Reflective Lifeworld Approach Research Articles

Legal age limits in accessing donor information: experiences of donor-conceived people, parents, sperm donors and counsellors

Research questionWhat are the lived experiences of donor-conceived people, parents, sperm donors and counsellors related to legal age limits on accessing donor information in the Netherlands? DesignA phenomenological study was carried out that included 20 donor-conceived individuals, 15 parents, 6 sperm donors and 5 counsellors. Data were collected through online qualitative in-depth interviews and focus groups. The data were analysed using Dahlberg's Reflective Lifeworld Approach. ResultsThe results show how: (i) age limits create challenges related to dependency, autonomy and loyalty to parents; (ii) donor information can be important for identity development, which looks different at different ages; (iii) inaccessible information can lead to unfair loss and may be perceived as negative; (iv) relational stability provides a good foundation for dealing with the (in)accessibility of donor information; (v) procedural barriers and age limits increase the inaccessibility of donor information; and (vi) comprehensive counselling is desired for donor-conceived individuals, parents and donors. ConclusionsThis study shows that legal age limits on accessing donor information can lead to several negative consequences. The age limits focus on one individual, which is not appropriate for questions about ancestry that always pertain to a relational network. Counselling should be tailored to the child's needs, and the child's family should be involved. Furthermore, the donor should receive independent counselling.

Trajectory of suicide as a transformation in obscurity-As told by the deceased's next of kin.

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in-depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co-occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self-governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.

“People are having lots of other kinds of sex”: Exploring sexual lifeworlds of LGBTQ+ young people in Bangladesh

A lack of recognition of sexual diversity in Bangladesh continues to contribute to a scarcity in in-depth research around lived experiences of sexual and gender diverse young people. In this article, we adapt a phenomenological reflective lifeworld approach to capture the essential aspects of sexual intimacy as described by diverse young people. This article is based on qualitative data collected in Dhaka, Bangladesh over nine months in 2019 as part of the first author’s doctoral research. Using thematic analysis, we draw on experiences of normative sexual expectations from biographical in-depth interviews with 14 self-identifying lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) individuals aged 18 to 24 years. According to participants, sexual intimacy as experienced by LGBTQ+ young people in Bangladesh meant desiring consensual sexual and romantic relationships with sexually “matched” partner(s) while navigating heteropatriarchal sexuality norms. We observed five interlinked themes which encompassed the sexual lifeworld of young people in our study: desire for romantic intimacy in sexual interactions; need for discretion when navigating sex and relationships; “matching” sexual roles in partnerships; challenges to relational power dynamics of masculinity; and embodying notions of sexual morality. Our findings captured the essence of young people’s sexual lifeworlds in our study and indicate a universality around sexual intimacy while still making space for intersections of diverse lived experiences and social orientations. Further research is required to better understand these nuances in sexual behaviour.

Living With Cardiovascular Disease: Existential Meaning of Lifestyle Change.

This study aims at exploring the perspectives of patients with cardiovascular disease (CVD) on the existential meaning of lifestyle change as an evidence base for spiritual care by nurses and other health professionals. This study has been carried out within the paradigm of phenomenological caring sciences. The sample of 18 participants was purposively selected. Data consisted of in-depth interviews among adults with an episode of CVD. Data analysis of transcribed audio recordings was done using the method of Reflective Lifeworld Approach. For patients with CVD, changing one's lifestyle is an experience of transition in self-image. This transition has a twofold dynamic. On the one hand, it entails alternating phases in what is meaningful for the patient: letting go (loss of the normal, of health, of bodily functions) and holding on (desire to be healthy and to be normal). On the other hand, through the vulnerability and loneliness patients often experience, patients report a need to be encouraged by and connected to others/the Other. Making brave choices and connecting to the patients' spiritual resources of inner strength are crucial for successful lifestyle changes and meaningful transition to a new lifestyle. Lifestyle change is not only a physical and psychological process for the patient with CVD but also an existential transition that involves fundamental views and values of being human. It is an experience that is in part socially influenced, that is, by encouragement from meaningful others. For the health care worker, knowledge of this experience may help provide spiritual care after CVD.

