Although the term empowerment is frequently and broadly used across disciplines, the meaning of the term is often ambiguous. The purpose of this qualitative hermeneutic phenomenological study was to explore the lived experience of individual members of Renters' Rights Group (RRG), a community development group focused on promoting safe and affordable housing, thereby creating a better understanding of the phenomenon of empowerment. The seven study participants, four males and three females, five of whom were Aboriginal, had been active members of RRG for two years or more. The theoretical framework for this study was Parse's Theory of Human Becoming. Four core concepts were identified as contributing to participants' sense of empowerment: connecting, struggling, contributing, and changing. The findings from this study can be used by nurses and other professionals who work with marginalized individuals or groups. Incorporation of Parse's Human Becoming Theory into practice, education, and research, may facilitate the reflection of caring upon which nursing is founded.

Although the term empowerment is frequently and broadly used across disciplines, the meaning of the term is often ambiguous. The purpose of this qualitative hermeneutic phenomenological study was to explore the lived experience of individual members of Renters' Rights Group (RRG), a community development group focused on promoting safe and affordable housing, thereby creating a better understanding of the phenomenon of empowerment. The seven study participants, four males and three females, five of whom were Aboriginal, had been active members of RRG for two years or more. The theoretical framework for this study was Parse's Theory of Human Becoming. Four core concepts were identified as contributing to participants' sense of empowerment: connecting, struggling, contributing, and changing. The findings from this study can be used by nurses and other professionals who work with marginalized individuals or groups. Incorporation of Parse's Human Becoming Theory into practice, education, and research, may facilitate the reflection of caring upon which nursing is founded.

Hearing loss is a silent, often overlooked condition which deprives people of the most basic of human needs--the ability to communicate effectively. The notion that there is a dearth of understanding by health care professionals when caring for persons with hearing loss has been acknowledged. This research study aimed to describe the meaning of what it is like to live with a different sense of hearing for seven Canadian participants. The process of inquiry was guided by Parses human becoming theory for nursing (1981, 1987, 1992, 1998). The Giorgi (1970, 1971, 1975, 1985, 1989, 1992) modification of the phenomenological method was used for analysis-synthesis. Five women and two men employed and ranging between 25 and 70 years shared their lived experiences with the researcher via email correspondence. Confidentiality and anonymity were assured. Participants were asked to write about what it is like for them to live with a different sense of hearing. The central finding of this study was: Living with a different sense of hearing is experiencing the joy-sorrow of hearing-not hearing unfolding through discovering gained-lost communication surfacing all-at-once with diminished-enhanced feelings of self while choosing the rhythm of revealing-concealing amid potential regard-disregard of others. The findings of this research build on Parses (1981, 1998) theory of human becoming and may enhance nurses understanding of what it is like to live with hearing loss, which may in turn alter the way nurses structure practice with persons who live with a different sense of hearing, making a difference in their quality of life.

Background: Pain is one of the most common and feared symptoms in palliative care and may cause suffering and reduced quality of life of the dying person. The pain has several different dimensions and is a subjective experience of each individual. How the nurse meets the palliative patient's pain is essential to good health of the patient, which allows a good and worthy death. Aim: The aim was to highlight nurses' experiences in meeting total pain in palliative care. Method: The literature review is based on ten scientific studies of which seven studies with a qualitative approach, a study using quantitative methods and two studies with mixed method. The studies included in the literature review has been reviewed and approved by an ethics committee. Searches were made in the databases MEDLINE and CINAHL Complete full text. Results: The results showed that nurses experienced difficulties to meet patients who experienced total pain. The nurses felt that they had insufficient knowledge and experience in meeting patients with total pain. The nurse worked much with existential conversation. Discussion: Nurses experienced an uncertainty in the face of existential questions, which is a difficult but important part of the work. This is discussed and anchored in Rosemarie Rizzo Parse nursing theory Human becoming along with the concept of caring. / Bakgrund: Smärta är ett av de vanligaste och mest fruktade symtomen i den palliativa vården och kan medföra lidande och försämrad livskvalitet hos den döende människan. Smärtan har flera olika dimensioner och är en subjektiv upplevelse hos varje enskild individ. Hur sjuksköterskan möter den palliativa patientens smärta är avgörande för en god vård av patienten vilket ger möjlighet till en god och värdig död. Syfte: Syftet var att belysa sjuksköterskors