The Lived Experience of Ambulatory and Perioperative RNs Displaced During the COVID-19 Pandemic: A Phenomenological Study.

During the patient surge associated with the onset of the COVID-19 pandemic in the spring of 2020, perioperative and ambulatory RNs at an acute-care specialty orthopedic hospital were redeployed to medical-surgical inpatient nursing units to care for patients with the disease. The purpose of this phenomenological study was to describe perioperative and ambulatory RNs' experiences during the redeployment. We used purposeful sampling to obtain representatives who worked routinely in perioperative (including postanesthesia care) and ambulatory settings before redeployment. Data saturation was reached after eight in-depth interviews that yielded rich descriptions of the nurses' experiences. Most participants indicated that the fundamental structure of the experience involved being "thrown into a war without weapons" and needing to find ways to fight. The results of this study provide a unique contribution to nursing literature and may assist nurses and leaders in the future.

The need to consider 'temporality' in person-centred care of people with motor neurone disease.

AIMS AND OBJECTIVES: The overall aim of this paper is to provide practical insight into the way that professionals caring for a person with motor neurone disease (MND) can recognise, respect and respond to that person's temporality; that is, the person that they have been, that they are now and that they will be in the future. BACKGROUND: MND is an umbrella term for a group of four rare, devastating neurodegenerative terminal diseases of middle/later life. Previously, we have acknowledged the importance of different time periods in the trajectory of MND as an illness, for example, during the diagnosis stage through to end of life and decision-making at that time. Living with MND can cause anxiety at all stages of the disease trajectory especially as it can be difficult for people living with MND to communicate their desires and concerns to professionals and carers. It is important that professionals continue to provide holistic care throughout the illness trajectory and the aim of this paper is to explore past research about caring for someone with MND in relation to the concept of person-centred care. METHOD: The paper is based on the concatenated exploration of the findings of a hermeneutic phenomenological project. Thus, this discursive paper links elements/studies which have been published previously to develop a model of person-centred care for people with MND which recognises and respects their temporality. CONCLUSIONS: We suggest MND has a significant impact on a person's lifeworld. The proposed person-centred care model focuses on understanding (interpreting) a person in a wider temporal frame and beyond the context of their illness. The expected collaborative outcomes are that: a person is acknowledged as more than a 'patient with MND' and that a professional is providing person-centred care based on individuality of the person, through a temporal lens. This requires a collaborative approach between the person, others and professionals. Such person-centred care, focused on individuality, may prevent a person experiencing life in crisis and suffering towards the end of life.

Questioning the value of present life: The lived experience of older people who see no future for themselves.

OBJECTIVES: To describe the lived experience of older people who see no future for oneself in the context of aging and the possible development of a wish to die. METHODS: Data were collected from 34 interviews with people of 55-92 years. A phenomenological hermeneutical analysis was performed using crafted stories as an analytical device. RESULTS: Four intertwined constituents together with the essence of the phenomenon provide a layered description of what it means to see no future for oneself. In all constituents: 1) not sharing everyday life, 2) looking for new commitments, 3) facing present losses and future fears and 4) imagining not waking up in the morning, the essence losing zest for life seeped through their daily experiences. CONCLUSIONS: As their horizon of future possibilities is shrinking, older people in our study experience a loss of zest for life and start to questioning the value of their present lives. And although a certain languishing mood can be discovered, the phenomenon 'seeing no future for oneself' does not entail a wish to die.

The Suicidal Process and the Role of Negative Emotions in Suicidal Behavior: A Phenomenological Study Among the Baganda.

This article is part of a phenomenological study that aimed at exploring the meanings of Deliberate Self-Harm among the Baganda in Uganda. It describes the suicidal process and the role of negative emotions among the Baganda involved in potentially suicidal self-harm behavior. Narrative interviews were conducted with 18 respondents (5 males and 13 females) aged 18-75 years who had engaged in self-harm. A case by case analysis was done using descriptive phenomenological method. The details of the narratives are described using the "suicidal process approach" proposed by van Heeringens. Comparing the narratives, we observed that most individuals found themselves unable to manage their negative emotions and for some, this situation persisted through multiple episodes. Hence, one of the suicide prevention strategy is to emphasize emotional regulation skills like self-awareness, being mindful and self-compassion in all forms of psychotherapy intervention at all levels.