Social work in difficult times: emerging value frame in India

ABSTRACT The contemporary global milieu is ridden with multiple tensions and conflicts and India is no exception. India is witness to a number of challenges in its social, political and economic domains. While the tumultuous man–nature relationship has life-threatening ramifications, the social, economic and political contexts are also rife with diverse challenges characteristic of a globalised world order. The situation has been compounded by the daunting COVID pandemic, which has demonstrated the interconnectedness of global challenges and has wrought an unprecedented impact on the wellbeing of people. The social work profession in India must play a meaningful role in diffusing the crisis by promulgating values that extend and consolidate human solidarities and human environment symbiosis. Located within the context of India, and based on a reflective lifeworld approach, this article reflects on the nature and role of social work values in capacitating social workers to play a more resolute role in resolving present day predicaments. It articulates the need to look beyond generic values, glean a more context-specific value frame and herald the process of transferring these values to students through suitable means.

Women’s lived experiences of induction of labour in late- and post-term pregnancy within the Swedish post-term induction study – a phenomenological study

ABSTRACT Purpose There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women’s experiences. The aim was to gain a deeper understanding of women’s lived experiences of induction of labour in late- and post-term pregnancy. Methods Phenomenology with a reflective lifeworld approach was chosen as the method. Twelve women participating in a larger study in which women were randomized to either induction of labour in week 41 or to expectant management until week 42, were interviewed one to three months after giving birth. Results The essence is described as follows: labour becomes another journey than the intended one. The women adapted to this new journey by seeing the advantages and handing themselves over to the healthcare system, but at the same time something about giving birth could be lost. The result is further described by its four constituents: planning the unplannable, being a guest at the labour ward, someone else controlling the labour, and overshadowed by how it turned out. Conclusion Induced labour presents a challenge to maternity personnel to support the birthing woman’s normal progress, not to rush her through labour, and to involve her in the process.

“You Know Where the Boundary Is When You Cross It” - A Phenomenological Understanding of Vulnerability as Experienced by Carers in Forensic Inpatient Care

In forensic nursing, carers must balance caring and limiting actions in encounters with patients. Interpreting suffering in others raises awareness of one’s own vulnerability. Hence, the aim of this study was to describe the phenomenon of vulnerability as experienced by carers in forensic inpatient care. Nine participants were recruited at a major forensic hospital, and their narratives were analysed with a reflective lifeworld approach. The findings revealed that vulnerability was both a strength and a burden. Vulnerability comprised becoming aware of one’s boundaries, being genuine and protecting oneself. Dealing with vulnerability enables carers to open up to patients.

An important task: Midwives’ experiences of identifying children at risk of neglect

BackgroundNeglect is a form of child abuse in which the child’s basic needs are not met. Early identification of the risk factors and protective factors is key to intervention strategies when a child is at risk of neglect. Few international studies describe midwives’ experiences of identifying children at risk of neglect, and no Swedish studies have been found. ObjectivesThe aim was to describe midwives’ experiences of identifying children at risk of neglect. MethodA qualitative method with a phenomenological reflective lifeworld approach. Interviews with ten midwives from two hospitals and six antenatal clinics in the western part of Sweden, with six from antenatal care and four from postpartum care. ResultsThe essential structure of midwives’ experiences is described as an important dimension of their profession that is a difficult, complex, ambiguous, and divided task. There is a fear of losing the relationship with the woman and worry about misinterpreting signals. Professional differences may arise when midwives are questioned by colleagues on decisions they have made when identifying children at risk of neglect. Midwives expressed their desire to work in a cohesive maternity healthcare system so that the women experience continuity during pregnancy, childbirth, and postpartum care. ConclusionsThe study shows how midwives, during both antenatal and postpartum care, have an important but difficult task in identifying children at risk of neglect. During pregnancy and postpartum care, midwives in Sweden meet almost all women and therefore have a unique opportunity for early detection and action.

