge en adekvat, personcentrerad vård. / Background: Breast cancer is common in Sweden. Breast cancer treatment results in side effects that affect their lived body and sexuality which cause tremendous suffering. The nurses’ responsibility is to prevent and relieve suffering. There is a need for a deeper understanding of patients’ experiences when diagnosed with breast cancer for the nurse to be able to give adequate care. Aim: To illustrate women experiences of changes in their lived body when diagnosed with breast cancer. Method: A qualitative study with descriptive content analysis of autobiographies. Result: An experience of being maimed after going through a mastectomy and a fear of hair loss emerged. There was a lost of the female identity. It was common to feel lack of energy during the treatment which affected everyday life. There was a concern about others thoughts regarding the new body. Sexuality was impaired and it affected their lived body. The ability to move became partially impaired after the treatments. Despite all side effects women started to accept their new body. Conclusion: The lived body and sexuality changes in connection with breast cancer. Both mental and physical health was impaired. The nurse needs to talk and listen to every patient to be able to give adequate, individual care.

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The thesis reflects on the dichotomy of language and speech. The separation, introduced by Ferdinand de Saussure and successfully interpreted and developed by Merleau-Ponty, is analyzed from a phenomenological perspective where the individual speech appears as live and intentional act; from this perspective, it gains advantages against the language as a system of signs. The problem of the diacricity of the meaning of speech is articulated keeping in mind that sensory perception is also diacritical. Moreover, sensory perception is expressive initially and always correlates to the expressivity of the lived body; therefore, the semantics of the philosophy of Merleau-Ponty represents embodied semantics. The author of the thesis agrees with the insight of Merleau-Ponty and his postulates that artistic painting, literature, and philosophy are forms of speaking whose resources are incrusted in the corporeity of human beings. Representing the extension of gestures and being determined by natural willingness of human beings to say and express something new, such forms of expression disclose the initial relationship of human beings with the world and witness the creativity of the linguistic activities of human beings. Defining the object of the research, it is reasonable to set the philosophical style and unmatched manner of speaking of Merleau-Ponty. It deliberates and substantiates the possibility of individual relationship of every human being with his/her speaking, and opens the... [to full text] / Disertacijoje apmąstoma kalbos ir kalbėjimo dichotomija. Ferdinando de Saussure’o įvesta ir Merleau-Ponty interpretuota bei vaisingai išplėtota perskyra analizuojama todėl, kad individualus kalbėjimas, pasitelkus fenomenologinę perspektyvą, atsiskleidžia kaip gyvas ir intencionalus, – šiuo požiūriu jis įgyja pranašumų kalbos, kaip uždaros ženklų sistemos, atžvilgiu. Kalbėjimo reikšmės diakritiškumo problema darbe artikuliuojama, turint omenyje, kad juslinis suvokimas yra diakritinis. Dar daugiau, juslinis suvokimas pirmapradiškai yra išraiškingas ir visada koreliuoja su gyvenamo kūno ekspresyvumu, todėl Merleau-Ponty filosofijoje semantika yra įkūnyta semantika. Disertacijos autorei pritariant Merleau-Ponty įžvalgai, postuluojama, jog tapyba, literatūra bei filosofija taip pat yra kalbėjimo formos, kurių šaltinis inkrustuotas žmogaus kūniškume. Pratęsdamos gestą ir būdamos apspręstos prigimtinio žmogaus troškimo išreikšti ir pasakyti kažką vis naujai, jos išreiškia pirmapradį žmogaus patiriamą santykį su pasauliu bei liudija kalbinės žmogaus veiklos kreatyvumą. Formuluojant šio tyrimo objektą, tikslinga išskirti ir paties Merleau-Ponty filosofavimo stilių bei ypatingą, analogo neturinčią kalbėjimo manierą. Ji išlaisvina bei pagrindžia kiekvieno žmogaus giliai asmeninio santykio su jo paties kalbėjimu galimybę ir atveria kelią naujai filosofavimo tendencijai, kuri numano žmogiškojo aš savęs bei jo prasmingo pasaulio ap-klausimą. Taigi, sekdama filosofo pavyzdžiu bei... [toliau žr. visą tekstą]

