Van Manen's Method Research Articles

Living on the threshold: The spatial experience of living alone with dementia

The purpose of this qualitative study was to understand the meaning of living alone for older people with dementia. Fourteen audio-taped open-ended interviews were conducted with eight such older women in Ontario, Canada. The data were analyzed using an adaptation of van Manen's method. Heidegger's philosophy informed interpretation of the findings through the theme living on the threshold. The study findings deepen understanding of `space' and `place' in the experience of living alone with dementia. Participants sought the middle-ground of dialectical tensions within the threshold space and shared insights about their spatial experience of: (a) being here, (b) being there, (c) being out, and (d) keeping out. These older women risked losing their threshold space when admitting to mistakes as their illness progressed. The authors conclude with examples of how this spatial interpretation may inform and improve communication with and care of older people in similar circumstances.

Spirit-Body Healing II

This article describes an advanced intervention for spiritual healing that evolved from spirit-body healing, a hermeneutic phenomenological research study. The research study examined the lived experience of art and healing with cancer patients in the Arts in Medicine program at Shands Hospital, University of Florida. Max Van Manen's method of researching the lived experience was used in 63 patients over a 4-year period. Healing themes that emerged from the research were (1) go into darkness, (2) go elsewhere, (3) art becomes the turning point, (4) slip through the veil, (5) know the truth and trust the process, (6) embody your spirit, (7) feel the healing energy of love and compassion, and (8) experience transcendence. The intervention we offer allows nurses to apply creativity and guided imagery as advanced therapeutics and to continue to provide the leadership needed for integrating spiritual healing into patient care. It is one that personifies the nursing mission formalized by many hospitals: a commitment to treat the bodies, minds, and spirits of patients to the best of our ability as part of our routine care.

Parenting Foster Children With Chronic Illness and Complex Medical Needs

The experience of parenting foster children with chronic illness and complex medical needs was explored in a phenomenological inquiry with 10 foster families. Thirteen participants currently fostering chronically ill children with complex medical needs were interviewed. Recorded interviews were transcribed and analyzed using van Manen's method. Data analysis yielded five essential themes: Foster parents described being committed to the child in their care, coming to know the needs of a medically complex foster child, and identifying effective and ineffective interventions encountered through day-to-day living with a medically complex child. Furthermore, they shared what it was like to experience loss of a child through relinquishment and death. Last, for these parents, fostering children with complex health care needs was a life-changing experience. The findings show that parenting a chronically ill foster child with complex medical needs is a multifaceted experience having implications for multiple disciplines.

Being family: the family experience when an adult member is hospitalized with a critical illness

The purpose of this qualitative study was to understand and interpret the 'family experience' with an adult member hospitalized with a critical illness. Nursing practice in critical care settings has traditionally focused on individual patient needs with only tangential recognition of family needs. Investigation to describe the family experience to illuminate family nursing practice has been lacking. The majority of studies thus far related to critical illness and family are quantitative and reveal constraints to family care and problematic nurse-family interactions. The logical next step is a new kind of family research to enhance nursing of the family as a whole. Family systems theory and existential phenomenology provided the frameworks guiding the study. Semi-structured 'family as a group' interviews were performed with 11 families. Data were analysed using Van Manen's hermeneutic method. Rigor was addressed with trustworthiness criteria. The family experience was analysed within Van Manen's framework of lived space, lived relation, lived body and lived time. A constitutive pattern of being family was revealed. Being family bonds families and makes them exceedingly strong during the critical illness experience. Being a family unit is what gives most families the ability to endure the emotional upheaval and suffering that come with the critical illness experience. Nurses have profound power to help families bear this experience. Family caring is enhanced with the presence of nurses who recognize the importance of 'Being Family' for the family, acknowledge the significance of the nurse-family relationship and act on a commitment to be with and for the family.

En grupp sjuksköterskors beskrivning av goda vårdsituationer i palliativ vård

Palliative care makes heavy demands on the home-care nurse. When caring for the patient the nurse might come very close to both patient and his or her family. The aim of this study was to describe the characteristics of a good palliative care situation in home-care nursing, according to the home-care nurse. Information was gathered by conducting narrative interviews, using one open-ended question. Five nurses, working in municipal health and medical services in Sweden, were interviewed. They were asked to describe one good palliative care situation in home-care nursing. The narratives were analyzed through van Manen's method. Four themes emerged from the narratives: confidence, presence, togetherness and a sensitive ear. These themes were construed as van Manen's existentials: spatiality, corporeality, temporality and relationality/communality. The results of this study contribute to the understanding of the life-world of the home-care nurses, while giving palliative care.

