Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

The present paper explores patients’ experience of lived space at the hospital and at home. To expand the understanding of the existential meaning of lived space the study revisited two empirical studies and a study of a meta-synthesis on health and caring. Phenomenological philosophy was chosen as a theoretical framework for an excursive analysis. The paper demonstrates that existential dimensions of lived space at the hospital and at home differ significantly. For the patients, the hospital space means alien territory as (...) opposed to the familiar territory of home. To some extent the experienced differences are due to the physical environment; however, as our analysis shows, other and more significant meanings are also involved. For patients, lived space at the hospital primarily concerns the influence of complex institutional power structures and specific cultural and social conventions, e.g. the role of the good patient and the ambiance of hospitals. Home, on the other hand, offers familiar lived space in which patients feel protected and safe. Further, the paper relates patients’ experience of lived space to a phenomenological view of lived space in order to illustrate the radical influence of illness on patients’ lifeworld and experience of lived space. The combination of illness and general discomfort may influence patients’ experience of home negatively; the former experience of home as a sanctuary changes into feelings of being left on one’s own and burdened by too much responsibility. Consequently, in the light of the increasing focus on patients’ self-monitoring at home, it is important for healthcare professionals to recognize the influence of spatial aspects on patients’ well-being both at the hospital and at home. (shrink)

Based upon a brief outline of existential-phenomenological ontology we present a theoretical and practical understanding of humanbeing, which is suited for a methodologically reflected approach to qualitative research. We present the phenomenological distinction between threedimensions of corporeal intentionality(structural, generative and dialectic intentionality) that form elementary events and structures of meaning. Various aspects of human being are better scrutinized with these concepts of intentionality, such as the association of individual being or collective being (e.g. groups) with the less differentiated anonymity of (...) human being. The aim of our framework is to support the qualitative researcher in grasping the experience of the human life in closer accord with how this being actually unfolds and is lived. Application of the presented framework is illuminated with empirical examples from educational, health and psychological contexts. Finally, we discuss the methodological implications that our approach has for qualitative investigations of human being. (shrink)

Excessive alcohol consumption can have adverse effects on health, and patients who suffer from alcohol use disorders are subject to much stigmatization. Nurses are often the first point of contact when patients enter the acute medical unit, and it is pivotal that this contact establishes the basis for future collaboration. The aim of this study is to elucidate nurses’ lived experience of providing care to patients suffering from alcohol use disorders. This present study has a qualitative research design, anchored in (...) phenomenological and hermeneutical methodology as described in reflective lifeworld research. Ten in‐depth, open‐ended interviews with nurses working in an acute medical unit were conducted. The analysis showed that providing care to patients suffering from alcohol use disorders was a highly complex task to accomplish. This required the nurse to engage with the patient in a sensitive cooperation in order to be dealing with the intricacy of the patient's life situation and balancing care between standardized procedures and the complexity of the patients. Further, a two‐sided feeling of responsibility emerged: a professional responsibility and a personal responsibility causing the provision of care as being caught between feelings of despondency and resignation. Nurses lack opportunities for being creative in determining how to provide care; instead, patients' perspectives of well‐being should be taken into account and should guide the provision of a meaningful care. Nurses must call for opportunities to deviate from the firmly established procedures restraining the care of this population. (shrink)