Growing up alongside a sibling with a disability: A phenomenological examination of growth and deficiency in adulthood.

BACKGROUND: A growing literature underscores the role played by sibling throughout life particularly for siblings with disabilities. However, limited research focuses on how growing up with a sibling with a disability impacts adult personality and well-being. AIMS: The current study is a qualitative examination of the long-term effects of growing up with a sibling who has a developmental disability, using both a deficiency and growth model perspective. METHODS AND PROCEDURES: Participants included 20 adult siblings of individuals with disabilities interviewed using a semi-structured interview. Interviews were conducted via an online platform. OUTCOMES AND RESULTS: Themes identified were: impact on personal character traits, social development through sibling and overcoming social challenges, impacts on religiosity, influence on career choice, influence on romantic relationships and finding a partner, and future planning and stress. Distinct patterns of growth were noted in areas of personal development, character traits, social development, and interpersonal skills. On the other hand, hardships and anxieties were noted in general with specific negative features relating to social embarrassment and concerns about how the sibling status will impact potential romantic partnerships and future family life. CONCLUSIONS AND IMPLICATIONS: The current study highlights the long-term impact of growing up with a sibling with a developmental disability with empirical and clinical implications.

A phenomenological reflection on women's lived experience of giving in circumstances of material scarcity.

There is a robust body of research that examines problems women with criminal-legal system involvement face, the support they need, how they get it, from whom, and how they use it. Rarely do we pause to consider what resources such women already have, the support they give, or what those experiences teach us about how to support them. In this study, my purpose was to reflect on the phenomenon of giving as experienced by women who have few material resources and whose lives have been disrupted by repeat incarcerations. I analyzed four lived experience descriptions of giving from interviews conducted in 2016-2017 with 10 women who had significant histories of criminal-legal system involvement, unstable housing, and little or no income. Using concepts from hermeneutic phenomenology and the practice of phenomenological study described by Max Van Manen, I analyzed giving wholistically, selectively, and in detail. I discerned that the women's experience of giving was relationally structured as exchange, with both past and future aspects. In selective and detailed analysis, themes of "taking in" and "being there" and a gem or essential feature of automaticity/personhood presented themselves. Women found meaning, value, and a sense of belonging in giving to others even when they struggled to meet their own needs. The findings suggest potential directions for nursing practice, research, and advocacy, including work to recognize, build on, and remunerate women's affiliative care-giving and support-while also putting pressure on community health and social services delivery systems to better serve those in need.

A gestalt-terapia como clínica do encontro: compreendendo a relação dialógica / Gestalt therapy as a clinic of engagement: understanding the dialogical relation / La Gestalt-terapia como clínica de encuentro: comprendiendo la relación dialógica

A gestalt-terapia constitui-se como uma psicoterapia dialógica, como uma clínica do encontro. Investigações empíricas sobre a interface existencialismo dialógico-psicoterapia gestáltica são escassas. Considerando a relação dialógica como eixo desta abordagem, objetivou-se compreender as experiências de profissionais de psicologia no tocante à relação dialógica em gestalt-terapia. Como recurso metodológico, utilizou-se a pesquisa qualitativa de método fenomenológico, de orientação semiótica. Foram realizadas entrevistas fenomenológicas abertas com cinco colaboradoras. Os dados foram gravados e transcritos na íntegra. A análise pautou-se na reflexibilidade fenomenológica, percorrendo pela descrição, redução e interpretação. Os resultados indicam a abertura, presença e o uso da epoché pelo terapeuta como elementos fundamentais para a relação dialógica. Experiências positivas de atitude Eu-Tu foram encontradas, sugerindo episódios culminantes deste processo. Houve confusão entre o conceito de atitude e momentos Eu-Tu, com valorização deste princípio em detrimento à atitude Eu-Isso, o que evidencia a necessidade de repensar a formação do gestalt-terapeuta. Assim, a relação dialógica em gestalt-terapia apresenta-se como um campo de pluralidades fenomênicas. Cabe ao profissional um andar cuidadoso e atento neste campo de inúmeras possibilidades.

