Living with diabetes, as a lifelong illness, is interlaced with learning and to face continual changes. However, the role of time in this learning process is not yet well understood. The overall aim of the thesis was to gain a deepened understanding of learning to live with diabetes for those recently diagnosed and over a three year period. The thesis, involving four studies where qualitative inductive content analysis and phenomenological hermeneutical interpretation were used, has a lifeworld approach and a qualitative (...) and longitudinal design. Thirteen persons, recently diagnosed with diabetes, were interviewed on three different occasions over a three year period. All interviews focused on the experience of living with diabetes and situations where diabetes had to be taken into account. The aim of study I was to reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis. The findings revealed to be taken over by a new reality, with a body that played a role in life with the health care service as a necessary partner. The aim of study II was to illuminate the meaning of learning to live with diabetes three years after being diagnosed. The findings revealed learning as making decisions through use of different sources of information and as solving the life-puzzle – a delicate balance to create a desired life. The aim of study III was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. In the findings five patterns were identified illuminating different learning processes emerging over time. A longer time living with diabetes did not per se mean increased satisfaction in living well with illness or increased confidence in understanding one’s own needs. The aim of the IV study was to illuminate the meanings of trigger situations in learning to live with diabetes. The findings revealed trigger situations, such as being encumbered by vulnerability and temporality in unsustainable situations with an unpredictable body and a life involving new concerns for the future. The thesis conducted that learning was an informal and ongoing everyday process in life. Time living with diabetes meant both an increased mastery of a changed life situation, but also increased difficulties in achieving well-being and with a dependency on health care. Hence, health care interventions must adhere to the individual’s needs and not be based on duration of illness. Understanding the body and the role of health care, as well as what facilitates and hampers learning, changed with time. It is therefore important that health care personnel illuminate the individual understanding and experiences of those living with diabetes as this was found to be important for the learning process as well as for their sense of well-being. (shrink)

The overall aim of the thesis was to understand elderly people's lived experiences of ageing and their life situation in very old age. The participating persons have been involved in and followed through all studies in the thesis. In study I some characteristics of quality of life in old age were illustrated by means of empirical data and Allardt's definition of the concept. To the elderly people investigated, quality of life meant contentment and a peaceful life, independence and health as (...) a resource for this, personal integrity in terms of moral quality and a caring attitude. A phenomenological hermeneutic approach was utilised in the subsequent studies. In study II 30 of the participants were followed up and interviewed in depth about their lived experiences related to quality of life in old age. Different patterns of life in old age appeared depending on the meaning that the participants ascribed to their experiences of quality of life: successful ageing, good old age, a comparatively good life in old age, bad ageing and a miserable life in old age. Data for studies III-V was collected in the form of thematic life story interviews with 15 participants. Study III illuminated eight participants' experiences of feeling old in advanced age. The understanding was that the very old persons who also felt old were in a phase of transition. The distinguishing qualities of those that felt old were also found to be in line with the dystonic dominance in the ninth stage designated by Joan Erikson and added to the previously described life cycle. Study IV aimed at identifying and revealing the meaning of central themes in very old people's life stories. The results showed that the interviewees by means of the central life themes communicated personal and functional meanings that were understood as influencing very old persons' experience of their everyday life in a positive way. Study V highlighted the very old persons' view of their future from the perspective of philosophy of life. The participants were found to view their future in ways that ranged from a tangible positive approach via a wait-and-see policy to a negative approach. Positive approaches were related to hope and feelings of purpose and meaning. The comprehensive understanding of the thesis was that the challenge in very old age will be to live a life as good as possible notwithstanding changes in health and in environment. In the process of ageing positive tendencies in balancing the developmental crises as described by EH Erikson will contribute to positive experiences of life. (shrink)