Hermeneutic Phenomenological Study Research Articles

Painful Dream of Motherhood: A Hermeneutic Phenomenological Study of Married Women with Ectopic Pregnancy in the Islamic Republic of Iran.

Ectopic pregnancy (EP) is a significant cause of maternal morbidity and mortality. This study aimed to explore the understanding and experience of women with EP in the Islamic Republic of Iran. This qualitative study carried out through a Heideggerian hermeneutic/interpretative phenomenological approach, using face-to-face semi-structured phenomenological interviews with twenty-five participants referred to a public maternity hospital in Rasht, Iran. Data were collected and analyzed using the seven-step analytical approach of Dickelman et al. (The NLN criteria of appraisal of baccalaureate programs: A critical hermeneutic analysis, NLN Press, 1989; Journal of Nursing Education. 32:245-250, 1993) to phenomenological studies. The results reveal how living in the shadow of Islamic Sharia Law in Iran turns EP into a trauma and creates a different experience and meaning of EP for each woman. In this view, multiple factors, including 'family support' and 'faith in Islamic Sharia,' have determined how married women experience sociocultural and psychological consequences of EP. These findings apply to women with EP in Iran. Given that EP is more than an anomalous pregnancy with socially culturally constructed suffering in the context of the Islamic Republic of Iran. Hence, policymakers and healthcare providers should consider a multidimensional approach to this devastating event in pregnancy and support and empower the women whose dream of motherhood is jeopardized and terminated by the experience of EP.

Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme.

Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.

Threat and adaptation: The maternal lived experience of continuing pregnancy after receiving a prenatal diagnosis of agenesis of the corpus callosum

One stated objective of prenatal screening and diagnosis is the preparation for delivering a baby with medical needs or disability, however, psychosocial outcomes of parents who received a prenatal diagnosis suggest that this objective is not yet realised. Preparation may be complicated by diagnostic and prognostic uncertainty. A prenatal diagnosis that includes significant uncertainty due to the heterogeneous presentations, classifications, causes and outcomes is agenesis of the corpus callosum. As a neuroanatomical anomaly identified in the second or third trimesters, the diagnosis is likely to cause distress for expectant mothers, yet there is limited guidance for holistic support. To begin to address the paucity of research, this hermeneutic phenomenological study sought to explore, and provide a telling of the maternal experience of continuing pregnancy after a prenatal diagnosis of agenesis of the corpus callosum. Through interviews and a series of online, asynchronous and facilitated focus groups, lived experiences during pregnancy from the time of diagnosis to birth were explored with 26 mothers who participated in this international study. Themes were constructed through reflexive thematic analysis to describe the experience of the lived phenomenon. The first theme, Under Threat, included subthemes of The Threat to the Life of the Baby and Threatened Image of the Expected Family. The second theme, Day to Day Toward Adaptation, included subthemes of Holding it Together and Falling Apart, and More Than Information, Searching for Meaning, Hope and Control. To realise the commonly stated objective of prenatal diagnosis, to support maternal preparation, healthcare professionals require awareness of the profound, yet individual experience of prenatal diagnosis to adequately respond and support mothers through their continued pregnancies. Healthcare services should be designed to flexibly respond in a woman- and family-centred manner to reduce the threat and support maternal adaptation after a prenatal diagnosis.

Young adults’ narratives about living with home mechanical ventilation – a phenomenological hermeneutical study

Purpose An increasing number of children and young adults with complex medical conditions and respiratory failure are treated with home mechanical ventilation (HMV). The current study aimed to describe how young adults using HMV experience their everyday life with the ventilator, their physical impairments and their opportunities for an educational and professional career. Materials and methods Data were collected via narrative interviews with nine young HMV users (3 females and 6 males, aged 18–31 years) in their homes. Two were ventilated invasively, six were ventilated non-invasively and one was treated with continuous positive airway pressure (CPAP) via facemask. Data were analysed using a phenomenological hermeneutical method. Result A multi-professional team contributed to participants’ safety and ability to participate in society through higher education and professional work. A good and valuable life, mostly feeling healthy were experienced but also prejudice and stiffened social society structures. Conclusion The findings of this study prove the importance of having long-standing access to a competent and supportive available multi-professional healthcare team when living with a long-term complex condition. These teams provided well-functioning human and technological support in everyday lives.

Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services.

Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations. This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home. This study has a qualitative design with a lifeworld approach. A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70-93 years. Care-dependent older persons' participation in prehospital emergency care means 'Entrusting life to professional caregivers' when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain. Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living. Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.

Demystifying the experience of participating in a root cause analysis: A hermeneutic phenomenological study

AimThis study aimed to explore registered nurses' experience participating in a root cause analysis (RCA) meeting because of their involvement in an adverse event. BackgroundAn RCA is the most common strategy used by organizations for adverse event investigations. Nursing healthcare professionals directly involved in an adverse event may be asked to participate in the RCA. However, no studies were found in the literature on their experience. MethodsSemi-structured audio-taped interviews were held with 13 registered nurses who participated in an RCA. Ricoeur's hermeneutic phenomenology guided data analysis. ResultsTwo structural elements represented the world of the nurses: 1) Learning about an RCA, and 2) being on the other side of the RCA table. Three phenomenological themes emerged: 1) anticipatory and embodied fear, 2) to speak or not to speak, 3) the aftermath. ConclusionNurses desire RCA education to assist in understanding and support from nurse leaders throughout the process. Healthcare organizations must create a safe and collaborative environment to empower nurses to speak up and have their voices heard during the RCA process. Implications for nursing leadersNurses want to participate in RCA meetings. However, leaders must demystify the RCA process for nurses through education and training.

"You're on a Rollercoaster, Just Hold On": The Lived Experience of the Dyad Following a Fetal Death.

Purpose: Pregnancy and birth is often a joyous period for a dyad. In the instance of fetal death, however, dyads are met with a devastating loss of their child, the hope for the future, and the new reality of becoming a bereaved parent. The purpose of this qualitative study was to investigate the lived experience of the dyad following a fetal death and capture the essence of the grief journey. Study design and methods: A hermeneutic phenomenological study was performed using van Manen's method for data collection and analysis. Semi-structured interviews were conducted via Zoom. Participants were recruited from national and local agencies providing education and resources about perinatal loss. Data analysis utilized the Dedoose software platform to track qualitative coding. Results: Ten dyads (20 individuals) from the United States and Canada participated. The data revealed four major themes with several subthemes. The major themes were as follows: "The child I'll never really know": Pregnancy loss grief; "You're on a rollercoaster, just hold on": The emotional journey; Climbing uphill: Barriers to healing; and Resurfacing from grief: Healing after loss Clinical implications: The death of a fetus over 20 weeks gestation provides a unique experience of grief. The findings support the need for additional resources needed beyond the hospital by nurses or other providers to facilitate healing and minimize complicated grief. Furthermore, the findings support the need for increasing awareness among healthcare providers and peers about how to communicate and care for dyads experiencing fetal death.

Flirting with Death: Finitude, Tradition, and Leisure during the COVID-19 Pandemic

In this hermeneutic phenomenological study I explored and interpreted the lived experiences of leisure of 11 African women immigrants living in Canada during the COVID-19 pandemic before the availability of vaccines. Gadamer’s theory of hermeneutic experience and Aristotle’s leisure philosophy afforded the philosophical bedrock. In-depth, online interviews were augmented with visual methods. After the initial shock of multidimensional loss as pandemic restrictions took hold, women quickly regrouped and were both courageous and resilient. They turned to their Christian faith to sustain them, making do with online services and finding solace in worship. The family circle sustained, and the home became a hive for leisure. Creative leisures were enthusiastically engaged in, and gardening, cultivating, and harvesting were essential to well-being. Through it all, the African ethic of ubuntu permeated their way of being and uplifted them even in the presence of plague and death.

