Van Manen's Method Research Articles

Exploring the ethical decision-making experience of caregivers of end stage cancer patients in Iran: a phenomenological study.

Ethical decision making is a complex issue because it strongly depends on the religion, beliefs, traditional laws and moral views of each society. The purpose of this study was to explore the experience of Iranian family caregivers of end stage cancer patients about ethical decision making. This qualitative study is based on van Manen's method of hermeneutic phenomenology. In-depth interviews were carried out to collect data. Participants were 12 caregiver. Audiotapes were transcribed and analyzed for common themes that represented the participants' experiences. Trustworthiness of the findings was established using the Lincoln and Guba's criteria. Three themes reflected the essence of caregivers' lived experience including; fluctuating between hope and despair, wandering dilemma, and ethical decision making. Each of these themes consisted of several subthemes. The present study revealed that, the caregivers of terminally ill cancer patients need different information about prognosis and end of life decision making process. Our perception of how families negotiate ethical issues in their decision-making is still developing. Opportunities should be created to empowering caregivers to talk about their uncertainties and concerns.

Lived Experience of Postpartum Women in Recovery for Opioid Use Disorder on Medication-Assisted Therapy

Abstract Purpose: The purpose of this study was to understand the lived experiences of postpartum women on medication-assisted therapy for opioid use disorder. Study Design and Methods: van Manen's interpretive hermeneutic phenomenological design was used. Recruitment and data collection from seven participants occurred at an outpatient office offering care for perinatal patients on medication-assisted therapy for opioid use disorder. Data collection occurred between September 2021 and March 2022 via in-person interviews using a demographic data sheet, interview guide, speech recognition software, and digital recordings. Demographic data were analyzed using descriptive statistics. Qualitative data were analyzed using precoding, coding, and thematic analysis via van Manen's interpretive hermeneutic phenomenological method. Results: Seven themes were identified: troubled origins, used opioids to deal with life issues, needed to be self-reliant, opioid use disorder overtook their life, the baby was a motivator to seek treatment, the need for combined medication-assisted therapy and collaborative care, and hope for a better life. Clinical Nursing Implications: Nurses can provide trauma-informed care, support the importance of medication-assisted therapy in recovery, incorporate a collaborative care team with expertise in postpartum opioid use disorder, continue the collaborative care team for a minimum of 1 year, and advocate for the patient's role as parent.

Teachers and Counselors Talk: The Psychological Impact of COVID-19 School Closures on Secondary School Students.

The COVID-19 pandemic significantly impacted students' education, mental health, and social well-being. Our research explores the experiences and perceptions of teachers and counselors of the psychological impact of COVID-19 school closures on secondary school students after returning to school. In this qualitative study, 21 teachers and counselors in Iran were purposefully involved and interviewed in-depth using a semi-structured format. The data was analyzed using Van Manen's 6-step phenomenological method, and Lincoln and Guba's criteria were implemented to maintain accuracy and trustworthiness. We have identified 15 categories and 6 themes. These themes encompass issues such as low self-esteem due to emotional or psychological damage, instability within schools, challenges faced by students with family problems, lack of motivation and patience among students, frustration experienced by students, and emotional detachment. To effectively guide and educate students, teachers and counselors must prioritize the psychological well-being of students absent from school due to illness or pandemics. They must also take adequate measures to address any arising psychological complications. Teachers and counselors must recognize and consider the psychological consequences of students absent; this will help develop effective measures to address and alleviate psychological complications.

Overactive bladder symptoms experiences of diabetic women in Türkiye: A qualitative study.

