The role of the lived body during the integration of the traumatic experience of the sternotomy scar: A case study.

BACKGROUND: Open heart surgery is a potentially traumatic experience for patients, thus posing a real risk to both the patient's physical and mental health as well as bodily integrity. All of these can greatly affect the emotional relationship to the sternotomy scar, the physical aspect of self-representation. Sternotomy scars mark patients for life, yet our knowledge of patients' subjective experiences is unknown. METHOD: In our case study, we explore the embodied experiences of a woman (42) who underwent open heart surgery with the method of interpretative phenomenological analysis combined with drawings. RESULTS: The body and the bodily experiences play a prominent role in the formation, healing process, and symbolism of a scar. The central core of the traumatic experience of open heart surgery is the attack against the patient's sensation of bodily integrity. The interviewee experiences the surgery as abuse committed on her body, a memory that is deeply etched both in the physical memory and in the form of a scar on the skin. CONCLUSION: Based on our study, it seems that the corporeal dimension of posttraumatic growth may develop after the traumatic experience of heart surgery, in which bodily intimacy with oneself and Significant Others plays a major role. In this case study, the objective reality of the heart as "sick" flesh and the "broken, pierced" bone (Körper), as well as the dissociation-and then its integration-of the lived, living body experience (Leib) are outlined. Our case study was analysed in the theoretical framework of phenomenology and psychoanalysis.

Preliminary study of the exploration patients' experiences of chronic respiratory experiences during the COVID-19 pandemic using interpretative phenomenological analysis.

During the first period of coronavirus pandemic, respiratory patients may have been more vulnerable to mental health problems in addition to their physical vulnerability. The aim was to explore and deepen our understanding of the experiences of chronic respiratory patients at risk of pandemic COVID-19 using interpretative phenomenological analysis. The study involved 8 participants with asthma, COPD or cystic fibrosis. Three main themes emerged: 1. respiratory illness as a defining experience in everyday life, 2. the impact of the COVID-19 pandemic on the self and identity organisation, and 3. adaptation to experiencing vulnerability. Breathlessness as the most frightening feature of progressive lung disease, can be linked to fear and anxiety in different ways. The experience of vulnerability is a fundamental part of their lives. The potentially contagious nature of COVID-19 draws a sharp line between the endangered Self and the dangerous Other. In terms of their adaptation, we observe essentially self-defense mechanisms and emotion-focused strategies.

The Role of Power in Health Care Conflict: Recommendations for Shifting Toward Constructive Approaches.

PURPOSE: The combination of power and conflict is frequently reported to have a detrimental impact on communication and on patient care, and it is avoided and perceived negatively by health care professionals. In view of recent recommendations to explicitly address power and conflict in health professions education, adopting more constructive approaches toward power and conflict may be helpful. This study examined the role of power in conflicts between health care professionals in different cultural contexts to make recommendations for promoting more constructive approaches. METHOD: The authors used social bases of power (positional, expert, informational, reward, coercive, referent) identified in the literature to examine the role of power in conflicts between health care professionals in different cultural settings. They drew upon semistructured interviews conducted from 2013 to 2016 with 249 health care professionals working at health centers in the United States, Switzerland, and Hungary, in which participants shared stories of conflict they had experienced with coworkers. The authors used a directed approach to content analysis to analyze the data. RESULTS: The social bases of power tended to be comparable across sites and included positional, expert, and coercive power. The rigid hierarchies that divide health care professionals, their professions, and their specialties contributed to negative experiences in conflicts. In addition, the presence of an audience, such as supervisors, coworkers, patients, and patients' families, prevented health care professionals from addressing conflicts when they occurred, resulting in conflict escalation. CONCLUSIONS: These findings suggest that fostering more positive approaches toward power and conflict could be achieved by using social bases of power such as referent power and by addressing conflicts in a more private, backstage, manner.

[Types of conflicts and conflict management among Hungarian healthcare workers]. / Konfliktustípusok és konfliktuskezelés magyar egészségügyi dolgozók körében.

INTRODUCTION: Efficient communication, conflict management and cooperation are the key factors of a successful patient care. AIM: This study is part of an international comparative research. The aim of this study is to unfold conflicts among healthcare workers. METHOD: 73 healthcare workers were interviewed using a standardized interview protocol. The in-person interviews used the critical incident method. 30 interviews (15 doctors, 15 nurses) were analysed with the Atlas.ti 7 content analysis software. The sources, types, effects of conflicts and conflict management strategies were investigated. RESULTS: The content analysis unfolded the specificities of conflicts in healthcare based on personal experiences. Organizational hierarchy was a substantial source of conflict, especially among physicians, which originates from implicit rules. As a result of the avoiding conflict management the conflicts remain partly unresolved which has negative individual and group effect. CONCLUSIONS: Our conceptual framework helps to develop a proper intervention specific to healthcare. Orv. Hetil., 2017, 158(16), 625-632.

The experience of voice hearing and the role of self-help group: An interpretative phenomenological analysis.

BACKGROUND: Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. MATERIALS: Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). DISCUSSION: The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. CONCLUSION: Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.

Assessing the experience of using synthetic cannabinoids by means of interpretative phenomenological analysis.