Language Barrier: Exploring the Lived Experiences of Assistant Language Teachers in Japan: A Hermeneutic Phenomenological Study

The purpose of this hermeneutic phenomenological study was to describe and interpret the lived experiences of Assistant Language Teachers (ALTs) in Japan as they faced some challenges with language barriers. There is still a gap that needs to be addressed because little did these foreign English teachers know that teaching English in a non-native English-speaking country like Japan comes with a lot of challenges especially with the language barrier. The theories that guided this study were Krashen’s (1981) Monolingual Approach and Bandura’s (1997) Social Cognitive Theory. The central questions of this study were intended to determine the lived experiences of ALTs with language barrier and how the ALTs ascribed to their experiences. Purposive sampling was used in which nine (9) participants consented to be a part of this study. Six (6) out of nine (9) participants were from Kyoto City, while the remaining three (3) were from Hamamatsu City. The study used in-depth interviews, which was cross-examined through behavioral observations from recorded videos and poetic transcriptions. The findings indicated that ALTs experienced language barriers when communicating with students and Japanese co-teachers, lesson planning, and lack of professional development and training.

Experiences of Professional Autonomy Among Critical Care Nurses in Kenya: A Qualitative Study

Background: Exercising autonomy allows nurses to demonstrate their knowledge and skills. However, more information is needed about the critical care nurses' perceptions of their professional autonomy in rural areas. Objective: To explore the perceptions, facilitators and barriers to professional autonomy among critical care nurses in rural Kenya. Methods: The hermeneutic phenomenological study design was used in this study. Data were collected in a critical care unit using a semi-structured interview guide. A sample of 10 participants were recruited. The study was conducted in Nyeri County Referral Hospital. Results: Three themes emerged from the study on the nurses' experiences of professional autonomy, perceptions of autonomy, facilitators of autonomy, and barriers to autonomy. Conclusion: Autonomy undeniably plays a pivotal role in defining the professional status of the nursing profession. Perceptions, facilitators and barriers to professional autonomy form the background of the current professional status. Nurses, therefore, exercise autonomy effectively when it aligns with patient care needs and when a conducive environment supports it.

A hermeneutic phenomenological study on the disease experience among young women with breast cancer

ObjectiveWomen diagnosed with breast cancer under the age of 40 face distinctive physical and psychosocial challenges resulting from the disease's pathological features and the developmental aspects associated with their youth. This study aims to investigate the lived experience of breast cancer among this group of young women. MethodsParticipants were purposefully selected from online communities and chat rooms in South Korea. A total of 15 young women with breast cancer were included in this study, and data were gathered through three focus group interviews. The interviews were transcribed verbatim and analyzed using the hermeneutic phenomenology method. ResultsFour essential themes emerged based on four lifeworld existentials: lived body, lived time, lived space, and lived others. These four essential themes were: a wounded and sick body, life robbed of youth and elderly years, crossroads of growth discovered at life's extremes, and a steadfast companion on a solitary journey. ConclusionsYoung women with breast cancer face unique challenges due to the intersection of a severe illness and its impact during their formative years. This study offers valuable insights for crafting customized interventions that directly target the physical and psychosocial requirements of young breast cancer survivors, ultimately enhancing their quality of life.

Stepping into middle leadership: a hermeneutic phenomenological study

ABSTRACT Several studies have examined the crucial role played by middle leaders in school improvement, but little is known about the experiences of novice middle leaders during their initial years in their positions, particularly the enabling and constraining factors they encounter. This study explored the narratives of six middle leaders over a three-year period as they stepped into their roles in K-12 settings in Lebanon. Employing a hermeneutic phenomenological methodology, semi-structured interviews were conducted with each middle leader at the end of each academic year for three consecutive years. Data from 18 semi-structured interviews were analyzed using Gadamar’s interpretational analysis system. The findings suggest that successful transition into middle leadership relies on seven core, interrelated constructs with high leverage and impact, encompassing 23 subsidiary concepts. These constructs include role clarity, personal qualities, trust, the ‘sandwiched’ position, versatile leadership, professional development, and culture.

Experiences of Family Caregivers Caring for Patient with Alzheimer's Disease: A Hermeneutic Phenomenological Study.