In diabetic patients, poor management of hyperglycemia and prolonged disease duration may lead to neuropathy-related overactive bladder (OAB) symptoms. To effectively manage OAB symptoms in women with type 2 diabetes, it is essential to know how patients perceive these problems, their lives, and strategies. This study aimed to understand the experience of OAB symptoms in Turkish women with type 2 diabetes from their point of view. A qualitative descriptive design was adopted with individual, semi-structured interviews. Participants were selected by purposive sampling. The data were evaluated by using Van Manen's thematic analysis method. The symptom management theory formed the conceptual framework of this study. The Consolidated Criteria for Reporting Qualitative Research checklist was used. A total of 18 patients were recruited and individually interviewed. Semi-structured interviews were conducted from May to August 2023. The three main themes emerged: (i) the meaning of OAB symptoms; (ii) difficulties caused by OAB symptoms; and (iii) coping with OAB symptoms. The subthemes included the negative effects of OAB symptoms on daily life, difficulties in physical, psychological, and sexual life, and positive and negative behavior in coping with OAB symptoms. OAB symptoms affect the physical, psychosocial, and sexual lives of women with type 2 diabetes. Women with type 2 diabetes try to cope in different ways but often do not receive the support they need from families. Therefore, nurses should integrate the urinary problems of women with type 2 diabetes into routine clinical assessments and provide counseling to women.

Understanding the meaning of the lived experience “maternal role” in women with multiple sclerosis and planning a supportive program: a combined exploratory study protocol

BackgroundThe maternal role is one of the most challenging yet rewarding roles that women experience in their lives. It begins when a woman becomes pregnant, and as the pregnancy progresses, she prepares to fulfill her role as a mother. A woman's health plays a crucial role in her ability to fulfill the maternal role. Multiple sclerosis (MS), as an autoimmune disease, presents unique challenges in achieving this role. Failing to fulfill the maternal role can have lasting consequences for both the mother and the baby. Given the increasing number of women with MS of reproductive age in Iran and the absence of specific programs for this group during pregnancy and postpartum, researchers have decided to develop a supportive program by exploring the meaning of the maternal role and identifying the needs of these women during this period.Methods/materialsThis study will be conducted in 3 stages. The first stage involves a qualitative study to explore the meaning of the "maternal role" in women with MS through a descriptive and interpretive phenomenological approach based on Van Manen's method. Data will be collected through semi-structured interviews with pregnant women with MS and mothers with MS who have children under one-year-old, recruited from the Multiple Sclerosis Society of Mashhad, Iran. The second stage will involve designing a support program based on the findings of the phenomenological study, literature review, and exploratory interviews. A logical model will guide the development of the program, and validation will be conducted using the nominal group technique.DiscussionThis study is the first of its kind in Iran to explore the meaning of the maternal role and develop a support program for women with MS. It is hoped that the results of this study will help address the challenges of motherhood faced by these women.

Nursing students' and faculty's experiences of first medication administration: A phenomenological inquiry

BackgroundLearning medication administration is essential for nursing students, but the first time can be stressful and shape their clinical development. Previous research primarily focused on student knowledge and technical aspects. PurposeThis phenomenological study helped explore the lived experiences of nursing students and faculty during student's first medication administration in the clinical setting to gain a deeper understanding of their thoughts, feelings, and perspectives. MethodSemi-structured interviews were conducted with female student and faculty informants (N = 12). Using a phenomenological study, data were analyzed using van Manen's hermeneutic six-step research activity method. ResultsFive overarching themes were found: administrating medication, (un)preparedness for complexities in the clinical environment, transformative experience, overcoming fears, and reaping the rewards. ConclusionFirst-time medication experiences are greater than an exercise in skill proficiency and may be improved if faculty provides more structured learning experiences and take sufficient time for student preparation in relating medication knowledge to the skill, technology usage, and supporting students' attitudes toward nurse-patient interactions. These are essential aspects of the medication administration learning process as nursing programs shift toward competency-based education. Clinical faculty also need support in their role as educators and to be facilitated to find this time, considering their multiple responsibilities.