Gestalt therapy constitutes itself as a dialogical psychotherapy, a clinic of engagement.Empirical research on the dialogical existentialism-gestalt psychotherapy interface is scarce.Considering the dialogical relation as the axis of this approach, the objective was to understand the experiences of psychology professionals regarding the dialogical relation in gestalt therapy.As a methodological resource, we used the qualitative research of a phenomenological method, with a semiotic orientation.Open phenomenological interviews were carried out with five collaborators.The data were recorded and transcribed in full.The analysis was based on phenomenological reflexivity, through description, reduction, and interpretation.Results indicate the opening, presence, and use of epoché by the therapist as fundamental elements for the dialogical relation.Positive I-You attitude experiences have been found, suggesting culminating episodes of this process.There was confusion between the concept of I-You attitude and I-You moments, with an appreciation of this principle to the detriment of the I-It attitude, which evidences the need to rethink the formation of the gestalt therapist. Thus, the dialogical relation in gestalt therapy presents itself as a field of phenomenal pluralities.It is up to the professional to thread carefully and attentively in this field of innumerable possibilities.

La Gestalt-terapia se constituye como una psicoterapia dialógica, como una clínica del encuentro. Investigaciones empíricas sobre la interface existencialismo dialógico-psicoterapia gestáltica son raras. Considerando la relación dialógica como eje de este abordaje, se ha objetivado comprender las experiencias de profesionales de psicología con respecto a la relación dialógica en Gestalt-terapia. Como recurso metodológico se ha utilizado la investigación cualitativa de método fenomenológico, de orientación semiótica. Han sido realizadas entrevistas fenomenológicas abiertas con cinco colaboradoras. Los datos han sido grabados y transcritos en la íntegra. El análisis se ha pautado en la reflexividad fenomenológica, con un recorrido hacia la descripción, reducción e interpretación. Los resultados indican la apertura, presencia y el uso de la epojé por el terapeuta como elementos fundamentales para la relación dialógica. Experiencias positivas de actitud Yo-Tú han sido encontradas sugiriendo episodios culminantes de este proceso. Hubo confusión entre el concepto de actitud y momentos Yo-Tú, con la valorización de este principio en detrimento a la actitud Yo-Eso, lo que evidencia la necesidad de repensar la formación del Gestalt-terapeuta. Así, la relación dialógica en Gestalt-terapia se presenta como un campo de pluralidades fenoménicas. Cabe al profesional un andar cuidadoso y atento en este campo de innúmeras posibilidades.

Aproximações entre E. Husserl e C. G. Jung: da crítica à fundação de uma nova psicologia / E. Husserl and C. G. Jung: from critique to founding a new psychology / E. Husserl Y C. G. Jung: de la crítica a la fundación de una nueva psicología

Pode-se encontrar aproximações entre a proposta fenomenológica de Edmund Husserl (1859-1938) com algumas ideias da Psicologia Analítica de C. G Jung (1875-1961), principalmente no que se refere à crítica que ambos promoveram em relação à Psicologia científica e à concepção de uma Psicologia mais humana. Esse estudo, seguindo o procedimento da pesquisa qualitativa teóricobibliográfica, teve o objetivo de explicitar e, em seguida, aproximar as duas propostas epistemológicas e metodológicas, trazendo os conceitos e estruturações da Fenomenologia e da Psicologia Analítica, correlacionando os pontos de convergência nos quais se equiparam e/ou complementam. Como resultado, observou-se que, tanto Husserl quanto Jung, elaboraram outra concepção filosófica, reagindo ao materialismo e naturalismo positivista; ampliaram o conceito de experiência (empiria); desenvolveram um método de investigação que considera a subjetividade pura; e, por fim, fundaram uma nova Psicologia (AU).

