The aim of this study is to analyze the intertwined ontology and hermeneutics of the famous Muslim figure Ibn al-&lsquo / Arab&amp / #299 / with a phenomenological hermeneutical approach. The research subject Ibn al-&lsquo / Arab&amp / #299 / is to be scrutinized in comparison with Western phenomenology and hermeneutics. Hence, both phenomenology and hermeneutics will be not only the subject of the present study, but also its method of analysis. Throughout the study, Ibn al-&lsquo / Arab&amp / #299 / &rsquo / s question of being and hermeneutics will be compared with Western phenomenology and hermeneutics, with particular focus on Heidegger, Merleau-Ponty and Gadamer. In his account of ontology, the encounter of human being with the world happens always subjectively. On the side of hermeneutics, the world, which is textual, unfolds itself always through and only with interpretation. These two points can be unified and summed up in Ibn al-&lsquo / Arab&amp / #299 / &rsquo / s claim that world is an imagination. World is disclosed always subjectively and via interpretation / it is an imagination both hermeneutically and ontologically.

The study aims to demonstrate the significance of educators lived experiences of stimulating children's physical development. It has been noted that children are occupying themselves with more and more sedentary activities, which may lead to that they do not develop motor skills at the pace expected. To understand educators lived experiences from a phenomenological hermeneutic perspective empirical relevance has been collected through narrative interviews. The results shows that educators find it difficult to understand the Curriculum goals for motor activity and that the desire to stimulate motor development is great, but the realization is conspicuous by its absence. The discussion highlights educator’s commitment and motivation and the importance of being a reflecting practitioner. / Syftet med studien är att belysa innebörder i pedagogers levda erfarenheter av att stimulera barns motoriska utveckling. Det har uppmärksammats att barn sysselsätter sig med allt mer stillasittande aktiviteter, vilket kan leda till att elever inte utvecklar motoriken i den takt som förväntas. Empirin har samlats in genom narrativa intervjuer för att kunna tolka pedagogers levda erfarenheter ur ett fenomenologisk hermeneutiskt perspektiv. Resultatet visar att pedagoger har svårt att tolka läroplanens mål för motoriken och att viljan till att stimulera till motorisk utveckling är stor, men handlandet lyser med sin frånvaro. Diskussionen belyser pedagogers engagemang och motivation samt vikten av att vara en reflekterande praktiker.

<p>Härtill 5 uppsatser.</p> / digitalisering@umu

The aims of this thesis are to illuminate the meaning of being cared for and treated by nurses and physicians, as narrated by psychiatric suicidal in-patients; the meaning of taking care of and treating patient at risk of committing suicide, as narrated by nurses and physicians; and the meaning of being met and having one’s suicidal relative taken care of by health personnel, as narrated by relatives. Narrative interviews were conducted with 42 adult patients at risk of committing suicide in an in-patient psychiatric unit, 19 RNs, 19 physicians, and 15 relatives at a hospital in Norway. The tape-recorded and transcribed interviews were interpreted using a phenomenological hermeneutic method. Nurses’ relations to patients at risk of committing suicide were illuminated via the dimension ‘Distance- Closeness’ (I). The relation of the suicidal patient to the nurses was illuminated via the dimension ‘Confirming- Lack of confirming’ (II). The relation of physicians to patients was illuminated via the dimension ‘Power to - Power over’. (III). The relation of suicidal patients to physicians was illuminated via the dimension ‘Participating approach-Observing approach’ (TV). Results from the relatives’ experiences of being met by health personnel of suicidal patients reveal that the context of being met was characterized by ‘being helpless-powerless’, and that the meaning of the experiences of ‘being met’ was reflected in six themes: ‘Being seen as a human being’; ‘Participating in an I-Thou relationship with personnel’; ‘Trusting personnel, treatment and care’; ‘Being trusted by personnel’; ‘Being consoled’; and ‘Entering into hope’ (V). The interpreted meanings of the experience of being cared for as a person at risk of committing suicide were illuminated as confirmation, communion, consolation and hope. Threaded through these meanings is the relation with self and others. Thus, the essence of the results that emerged from this study indicates the presence of a relational view of the care received by people at risk of committing suicide. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 2001, härtill 5 uppsatser</p> / digitalisering@umu