Alzheimer's disease (AD) becomes one of the diseases that greatly increased in the older adult population. Family caregivers play an important role in caring for family members who suffer from AD. The aim of this study was to illuminate the meaning of family caregivers' lived experiences caring for a family member with AD from the perspective of an Indonesian. Narrative interviews were conducted with 13 family caregivers. These interviews were audio-taped and transcribed verbatim and analyzed using a phenomenological hermeneutic approach. The findings are presented under two main themes: Descent and ascent in caring for which emerged from category from being denial to acceptance, from lack of patience to compassion, from using to not using medication, and desperate yet responsibility. Another theme, caregivers' life learning emerged from the category of ongoing caring for and getting through in caring for. Expressed concerns have shown that family caregivers not only face challenges in caring for family members suffering from AD, but also gain a lesson for life. It is necessary for family caregivers to manage caring processes for family members who suffer from AD.

The influence of practice experiences on feelings of role proficiency in emergency nurse practitioners: A phenomenological study

IntroductionThis research explores how emergency nurse practitioners (ENPs) become role proficient given experience variation and lack of role standardisation. AimTo understand how ENPs experiences in practice influence their feelings of role proficiency. MethodsA hermeneutic phenomenological study was undertaken utilizing an interpretive standpoint. A two-phase approach was adopted with ten participants using a digital diary informing a semi-structured interview. A three-stage data analysis approach was applied. FindingsSix themes emerged: the meaning of role proficiency, relationships, confidence, learning and knowledge, exposure and experience, and care. Models of proficiency and its development are presented. DiscussionProficiency is defined where confidence in the components that proficiency consists of and their application to each clinical presentation is required. Proficiency is a continuum supported by regulatory mode theory. Inconsistency of role understanding gives rise to three ENP groups, resistors, maintainers, and innovators. ConclusionRole clarity is required to establish a consistent culture within organisations founded on the voice of the ENP as captured in this research. This model of proficiency be incorporated in ENP role development for current and future ENPs.

은둔형 외톨이의 자활경험에 대한 해석학적 현상학 연구

은둔형 외톨이의 자활경험에 대한 해석학적 현상학 연구

Knowing Me, Knowing Them: Using Penned Illustrations with Known Participants

In practice-based studies, participants are often known to the researcher as part of their professional realm. This can result in the researcher bringing preconceptions of the participants to the study, which may influence the findings. In this paper, we demonstrate how researchers can utilise reflexivity and imaginative curiosity to expose often unconsidered presuppositions about such participants using penned illustrations. We suggest that penned illustrations of known participants should be undertaken to unpack preconceptions of the known participants creatively and imaginatively. This paper provides an applied demonstration of how penned illustrations can be used in a hermeneutic phenomenological study, along with the philosophical foundations supporting this method. The paper guides the reader through why penned illustrations can be helpful in qualitative, hermeneutic phenomenological research when the insider-researcher needs to recognise, manage, and ethically work with the duality of their overlapping researcher and professional roles.

From suffering towards communal well-being: experiences of a Dalcroze-inspired workshop for a community in crisis.

This qualitative hermeneutic phenomenological study aims to describe the meaning that members of the Parys community ascribed to their experiences of a Dalcroze-inspired workshop. Stakeholders were a number of local residents of Parys, a scenic town situated on the banks of the Vaal River in South Africa's Free State Province. Local residents were asked to share their water-related experiences at a workshop organized by a North-West University research group. It became clear from their stories that they had experienced severe stressful circumstances. They had suffered stress because of the health risks posed by polluted water and the frequent lapses in the town's water supply system. Dalcroze-inspired activities were used to facilitate this meeting. Data were collected through focus group interviews, open-ended individual interviews, photos, videos, and observations. All these data were consolidated in one heuristic unit in ATLAS.ti, a computer-assisted qualitative data analysis software program. The codes were organized into categories and themes. Friese's (2014) notice, collect and think (NCT) method for computer-assisted qualitative data analysis was used. From the data analysis, five themes emerged related to the Dalcroze-inspired activities. It included: joyful experiences, which facilitated social interaction that made it possible for personal relationships to be transformed. Virtues arose from this transformation, and participants' experience was that the group engagement supported their well-being. We, therefore, argue that the Dalcroze approach can be used in communities in crisis to facilitate conflict resolution and transform relationships.

