The overall purpose of this cross-country Nordic study was to gain further knowledge about maintaining and promoting dignity in nursing home residents. The purpose of this article is to present results pertaining to the following question: How is nursing home residents’ dignity maintained, promoted or deprived from the perspective of family caregivers? In this article, we focus only on indignity in care. This study took place at six different nursing home residences in Sweden, Denmark and Norway. Data collection methods in (...) this part of this study consisted of individual research interviews. Altogether, the sample consisted of 28 family caregivers of nursing home residents. The empirical material was interpreted using a hermeneutical approach. The overall theme that emerged was as follows: ‘A feeling of being abandoned’. The sub-themes are designated as follows: deprived of the feeling of belonging, deprived of dignity due to acts of omission, deprived of confirmation, deprived of dignity due to physical humiliation, deprived of dignity due to psychological humiliation and deprived of parts of life. (shrink)

The aim of this study was to obtain in-depth knowledge about caring confirmation of patients with cancer, from the patients’ point of view. The research topic was: what is the significance for patients of their being confirmed by nursing personnel? Fifteen men and women between 43 and 80 years of age participated in this study. The method of data collection used was qualitative research interviewing. A hermeneutic approach was used to interpret the data, in which Kvale’s self-perception, the ‘common sense’ (...) level, and theoretical levels were applied. The results are summarized in three areas: an outer confirmation, an inner confirmation, and a lack of the latter. Outer confirmation meant being understood and taken seriously; the maintenance of human dignity and worth indicated inner confirmation. A lack of inner confirmation is primarily manifest in terms of patients’ mental, spiritual and existential concerns. In relation to the theory of Eriksson, these patients were confirmed at the level of having and being, but seldom at the level of becoming. (shrink)

The Avaldsnes Royal Manor project explores early kingship in Northern Europe, spanning the period c. AD–1320 AD. The principal case is the Norwegian kingdom and the core site is Avaldsnes near Haugesund, Western Norway. 9th–10th century skaldic poems as well as 13th century sagas implies that Avaldsnes was the principal Viking Age royal manor. The site has produced numerous exquisite gravefinds from the Roman period onwards. Among them are the third century Flaghaug grave and two ship graves from the late (...) 8th century. Also, the Oseberg ship, excavated near Oslo, is now proven to have been built c. 820 near Avaldsnes. The Museum of Cultural History, University of Oslo, excavated the Avaldsnes settlement in 2011–12. A team of 23 scholars from prominent academic institutions, including the University of Cambridge and University College London, participate in the research. This first of two volumes contains their results regarding the manor and its setting on the island of Kǫrmt by the Norðvegr, the sheltered sailing route along the West-Scandinavian coast. Together, the chapters produce a detailed 1000-years’ history of a complex central-place area, its monuments and buildings, its activities and functions, its blooming and fading, and eventually its downfall in the 14th century. (shrink)

Finanskrisen har satt fornyet fokus på den praktiske betydningen av samfunnsøkonomifaget. I det følgende vil jeg diskutere fagets problematiske posisjon i overgangen mellom teori og praksis. Dette danner utgangspunkt for min påstand om at økonomene bærer et moralsk ansvar for hvordan faget direkte og indirekte legger premisser for økonomisk politikk og dermed også for den økonomiske utviklingen i samfunnet, finanskrisen inkludert. Jeg vil argumentere for at dette påkaller en etisk og epistemologisk bevisstgjøring av samfunnsøkonomiprofesjonen, og jeg antyder noen forslag til (...) hvordan dette kan angripes. (shrink)

Background Interest in strengthening residents’ autonomy in nursing homes is intensifying and professional caregivers’ experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents’ dignity. Research question/aim This study explored how residents experience paternalism in nursing homes. Research design This study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer’s (...) hermeneutics. Participants and research context Eleven residents were interviewed after a period of participant observation in two nursing homes. Ethical considerations The study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident’s consent was assessed continuously. Three interviews were terminated for ethical reasons. Findings The resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms. Conclusions Residents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents’ capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence. (shrink)