erfarenheter av att möta total smärta i palliativ vård. Metod: Litteraturöversikten baseras på tio vetenskapliga studier varav sju studier med kvalitativ metod, en studie med kvantitativ metod samt två studier med mixad metod. De studier som inkluderats i litteraturöversikten har granskats och godkänts av en etisk kommitté. Sökningar gjordes i databaserna Cinahl Complete och MEDLINE full text. Resultat: Resultatet visade att sjuksköterskor upplevde svårigheter att möta patienter som upplevde total smärta. Sjuksköterskorna upplevde sig ha bristande kunskap och erfarenhet av att möta patienter med total smärta. Sjuksköterskan arbetade mycket med existentiella samtal. Diskussion: Sjuksköterskor upplevde en osäkerhet i att möta existentiella frågor, vilket är en svår men viktig del i arbetet. Detta diskuteras och förankras i Rosmarie Rizzo Parses omvårdnadsteori Mänsklig tillblivelse tillsammans med begreppet vårdande.

Depuis plusieurs années, la définition des soins palliatifs a été élargie pour inclure toutes les maladies ayant un pronostic réservé. Le Québec s’est doté d’une politique de soins palliatifs dont l’un des principes directeurs est de maintenir les patients dans leur milieu de vie naturel. Alors que présentement environ 10 % de la population nécessitant des soins palliatifs en reçoit, on peut s’attendre à une augmentation des demandes de soins palliatifs à domicile dans les CSSS du Québec. La présente étude a pour but de décrire et comprendre l’expérience de dispenser des soins palliatifs à domicile pour des infirmières travaillant dans un contexte non spécialisé. Une étude qualitative ayant comme perspective disciplinaire la théorie de l’humain-en-devenir de Parse a été réalisée. Des entrevues ont été effectuées auprès de huit infirmières travaillant au maintien à domicile d’un CSSS de la région de Montréal qui font des soins palliatifs dans un contexte non spécialisé. L’analyse des données a été effectuée selon la méthode d’analyse phénoménologique de Giorgi (1997). Les résultats s’articulent autour de trois thèmes qui décrivent l’expérience de dispenser des soins palliatifs à domicile pour des infirmières qui travaillent dans un contexte non spécialisé. Elles accompagnent les patients et leur famille, en s’engageant à donner des soins humains, et développant une relation d’accompagnement avec le patient et ses proches. Elles doivent composer avec les réactions du patient et de sa famille et doivent parfois informer le patient de la progression de son état de santé. De plus, elles se préoccupent de donner des soins de qualité en composant avec la complexité des soins palliatifs à domicile tout en s’assurant de soulager les symptômes des patients et de tenter de développer leur expertise. Finalement, le fait d’être confrontée à la mort permet de cheminer. Ainsi, les infirmières vivent des émotions, reçoivent du soutien, sont touchées personnellement par la mort, éprouvent de la satisfaction envers les soins qu’elles donnent et apprennent personnellement de leur expérience. L’essence du phénomène à l’étude est que lorsque les infirmières font un véritable accompagnement du patient et de sa famille en s’efforçant de donner des soins de qualité, cela crée des conditions permettant qu’un cheminement personnel et professionnel sur la vie et la mort soit effectué par les infirmières. / In the past few years, the definition of palliative care was extended to include all diseases with a poor prognosis. The province of Quebec modified the health care system to focus more on ambulatory care and created a palliative care policy with one of its principal directives being to maintain patients in their own milieu. As only 10% of patients requiring palliative care presently receive it, we can expect an increase in demands for palliative home care in the CSSS’s of Quebec. The goal of the present study is to describe and understand the lived experiences of the nurses of a CSSS of the Montreal sector who deliver palliative home care in a nonspecialized context. A qualitative phenomenological research was developed with the Human Becoming Theory of R.R. Parse as a theoretical framework. Eight semi-directed interviews were done with nurses working in home care of a CSSS of the Montreal region. These nurses do palliative care in a non-specialized context. Giorgi’s (1997) phenomenological method was used for data analysis. Three themes describing the experiences of home care nurses providing palliative care in a non specialized context emerged from the analysis. Nurses accompany patients and their families, by committing themselves to providing humane care and by developing an accompaniment relationship with the patient and his/her loved ones. Nurses must cope with the patient’s and family’s reactions and often need to inform the patient of the progression of his/her disease. Secondly, nurses are dedicated to provide quality care by dealing with the complexity of providing palliative care at home, while doing symptoms management and attempting to develop their expertise. Finally, the theme which has the most interesting results is that being confronted by death allows nurses to grow. Nurses personally go through emotions, received support, are personally touched by death, experience satisfaction by the care they give and personally learn by their experience. The essence of the phenomenon is that when nurses providing palliative home care in a non specialized context accompany truly patients and their family, while giving quality care, it creates conditions for the nurses to grow personally and professionally on their views of life and death.

