Phenomenological Lifeworld Perspective Research Articles

Don´t set us aside! Experiences of families of people with BPD who have access to Brief admission: a phenomenological perspective

ABSTRACT Aim To highlight the experiences of family members of people with borderline personality disorder (BPD) and self-harming behaviour who have access to brief admission. Methods To understand the families lived experience a phenomenological lifeworld perspective was adopted to this study. Twelve in-depht interviews were performed in November and December 2021 with family members of people with BPD and self-harming behaviour who have accessed BA. The phenomenological life-world perspective guided the analysis. Results Families’ life-world was characterized by anxiety and constant protection of their loved one. They live with constant fear of how their loved ones are feeling and whether they will injure themselves. When access to BA was available this gave hope and provided conditions for families to maintain everyday routines and also enhanced relationships among family members. When families’ loved ones were denied BA, they felt betrayed which contributed to negative feelings towards the medical profession, and the families lost confidence in psychiatry. Conclusion By interviewing families of people with BPD and self-harming behaviour who had access to BA, it emerged they possess valuable knowledge. BA can be developed if the needs of families are taken into consideration, and if families are given the opportunity to share emotions and the high burden of responsibility with staff or families in similar situations. If health care staff gives family members a more central role in care and makes their shared life-world visible it could thereby hopefully increase well-being and benefits for the whole family.

The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study.

ObjectiveSedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.MethodsThe study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64 to 75 years. Data were analyzed using the empirical phenomenological psychological method.ResultsThe participants described that voluntary sedentary time was positively related to general health and well-being, whereas involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed 3 typologies: in light of meaningful SB, in the shadow of involuntary SB, and a dual process—postponing SB with physical activity.ConclusionIncreased SB was perceived as natural when aging but something that may be postponed by conscious choices. SB was perceived as associated with health, rest, and recovery but also with the risk of deteriorating health.ImpactThis knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.

"Finding oneself after critical illness": voices from the remission society.

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants' lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants' narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger's concept of homelikeness and Arthur Frank's typologies of illness narratives. In conclusion listening to and acknowledging the patients' lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients' lived experience of critical illness and its aftermaths.

To take charge of one's life - group-based education for patients with type 2 diabetes in primary care - a lifeworld approach

ABSTRACT Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient’s empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care. Purpose: The specific aim in this study was to describe patients’ experiences of group-based education using the Taking charge of one’s life with type 2 diabetes model. Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books. Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others’ experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning. Conclusion: The results showed that from the patients’ perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning.

The ambivalence of losing weight after bariatric surgery

This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women's experiences, a meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change. This consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience.

Sensory stimulation—A way of creating mutual relations in dementia care

The overall aim of this 2-year Norwegian action research study was to improve the interaction between care workers and patients with dementia in a nursing home by means of sensory stimulation. Furthermore, the aim was to investigate how the staff experienced the interaction with patients suffering from behavioral and psychological symptoms of dementia before, under, and after introduction of sensory stimulation methods in clinical practice. An intervention program consisting of lectures and practical guiding in sensory stimulation was implemented. The care workers participated in group meetings to reflect on the progress. Focus group interviews and participant observations were conducted initially to map exciting practice, and at the end to evaluate potential changes in attitude and skills. Observation notes and interview transcripts were analyzed by means of thematic analysis which revealed a gradual emergence of person-centered care. A phenomenological life-world perspective may serve as a theoretical basis to deepen the understanding of the use of sensory stimulation.

Body awareness in persons diagnosed with rheumatoid arthritis

Living with rheumatoid arthritis (RA) poses physiological and psychological demands on a person. RA is a autoimmune disease that can cause pain, disability, and suffering. The ability to notice bodily inner sensations and stimuli (body awareness, BA) is described in the literature in ways that could have either a positive or a negative impact on a person's health. The concept of BA is complex and a thorough understanding is needed about what BA means from the patient's perspective. This study was therefore conducted to acquire greater insight into this phenomenon. The study is grounded in a phenomenological life-world perspective. Eighteen narrative interviews were conducted in patients (age range 23–78 years) with RA. The interviews were analyzed using the Empirical Phenomenological Psychological method. General characteristics were found running through all 18 interviews, indicating that the disease resulted in a higher degree of negatively toned BA. BA was either a reactive process of searching or controlling after disease-related symptoms or a reactive process triggered by emotions. BA was an active process of taking an inventory of abilities. All participants had the ability to shift focus from BA to the outside world. Four typologies were identified: “A reactive process on symptoms,” “A reactive process on emotional triggers,” “An active process of taking an inventory of abilities,” and “A shifting from BA to the outside world.” In conclusion, because BA can be both positively and negatively toned, health care professionals must have a good understanding of when BA is positive and when it is negative in relation to the patient. RA had caused a higher degree of negatively toned BA. Thus, the ability to shift attention from BA to activity in the outside world could sometimes be beneficial for the patient's general health.