포스트휴먼 존재로서 어린이의 발현적 연극놀이 탐색

The purpose of this study is to examine through expressive theatrical play that children are rich posthuman beings. This study utilized participatory observation and a posthumanist approach, drawing on van Manen's hermeneutic phenomenological analysis method. The study was conducted at Y Kindergarten in Busan, focusing on one class of four-year-old children, from early October 2022 to the end of January 2023, with observations conducted four to five days a week, approximately from 9:00 to 13:00, totaling 70 sessions. The research findings and their significance can be summarized as follows. First, as posthuman beings, young children initiate dramatic play from the arrangement of materials, and in their dramatic play, various theatrical elements such as stories, props, characters, and backgrounds are enacted and manifested. Second, as posthuman beings, young children experience heightened dramatic experiences within their dramatic play, and their unique characteristics are expressed.Third, as posthuman beings, young children establish relationships with materials within their environment. This study is significant in that it views infants as posthuman beings and examines the emergent nature of infant existence revealed in expressive theatrical play. In the future, it is hoped that children will be recognized as posthumans in early childhood education and that expressive theatrical play will be actively carried out.

Aging and Caring: Exploring Older Adults' Motivation for Informal Caregiving to Other Aging Individuals in Nigeria.

Because of the global population aging, more informal carers become older adults. In Nigeria, the African country with the largest population of adults aged 60 years and older, self-construal rooted in the African collectivist philosophy generally shapes informal caregiving for older adults. However, there is a general paucity of studies on older adults' informal caregiving roles, particularly about their motivations for caregiving. This study explored older adults' motives for informal caregiving to their care recipients in urban Southeast Nigeria. This study adopted a hermeneutic phenomenological research design. In-depth interviews were conducted with 30 purposively selected older adults aged 54-88 who were the primary carers of other older adults in the family and community. The collected data were analyzed using van Manen's thematic analysis method, using QSR NVivo 12 software. A total of 4 main themes emerged from the participants' responses: reciprocity of kindness, altruism, a sense of moral responsibility, and eagerness for peaceful longevity. The findings generally showed that religion and culture were the latent factors ingrained in these motivations for informal caregiving. Although the African philosophy emphasizes altruism, reciprocity seems more prominent in specific traditional African communities, as observed in Southeast Nigeria. It serves as a means to prioritize family members' needs. The findings indicate the need for the government to establish sustainable programs and policies that support older people in their caregiving role. Doing so will enable carers to derive psychosocial gains from informal caregiving and sustain the caregiving culture of Nigeria.

Usability of Public Play Spaces for Children with Disabilities.

To investigate the usability of public play spaces for children with disabilities by exploring their experiences in accessing and using these spaces and to further discuss recommendations for designing such spaces that are usable for these children. A hermeneutic phenomenological approach was employed to explore the experience of children with disabilities regarding the public play spaces. Seven children and their caregivers from two inclusive elementary schools in Central Java Province, Indonesia, participated in the study. Online semistructured interviews with the children were held using Zoom, followed by telephonic interviews with their parents. In addition, video recordings of the observation of the children's participation in the play spaces were gathered. The interview and video observation data were analyzed using van Manen's hermeneutic phenomenology thematic analysis method. Five themes arose regarding the experiences of children with disabilities of accessing and using the public play spaces: (1) where time appeared to speed up, (2) "I like the tall one … I like extreme," (3) fostering connectedness, (4) the need for a safe space, and (5) how a play space should be. The public play spaces have meaningful values for the children with disabilities and their family, as they offered the opportunities to play, explore, interact with friends and families, enjoy nature, interact with animals, and learn. However, it is essential to provide a safe space in which children are free from physical and emotional harm, so that they can fully participate with confidence and a sense of autonomy. Nevertheless, it was also found that children, regardless of their abilities, craved risky and challenging play opportunities. This study also highlights the necessity of awareness-raising intervention programs to foster the inclusion of children with disabilities in public play space settings.