Background: People with progressive cancer experience that their bodies change due to disease and/or treatment. The body is integral to the unity of the human being, a unity that must be perceived as whole if dignity shall be experienced. Relatives are in touch with the suffering bodies of their dear ones, physically, socially, mentally, and existentially, and thus the relatives’ experiences of the bodies of their dear ones might yield insight into the concept of dignity. Aim: The aim of this (...) study is to explore relatives’ experiences of the patients’ bodily changes from a perspective of dignity. Research design and method: A total of 12 relatives from a hospice in Norway were interviewed. Gadamer’s ontological hermeneutics inspired the interpretation. Ethical considerations: The principles of voluntariness, confidentiality, withdrawal, and anonymity were respected during the whole research process. The Norwegian Social Science Data Services approved the study. Results and conclusion: The conversations about the body were conversations about ambivalent or paradoxical matters that shed light on the concept of dignity. The results show that the relatives got in touch with elements that otherwise would have remained tacit and unspoken, and which gave glimpses of a deeper truth, which might reveal the core of dignity. Furthermore, the relatives’ confirmation of the ambivalence might be understood as a strong ethical obligation to treat the other with dignity. The confirmation may also reveal the relatives’ unselfish love of the other, which can be understood as the core of ethics and ethos. Finally, the results reveal the relatives’ limited insight into their dear ones’ bodily changes, and we discuss the challenges of truly seeing the other. Body knowledge and the relationship between body and dignity as phenomena cannot be ignored and needs more attention and articulation in clinical nursing practice and in nursing research. (shrink)

The main findings on embodied spirituality within the Toronto Blessing are presented in this article. The aim of this study is to interpret ecstatic religious experiences from a psychological point of view. The theoretical framework is interdisciplinary, using theories from ego-psychology, social psychology, sociology, cultural anthropology, and ritual theory. Regarding the latter notion, Thomas Csordas has developed cultural phenomenology, which is a culturally constructed way of understanding a situation through using bodily senses in a sort of sensory engagement that is (...) linked with inter-subjectivity. This way of thinking assumes that the body can impart knowledge and help us understand apparently non-rational phenomena. Ecstatic phenomena can be interpreted as bodily knowledge, a habitus, stored or saved in the body to be later activated in a cultural and ritual context. (shrink)

An appraisal of the current status of the modalities and of quine's arguments against them. The author accepts "quine's thesis," that one cannot quantify into referentially opaque contexts, And argues that nobody has succeeded in making sense of such quantification. However, It is shown that modal constructions, Being constructions on general terms and sentences, Can be referentially transparent and extensionally opaque and that consequently the collapse of modal distinctions warned against by quine in "word and object" can be avoided. This (...) combination of referential transparency and extensional opacity is just what quine means by essentialism, And the author therefore agrees with quine that quantified modal logic commits one to essentialism. (shrink)

Background:Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient’s dignity in their clinical work.Objectives:The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice. The chosen research question is “How do nurses participate in ethical decision-making for the patient?”Design (...) and method:We use Gadamer’s philosophical hermeneutics as well as Kvale and Brinkmann’s three levels of understanding in interpreting the data material. Nine registered nurses were interviewed.Ethical considerations:The Ombudsman of Norwegian Social Science Data and the head of the hospital approved the investigation. The participants received both oral and written information about the study and they gave their consent. We informed the participants that the participation was voluntary and that they were free to withdraw at any point in the course of the study. The requirement of anonymity and proper data storage was in accordance with the World Medical Association Declaration of Helsinki. The participants were assured that privacy, and confidentiality would be duly protected.Results:Four key themes emerged: confusion in relation to professional and operational expectations of role, ideal somnolence, inadequate argumentation skills, and compound pressure.Conclusion:Ethical ideals appear to be latent in the mindset of the participants; however, the main finding of this investigation is that nurses need to activate the ideals and apply them into practice. Furthermore, management needs to initiate professional reasoning and interdisciplinary discussions leading to common goals for patients. (shrink)