It is possible to find approximations between Edmund Husserl's phenomenological proposal (1859-1938) and some ideas from C. G Jung's Analytical Psychology (1875-1961), mainly regarding the criticism that both promoted in relation to scientific Psychology and the conception of a human Psychology. This study, following the procedure of theoretical-bibliographical qualitative research, had the objective of explaining and bringing together the two epistemological and methodological proposals, bringing the concepts and structuring of Phenomenology and Analytical Psychology, correlating the points of convergence in which they are equated and/or complementary. As a result, it was observed that Husserl and Jung elaborated another philosophical conception, reacting to positivist's materialism and naturalism; expanded the concept of experience (empiria); developed a method of investigation that considers pure subjectivity; and, finally, founded a new Psychology (AU).

Se pueden encontrar aproximaciones entre la propuesta fenomenológica de Edmund Husserl (1859-1938) con algunas ideas de la Psicología Analítica de C. G Jung (1875-1961), sobre todo en lo que se refiere a la crítica que ambas promovieron en relación con la Psicología científica y la concepción de una Psicología más humana. Este estudio, siguiendo el procedimiento de la investigación cualitativa teórico-bibliográfica, tuvo como objetivo explicar y luego reunir las dos propuestas epistemológicas y metodológicas, trayendo los conceptos y la estructuración de la Fenomenología y la Psicología Analítica, correlacionando los puntos de convergencia en los que se equiparan y/o complementan. Como resultado, se observó que Husserl y Jung elaboraron otra concepción filosófica, reaccionando al materialismo y al naturalismo positivista; ampliaron el concepto de experiencia (empiria); desarrollaron un método de investigación que considera la subjetividad pura; y, finalmente, fundaron una nueva Psicología (AU).

Emoção e afetividade na fenomenologia e nas ciências cognitivas: uma compreensão a partir da fenomenologia de Dietrich von Hildebrand e Natalie Depraz / Emotion and affection in phenomenology and cognitive sciences: an understanding from the phenomenology of Dietrich von Hildebrand and Natalie Depraz

Este artigo tem por objetivo explanar sobre o fenômeno da emoção e da afetividade na Fenomenologia e nas Ciências Cognitivas, de modo a destacar alguns aspectos convergentes e divergentes entre ambas. Nas ciências cognitivas, a emoção é uma função psicofísica, passível de apreensão por uma avaliação cognitiva, embasada em uma análise feita pelo indivíduo sobre determinado evento experienciado. Nas análises fenomenológicas, a emoção também possui base cognitiva, mas descritas por outras bases, tais como: as crenças, suposições, percepções ou fantasias perceptivas. No intuito de exemplificar cada uma dessas duas áreas, trazemos as contribuições de Dietrich von Hildebrand, que investiga a afetividade a partir do conceito husserliano de intencionalidade, evidenciando a estrutura essencial dos afetos em sua resposta afetiva; e de Natalie Depraz, contemporânea das recentes descobertas sobre mente, cérebro e consciência, em cuja análise sobre as emoções, constrói uma articulação entre o físico e o psíquico, destacando as implicações da intencionalidade. A partir desse panorama, apresentamos o conceito de emoção para cada autor e apontamos os pontos de convergências, em eco à ideia de que a melhor contribuição científica reside nas passagens e diálogos epistemológicos.

This article aims to explain about the phenomenon of emotion and affectivity in Phenomenology and Cognitive Sciences, in order to highlight some converging and divergent aspects between both. In the cognitive sciences, emotion is a psychophysical function, subject to apprehension by a cognitive assessment, based on an analysis made by the individual about a certain experienced event. In phenomenological analyzes, emotion also has a cognitive basis, but described by other bases, such as: beliefs, assumptions, perceptions or perceptual fantasies. In order to exemplify each of these two areas, we bring the contributions of Dietrich von Hildebrand, who investigates affectivity from the Husserlian concept of intentionality, highlighting the essential structure of affects in his affective response; and Natalie Depraz, contemporary of recent discoveries about, brain and consciousness, in whose analysis of emotions, builds an articulation between the physical and the psychic, highlighting the implications of intentionality. From this panorama, we present the concept of emotion to each author and point out the points of convergence, in echo to the idea that the best scientific contribution lies in the epistemological passages and dialogues.

A new experimental phenomenological method to explore the subjective features of psychological phenomena: its application to binocular rivalry.