Diabetic Ketoacidosis In Children With Type 1 Diabetes: Behavioral Patterns And Clinical Manifestation As Predictive Factors

Background: Type 1 Diabetes Mellitus (DM type 1) is occasionally becoming more common in Indonesia. According to the Indonesian Pediatrician Association (IDAI), as many as 1220 children in Indonesia had kind 1 DM in 2018. Lack of family education on type 1 DM might be fatal for sufferers. Diabetic ketoacidosis is one of the most prevalent side effects (DKA). Children can die if they do not receive care promptly. This study aims to detect behavioral trends and clinical manifestations in kids with type 1 diabetes to forecast the likelihood of developing DKA. Methods: A qualitative phenomenology-based research design was adopted for this study. Unstructured interviews were used to gather the data, which was analyzed using the Van Manen method. Twenty-four participants are selected by saturation when all participant's answers are similar. All data was collected by recording on devices for 45-60 minutes to interview each participant. Results: The findings revealed that the individuals' eating habits included consuming sugary drinks, buying prohibited items away from the house without their parent's knowledge, and eating portions that increased over time. Weight loss, frequent drinking, shortness of breath, and diminished consciousness are clinical symptoms. Conclusion: The sooner the patient receives assistance to prevent his condition from worsening, the sooner the symptoms and behavioral abnormalities can be recognized

"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.

중증 뇌성마비 장애인의 홈의 의미와 입소 거주시설의 주거선택

This study analyzed the meaning of housing(home) and the reason for the choice of main character Mateusz, a severely disabled person with cerebral palsy, by combining a movie analysis of life feels good and a phenomenological approach that focuses on the essence of dwelling as an existential space. Specifically, Van Manen's hermeneutic phenomenological analysis method was used in movie. In the analysis results, the essential themes derived from the home experience at Mateusz' house include comfortable safety where you can play and study as you please, a place of protection (spatiality), intimacy of the body (corporality), a special child who receives the best love(ralationality), and my time will be good (temporality). And as the reasons why Mateusz finally chose the existing residential facility for the intellectually disabled people as a settlement include change of the owner of the primary territory, changes in the body, growth in thinking about people, optimism for the future through the creation of close relationships with the fellow disabled, employees, the facility's special consideration for Mateusz, and continuous ties with the elder brother.
 Based on these analysis results, this study presented implications and suggestions.

Sexuality experiences of women with multiple sclerosis reporting overactive bladder: a qualitative study.

To effectively manage sexual dysfunction in women reporting overactive bladder, it is essential to know how patients perceive these problems, their lives, and their strategies. In this study we aimed to understand the sexual life experiences of women with multiple sclerosis (MS) who report overactive bladder from their point of view. This study included 12 women with MS and was conducted as a qualitative study with a hermeneutic phenomenological framework. The data were evaluated by using Van Manen's thematic analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used. In this study, thematic codes of sexual symptoms in women with MS with overactive bladder were defined and evaluated. As a result of the analysis of the data, four main themes and nine subthemes were identified. The main themes were "sexual self-concept," "sexual relationships," "sexual function," and "coping with problems". Subthemes such as body image, sexual esteem, the meaning of sexuality, communication, intimacy, coping with overactive bladder and sexual problems, and getting support showed that overactive bladder symptoms negatively affected women's sexual health. Given the variety of sexual problems experienced by women with MS who report overactive bladder, these problems should be a routine part of clinical evaluation. This study is to our knowledge the first to examine the sexual life experiences of MS women reporting overactive bladder in depth based on the holistic view of sexuality theory. However, the sample is small and includes only women with MS who have reported overactive bladder. The sexual experience of women with MS who reported overactive bladder was multi-dimensional. Women with MS cope with their sexual problems alone and cannot receive the necessary support from their husbands, nurses, or other health professionals.

