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.

The New Zealand education system has undergone some two decades of substantial reform. There can be little doubt that this has brought significant change to the nature of what is expected of people occupying positions of leadership in schools and educational institutions (Ball, 2007; Bottery, 2004; Codd, 2005). Against this contextual backdrop, and in the researcher’s experience as a teacher and former holder of a position of leadership, there is an observable phenomenon of educational leaders stepping aside from position and yet continuing to work as teachers within the same workplace. Despite claims of a leadership ‘crisis’, and international acknowledgement of concern over the retention of educational leaders (Brooking, 2007; Brundrett & Rhodes, 2006; Fullan, 2005), the human experience of this phenomenon appears unrepresented in current research literature. The present study has sought to capture this experience through addressing the central research question “What is the lived experience of the voluntary relinquishing of the position of leader, yet choosing to remain within the same educational workplace?” In order to gather rich qualitative data, a descriptive multiple case study design was employed. In-depth unstructured interviews were carried out with eight educational leaders who had relinquished position within the contexts of New Zealand State Secondary Schools and Private Training Establishments, and chosen to continue working in these same contexts. The subsequent analysis drew on the tradition of hermeneutic interpretation (van Manen, 1990) to arrive at interpretations of the uniqueness of individual experiences, and offer understandings of the shared meanings of the experience in the form of essential themes. The key findings which emerged in this study were those of a sense of the ‘a-lone-ness’ of leadership, the ‘ready-suddenness’ of the decision to step aside, a seeking of ‘balance’ in the relinquishing of position, a powerful sense of ‘re-turning’ to the call of teaching, and varying degrees of ‘ease’ and ‘dis-ease’ in the experience of ‘letting go and holding on’ following positional relinquishment. These findings serve to extend aspects of those of earlier leadership and role exit studies, and offer previously undocumented understandings. Thus, a major contribution of this study is in the bringing-to-voice of the stories of those who step aside from leadership position yet remain in the workplace, and in the opening of avenues for further research.

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.

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.

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.

Supervision has a strong impact on students` professional development. It is during clinical education that students will receive help in linking theory and practice. This study aimed to describe the meaning of good supervision among nursing students in clinical practice. A qualitative design was used. Nine nursing students in western Sweden, who had all experienced good supervision in clinical practice, were interviewed.The interviews were analyzed using a descriptive phenomenological methodology.The meaning of the phenomenon, good supervision in clinical education among nursing students, was shown as the students were gradually piloted to increased responsibility. The students felt secure with their supervisor and the environment in which supervision takes place, and have continuously moments for communication and reflection with their supervisor. A prerequisite is that the supervisor is involved and actively present. Good supervision also means that students have confidence to act independently, and have the opportunity to prepare for new situations. Finally good supervision means that the supervisor shows an understanding attitude to the students` lack of clinical experience. / Handledning har en stark påverkan på studentens professionella utveckling. Det är under den verksamhetsförlagda utbildningen som studenten ska få hjälp att knyta samman teori och praktik. Syftet med studien var att beskriva innebörden av god handledning bland sjuk­- sköterskestudenter i verksamhetsförlagd utbildning. En kvalitativ design användes. Nio sjuksköterske­studenter i västra Sverige intervjuades, som alla hade erfarenhet av god handledning i verksamhetsförlagd utbildning. Intervjuerna analyserades med en deskriptiv fenomenologisk metod. Fenomenet god handledning i verksamhetsförlagd utbildning visade sig som att studenten successivt lotsas till ett ökat ansvar. Studenten kände sig trygg med handledaren och i den miljö där handledningen skedde, och hade kontinuerligt möjlighet till kommunika­tion och reflektion med handledaren som var engagerad och aktivt närvarande. Studenten hade möjlighet att agera självständigt och förbereda sig inför en omvårdnadssituation. Slutligen visade sig god handledning när handledaren visade förståelse för studentens bristande erfarenhet.