The overall purpose of this thesis is to illuminate meanings of living with severe chronic heart failure (CHF) in palliative advanced home care (PAHC) as disclosed through patients’, close relatives’ and nurses’ narratives. This thesis comprises four papers that illuminate the phenomenon from various perspectives and with different focus. In paper I four patients with severe CHF in PAHC were interviewed. In paper II three of their close relatives were interviewed. In paper III one man and his wife in PAHC were interviewed at 3-5 month intervals over a 4.5-years period. In paper IV 11 nurses in PAHC were interviewed. In all papers narrative interviews were conducted and the text was interpreted using a phenomenological-hermeneutic method. The result shows that meanings of living with severe CHF in PAHC is to be ‘knocking on death’s door’ yet surviving. This means never knowing what to expect of tomorrow as one suffers from a complex array of unpredictable, interwoven symptoms. The course of the illness forces sufferer to ride a symbolical ‘roller coaster’, an ongoing oscillation between ‘ups and downs’. Being offered a safety belt in the ‘roller coaster’ by the PAHC team means feelings of safety (I). Meanings of being a close relative of a person with severe CHF in PAHC is to be following the life- threatening ups and downs that the ill person goes through. It is like being a fellow passenger on the ‘roller coaster’ ride that is their loved one’s disease, with burdensome responsibility for easing the ‘downs’ and supporting the ‘ups’. This means being on primary call, always on standby to mediate security and pleasure. In the deepest downs it is also to call for the back-up call i.e. the PAHC team (II). Meanings of living the ‘ups and downs’ over time is being captive in a roller-coaster ride, side by side, with the ‘ups and downs’ caused by the illness. Living close to death is inescapable when recurrent periods of deepest ‘downs’ force one to face that one’s life together is coming to an end. The relationship between the spouses is severely tested but seems to withstand the strain and meaning is found in togetherness in life. Sharing the safety belt on the ‘roller coaster’, offered by the PAHC team, evokes feelings of security. However, the safety belt is adjusted to the man with severe CHF leaving the wife partly without comfort and at times uncertain, especially in the deepest ‘downs’ (III). Meanings of being a palliative nurse for patients with severe CHF in PAHC is being firmly rooted and guided by the values of palliative culture. Being a facilitator for the patient with CHF to live his/her everydaylife in the best way possible is difficult, challenging but overall positive. The nurses get into a tight corner when palliative culture values clash and do not correspond to nurses’ interpretation of what is good for the patient with severe CHF. There is a limit to nurses’ pliability to patients’ and close relatives’ will, as they are strongly convinced that resuscitation is not an option. Nurses have already made up their mind about that they do not perform heart- lung resuscitation (IV). The comprehensive understanding is that meanings of living with severe CHF in PAHC is being captive in a ‘roller-coaster’ life with varying periods between unpredictable improvement and deterioration of the body, for the rest of life. Living with the unpredictable, deteriorated body means to oscillate between enduring the suffering in ‘downs’ and enjoying life in ‘ups’ (I-III). Living with death so close over and over again i.e. being in a limit situation evokes feelings of uncertainty (I-IV) and confidence (I-III). Being positive dependent on PAHC facilitates a life as normal as possible in togetherness at home (I-IV). The comprehensive understanding of the four papers (I-IV) are discussed in the light of a theoretical framework from the German psychiatrist and philosopher Karl Jaspers thoughts about limit situation, the Danish philosopher K.E Lögstrup thoughts about the ethical demand, palliative theories and relevant empirical studies.