The subjective features of psychological phenomena have been studied intensively in experimental science in recent years. Although various methods have been proposed to identify subjective features of psychological phenomena, there are elusive subjective features such as the spatiotemporal structure of experience, which are difficult to capture without some additional methodological tools. We propose a new experimental method to address this challenge, which we call the contrast-based experimental phenomenological method (CEP). CEP proceeds in four steps: (i) front-loading phenomenology, (ii) online second-personal interview, (iii) questionnaire survey, and (iv) hypotheses testing. It differs from other experimental phenomenological methods in that it takes advantage of phenomenal contrasts in collecting phenomenological data. In this paper, we verify the validity and productivity of this method by applying it to binocular rivalry (BR). The study contributes to empirical research on BR in three respects. First, it provides additional evidence for existing propositions about the subjective features of BR: e.g. the proposition that the temporal dynamics of the experience depend upon subject-dependent parameters such as attentional change. Second, it deepens our understanding of the spatiotemporal structures of the transition phase of BR. Third, it elicits new research questions about depth experience and individual differences in BR. The presence of such contributions demonstrates the validity and productivity of CEP.

Heideggerian hermeneutic phenomenology as method: modelling analysis through a meta-synthesis of articles on Being-towards-death.

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it's clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger's philosophy that there is either an inauthentic positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical 'hooks' for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials.

The Bathtub Illusion.

When a person looks at the fingers of their own hand as they line up in depth, the impression may emerge that the little fingers, which are farther away, are located too far and if so they are not part of the same hand. I describe the conditions and suggest this is due to the size difference between fingers (size-distance scaling). A role of size on perceived distance here is more powerful than knowledge about our own body.

Rebuttal Rejoinder: Present IPA For What It Is-Interpretative Psychological Analysis.

I appreciate this opportunity to join Jonathan Smith in his rebuttal to my discussion of the meaning and method of his interpretative phenomenological analysis (IPA). Different forms of inquiry make unique contributions to our understanding of professional practices of psychology, education, pedagogy, nursing, medicine, and other health sciences. So, it should be worthwhile to understand the nature of these potential contributions and their methods. But what if some methods are misnamed, misconstrued, or misdirected? Does it matter? Perhaps or perhaps only academically. I am happy to engage in this rejoinder with Jonathan Smith-certainly there is merit in dialogue and discussions surrounding our understandings of phenomenology as a method for human science research. In addition, I feel collegial amity for Jonathan and his interest in phenomenology and willingness to engage in conversation. In this rejoinder, I will express my views of IPA and Jonathan's rebuttal in some brief detail and with considered care.

Estudo de caso em gestalt-terapia: leituras fenomenológicas do desenho infantil / Case study in gestalt therapy: phenomenological readings of children's drawing / Estudio de caso en la terapia gestalt: lecturas fenomenológicas de dibujo infantil

O presente estudo aborda o desenho infantil como um recurso revelador da criança. Tem por objetivo ilustrar o processo psicoterapêutico de um menino de 6 anos por meio da leitura fenomenológica de sete desenhos realizados por ele ao longo de seus atendimentos. Ademais, pretende refletir sobre as contribuições desse caso para a compreensão e intervenção na clínica infantil na perspectiva da Gestalt-terapia. Para tanto, realizou um estudo de caso documental ex post facto descritivo com base no diário de campo da psicoterapeuta, que continha os desenhos do participante e suas respectivas anotações. A metodologia fenomenológica favoreceu o acesso ao vivido por meio de descrições do cliente que puderam ampliar o contato com sua experiência. O autor da produção gráfica é concebido, portanto, como detentor único do sentido de sua obra. Esse estudo evidencia que o desenho pode favorecer a expressão de algumas crianças de modo a contribuir com o processo psicoterapêutico na Gestalt-terapia.

The present study approaches children's drawing as a revealing feature of the child. It aims to illustrate the psychotherapeutic process of a boy of 6 years from the phenomenological reading of seven drawings made by him during his visits. In addition, it intends to reflect on the contributions of this case to the understanding and intervention in the children's clinic from the Gestalt therapy perspective. To do so, he carried out a documentary case study ex post facto descriptive from the field diary of the psychotherapist, which contained the drawings of the participant and their respective notes. The phenomenological methodology favored the access to the lived one through descriptions of the client that could extend the contact with its experience. The author of graphic production is therefore conceived as the sole holder of the meaning of his work. This study shows that the design may favor the expression of some children in order to contribute to the psychotherapeutic process in Gestalt therapy.