Depuis plusieurs années, la définition des soins palliatifs a été élargie pour inclure toutes les maladies ayant un pronostic réservé. Le Québec s’est doté d’une politique de soins palliatifs dont l’un des principes directeurs est de maintenir les patients dans leur milieu de vie naturel. Alors que présentement environ 10 % de la population nécessitant des soins palliatifs en reçoit, on peut s’attendre à une augmentation des demandes de soins palliatifs à domicile dans les CSSS du Québec. La présente étude a pour but de décrire et comprendre l’expérience de dispenser des soins palliatifs à domicile pour des infirmières travaillant dans un contexte non spécialisé. Une étude qualitative ayant comme perspective disciplinaire la théorie de l’humain-en-devenir de Parse a été réalisée. Des entrevues ont été effectuées auprès de huit infirmières travaillant au maintien à domicile d’un CSSS de la région de Montréal qui font des soins palliatifs dans un contexte non spécialisé. L’analyse des données a été effectuée selon la méthode d’analyse phénoménologique de Giorgi (1997). Les résultats s’articulent autour de trois thèmes qui décrivent l’expérience de dispenser des soins palliatifs à domicile pour des infirmières qui travaillent dans un contexte non spécialisé. Elles accompagnent les patients et leur famille, en s’engageant à donner des soins humains, et développant une relation d’accompagnement avec le patient et ses proches. Elles doivent composer avec les réactions du patient et de sa famille et doivent parfois informer le patient de la progression de son état de santé. De plus, elles se préoccupent de donner des soins de qualité en composant avec la complexité des soins palliatifs à domicile tout en s’assurant de soulager les symptômes des patients et de tenter de développer leur expertise. Finalement, le fait d’être confrontée à la mort permet de cheminer. Ainsi, les infirmières vivent des émotions, reçoivent du soutien, sont touchées personnellement par la mort, éprouvent de la satisfaction envers les soins qu’elles donnent et apprennent personnellement de leur expérience. L’essence du phénomène à l’étude est que lorsque les infirmières font un véritable accompagnement du patient et de sa famille en s’efforçant de donner des soins de qualité, cela crée des conditions permettant qu’un cheminement personnel et professionnel sur la vie et la mort soit effectué par les infirmières. / In the past few years, the definition of palliative care was extended to include all diseases with a poor prognosis. The province of Quebec modified the health care system to focus more on ambulatory care and created a palliative care policy with one of its principal directives being to maintain patients in their own milieu. As only 10% of patients requiring palliative care presently receive it, we can expect an increase in demands for palliative home care in the CSSS’s of Quebec. The goal of the present study is to describe and understand the lived experiences of the nurses of a CSSS of the Montreal sector who deliver palliative home care in a nonspecialized context. A qualitative phenomenological research was developed with the Human Becoming Theory of R.R. Parse as a theoretical framework. Eight semi-directed interviews were done with nurses working in home care of a CSSS of the Montreal region. These nurses do palliative care in a non-specialized context. Giorgi’s (1997) phenomenological method was used for data analysis. Three themes describing the experiences of home care nurses providing palliative care in a non specialized context emerged from the analysis. Nurses accompany patients and their families, by committing themselves to providing humane care and by developing an accompaniment relationship with the patient and his/her loved ones. Nurses must cope with the patient’s and family’s reactions and often need to inform the patient of the progression of his/her disease. Secondly, nurses are dedicated to provide quality care by dealing with the complexity of providing palliative care at home, while doing symptoms management and attempting to develop their expertise. Finally, the theme which has the most interesting results is that being confronted by death allows nurses to grow. Nurses personally go through emotions, received support, are personally touched by death, experience satisfaction by the care they give and personally learn by their experience. The essence of the phenomenon is that when nurses providing palliative home care in a non specialized context accompany truly patients and their family, while giving quality care, it creates conditions for the nurses to grow personally and professionally on their views of life and death.