BACKGROUND: New psychoactive substances (NPS) have been increasingly consumed by people who use drugs in recent years, which pose a new challenge for treatment services. One of the largest groups of NPS is synthetic cannabinoids (SCs), which are intended as a replacement to cannabis. While there is an increasing body of research on the motivation and the effects associated with SC use, little is known about the subjective interpretation of SC use by the people who use drugs themselves. The aim of this study was to examine the experiences and personal interpretations of SC use of users who were heavily dependent on SC and are in treatment. METHODS: A qualitative research method was applied in order to explore unknown and personal aspects of SC use. Semi-structured interviews were conducted with six participants who had problematic SC use and entered treatment. The research was conducted in Hungary in 2015. We analyzed data using interpretative phenomenological analysis (IPA). RESULTS: Participants perceived SCs to be unpredictable: their initial positive experiences quickly turned negative. They also reported that SCs took over their lives both interpersonally and intrapersonally: the drug took their old friends away, and while initially it gave them new ones, in the end it not only made them asocial but the drug became their only friend, it hijacked their personalities and made them addicted. CONCLUSIONS: Participants experienced rapid development of effects and they had difficulties interpreting or integrating these experiences. The rapid alteration of effects and experiences may explain the severe psychopathological symptoms, which may be important information for harm reduction and treatment services. Since, these experiences are mostly unknown and unpredictable for people who use SCs, a forum where they could share their experiences could have a harm reducing role. For a harm reduction point of view of SCs, which are underrepresented in literature, it is important to emphasize the impossibility of knowing the quantity, purity, or even the number of different SC compounds in a particular SC product. Our study findings suggest that despite the adverse effects, including a rapid turn of experiences to negative, rapid development of addiction and withdrawal symptoms of SCs, participants continued using the drug because this drug was mostly available and cheap. Therefore, a harm reduction approach would be to make available and legal certain drugs that have less adverse effects and could cause less serious dependence and withdrawal symptoms, with controlled production and distribution (similarly to cannabis legalization in the Netherlands).

[Assessing identity formation of synthetic cannabinoid products' users - an interpretative phenomenological analysis].

INTRODUCTION: The psychoactive substance addiction often leads to change in identity and the formation of the "user self". During recovery this "user self" or the "spoiled identity" (as Goffman described it) transforms into the identity of recovery. Due to the novel symptoms of synthetic cannabinoid products (SCPs), a new type of psychoactive substances and the lack of previous research the identity work of SCPs users is unpredictable. The aim of this study was to examine how the users of SCPs interpret their experiences delivered from SCPs consumption and how do they perceive the identity, for this we assessed the interpretative phenomenological analysis (IPA). METHOD: Based on the method of IPA a purposive sample was recruited, including 6 males (their age was between 20 and 27) who were self-identified SCPs users. They had been using the drug for 2-6 years, and before the analysis they were abstinent for at least one month. Semi-structured interviews were conducted and analyzed using IPA. RESULTS: During the analysis two master themes emerged; 1. The impact of SCPs use experience on self and identity formation, and 2. The transformed self and the user self. CONCLUSIONS: the experiences of SCPs users can be compared with some specificities of traumatic experience; therefore, the experience of SCPs use may be treated as a particular type of trauma. As a result, the resources of SC users to change their self and construct a new non-addict identity are limited, which may mean a significant obstacle in recovery. Hence, treatment should focus on identity work more emphatically.

[The experience of auditory hallucination and the role of self-help groups: an interpretative phenomenological analysis]. / A hanghallás élménye és az önsegito csoport szerepe: interpretatíve fenomenológiai analizisen alapuló kutatás.

INTRODUCTION: the aim of this study was to examine and to understand the experience of voice hearing, the meaning and participants' relationship with their voices. And also to explore what 'recovery' means in this context, and the role of self-help group. METHOD: six semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis (IPA). Emerging themes were identified and clustered into master themes, then interpreted. SUBJECTS: 6 (3 females, 3 males) voice hearers, recovering from psychosis. RESULTS: Analysis resulted in four master themes to represent the key points of life story interviews; the role of voices (first master theme), relationship with voices (second master theme); asymmetric and symmetric relational concept, position of voices (outside or inside). The third and fourth master theme refer to the role of self-help group, and the method applied by the group. CONCLUSION: applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.

[Recovering helpers in the addiction treatment system in Hungary: an interpretative phenomenological analysis]. / Addiktológiai területen dolgozó tapasztalati szakértök: interpretative fenomenológiai analízisen alapuló kutatás.

INTRODUCTION: The work of recovering helpers who work in the addiction rehabilitation centres was studied. The aim was to investigate the process of addicts becoming recovering helpers, and to study what peer help means to them. METHODS: According to interpretative phenomenological analysis (IPA) design, subjects were selected, data were collected and analysed. SUBJECTS: 6 (5 males, 1 female), working as recovering helpers at least one year at addiction rehabilitation centres. Semi-structured life interviews were carried out and analysed according to IPA. RESULTS: Emerging themes from the interviews were identified and summarized, then interpreted as central themes: important periods and turning points of the life story interviews: the experience of psychoactive drugs use, the development of the addiction (which became " Turning Point No 1") then the "rock bottom" experience ("Turning Point No 2"). Then the experience of the helping process was examined: here four major themes were identified: the development of the recovering self and the helping self, the wounded helper and the skilled helper, the experience of the helping process. DISCUSSION: IPA was found to be a useful method for idiographic exploration of the development and the work of the recovering helpers. The work of the recovering helpers can be described as mentoring of the addict clients. Our experiences might be used for the training programs for recovering helpers as well as to adopt their professional role in addiction services.