Kalba ir kalbėjimas Maurice’o Merleau-Ponty fenomenologinėje filosofijoje Disertacijoje apmąstoma kalbos ir kalbėjimo dichotomija. Ferdinando de Saussure’o įvesta ir Merleau-Ponty interpretuota bei vaisingai išplėtota perskyra analizuojama todėl, kad individualus kalbėjimas, pasitelkus fenomenologinę perspektyvą, atsiskleidžia kaip gyvas ir intencionalus, – šiuo požiūriu jis įgyja pranašumų kalbos, kaip uždaros ženklų sistemos, atžvilgiu. Kalbėjimo reikšmės diakritiškumo problema darbe artikuliuojama, turint omenyje, kad juslinis suvokimas yra diakritinis. Dar daugiau, juslinis suvokimas pirmapradiškai yra išraiškingas ir visada koreliuoja su gyvenamo kūno ekspresyvumu, todėl Merleau-Ponty filosofijoje semantika yra įkūnyta semantika. Disertacijos autorei pritariant Merleau-Ponty įžvalgai, postuluojama, jog tapyba, literatūra bei filosofija taip pat yra kalbėjimo formos, kurių šaltinis inkrustuotas žmogaus kūniškume. Pratęsdamos gestą ir būdamos apspręstos prigimtinio žmogaus troškimo išreikšti ir pasakyti kažką vis naujai, jos išreiškia pirmapradį žmogaus patiriamą santykį su pasauliu bei liudija kalbinės žmogaus veiklos kreatyvumą. Formuluojant šio tyrimo objektą, tikslinga išskirti ir paties Merleau-Ponty filosofavimo stilių bei ypatingą, analogo neturinčią kalbėjimo manierą. Ji išlaisvina bei pagrindžia kiekvieno žmogaus giliai asmeninio santykio su jo paties kalbėjimu galimybę ir atveria kelią naujai filosofavimo tendencijai, kuri numano žmogiškojo aš savęs bei jo... [toliau žr. visą tekstą] / The thesis reflects on the dichotomy of language and speech. The separation, introduced by Ferdinand de Saussure and successfully interpreted and developed by Merleau-Ponty, is analyzed from a phenomenological perspective where the individual speech appears as live and intentional act; from this perspective, it gains advantages against the language as a system of signs. The problem of the diacricity of the meaning of speech is articulated keeping in mind that sensory perception is also diacritical. Moreover, sensory perception is expressive initially and always correlates to the expressivity of the lived body; therefore, the semantics of the philosophy of Merleau-Ponty represents embodied semantics. The author of the thesis agrees with the insight of Merleau-Ponty and his postulates that artistic painting, literature, and philosophy are forms of speaking whose resources are incrusted in the corporeity of human beings. Representing the extension of gestures and being determined by natural willingness of human beings to say and express something new, such forms of expression disclose the initial relationship of human beings with the world and witness the creativity of the linguistic activities of human beings. Defining the object of the research, it is reasonable to set the philosophical style and unmatched manner of speaking of Merleau-Ponty. It deliberates and substantiates the possibility of individual relationship of every human being with his/her speaking, and opens the... [to full text]

This thesis investigates the structure of knowing, and it argues that existential trust is an epistemological category. The aim of the dissertation is to develop a view according to which all human activity is seen as an activity of a lived body, and in which the understanding of the structure of such activity is regarded as central for the solution even of epistemological problems. This view is not rooted in any one philosophical tradition, but circles around activity of the lived body. It connects thinkers who in other respects belong to different "isms" in philosophy. Central to the dissertation are Aristotle, Dewey, Merleau-Ponty, Wittgenstein, Ryle, Anscombe, Polanyi, and Grene. Michael Polanyi's concept of tacit knowledge, and connected concepts like attend to, attend from, and subsidiary awareness, are presented. Different kinds of subsidiary awareness, not noted by Polanyi, are distinguished. It is also argued that Polanyi has not seen all the implicatons of his view that instruments can be interiorized and be part of the lived body. Conversely, parts of the normally lived body can be exteriorized. Nor has Polanyi seen that one has subsidiary awareness of oneself as a certain kind ofperson. This fact, in turn, is shown to have implications for the way we constitute ourselves as agents. Since we are engendered agents, we always attend from gender. In the last decade, the concept of trust has definitely entered epistemology. Mostly, it has been in terms of trusting testimony and/or testifier. This thesis wants to deepen that account. There is a more fundamental kind of trust, namely trust in oneself and trust in the world. It is called existential trust, and it is of epistemological importance, too. Existential trust, it is claimed, is necessary in all acts of knowing. Probably, this fact is hard to discover without having recourse to a distinction like that between attending from and attending to. Existential trust is shown in the way we attend from something. Observation and thinking are central epistemological categories, of course, but they should be supplemented by trust. Without trust they cannot perform any epistemological work. Linguistically, 'to know' is a state verb. Superficially, it describes only a state, not an activity. This fact, however, does not contradict the view of knowledge put forward in the dissertation. To know is to have a disposition to perform successfully either some kind of action (= knowing how), or to perform some kind of true assertive speech act (= knowing that). Basically, knowing is an activity. / digitalisering@umu