The purpose of this thesis is to explore how men experience living with localized prostate cancer. It includes four substudies carried out between 1997 and 2005. To gather data, the men were interviewed at home and the interviews were recorded. The men (n=27; ages 60-70) who participated in the substudies had a PSA ≤10 ng/ml at the time of diagnosis, and had what is known as low-risk prostate cancer. Seven of the men chose to “wait and see” how the disease would progress after receiving the diagnosis. Twenty men chose curative treatment (10 men external radiation therapy, 10 men radical surgery). The interviews were analyzed using a phenomenological hermeneutical method inspired by the philosophy of Paul Ricoeur, and qualitative content analysis. Men who live with localized prostate cancer perceive the disease as life-threatening, unpredictable, and without early symptoms, which creates a sense of uncertainty, worry, anxiety, despair, and fear of death. Men primarily share perceptions of the disease and treatment with their wives and relatives, as well as with other men in the same situation. They avoid talking about their illness, and keep their innermost thoughts about their disease, prognosis, and the future to themselves. The choice to share their thoughts and feelings only sparingly with others is related in part to the perceived stigmatization of the diagnosis, as well as to consideration for friends and family. The men report that external radiation therapy and radical surgery have negative side effects such as erectile dysfunction, urinary incontinence, and intestinal leakage. They describe the side effects as socially isolating; for example, urinary leakage can require a change of incontinence pads and clothing, and they feel that they smell bad. Men with erectile dysfunction describe themselves as maimed, and their sex lives have changed or disappeared. They report a change in their self-esteem and identity as men and they long for life as it was before the diagnosis, when they felt they had control over their bodily functions. A few men describe a sense of being literally and figuratively “exposed” when they are undressed for examinations or participate in discussions with female doctors and nurses about their erectile dysfunction. They do not describe this perception in the same way with respect to contact with male personnel. In the new situation after treatment, men try to regain a perceived sense of control in their daily lives, over the disease and the effects of treatment. They experience a sense of control over the disease through regular PSA tests; the implications of regular PSA tests can be interpreted as a life preserver in an uncertain world, considering that at the time they were diagnosed they had no symptoms and only had a PSA elevation. The PSA is important for this sense of control, and each PSA test is preceded by tense expectation. The PSA level is described as a reliable expression of the medical condition. The men cannot trust that their own perception of feeling healthy means that the disease is under control. Low and stable PSA levels over a long period of time give a sense of safety, security, and control over the situation. If the PSA climbs, the men feel that despite everything, they have caught it in time for further treatment. Discussions with other men with prostate cancer are also described as a way of having control over the situation. The men's endeavor to reconcile themselves to the new situation can be understood as a process, where they describe various strategies which can be used to forget the “cancer perspective” and achieve a perception of safety and security. Reconciliation with a new situation can be interpreted as a reorientation after the trauma of the cancer diagnosis. The study results show that the men are restrained in communicating their needs to others, which can be interpreted as their having a greater need for support and information than indicated by their signals. Having an internal image of what a man should be like can be an obstacle to showing these needs.

The overall aim of this thesis is to illuminate meanings of the relation between human beings, technology and care, as narrated by critical care nurses and people in need of home mechanical ventilation (HMV). The data are based on narrative research interviews with six intensive care nurses (I), 13 people who were about to start HMV (II), these 13 people were interviewed for a second time six to eight months after HMV had started (III), and nine persons with more than two years HMV experience (IV). The text was analysed using a phenomenological-hermeneutic research method as described by Lindseth and Norberg. The method is developed from the writings of the French philosopher Paul Ricoeur. The findings illuminate meanings of nursing care in an intensive care unit (I) as undertaking the role of advocacy as a caring response to another human being. The basic condition for this caring response depends on the nurses' openness and sensitivity to the needs of patients or patients' next of kin. The nurses were aware of the influence of technology and tried to modify its negative effects. Meanings of becoming dependent on HMV (II) are interpreted and metaphorically expressed as "to get one's breath" and "to hold one's breath" respectively. On the one hand, breathing ensures the cellular oxidation process within the body, but on the other hand there can be "shortness of breath" in "spiritual breathing", and starting HMV will influence patients' whole life situation, body and spirit. After using a ventilator six to eight months, meanings of a life dependent on a ventilator was interpretd as either a closure or an opening of the lived body to oneself, other people and the world. This interpretation is illustrated by two images. A life on a ventilator at home is not to be seen as static being. On the contrary, it is a being which moves and changes over time. Being dependent on a ventilator and living at home, as narrated by adults with more than two years of HMV experience (IV), was interpreted as being able to rise above yourself and your personal boundaries in order to live a good life. These meanings are bound up with experiencing a vital force and interdependency, and despite fragility being able to reach others and the outside world. Design and function of technology had an impact on the lived body. The comprehensive understanding of the four articles (I-IV) unfolded meanings of the relation between human beings, technology and care, as an interchange and a creation of physical and spiritual energy among humans and between human and technology. It could be an experience of the lived body being filled with as well as emptied of energy. This interpretation points at a call for the caring personnel to be attentive and to listen to the voices of the lived body in health and illness, and to bear witness to those who suffer. Technology acts between the person and the world and in order to be embodied, technology must be "transparent", i.e. beautiful and fit to its use.