Being in the shadow of the unknown — Swedish women’s lived experiences of pregnancy during the COVID-19 pandemic, a phenomenological study

BackgroundThe COVID-19 pandemic has had a profound effect on the emotional well-being of expecting mothers. Sweden’s unique strategy for managing COVID-19 involved no national lockdown. Emphasis was instead placed on limiting crowding and asking citizens to practice social distancing measures. AimTo gain a deeper understanding of how women not infected by SARS-CoV-2 experienced pregnancy during the COVID-19 pandemic in Sweden. MethodsThis was a qualitative study with a reflective lifeworld approach. Fourteen women that had not contracted COVID-19 and who were pregnant during the first and second wave of the pandemic were interviewed. Data were analysed with a phenomenological reflective lifeworld approach. FindingsThe essence of the women’s experiences of being pregnant during the COVID-19 pandemic was best described as being in the shadow of the unknown, where the COVID-19 pandemic could at times totally overshadow the experience of being pregnant, while at other times, rays of sunlight pierced through the clouds. The experience was characterised by having to deal with the uncertainties caused by the pandemic and feelings of being in an information echo. Women felt socially isolated and had to face maternal check-ups without the support of their partners. There was, however, a strong trust in maternal health-care services despite the lack of information available. ConclusionBeing in the shadow of the unknown represents the uncertainties posed by the COVID-19 pandemic on the experience of pregnancy. Sufficient information, a companion of choice and screening for emotional well-being are important factors in maternity care during pandemics.

‘Time is our utmost enemy’: First responders’ experiences of ‘While Waiting For the Ambulance’ assignments in rural environments – A phenomenological study

Firefighters around the world have the ability to provide first aid before ambulance staff arrive. In Sweden, this assignment is called ‘While Waiting For the Ambulance’ (WWFA). There is limited knowledge about WWFA in rural environments, therefore the aim of this study was to describe the WWFA assignment in a rural environment from the perspective of the firefighters and the ambulance staff. A descriptive design was used with a reflective lifeworld approach, including 16 telephone interviews with firefighters and ambulance staff. The COREQ checklist was applied. A directed responsibility emerges towards affected persons with a situation-adapted attitude during alarms in a WWFA assignment. The firefighters and ambulance staff are each other’s support with a simultaneous need for support from involved organisations. To strengthen this support, training is required, consisting of interprofessional training, feedback from relevant organisations about first aid efforts and expansion of WWFA assignments. Finally, there is a need for a more coordinated picture in order to provide better conditions for future action by the organisations involved, with increased opportunities to save lives in individual local environments.

Being a gift- Multilingual healthcare professionals in neonatal care

BackgroundParents said that they sometimes wished they had a multilingual physician as an interpreter, because the physician would understand the child's care and treatment and share a language with the parents. AimTo understand and describe the lived experience of multilingual neonatal healthcare professionals dealing with interpreting in their workplace, performing as interpreters in addition to their regular work. MethodsInterviews with multilingual neonatal healthcare professionals and analysed using a phenomenological reflective lifeworld approach. ResultsMultilingual healthcare professionals understood the interpreting experience as being a gift, comprising three themes: feeling satisfaction – happiness from helping workplace colleagues; identifying with families – empathy from having been in the same situation; and expected to be available – colleagues expected them to provide interpreting services. ConclusionThis study found that it is common in neonatal care to use multilingual healthcare professionals to interpret communication with parents when language barriers exist.

Solidarity in a Community of Nursing Colleagues.

IntroductionSeveral concepts have been used to describe the qualities of communities of nursing colleagues. Nonetheless, few studies have shed light on nursing communities by drawing on the concept of solidarity.ObjectiveTo explore solidarity among a community of nursing colleagues.MethodsA qualitative research design with a reflective life world approach was selected. This study reused data from a larger Norwegian empirical study. The data from the original study consisted of qualitative interviews and follow-up interviews with 13 nurses (RNs). The research context was municipality and specialist health services. A secondary data analysis was conducted. The study was based on the SRQR reporting guidelines.ResultsThe results were formulated under two themes: 1) having indispensable relationships and 2) encountering a relative absence of sympathy.ConclusionA sense of community among nursing colleagues seems to rely on solidarity: whatever affects one nurse affects another. The solidarity that arose from the content of commonalities involved maintaining indispensable relationships with nursing colleagues by supporting and aiding them and simultaneously enduring a relative absence of sympathy. Solidarity among the community in this study was not a peripheral concept of the general notion of solidarity, implying that the commonalities within the collegial relationships were ambiguous and could shift from something good to something relatively good and vice versa. Such a shift was evidenced by nurses’ experiences of their community.