Important Meetings with Important Persons

In this study families that have struggled with their relationships to their children have identified people who have had a positive influence on the child or the family. By enabling meetings between the parents and these key figures the participants were given an opportunity to together recall their contact. The aim of the study was to examine the understanding they constructed of these beneficial processes. Interpretation according to Max van Manen's hermeneutic-phenomenological method led to the crystallization of a number of central themes. These themes together constitute the following whole: these are narratives about ‘emerging mutual trust’, which ‘overcomes obstacles’. The key figures or ‘important persons’ have a ‘clear orientation’ in their occupation and they work in ‘the essential everyday world’ to find and establish ‘contexts that nourish development’ in children and parents. The outcome of this is the creation of ‘new narratives’ that replace the old ones.

Spirit Body Healing???A Hermeneutic, Phenomenological Study Examining the Lived Experience of Art and Healing

Spirit-Body Healing was a hermeneutic, phenomenological research study that examined the lived experience of art and healing (using Max Van Manen's method of researching the lived experience) of 63 participants over a 4-year period. Data included taped interviews with artists and hospitalized cancer patients who could articulate their lived experience of art and healing, observations of artists at work, journal writings, and material from the Arts In Medicine program at Shands Hospital, University of Florida. The researcher interpreted data through Van Manen's method of writing as inquiry to elucidate the themes of the participants' experiences. The themes that emerged were (1) going into the darkness, (2) going elsewhere, (3) making art as a turning point, (4) slipping through the veil, (5) feeling the healing energy of love and compassion, (6) surrendering to the process, (7) knowing the truth, and (8) experiencing transcendence. Understanding the power of art to heal mind, body, and spirit has important implications for cancer nursing practice, and nurses can provide the leadership and commitment to integrate the arts into patient care.

The Lived Experience of Fibromyalgia in African American Women

This study aimed to learn what it is like for African American women to live with fibromyalgia. Van Manen's phenomenological method of writing and rewriting guided the inquiry. The sample included 10 women, who were interviewed for 30 to 60 minutes each. Two agreed to second interviews, for a total of 12 interviews for data analysis. Data analysis revealed the following themes: (a) managing the symptoms, (b) becoming a self-advocate, (c) medications camouflage the pain, (d) coming to grips with the illness means making changes, (e) being accused of "taking a free ride" angers them, (f) support comes from self and spiritual connections, and (g) a certain amount of secrecy makes it easier to live with the illness. Recommendations focus on using a holistic approach to help African American women achieve or maintain their integrity.

Preliminary study of the lived experience of exercise for cancer survivors

There is a growing body of evidence indicating the physical and psychosocial health benefits of exercising during cancer rehabilitation. However, physical activity levels of cancer survivors are generally low. This study adopted a qualitative approach to increase understanding of the lived experience of exercise for cancer survivors. Semi-structured interviews were carried out with six female cancer survivors who had taken part in the 2003 Race for Life fundraising event for Cancer Research UK. Following verbatim transcription of interviews, data reduction was carried out using Van Manen's method of thematic content analysis. Assimilation of central themes forms the basis of the final report. The essence of cancer survivors' experience of exercise was determined as 'going forward'-to move on, physically and mentally following treatment, to rebuild social networks, and to restore a positive, confident outlook towards the future. The central theme of 'going forward' was identified in aspects of participants' physical and mental recovery, and their future intentions for exercise. Race for Life represented a positive focus for participants after cancer treatment, and proved to be an appropriate starting point for initiating, or returning to exercise following cancer. The results of the study support the suggestion that advice regarding exercise should be included in rehabilitation care for some cancer patients.

MIDLIFE WOMEN'S NARRATIVES OF LIVING ALONE

Women who live alone in the United States maintain connectedness in ways that are not fully understood. The purposes of this study were to (1) describe midlife women's definitions of themselves and how these are related to living alone; (2) identify the role of connections in relation to self; and (3) describe how self-definition is related to well-being. Van Manen's interpretive phenomenology and Riessmann's method of narrative analysis were used to examine the role of connections and well-being. Living alone was a core component of self. Outside connections supported the women's well-being. Women's future concerns included disability and financial viability. Directions for further study include examining the concepts of mattering and belonging in relation to women's emotional health.