Making it possible for persons with Alzheimer‟s disease (AD) to retain a sense of identity and personal worth during the process of the disease poses a great challenge to caregivers. The objective of the study was to investigate if the view of life of persons with AD could be understood in the frame of their life story and to elucidate the role of view of life in connection to their sense of identity. The view of life of an individual is defined as a conception of reality, a central system of values and a basic emotional attitude.Twenty-one persons with mild to moderate stages of AD were interviewed about their life story and their view of life. The narratives were interpreted using a phenomenological hermeneutic method.Despite their cognitive deterioration it was possible to understand the view of life of the participants in the frame of their life story. Their view of life was not erased by the disease. No exceptional characteristics that could be traced to AD were found in the participants‟ view of life. Their view of life seemed to guide them towards selecting mainly emotionally powerful and value-oriented memories. The origins of their present central values and basic emotional attitude were interpreted to have been established already in early life. A sense of meaningfulness and continuity when looking back on life was also expressed. Despite progressive memory loss and cognitive deterioration, the participants‟ view of life was interpreted as a vital aspect of their sense of identity.The study implicates that knowledge of the view of life of persons with AD is valuable for confirming and supporting their sense of identity.

Bakgrund: Öppenhet om psykisk ohälsa är något som har fått allt mer medial uppmärksamhet. Konceptet öppenhet är brett och innefattar flertal definitioner såsom transparens, som i att vara ärlig och inte gömma information, samt ett förhållningssätt som präglas av bland annat tolerans och förmågan att acceptera nya perspektiv och idéer. Öppenhet avhandlas i denna studie från perspektivet av sjuksköterskor med egen erfarenhet av psykisk ohälsa. Syfte: Denna studie syftar till att utforska sjuksköterskors upplevelser och erfarenheter av öppenhet gällande psykisk ohälsa samt att avtäcka öppenhetens meningsbärande enheter utifrån ett omvårdnadsperspektiv. Metod: Studien har en kvalitativ studiedesign med en fenomenologisk hermeneutisk forskningsansats. Information samlades in via semistrukturerade intervjuer. Resultat: Analysen resulterade i 3 övergripande teman: öppenhet som transparens, öppenhet som förhållningssätt och öppenhetens kraft och fundamentala växelverkan. Helhetstolkningen  visade att öppenhet är en förutsättning för all typ av medmänsklig interaktion och kommunikation. Att dela med sig av erfarenheter av psykisk ohälsa är transparens med intentionalitet kopplat till både strävan efter en bättre värld och ett sätt att visa omsorg. Helhetstolkningen mynnade ut i att sjuksköterskors öppenhet gällande egen erfarenhet av psykisk ohälsa i hög grad påverkades av upplevd stigma. Slutsats: Öppenhet har en inre självförstärkande kraft: öppenhet leder till öppenhet. Att dela med sig av egna erfarenheter av psykisk ohälsa ter sig har en stor potential i att skapa relationer präglade av ömsesidighet och medmänsklighet. Att bemöta med öppenhet är nyckeln till att ge transparensen en möjlighet att skapa en mer humanistisk och rättvis vård. / Background: Openness around mental health issues has gained increased media attention. The concept of openness is vast and includes multiple definition like transparency, as in to be honest and not hiding information, and also an approach characterized by, among others, tolerance and the ability to accept new perspectives and ideas. In this study openness is presented from the perspective of nurses with own experience of mental health issues. Aim: This study aims to explore nurses’ experiences and knowledge of openness regarding mental health issues and also uncover the meaning entities within the concept of openness from a nursing perspective. Method: The study uses a phenomenological hermeneutical method. Information was gained through semi-structured interviews. Findings: The analysis resulted in 3 main themes: openness as transparency, openness as an approach and the power and fundamental interactions of openness. The comprehensive understanding exposed openness as a postulate to all human interaction and communication. To share own experiences of mental health issues is transparency with intentionality including striving for a better world and mediate caring. The comprehensive understanding also indicated that nurses’ openness in sharing own experiences of mental health issues was impacted negatively by stigma experiences. Conclusion: Openness has an inner amplifying power: openness leads to openness. To share experiences regarding mental health issues appears to possess a great potential in creating relationships characterized by mutuality and compassion. To approach with openness is the key to give transparency the ability to create a more humane and just health care.