Continuing to Participate in the Dance of Life as Oneself: The Lived Experience of Meaning in Life for Older Adults With Alzheimer's Disease.

Meaning in life is an important aspect of positive psychological functioning for older adults. Limited work suggests the relevance of the experience of meaning for people with dementia, but research into this experience from their personal perspective is lacking. The current study provides an in-depth investigation of the lived experience of meaning in life for older adults with Alzheimer's disease. The study was conducted following the phenomenological reflective lifeworld approach. In-depth interviews were conducted with 16 older adults (+65) with Alzheimer's disease living either at home or in a nursing home in Belgium. Data analysis was an iterative process aimed at illuminating the constituents and essence of the phenomenon. The essence of the experience of meaning in life for participants was understood as "continuing to participate in the dance of life as oneself." This experience was further clarified in four closely intertwined constituents: (a) feeling connected and involved, (b) continuing everyday life as oneself, (c) calmly surrendering and letting go, and (d) desiring freedom, growth, and invigoration. Our findings contribute to a deeper understanding of meaning in life as experienced by older adults with Alzheimer's disease themselves. They emphasize the relevance of the concept for psychological dementia research and offer original insight for the inclusion of meaning in life as an important aspect of holistic dementia care.

An Understanding of Religious Doing: A Photovoice Study

The ability to participate in everyday activities that hold meaning and value is a determinant of health and wellbeing. Occupational therapists work with people when health and social barriers limit this valued participation. However a challenge persists in including religious practice or ‘doing’ within therapy, with many occupational therapists feeling ill-equipped and reluctant to address religious doing. The study reported here examines religious doing within the lives of participants from a number of faith traditions. A photovoice method is used, with participants discussing photographs that they have taken to describe their religious doing. Data are analyzed using a phenomenological reflective lifeworld approach. Findings are grouped into six themes and are explored using both verbatim quotes from transcripts and some of the photographs taken by participants. A reflective description of the core aspects of participants’ practical religious doing is constructed from the data, with the intention of providing occupational therapists with a basis from which to begin to consider practical religious doing within the lives of their clients. It is proposed that occupational therapists do not need an in-depth knowledge of theology and doctrine but rather an understanding of key and familiar occupational principles such as person-centred habits and routines, and community connectedness.

‘I can only be properly myself when I’m with her’: Early adolescent intra-ethnic immigrant group friendships as a safe space for identity exploration, negotiation and validation

Intra-ethnic adolescent friendships can provide a safe space for the development of a sense of identity and belonging and this study explores the intra-ethnic friendship experiences of fifteen 11- to 12-year olds with non-Irish heritage in Ireland. The incorporation of principles and practices from expressive arts psychotherapy into creative focus groups and journaling within the governing framework of Dahlberg et al.’s reflective lifeworld approach provides different sensory pathways designed to optimise participant expression. Findings indicate that these friendships provide an affirming context for identity exploration, negotiation and enactment, with the journaling activity evoking more personal in-depth disclosures.

Experiences of striving to maintain daily life among women with osteoporosis

ABSTRACTIn order to describe how women with osteoporosis strive to maintain daily life we interviewed 11 women using a reflective lifeworld approach based on phenomenological analysis. Osteoporosis is a major public health concern in the Western world, and is predominant among women. Our findings indicated that meanings of striving to maintain daily life imply a belief in oneself and one’s own capabilities. The women expressly speak out for themselves as a way of finding reconciliation without giving in to the illness. Women with osteoporosis expect to gain support early in the course of their illness. They require advice on how to manage the disease as well as support for striving to maintain daily living. Therefore, it is crucial that the women not only are given information about the disease. Equally important is to establish continuity in healthcare encounters, and that health care offers support founded in the women’s lived experiences with focus on their capacities.