Sommaire La situation actuelle des infections nosocomiales dans les établissements de santé est préoccupante. En ce qui concerne le Clostridium difficile (C. difficile), son émergence et son impact sur la morbidité et la mortalité sont bien connus. De plus, la population vieillissante est à risque élevé d’avoir des diarrhées associées au C. difficile et, de ce fait, de se retrouver en isolement de contact. Les personnes âgées sont déjà vulnérables au moment d’une hospitalisation, alors qu’en est-il lors d’un isolement de contact relié à une infection au C. difficile? Dans cette perspective, les connaissances sur l’expérience des personnes âgées lors d’un isolement étant peu développées, cette étude s’est intéressée au vécu des personnes âgées durant l’isolement de contact et aux effets de cet isolement sur leur vécu. Le but de cette étude phénoménologique, prenant appui sur la Théorie de l’humain en devenir de Parse (2003), était de décrire et comprendre l’expérience de personnes âgées de 75 ans et plus lors d’un isolement de contact en milieu hospitalier causé par une infection au C. difficile. Ainsi, des entrevues semi-structurées furent réalisées auprès de cinq personnes âgées qui ont accepté de participer à l’étude, puis la transcription de leurs propos fut analysée selon la méthode proposée par Giorgi (1997). De cette analyse sont ressortis trois thèmes : 1) Vivre les effets du Clostridium difficile; 2) Vivre de l’inquiétude et 3) Vivre de la déception dans la relation avec le personnel soignant. Poussant plus loin l’analyse des thèmes et sous-thèmes, il a été possible de proposer que l’essence de l’expérience de personnes âgées de 75 ans et plus lors d’un isolement de contact en milieu hospitalier causé par une infection au C. difficile était de « vivre à la fois en conjonction avec le besoin d’être isolé pour protéger son univers et en séparation avec le besoin de recevoir des soins qui respectent leur dignité, et ce, malgré la vulnérabilité induite par leur état de santé ». Ces résultats pourront sensibiliser les personnes soignantes qui accompagnent au quotidien les personnes âgées en isolement. La compréhension de leur vécu pourra favoriser la mise en place de soins davantage centrés sur la personne qui tiennent compte de leurs inquiétudes, de leurs craintes et de l’importance de préserver leur dignité. Mots clés : Effets psychologiques, expérience de l’isolement de contact, Clostridium difficile, personnes âgées, phénoménologie, théorie de l’humain en devenir. / Summary The current situation of nosocomial infections in health facilities is a concern. With regard to Clostridium difficile (C. difficile), its emergence and its impact on morbidity and mortality is well known. Moreover, the aging population is at high risk of having diarrhea associated with C. difficile and, therefore, of being in contact isolation. Seniors are already made vulnerable by a hospitalization, then what about when there is a contact isolation related to an infection with C. difficile? In this perspective, since knowledge about the experience of older people being isolated is not quite developed, this study examined the experiences of seniors during the isolation contact and the effects of this isolation on their experiences. The purpose of this phenomenological study, building on the Theory of human becoming of Parse (2003), was to describe and understand the experience of people aged 75 and over and hospitalized in a contact isolation, caused by infection with C. difficile. Thus, semi-structured interviews were conducted with five seniors who agreed to participate in the study, and the transcript of their remarks was analyzed by the method suggested by Giorgi (1997). From this analysis emerged three themes: 1) Living the effects of Clostridium difficile, 2) Living anxiety and 3) Living the disappointment in the relationship with the nursing staff. Pushing further the analysis of themes and sub-themes, it was possible to propose that the essence of the experience of people aged 75 and over hospitalized in a contact isolation caused by infection C. difficile, was “to live both in conjunction with the need to be isolated to protect their world and separation from the need to receive care which respects their dignity, despite the vulnerability induced by their state of health”. These results may sensitize caregivers who accompany elderly on a daily basis in isolation. Understanding their experience will encourage the development of care that takes into account their concerns, their fears and the importance of preserving their dignity. Keywords: Psychological impact, experience of isolation contact, Clostridium difficile, elderly, phenomenology, theory of human becoming.