Breastfeeding in chronic illness: the voices of women with fibromyalgia.

To describe what it is like for women with fibromyalgia (FM) to breastfeed their infants. Nine women with FM who chose to breastfeed their infants were the sample for this qualitative study. van Manen's phenomenological method of reflection, writing, and rewriting was used to analyze the data collected through in-depth tape-recorded interviews and written stories. All nine women felt that they were not successful in their attempts to breastfeed, and felt frustrated. Themes included (a) muscle soreness, pain, and stiffness made it difficult to breastfeed the baby; (b) fatigue interfered with the breastfeeding process; (c) the need for medication, perceived insufficient milk supply, and sore nipples led to forced unplanned weaning; and (d) being forced to wean the infant when not ready to do so created sadness and a feeling of depression. Nurses who work with women with FM who choose to breastfeed need to be proactive in providing informational, emotional, and physical support to facilitate a successful breastfeeding experience for these women. Knowing that the pain, muscle soreness, stiffness, and fatigue of FM may affect breastfeeding can direct nurses to help women with FM plan for support after childbirth and learn techniques to control/reduce the muscle pain and stiffness. Nurses are encouraged to refer breastfeeding women with FM to lactation consultants and support groups for encouragement and validation regarding their concerns about breastfeeding. It is important that nurses continue to serve as advocates for breastfeeding women with FM and keep other healthcare providers informed about the issues related to breastfeeding for women with FM.

Exploring the beliefs and experiences of potential egg share donors.

To date there are few attitudinal studies of women's experiences of egg donation, motivation to donate or their thoughts about eggs donated. Studies are predominantly discussed in terms of a specific treatment option and the ethical implications of different treatments. These studies are mainly designed by professionals working in assisted reproductive technology in line with a clinical agenda. This study aimed to explore the beliefs and experiences of potential egg share donors using an interpretative phenomenological methodology to equip health care practitioners to deal better with patients' needs and desires. Open-ended interviews were conducted immediately following introductory consultations with 11 potential egg share donors from one fertility centre in the United Kingdom (UK). The sample was opportunistic. Data collection took 8 months and van Manen's interpretative phenomenological method was used. Analysis revealed six themes of egg sharing: motherhood (the predominant theme within which all other themes could be subsumed), context, doubt, coping, exchange and empathy. Themes illustrated women's continuation with the scheme despite fears about giving away eggs, the parenting skills of recipient couples and future repercussions of positive outcomes for donor and recipient. Egg sharing could be seen as a marker of hope. Buoyed up by the possibility of a successful outcome, women are prepared to undertake repetitive treatment attempts despite continued failure to conceive and knowledge of a slim chance of a positive outcome. Implications for practice, policy and ethics result in recommendations for more in-depth interview work by independent researchers to gain a clearer picture of women's responses to reproductive technologies and the development of services in line with patient need and individual expectation.

The meaning of stroke in elderly women: a phenomenological investigation.

The objective of this article is to discover meanings of stroke in elderly, non-institutionalized women survivors. Using a qualitative design, a purposive sample of five elderly women in residential settings was studied. Data were gathered through interviews and analyzed using van Manen's method of thematic analysis. An overarching theme of transition with transformation from stroke was identified. Five sub-themes were identified, including deterioration and decline, loss and helplessness, regret, uncertainty and anxiety about the future, and resiliency. Six interwoven additional themes were also identified. Informants experienced numerous changes as a result of stroke that affected ways women perceived themselves and their lives. Knowing meanings of stroke experiences may enable nurses to view stroke survivors with a wider lens, enabling responsive, appropriate care that embraces humanistic perspectives.

A phenomenological study of meaning in life in suicidal older adults

The purpose of this hermeneutical phenomenological study was to explore how older adults who were suicidal experienced meaning in their lives. Eleven older persons between the ages of 64 and 92 years were interviewed about their subjective experiences of feeling suicidal. Data were analysed using van Manen's (1990) method of hermeneutical analysis. Three main themes evolved as characteristic of the fundamental thematic structure of the participants' experiences of meaning. These themes were conceptualized under a broader theme of alienation, a theme which was characterized by broken connections with individuals and meaningful activities. The question of meaning in life for these older persons was reflected not only from the perspective of meaningfulness, but also from the viewpoint of meaninglessness. Their narratives contribute to a deepened understanding of what it is like to be old, suicidal, and to feel like life has no meaning and purpose.