To challenge oneself as a childbearing woman—the lived experience of vaginal birth after caesarean section in Sweden

ABSTRACT Purpose: There is a need to gain deeper knowledge about women’s experience of vaginal birth after caesarean section (VBAC). Considerable research has been conducted on VBAC; however, only a few qualitative studies focus on women’s experiences. Therefore, the aim of this study was to describe the lived experiences of VBAC among women resident in Sweden, a country with a high VBAC rate. Method: This studywas performed in accordance with a phenomenological reflective lifeworld approach. Interviews were conducted with nine women in an urban region of Sweden one year after their VBAC birth. Results: The essential meaning of the studied phenomenon is “to challenge oneself as a childbearing woman”, which is further described by its four constituents: “striving for support from professionals”, “desiring the experience”, “contrasting and comparing memories of two different births” and “being part of the birthing culture”. Conclusions: The experience of VBAC meant regained trust in the ability to give birth vaginally. The women lacked follow-up and support after the caesarean section (CS), during the subsequent pregnancy and the forthcoming VBAC. Enhanced support could be a key factor in helping women meeting the challenge and feel confident about giving birth vaginally despite their previous experiences of CS. Abbreviations: VBAC: vaginal birth after caesarean section; CS: caesarean section

"Like Every Normal Person?!" The Paradoxical Effect of Aging With Schizophrenia.

Studies on aging with schizophrenia have focused mainly on the adversities of aging with mental illness. The present study, however, examined the subjective experience of well-being among individuals with schizophrenia. Taking a phenomenological reflective life-world approach, in-depth, semistructured interviews with 18 aging individuals with schizophrenia were thematically analyzed. Four main themes emerged: (a) "I love the pills . . . they are very helpful": A balanced course of the illness as a basis for well-being in old age; (b) "I'm going to have my own exhibition at the museum": Self-fulfillment as promoting well-being; (c) "It's just like a family here": Experiencing a sense of belonging; and (d) "I live like everyone else": Aging as an opportunity for normalization. Alongside hardship, the participants perceived old age as a "window of opportunity," enabling the fulfillment of lifelong desires for a social life, acceptance, and a satisfying occupation. Implications regarding interventions with this unique population are discussed.

Midwives’ lived experience of caring for new mothers with initial breastfeeding difficulties: A phenomenological study

ObjectiveThe aim of this study is to obtain a deeper understanding of midwives’ lived experiences of caring for new mothers with initial breastfeeding difficulties. MethodsA reflective lifeworld approach was used. Six midwives were recruited from a hospital in western Sweden. Data were collected via individual lifeworld interviews and analysed using phenomenological methods. ResultsThe essential meaning can be described as a midwife’s wish to help new mothers reach their breastfeeding goals by trying to interact with them as individual women in unique breastfeeding situations. This wish constitutes a contradiction to the midwife’s own desire to succeed in enabling mothers to breastfeed and the perceived risk of failure as a midwife if the mothers decide not to breastfeed. This is further described by five constituents: striving to provide individualised care, collegial and personal responsibility both enables and prevents care, a struggle to be sufficient, an uphill struggle and mutual joy becomes the motivation to care. ConclusionsCaring for new mothers with initial breastfeeding difficulties is a balancing act between the midwife’s personal desire to succeed in enabling mothers to breastfeed, the mothers’ wishes, the infants’ needs, the importance of collective collegial competence and the limitations in the health care organisation. This makes the midwife's efforts to provide individualised care frustrating and demanding as well as motivating.

Home healthcare nurses’ experiences of being on stand by as a first responder in a ‘While Waiting For the Ambulance’ assignment

The aim of the study is to describe experiences of the ‘While Waiting for the Ambulance’ (WWFA) assignment, as described by home healthcare nurses (HHCNs). Since the early 1990s, municipal resources in Sweden, preferably firefighters, have been dispatched on WWFA. In order to further assist the local residents on an island in the southwest of Sweden, HHCNs have recently begun accompanying firefighters on WWFA. A reflective lifeworld approach was used for data analysis including in-depth interviews with eight HHCNs. When WWFA was established, the HHCNs experienced lack of clarity in where their responsibilities start and end. A split role is described, and there is a paradox in that the responders are meant to collaborate toward saving lives, when the assignment itself has a lack of collaborative structure. Ethical dilemmas and inner emotional worries led to the nurses expressing a need for support before, during and after WWFA.