Sommaire La situation actuelle des infections nosocomiales dans les établissements de santé est préoccupante. En ce qui concerne le Clostridium difficile (C. difficile), son émergence et son impact sur la morbidité et la mortalité sont bien connus. De plus, la population vieillissante est à risque élevé d’avoir des diarrhées associées au C. difficile et, de ce fait, de se retrouver en isolement de contact. Les personnes âgées sont déjà vulnérables au moment d’une hospitalisation, alors qu’en est-il lors d’un isolement de contact relié à une infection au C. difficile? Dans cette perspective, les connaissances sur l’expérience des personnes âgées lors d’un isolement étant peu développées, cette étude s’est intéressée au vécu des personnes âgées durant l’isolement de contact et aux effets de cet isolement sur leur vécu. Le but de cette étude phénoménologique, prenant appui sur la Théorie de l’humain en devenir de Parse (2003), était de décrire et comprendre l’expérience de personnes âgées de 75 ans et plus lors d’un isolement de contact en milieu hospitalier causé par une infection au C. difficile. Ainsi, des entrevues semi-structurées furent réalisées auprès de cinq personnes âgées qui ont accepté de participer à l’étude, puis la transcription de leurs propos fut analysée selon la méthode proposée par Giorgi (1997). De cette analyse sont ressortis trois thèmes : 1) Vivre les effets du Clostridium difficile; 2) Vivre de l’inquiétude et 3) Vivre de la déception dans la relation avec le personnel soignant. Poussant plus loin l’analyse des thèmes et sous-thèmes, il a été possible de proposer que l’essence de l’expérience de personnes âgées de 75 ans et plus lors d’un isolement de contact en milieu hospitalier causé par une infection au C. difficile était de « vivre à la fois en conjonction avec le besoin d’être isolé pour protéger son univers et en séparation avec le besoin de recevoir des soins qui respectent leur dignité, et ce, malgré la vulnérabilité induite par leur état de santé ». Ces résultats pourront sensibiliser les personnes soignantes qui accompagnent au quotidien les personnes âgées en isolement. La compréhension de leur vécu pourra favoriser la mise en place de soins davantage centrés sur la personne qui tiennent compte de leurs inquiétudes, de leurs craintes et de l’importance de préserver leur dignité. Mots clés : Effets psychologiques, expérience de l’isolement de contact, Clostridium difficile, personnes âgées, phénoménologie, théorie de l’humain en devenir. / Summary The current situation of nosocomial infections in health facilities is a concern. With regard to Clostridium difficile (C. difficile), its emergence and its impact on morbidity and mortality is well known. Moreover, the aging population is at high risk of having diarrhea associated with C. difficile and, therefore, of being in contact isolation. Seniors are already made vulnerable by a hospitalization, then what about when there is a contact isolation related to an infection with C. difficile? In this perspective, since knowledge about the experience of older people being isolated is not quite developed, this study examined the experiences of seniors during the isolation contact and the effects of this isolation on their experiences. The purpose of this phenomenological study, building on the Theory of human becoming of Parse (2003), was to describe and understand the experience of people aged 75 and over and hospitalized in a contact isolation, caused by infection with C. difficile. Thus, semi-structured interviews were conducted with five seniors who agreed to participate in the study, and the transcript of their remarks was analyzed by the method suggested by Giorgi (1997). From this analysis emerged three themes: 1) Living the effects of Clostridium difficile, 2) Living anxiety and 3) Living the disappointment in the relationship with the nursing staff. Pushing further the analysis of themes and sub-themes, it was possible to propose that the essence of the experience of people aged 75 and over hospitalized in a contact isolation caused by infection C. difficile, was “to live both in conjunction with the need to be isolated to protect their world and separation from the need to receive care which respects their dignity, despite the vulnerability induced by their state of health”. These results may sensitize caregivers who accompany elderly on a daily basis in isolation. Understanding their experience will encourage the development of care that takes into account their concerns, their fears and the importance of preserving their dignity. Keywords: Psychological impact, experience of isolation contact, Clostridium difficile, elderly, phenomenology, theory of human becoming.

