The movement of virtue from ethos to action.

In this paper, we explore the concept of virtue in nursing care. We particularly examine the description of 'virtue' offered by Aristotle, who considers it the mental constitution that forms the basis for laudable social behaviour. We then turn to Katie Eriksson's work on caritative caring ethics and draw parallels between the Aristotelian concept of virtue and being a good nurse. Eriksson suggests that embracing an ethos, a set of basic values, affects nurses' attitudes as well as the way they speak and take on their responsibility for the patient. We discuss these ideas in relation to a tentative ideal model of the movement from ethos to action to understand and address nurses' ethical thinking and acting. Here, we focus on the catalytic role of virtue as a means for realizing a deliberate, intentional acting with the best of the patient in mind. As an outcome of our analysis, we suggest that the movement of virtue from ethos to action is most usefully conceptualized as knowledge about facts, habits of the heart, deeds of the hand and the power of words. Implications for nursing leadership are suggested, including incorporating organizational values through the means of ethical conversations.

The core of Katie Eriksson's caritative caring theory - a qualitative study from a postdoctoral perspective.

BACKGROUND: For about 40 years, Katie Eriksson developed the caritative caring theory at Åbo Akademi University in Finland. However, a description regarding the most substantial concepts and the relationships between these is lacking and thus needs to be explored. AIMS: The aim of the study was twofold: to explore and describe central concepts in the development of caritative caring theory from a postdoctoral perspective and to uncover and explore the relationships between the concepts. METHODOLOGY: The design of the study was qualitative with a mixed method approach. The material was collected from a postdoctoral group (n = 38) mainly through electronic questionnaires. The texts were interpreted through manifest and latent content analysis. FINDINGS: The analyses generated five main categories including subcategories. The main categories were 'Caring' 'Ethos', 'Suffering' 'Health' and 'The human being'. The relation between the main concepts compiled as 'A tentative synthesis of the main concepts and the relationships between them'. CONCLUSION: This study contributes to an understanding of the most fundamental and valuable concepts in the development of caritative theory during its first 40 years according to postdoctoral researchers' perspectives. This study also displays that the concepts ethos and caring have the strongest relationship followed by that between caring and health, indicating the inner core of ethos and love within caring which bears the potential of enhancing the patient's well-being and health.

The theory of caritative caring: Katie Eriksson's theory of caritative caring presented from a human science point of view.

The Finnish nursing theorist Katie Eriksson's (1943-2019) theory of caritative caring represents a non-medical paradigm concerning the phenomena of nursing. The aim of this article was to present an oversight of the development of Eriksson's theory of caritative caring from a human science point of view. The historical development of the theory is outlined, combined with a brief overview of its philosophical connections, its impact on contemporary caring science research and its implications for nursing care. Caring science is considered a human science in the Nordic tradition, as it is deeply rooted in basic issues of human life and existence. The key ideas of Eriksson's theory of caritative caring are linked to the metaparadigm concepts of human being, health and suffering, caring and environment. All of these are permeated with the ethos of caritative caring, that is, the caritas thought of human love and mercy, and the honouring of the absolute dignity of human beings. Epistemologically, Gadamer is the most influential philosopher when it comes to the theory of caritative caring. Eriksson's theory is used in, for example, intercultural caring, caring for patients suffering from addiction, the importance of aesthetic surroundings, providing ethically good care for older people and mothers as patients in psychiatric care. In these fields of research, Eriksson's ideas of ethics, caring and suffering are highlighted in various clinical contexts. Beyond the areas of nursing care in which Eriksson's work has been cited and developed, there are at least two areas that have been actively enhanced by her works: the field of leadership and education for nursing teachers. According to Eriksson, it is momentous to ponder scientific results as not limited to empirically strengthened, randomized outcomes. Part of making the results of scientific work evident is up to the individual nurses and their being in the world.

Nurses' activities and time management during home healthcare visits.