Background:Suffering in a suicidal crisis includes feelings such as despair, loneliness, anxiety, fear, shame, guilt and hopelessness. This study highlights the experiences of patients in the aftermath of suicide attempts. The research question was, what do suicidal patients see as meaningful help in care and treatment situations?Methodology:The methodology is inspired by Gadamer’s hermeneutics, where the parts are understood in light of the whole, and the whole is understood in light of the parts. Qualitative interviews were employed.Participants and research context:A total (...) of 10 persons, 4 women and 6 men 21–52 years old, were informed and asked to participate by specialists in psychology at two emergency psychiatric wards and by one crisis resolution team. Nine of the participants had experienced one or more suicide attempts using drugs and alcohol. Forced hospitalization prevented one of the 10 participants from attempting suicide.Ethical considerations:Before the participants signed an informed consent form, the interviewer met all participants to provide the written information, talking about the interview. A meeting to terminate contact was arranged after the participants had read their own interviews.Findings:Three themes were generated by the methodology we applied: experiencing hope through encounters, experiencing hope through the atmosphere of wisdom and experiencing a ray of hope from taking back responsibility.Discussion:The findings are discussed in the light of Eriksson’s suffering theory and Lindström’s theory about psychiatric care, as well as earlier research and theories about suicidality.Conclusion:The study reinforces possibilities that hope in suicidal patients can be inspired in encounters with healthcare personnel and within caring cultures. Through dialogue and cooperation, patients’ safety and ability to cope with suffering is created and thereby the hope and will to struggle for life. (shrink)

Background: Suicidality is a life-and-death struggle in deep loneliness and psychological pain. There is a lack of knowledge about what could help the suicidal patients’ struggle for continued life. The aim of this study was to develop a deeper understanding of suicidal patients in the aftermath of suicidal attempts. The research question was ‘What resources in the person himself or herself and his or her surroundings are crucial in a suicidal crisis to maintaining the will to live and hope for (...) life’? Methodology: The study has a hermeneutic approach and an explorative design. Data were collected using semi-structured interviews with 10 participants: men and women 21–52 years of age. The context was two emergency psychiatric units and one crisis resolution team. Ethical considerations: The participants signed an informed consent before the interviews were conducted. Findings: This article presents three themes: becoming aware of the desire to live, an experience of connectedness and someone who cares. Discussion: The suicidal person’s awareness of wishes, dreams, hopes and will, but also of their feelings in the aftermath of the suicide attempt, seemed to play a crucial role in a suicidal crisis. Experiences of connectedness remind the person of the responsibility in his or her own life and in the lives of others and seemed to strengthen the urge to go on. Private and professional relationships seem to be crucial in stimulating the desire and hope to go on living. Conclusion: Becoming aware of the desire to live, being connected to others and experiencing someone who cares is necessary for life. Both private and professional networks seemed to be important resources that could remind the suicidal person of his or her own dignity as part of being human. (shrink)

In this article, an attempt is made to analyse important implications of the hermeneutic approach in qualitative studies. The article discusses the hermeneutic circle with regard to reasoning contexts, on which the researcher's interpretation is based. Problems in connection with achievement of ‘proper’ understanding in an interpretative process are discussed in light of Gadamer's hermeneutic philosophy. Some features of qualitative studies are addressed. This is concerned with arguments in the presentation of findings in qualitative studies using the hermeneutic approach. The (...) essence of the article is there are grounds for reasonable understanding, even though it cannot be absolute in the hermeneutic. (shrink)

The purpose of this study was to explore the challenges met by nursing staff in a rehabilitation ward. The overall design was qualitative: data were derived from focus interviews with groups of nurses and analyzed from a phenomenological-hermeneutic perspective. The main finding was that challenges emerge on two levels of ethics and rationality: an economic/administrative level and a level of care. An increase in work-load and the changing potential for patient rehabilitation influence the care that nurses can provide in rehabilitating (...) patients, and therefore also affect patients’ feelings of self-worth and dignity. Some patients wish to maintain their independence and autonomy, whereas others seem to ‘lose themselves’. Independence and autonomy are associated with dignity, but their lack is contrary to it. (shrink)