This study was designed to understand the meaning of the lived experiences of incarcerated male juveniles who had committed drug-related crimes and to suggest guidelines for their rehabilitation with specific reference to their health care needs. In order to achieve these objectives, the researcher used Parse’s (1998) Theory of Human Becoming as a theoretical framework for the study and Parse’s (1998, 2005) phenomenological-hermeneutic research method. This study was restricted to three juvenile correctional centres in the Gauteng province, Republic of South Africa (RSA). A sample of 15 male juveniles (5 at each of the three juvenile correctional centres) was used for the purpose of individual dialogical engagements with the participants. Focus group interview sessions were held with two groups (5 members per group) at two identified juvenile correctional centres. A qualitative content analysis according to methods recommended by Graneheim and Lundman (2004) was performed on the data that was collected from the individual dialogical-engagements and the focus group interviews. The researcher attempted to elucidate the meanings that the participants attached to their experiences of incarceration as narrated by them and analysed the data according to Parse’s (1998; 2005) phenomenological-hermeneutic method comprising of extraction-synthesis and heuristic interpretation. The findings of this research confirm that problems of drug abuse and criminal activity represent a multifaceted, complex and often intractable phenomenon. The research also confirmed that the participants suffer from a variety of emotional and psychological problems such as depression, anxiety, fear, guilt, remorse, regret and a craving for the drugs that they had abused before their incarceration. It appears that the participants find it extremely difficult to deal effectively with these disorders on their own and that they are generally averse to asking for professional help and assistance. Interventions to alleviate these problems are crucial for the success of the current rehabilitation programmes being pursued in the correctional centres where the participants are accommodated. / Health Studies / D. Litt. et Phil. (Health Studies)

This study was designed to understand the meaning of the lived experiences of incarcerated male juveniles who had committed drug-related crimes and to suggest guidelines for their rehabilitation with specific reference to their health care needs. In order to achieve these objectives, the researcher used Parse’s (1998) Theory of Human Becoming as a theoretical framework for the study and Parse’s (1998, 2005) phenomenological-hermeneutic research method. This study was restricted to three juvenile correctional centres in the Gauteng province, Republic of South Africa (RSA). A sample of 15 male juveniles (5 at each of the three juvenile correctional centres) was used for the purpose of individual dialogical engagements with the participants. Focus group interview sessions were held with two groups (5 members per group) at two identified juvenile correctional centres. A qualitative content analysis according to methods recommended by Graneheim and Lundman (2004) was performed on the data that was collected from the individual dialogical-engagements and the focus group interviews. The researcher attempted to elucidate the meanings that the participants attached to their experiences of incarceration as narrated by them and analysed the data according to Parse’s (1998; 2005) phenomenological-hermeneutic method comprising of extraction-synthesis and heuristic interpretation. The findings of this research confirm that problems of drug abuse and criminal activity represent a multifaceted, complex and often intractable phenomenon. The research also confirmed that the participants suffer from a variety of emotional and psychological problems such as depression, anxiety, fear, guilt, remorse, regret and a craving for the drugs that they had abused before their incarceration. It appears that the participants find it extremely difficult to deal effectively with these disorders on their own and that they are generally averse to asking for professional help and assistance. Interventions to alleviate these problems are crucial for the success of the current rehabilitation programmes being pursued in the correctional centres where the participants are accommodated. / Health Studies / D. Litt. et Phil. (Health Studies)