Bakgrund: Varje år får cirka 7000 kvinnor i Sverige bröstcancer. Beskedet sätter kvinnorna i en kris där hela deras tillvaro hotas. Vardagen förändras och grundtryggheten försvinner vilket skapar starka känslor. Sjuksköterskor har ett ansvar att uppmärksamma och bemöta kvinnors sjukdomsupplevelse utifrån en helhetssyn. För att kunna ge en holistisk och etisk vård till bröstcancerdrabbade kvinnor i olika skeden behöver kunskap tillföras som bidrar till en ökad förståelse för deras situation. Syfte: Syftet är att beskriva upplevelsen av att leva med bröstcancer genom sjukdomens olika skeden. Metod: Vi har genomfört en litteraturstudie baserad på nio kvalitativa studier. Studierna söktes via CINAHL, MedLine och PubMed. Alla studier är utförda i västvärlden och belyser kvinnors upplevelse av sin sjukdom genom dess olika skeden. Resultat: Analysen av artiklarna mynnade ut i fem huvudkategorier: Vardag i förändring, Upplevelser av en förändrad kropp, Att börja se sig själv med nya ögon, Upplevelser av ny mening i tillvaron och Det önskade stödet i förändring. Därtill identifierades ett antal underkategorier. Att gå igenom bröstcancer präglade starkt kvinnornas syn på sig själva och sina kroppar. Genom sjukdomsförloppet gav det dödliga hotet upphov till en kamp för livet kantad av förluster. Kampen väckte en oväntad styrka och en drivkraft att överleva. Att komma ut på andra sidan var en ensam vandring. Diskussion: I resultatdiskussionen har begreppet livsvärld och Merleau-Pontys teori om den levda kroppen använts för att belysa kvinnornas förändrade vardagsliv, påverkan av självet och den kvinnliga identiteten genom sjukdomens olika faser. Krisen fick kvinnorna att rikta om sin uppmärksamhet mot det sjuka bröstet vilket gav ett främmandeskap inför sig själv och världen. Att återta tillgången till livet innebar att osäkert känna sig fram steg för steg. Utsattheten ledde till att många kvinnor omvärderade sina liv vilket resulterade i en ny identitet.

Made available in DSpace on 2015-05-14T12:11:45Z (GMT). No. of bitstreams: 1 Arquivototal.pdf: 633797 bytes, checksum: 1d551e5f29abe8b204fe26a85234d19f (MD5) Previous issue date: 2012-05-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Empiricism and intellectualism are distinct perspectives which, taking as a starting point the modernity with the thought of Rene Descartes and the English empiricists, guide the epistemological statute of various areas of scientific knowledge. In the contemporaneity, such perspectives are observed in areas such as anatomy, physiology, medicine, biology, psychology, among others. The comprehension of the body, which is influenced by the cited perspectives, often suffers from a reductionism which one moment tends to the psychologism, and one another to physicism. An approach which proposes an integral understanding of the body needs to take into account the various and complex aspects which compose it. The thought of Maurice Merleau-Ponty and of Sigmund Freud allows a reading of the body as a live and pulsatory instance which resists to the pretension of an objective definition of the body. The subjectivity which permeates all the corporal parts and mechanisms, as well as the pulsional forces which act on them, subvert all and any pretension of a reductionist framework, and impose on the corporeity a living and amazing character. / Empirismo e intelectualismo são perspectivas distintas que, sobretudo a partir da modernidade com o pensamento de Rene Descartes e dos empiristas ingleses, norteiam o estatuto epistemológico de diversas áreas do conhecimento científico. Na contemporaneidade, tais perspectivas se fazem perceber em áreas como a anatomia, fisiologia, medicina, biologia, psicologia, dentre outras. Não raro a compreensão do ser humano que advém dessas perspectivas padece de um reducionismo que hora tende ao psicologismo, hora ao fisicismo. A compreensão e a abordagem do corpo, por exemplo, padecem desse reducionismo. Uma abordagem que pretenda uma compreensão integral do corpo carece levar em conta os diversos e complexos aspectos que o compõem. O pensamento de Maurice Merleau-Ponty e de Sigmund Freud possibilita uma leitura do corpo como uma instância viva e pulsional que resiste a pretensão de uma definição objetiva do corpo. A subjetividade que permeia todas as partes e mecanismos corporais, bem como as forças pulsionais que agem sobre os mesmos, subvertem toda e qualquer pretensão de enquadramento reducionista, e impõem à corporeidade um caráter vivido e surpreendente.