AIM: To describe nurses' activities and time management during HHC visits from the perspective of master's-level nursing students. BACKGROUND: The shift from community-based hospitals to home-based, person-centred services for patients with a variety of acute or chronic health problems challenges nurses' professional competence and time management during home healthcare visits. DESIGN AND METHODS: A cross-sectional study in accordance with STROBE guidelines. Observation sheets (n = 196) from two municipal home healthcare organisations were analysed with descriptive quantitative analysis. ETHICAL ISSUES AND APPROVAL: While no external ethical committee evaluation was necessary for this quality improvement study, research ethical principles were followed. RESULTS: The nurses spent 50% of each eight-hour shift on indirect patient contact activities and about 38% on direct patient contact activities. The majority of activities underlying the home visits could be linked to long-term illnesses: medication (57%), blood samples (23%), wound care (17%) or measurement of blood pressure (14%). Patient education was offered during only 3.5% of visits. LIMITATIONS: The accuracy of the students' observations is related to their individual capacity to objectively and selectively observe. CONCLUSIONS: There were a number of activities conducted for the patient, to promote continuous intra- and interprofessional patient care, but fewer nursing activities conducted with the patient. To ensure integrated, person-centred, safe patient care, vital reforms are needed. RELEVANCE TO CLINICAL PRACTICE: The appropriate balance between indirect and direct patient contact activities should be discussed intra- and interprofessionally, delineated and made explicit in nurses' work plans and nursing documentation, alongside discussions pertaining to relevant resource allocation.

Working in home healthcare and suggestions for development.

In order to describe nurses' experiences of working in home health care and their suggestions for the development of this public health-care sector, interviews with 18 home health-care nurses were analyzed with qualitative thematic content analysis. The nurses perceived the working shifts either affirmative or non-affirmative, depending on the contextual and organizational factors affecting nurses' workload. The more the nurses perceived they could influence their work, the more engaged they were in patient-related nursing activities, patient-centeredness, collaboration, and forward planning. Several concrete suggestions for the development of home healthcare on the organizational, interprofessional, team and individual levels were given.

Ethos: The heart of ethics and health.

BACKGROUND:: Ethics in nursing care are traditionally discussed in terms of moral norms or principles. When taking an ontological approach to ethics, ethics is about ethos. Ethos involves both an internal and an external side of ethics. Considering ethics and health from an ontological perspective can provide a different understanding of ethics and health in caring and nursing. AIM AND RESEARCH QUESTION:: The aim of this study is to deepen the ontological understanding of ethics and health in caring and nursing. The research question is as follows: What is the ontology of health and ethics in caring and nursing? RESEARCH DESIGN:: The study follows a hermeneutical design inspired by Gadamer. Participants and research context: essays about ethics and health were gathered from PhD students in nursing and caring sciences. ETHICAL CONSIDERATIONS:: The research follows Responsible conduct of research guidelines provided by the Finnish Advisory Board on Research Integrity. FINDINGS:: An ethos with the values of freedom and responsibility seem to ontologically be important for ethics and health. These values allow a movement between the internal and the external sides of ethics that is important for health. DISCUSSION:: The ethos of freedom and responsibility that is essential for ethics and health can provide the current ethical debate a new starting point that previous research asks for. CONCLUSION:: Ontologically, an ethos of freedom and responsibility is essential for ethics and health in nursing and caring.

The meaning of caring in prenatal care from Swedish women's perspectives.

AIM: To deepen understanding of the meaning of caring in prenatal care from Swedish women's perspectives. METHOD: Ten women, who had given birth between 1 and 2 months previously, were interviewed. The women have taken part in the routine programme that constitutes maternity care Sweden. A hermeneutic approach inspired by Gadamer was used to analyse the data and gain a deeper understanding of the women's experiences. FINDINGS: Three themes were identified in the hermeneutical analysis. The themes highlight an existential and ontological aspect for caring as experienced of the women in the study: invitation and caring promise, witnessing and confirmation, and caring emerges in vulnerability. CONCLUSION: The life-changing gravidity and vulnerability motivates caritative care during pregnancy. Reception of caring is not just a superficial feeling, but gives a new understanding of life on an ontological level. In a genuine caring relationship, the pregnant woman not only receives something but also a power and an opportunity to go further and find her own inner strength.

Expecting a child: pregnancy in light of an ontological health model.

AIM: To make visible the existential character of pregnancy by searching for its health dimensions as it is described in the ontological health model. METHOD: Eight women were interviewed two or three times during their pregnancy and one time shortly after birth. The women have taken part in the routine programme that constitutes maternity care in Sweden. A hermeneutic approach inspired by Gadamer was used to analyse the data. An ontological health model was used to interpret the findings. FINDINGS: Nine themes on a rational and a contextual level were clustered to three themes on an existential level: A new life stage, The new life takes shape and Health is jeopardised. Contents of these themes were interpreted together with an ontological health model. Expecting a child means to do, be and become in expectation of the new life. Suffering and health are two different dimensions in a woman's life during pregnancy; they are integrated with one another and ever-present. It is in the meeting with the inevitable, life-changing gravidity and vulnerability that the integrative movement creates the new. Longing is the desire that provides motivation to continue.