Meaning of life after cancer: An existential-phenomenological approach to female cancer survival

Synopsis Cancer survivors actively construct their lives and the meaning of cancer to better understand the process of adjustment following the disease. The aim of this study was to understand the significance of lived relations (relationality) for cancer survivorship. The methodology used was a qualitative, phenomenological lifeworld perspective focused on the stories of the participants' lived experiences as gynecological cancer survivors. Data was collected through semi-structured interviews of ten female cancer survivors. A phenomenological hermeneutic method was used to interpret the transcribed interviews. The findings revealed three main themes: mediation between the subject and the world, between subjects, and between the subject and herself. Survivorship can be best attained when individual strengths are the focus of intervention and help guide positive outcomes. Health practitioners should be aware of the potential for positive changes in their patients following trauma and adversity.

Living in a Changed Female Body After Gynecological Cancer

In this article we elaborate on how living in a changed female body after gynecological cancer is experienced 5 to 6 years after treatment. Based on a phenomenological life-world perspective, 32 interviews with 16 women showed that changes involved dealing with unfamiliarity related to experiences of bodily emptiness, temperature fluctuations, sex-life consequences, vulnerability, and uncertainty. Findings are discussed in relation to Svenaeus's perspective on illness as an unhomelike being-in-the-body and being-in-the-world. This perspective could spur health personnel to improve patient information and dialogue and thus facilitate a process leading to more familiarity and homelikeness for patients during treatment and follow-up.

Aspects of care culture in municipal care for elderly people: a hermeneutic documentary analysis of reports of abuse

Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations that go beyond the everyday routine, such as cases of abuse. In Sweden, health care professionals are obliged to document and report any suspected bad conditions. Although the reports have the potential to communicate underlying values and assumptions about the care culture, such studies have not been performed. The aim of this study was to understand how elderly care abuse in institutions could be understood from a care culture perspective. A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four-stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective. The care of the elderly in the municipality was based on a social culture that placed residents' needs at the centre. Following routines were considered important in preventing mistreatment and were intended to ensure that all patients were treated fairly and equally. Care was described as task oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was interpreted that in the municipalities' care of the elderly, there was a focus on elderly people's freedom at the expense of the vulnerability aspects of well-being. Raising awareness of the care culture underlying abuse could help to improve understanding of care practice. Change may be only possible when reflected on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring.

The Use of Nurses in Community Palliative Care

This qualitative study uses a phenomenological life world perspective to examine the utilization of nurses in community palliative care for people with noncancer conditions with a life expectancy of 2 years. Sited in Otago, New Zealand, while there was a number of health professionals involved in providing palliative care in the community for people with malignant conditions, none of the participants with nonmalignant disease were receiving specialist palliative care at the time of interview. Support services used a rehabilitative model of care that was not always appropriate in meeting the needs of the people who were dying and their families.

The significance of lifeworld and the case of hospice

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed.

Cancer as a life-changing process: Women's experiences fi ve years after treatment for gynaecological cancer

This article presents and discusses the essential structure appearing in a phenomenological study focusing on women's experiences of living as long-term survivors after gynaecological cancer, namely Cancer as a life-changing process. The aim of the study was to gain a deeper understanding of living beyond gynaecological cancer. The study is founded on a phenomenological lifeworld perspective, and based on 32 in-depth interviews with 16 women aged 39 to 66, all free of illness. The interviews were made fi ve and six years after treatment for cancer, respectively. Surviving cancer entails living with profound life-changes, demanding as well as enriching, even though the women have been declared cured. The essential structure consists of two interrelated constituents; “living between life courage and life anxiety” and “living between existential loneliness and relational caring”. The constituents are illuminated by the perspective of Danish life-philosophy, represented by Ludvig Feilberg and Knud Ejler Logstrup—and Mogens Pahuus' interpretation of their thinking. The empirics clearly show that life phenomena are still “ploughed up” fi ve to six years after treatment when the women have been declared long-term survivors. The study points out that experiencing cancer can move the women deeply in their lives. This may challenge health care personnel in their encounters with women surviving gynaecological cancer. Key words: Gynaecological cancer, long-term survival, life phenomena, vulnerability, cancer care.

Cancer as a life-changing process: Women's experiences five years after treatment for gynaecological cancer

This article presents and discusses the essential structure appearing in a phenomenological study focusing on women's experiences of living as long-term survivors after gynaecological cancer, namely Cancer as a life-changing process. The aim of the study was to gain a deeper understanding of living beyond gynaecological cancer. The study is founded on a phenomenological life-world perspective, and based on 32 in-depth interviews with 16 women aged 39 to 66, all free of illness. The interviews were made five and six years after treatment for cancer, respectively. Surviving cancer entails living with profound life-changes, demanding as well as enriching, even though the women have been declared cured. The essential structure consists of two interrelated constituents; “living between life courage and life anxiety” and “living between existential loneliness and relational caring”. The constituents are illuminated by the perspective of Danish life-philosophy, represented by Ludvig Feilberg and Knud Eilert Løgstrup—and Mogens Pahuus’ interpretation of their thinking. The empirics clearly show that life phenomena are still “ploughed up” five to six years after treatment when the women have been declared long-term survivors. The study points out that experiencing cancer can move the women deeply in their lives. This may challenge health care personnel in their encounters with women surviving gynaecological cancer.