Nurses’ experiences of managing cognitive problems in intensive care unit patients: A qualitative study

ObjectivesNurses hold a key position in identifying symptoms and initiating preventive strategies for cognitive impairment in delirious and non-delirious intensive care unit patients. However, it remains unclear whether nurses consider cognitive impairment as a distinct concern from delirium. By understanding nurses’ perspectives, we may identify barriers and facilitators in caring for patients with cognitive challenges in the intensive care unit.The objective of this study was to explore nurses’ experiences of cognitive problems in patients admitted to an intensive care unit. Research methodologyA phenomenological-hermeneutic study of interviews with ten nurses from intensive care units. Data were collected in March-April 2022 and analysed using a Ricœur-inspired method of interpretation. FindingsThree themes related to nurses’ experiences of cognitive problems emerged through analysis; 1) Cognitive problems and delirium are seen as two sides of the same coin, 2) Searching for the person behind the patient, and 3) Maintaining a sense of normality in a confusing environment. ConclusionsThe interconnected concept of cognitive impairment and delirium syndrome meant that nurses assessed and managed cognitive problems in intensive care unit patients by focusing on preventing delirium. Apart from delirium screening, nurses relied on relatives’ knowledge to assess patients’ cognition. Most significantly, our study revealed a previously unexplored approach by nurses to manage patients’ cognition, which involved “shielding” patients from the noisy and disruptive intensive care unit environment. Implications for clinical practiceEffective communication methods, coupled with family involvement may aid nurses in identifying patients’ cognitive problems. In the acute phase of critical illness, distinguishing between delirium and cognitive problems may not be clinically relevant, as delirium protocols may protect patients’ cognition.Further investigating the concept of shielding may reveal previously unexplored nursing approaches to manage cognitive problems.

Impact of postmenopausal osteoporosis on the lives of Omani women and the use of cultural and religious practises to relieve pain: A hermeneutic phenomenological study.

Osteoporosis is a significant clinical and public health concern worldwide. Despite the impact of this condition on women's lives, most studies have focused on its clinical manifestations, drug efficacy, and medical treatment. Furthermore, most studies have been conducted in the West. This study aimed to uncover the personal experiences of postmenopausal Omani women living with osteoporosis. In this interpretive phenomenological study, a purposive sample of 15 postmenopausal Omani women with osteoporosis was recruited from primary and secondary care facilities in Muscat, Oman. Semi-structured one-to-one interviews were conducted via Zoom and telephone because of coronavirus disease 2019 restrictions. The interviews were audio-recorded, and the Ajjawi and Higgs framework was used to analyse the data thematically. The following key themes were constructed from the interviews: the impact of osteoporosis on religious practices, cultural and social life, and financial status, and the benefits derived from religious and cultural practices and rituals, including Muslim prayer, recitation of Quranic verses, and herbal remedies to cope with osteoporosis-related pain and suffering. Osteoporosis and fragility fractures have a significant impact on the religious, cultural, and financial lives of postmenopausal Omani women with osteoporosis. Muslim prayers, recitation of Quranic verses, and herbal remedies are coping strategies for pain in this population. Postmenopausal Omani women with osteoporosis participated in this study through interviews and contributed their lived experiences. Orthopaedic doctors helped recruit patients with postmenopausal osteoporosis.

We Wear the Mask: The Lived Experiences of Black Undergraduate Music Education Students in Predominantly White Schools of Music

The purpose of this hermeneutic phenomenological study was to understand how Black undergraduate music education students make meaning of their lived experiences in predominantly White schools of music (PWSOM). The study was guided by the overall research questions: (1) What makes the lived experience of Black undergraduate music education students unique? and (2) What meaning(s) and understanding(s) do Black undergraduate music education students ascribe to their experiences in PWSOM? Data were collected primarily through open-ended interviews with nine Black undergraduate music education students in PWSOM in the United States. Data analysis revealed seven emergent themes, including (a) navigating the negative perceptions of White people; (b) making White people comfortable; (c) working harder to prove myself; (d) “Do I belong here?”; (e) a climate of racial and cultural insensitivity; (f) distrust of White faculty; and (g) sacrifice and survival. Findings were interpreted using Du Bois’s theory of double consciousness and van Manen’s four existentials of lived experience. Interpretation revealed the essence of the phenomenon to be living a dissonant existence.