Lived experience caring for a child with Covid-19 disease: A phenomenological study

BackgroundCaregivers of COVID-19 patients, including mothers with an infected child, are affected by adverse physical and psychological effects. Since mothers perform an important role in caring for a child with Covid-19, explaining their challenges and experiences positively affects the health conditions of children and society, in general. AimThis study aimed to explain mothers' experiences with children diagnosed with COVID-19, who were referred to Bandar Abbas Children's Hospital. MethodThe present study was qualitative and used the Van-Manen method. The statistical population included 13 mothers with children hospitalized for coronary heart disease and COVID-19, who were selected by purposive sampling. Semi-structured interviews were implemented to collect data until saturation. Data analysis was performed using MAXQDA 10 software. Lincoln and Guba's criteria were used to evaluate the data's accuracy and strength. ResultsThe mean age of mothers participating in the study was 37.92 ± 4.87. On the other hand, the mean age of children was 5.15 ± 2.07 years. Three main themes and 13 sub-themes were extracted from the data analysis. The main themes were “Inability to Caring”, “Mental and Physical drain” and “Conflict of Roles and Responsibilities”. In this study, when a child develops COVID-19 disease, the mother experiences a series of negative emotions, which lead to feelings of helplessness and inability to care for the child. ConclusionMental and physical manifestations strains were the most important issues that the mothers experienced. The majority of the participants need psychological support to cope with the disease. Therefore, it is recommended to make a proper design to psychologically and socially support these mothers, while alleviating the physical manifestations of their children's disease.

Exploration of adaptation process and experience among the HIV/AIDS patients based on the comprehensive task-based adaptation model.

Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) confront multiple difficulties during the disease adaptation process. Based on the comprehensive task-based adaptation model, this study aims to explore the process and experience of adapting to living with HIV among HIV/AIDS patients and to provide evidence for promoting the adaptation of this population. With the design of the phenomenon study, we purposefully recruited 43 HIV/AIDS patients and conducted semi-structural interviews. The qualitative data was analyzed by Van Manen method. There were 1 307 significant quotes and 6 themes with 14 sub-themes. "The shadow comes along with the sunshine" was proposed to describe the process of adapting to life with HIV. Another 5 themes emerged to represent the tasks as follows: the direction of the mental anchor, the management of physical tasks, social network and support, the occupational dilemma and benefits, and the consideration of the future. The adapting process possesses both common and personalized characteristics. Future intervention development should address the integrality and interaction of the adaptation tasks, contributing to the positive adaptation outcomes of HIV/AIDS patients.

Colostomy may offer hope in improving quality of life: a phenomenological qualitative study with patients dependent on a wheelchair.

This study aimed to evaluate the perspectives of patients who had spinal cord injuries and were wheelchair-dependent on colostomy surgery, which is among the bowel movement methods. In this qualitative study, which was based on Heidegger's hermeneutical phenomenological approach, the Van Manen method was used to reveal how patients were affected by their experiences. The data of the study were collected by directly interviewing the patients and using a semi-structured interview guide. The interviews were recorded with a voice recorder device with the permission of the participants. Nine patients who were leading a life dependent on a wheelchair as a result of spinal cord injury made up the sample of the study. Six of the participants were female. The ages of participants ranged between 32 and 52, and all of them were married. The results of the interviews indicated that the experiences of participants who were dependent on a wheelchair about bowel movement management consisted of three main themes: (a) difficult experiences; (b) coping with difficulties; and (c) colostomy awareness experience. Results showed that knowledge of a stoma obtained from different sources was a glimmer of hope for patients but that healthcare professionals did not exhibit a supportive attitude toward this hope.

What it does and does not do: Effects of ultrasound viewing on women's intention to terminate a pregnancy.

Ultrasound imaging is a renowned prenatal technology used globally to assess foetal growth, viability and abnormalities. In South Africa, ultrasound viewing has not been made mandatory for women who want to terminate their pregnancies. The purpose of this study was to provide a deeper understanding of the effects of ultrasound viewing on women's intention to terminate their pregnancies. Fifteen women in their first trimester were recruited for the study from a community health centre mandated for abortion. Van Manen's hermeneutic phenomenological analysis method was adopted for the study. Three major themes emerged from the data analysis: motivation beyond ultrasound viewing, the emotional burden of the experience, and viewing the ultrasound image as punishment. The study concluded that even though most participants reported the ultrasound viewing negatively affected their person, their reason for termination was so strong that they would not change their minds. However, the ultrasound viewing helped three participants to earnestly reflect on their situations, weigh the pros and cons, and subsequently decide to continue their pregnancy.