Substance abuse and suicidal behaviour are major challenges to public health. These phenomena are mainly studied by quantitative designs. This qualitative thesis aims at gaining a deeper understanding of substance abuse and suicidal behaviour, as experienced by young men in different types of treatment. By describing, exploring and interpreting lived experiences, in this thesis I try to give a more nuanced language of both substance abuse and suicidal behaviour, also in young migrating men. I also focus on the system of services related to the prevention and follow-up of life-threatening overdoses by describing and exploring how this phenomenon is experienced by individuals and professionals in Oslo. By researching the lived experiences of substance abuse and suicidal behaviour, combined with researching the phenomenon of life-threatening overdoses, a deeper insight is gained and this can be an important source to both prevention and health promotion for the group in question. The first three papers are based on descriptive, explorative and interpretative studies. How meaning is constructed is the core research question. In the fourth study I describe and explore life-threatening overdoses as a contemporary phenomenon in its context. The research questions are on a descriptive level. In the first three papers, the research object is the personal narratives from in-depth interviews, which are analysed using a phenomenological hermeneutic method. The case study is composed of data collected from different sources, and analysed by triangulation. The main finding in the first paper is that substance abuse and suicidal behaviour can be understood as goal-oriented, communicative and meaning-making activities about the individuals’ balance between death as an escape from pain and the hope of a life. In the second study, metaphorical expressions about a shifting sense of self is understood as balancing being an agent or a victim. In migrating young men these phenomena are interpreted as goal-oriented, communicative and meanig-making activities about existing in a maze that is perceived as closed. The findings of the case study show that different forms of life-threatening overdoses in Oslo are experienced in a state of existential and material stress. A wish of follow-up might not be expressed by the individual. Due to structural problems, such as lack of goals, professionals do not prevent such events in a planned way, nor do they cooperate between different levels. Professionals decide what is good quality in prevention and follow-up of life-threatening overdoses / Rusavhengighet og selvmordsadferd representerer store folkehelseproblemer. Disse fenomenene er hovedsakelig studert med kvantitative design. Målet med denne kvalitative avhandlingen er å få dypere kunnskap om rusavhengighet og selvmordsadferd slik fenomenene er opplevd av yngre menn i ulike typer behandling. Gjennom å beskrive, undersøke og tolke levde opplevelser forsøker avhandlingen å få fram en mer nyansert forståelse av, og språk om, både rusavhengighet og selvmordsadferd, også hos yngre menn med migrasjonserfaring. Avhandlingen fokuserer systemnivået gjennom å beskrive og undersøke hvordan livstruende overdoser oppleves og erfares som levde erfaringer og som yrkesutfordring i Oslo. Et omverdensperspektiv, kombinert med en dypere forståelse og et rikere språk kan være viktige bidrag til forebyggende og helsefremmende tiltak. Det første, andre og tredje arbeidet i avhandlingen er beskrivende, undersøkende og tolkende studier som fokuser yngre menns levde erfaringer med rusavhengighet og selvmordsadferd. Hvordan mening konstrueres er det sentrale forskningsspørsmålet. Det fjerde arbeidet, case studien, undersøker livstruende overdoser i en nå-tidig kontekst, og forskningsspørsmålene er beskrivende. I de første tre arbeidene er forskningsobjektet personlige narrativer samlet gjennom åpne dybdeintervjuer, og som er tolket ved bruk av en fenomenologisk hermeneutisk analyse. I case studien er data fra ulike kilder analysert ved hjelp av triangulering. Hovedfunnet i den første studien er at rusavhengighet og selvmordsadferd kan forstås som måltettede, kommunikative og meningsfulle handlinger om personens balanse mellom døden som befrielse fra smerte og håpet om et bedre liv. I den andre studien kommer metaforiske beskrivelser av en skiftende opplevelse av seg selv i prosessene knyttet til både rusavhengighet og selvmordsadferd tydelig fram. Dette kan forstås som å balansere en selvopplevelse mellom aktør og offer. I den tredje studien kan rusavhengighet og selvmordsadferd hos migrerte menn forstås som målrettede, kommunikative og meningsfulle handlinger om personens opplevelse av å eksistere i en stengt labyrint. Funnene i case studien tyder på at livstruende overdoser i Oslo erfares i eksistensielt stressfulle omstendigheter. Et personlig ønske om oppfølging gis ikke alltid eksplisitt. Strukturelle problemer medfører at profesjonelle arbeider med livstruende overdoser uten overordnete mål og uten samordnet planlegging. Profesjonelle bestemmer derfor selv hva som er god kvalitet når det gjelder forebygging og oppfølging av livstruende overdoser