The Experiences of Patients with Diabetes and Strategies For Their Management During the COVID-19 Pandemic: A Qualitative Study

Self-care is a key point for patients with Diabetes Mellitus (DM) to maintain normal blood sugar levels. During the COVID-19 Pandemic, patients with DM experienced limitations in carrying out self-care. The study explores in-depth the experiences of patients with DM in carrying out self-care during the pandemic of COVID-19. This type of research was qualitative research with a phenomenological approach. The number of participants in the phenomenological study was patients with DM at the Keputih Surabaya Health Center with ten people. The determination of participants is determined using the purposive sampling technique. The collecting data through in-depth interview techniques online and offline. Data analysis used the Van Manen method. There are five themes related to the self-care behavior of patients with DM during the COVID-19 pandemic in this study, namely: poor diabetic diet, absence of physical activity, impaired monitoring of blood glucose levels, change of medication pattern, and absence of foot care. DM patient's self-care behavior obtained is a decrease in diet, physical activity, monitoring blood glucose levels, and foot care. This decrease was caused by various conditions that occurred during the pandemic. In treatment behavior, it was found that there was the use of herbs as a companion to medical treatment. Furthermore, researchers need to carry out further research on strategies for implementing appropriate self-care in patients with DM during a pandemic, especially the use of herbs as a complement to treatment.

Blaming in women with breast cancer subjected to intimate partner violence: A hermeneutic phenomenological study

ObjectiveThe present study was conducted to determine the blaming experiences of women with breast cancer subjected to intimate partner violence (IPV). MethodsThis hermeneutic phenomenological study explored blaming experiences of women with breast cancer subjected to IPV. Nine women with a mean age of 47.5 years referred to oncology hospitals in Tabriz (Iran) were interviewed using semi-structured in-depth interviews. Data analysis was performed based on Van Manen's thematic analysis method. ResultsThe main theme emerged from the data is “blaming as a shifting cognitive judgment” with three subthemes of patient blaming partner, partner blaming patient, and self-blame. ConclusionsThe findings of the present study revealed that cognitive judgment shifting could be emerged as different types of blaming in the patients with breast cancer exposed to IPV. It is suggested that oncology nurses heed the psychological needs of women with breast cancer through holistic nursing considering couple and family-centered care.

Need Asseesment on Maternal Mental Health Care for Perinatal Mothers during COVID-19: A Qualitative Study.

During COVID-19 pandemic, the isolation, socialization, and extreme changes in daily life have some potential mental health consequences which should be recognized as a critical public health concern, especially for perinatal mothers. Therefore, it is very important to assess the needs for maternal mental health care in perinatal mothers during COVID-19 pandemic. This study aimed to explore mothers' needs for maternal mental health care in the perinatal period during COVID-19 pandemic. Realistic phenomenological approach was carried out in this qualitative study. The study was conducted at five community health centers in the city of Tangerang, Indonesia. In-depth interviews were conducted to 11 mothers who were pregnant, in labor, during puerperium and two months after giving birth with purposive sampling. Data were collected from May to August 2021. Interviews were conducted face to face, audio recorded, and transcribed verbatim. Data were analyzed by using Van Manen's phenomenological method. Initial finding revealed 254 codes, which were then reduced to 122 codes, 98 sub-categories, 22 categories, and 5 themes. There were five themes related to mothers' needs for mental health care during COVID-19, i.e., health protocol during pandemic, psychological support, health education, simple coping mechanism, and support system. The needs can be fulfilled by the closest people the mothers have and healthcare system for perinatal mental health. Vaccination, health protocol, and psychological resilience should be delivered to mothers during COVID-19.