Este estudio se ocupa de dibujo infantil como una característica que revela el niño. Su objetivo es ilustrar el proceso psicoterapéutico de un niño de 6 años de edad con la lectura fenomenológica de siete dibujos realizados por él durante su tratamiento. Además, se pretende reflexionar sobre las contribuciones del caso para la comprensión e intervención en la clínica de los niños desde la perspectiva de la terapia Gestalt. Para este propósito, se realizó un estudio de caso descriptivo documental a posteriori del diario de campo de psicoterapeuta, que contiene dibujos de lo partícipe y sus respectivas notas. La metodología fenomenológica favoreció el acceso a vivido a través de las descripciones de los clientes que podrían ampliar el contacto con su experiencia. El autor de la producción gráfica está diseñada, por lo tanto, como único titular del significado de su obra. Este estudio muestra que el diseño puede favorecer la expresión de algunos niños con el fin de contribuir al proceso psicoterapéutico en la terapia Gestalt.

Por um núcleo de atendimento clínico a pessoas em risco de suicídio / Toward a clinical care center for people at risk of suicide / Hacia a un centro de atención clínica a personas con riesgo de suicidio

O estudo versa sobre a criação de um núcleo de atendimento psicológico a pessoas em risco de suicídio por meio de uma análise fenomenológica daquilo que nos diz aquele que pensa em suicídio em suas diferentes etapas: a redução fenomenológica, a descrição dos vetores internos ao fenômeno e a explicitação das experiências. Para tanto, acompanhamos as questões que foram apresentadas pelas duas primeiras pessoas encaminhadas pelo Núcleo de Atenção ao Estudante (NACE) da Universidade do Estado do Rio de Janeiro ao Núcleo de Atendimento Clinico (NAC) a pessoas com risco de suicídio e concluímos que antes de cometer o suicídio algumas pessoas procuram por ajuda, o que justifica a pertinência e a urgência da criação de núcleos de atendimento clínico com psicólogos devidamente preparados para a lida com essa situação.

This study is about the establishment of a psychological service center for people at risk of suicide. It will work by means of a phenomenological analysis of what is in question in the different stages of the possible suicide: the phenomenological reduction, the description of internal vectors of the phenomenon and the explanation of the experiments. To do so, we followed the issues that were presented by the first two people referred by the Student Care Center (NACE) of the State University of Rio de Janeiro to the Psychological Service Center (NAC) for people at risk of suicide. We concluded that before committing suicide some people look for help, which justifies the relevance and urgency of creating clinical care centers with psychologists properly prepared to deal with this situation.

El estudio es sobre la creación de un centro de servicios psicológicos a las personas en riesgo de suicidio a través de un análisis fenomenológico de lo que nos dice aquellos que tienen pensamientos de suicidio en sus diferentes etapas: la reducción fenomenológica, la descripción de vectores internos al fenómeno y la explicación de experiencias. Para ello, seguimos los temas que fueron presentados por las dos primeras personas remitidas por el Centro de Atención al Estudiante (NACE) de la Universidad del Estado de Rio de Janeiro al Centro de Atención Clínica (NAC) en personas con riesgo de suicidio y la conclusión a que llegamos es que antes de suicidarse las personas buscan ayuda, lo que explica la importancia y la urgencia del establecimiento de la atención clínica con psicólogos debidamente preparados para lidiar con esta situación.

Giving birth on our own terms-Women's experience of childbirth at home.

BACKGROUND: home births are quite rare and are not supported as part of mainstream health care services in most European countries. Women who choose home as the place of birth often do so because maternity services in hospitals do not offer the options that they want. The aim of the present study is to describe women's experiences of giving birth at home and to produce a comprehensive structure of meaning regarding giving birth at home. DESIGN: a phenomenological study based on analysis of open-interview transcripts using Colaizzi's approach. PARTICIPANTS: women who gave birth at home FINDINGS: women who have given birth at home experience having control over their own body, the care they are given, and the practical arrangements surrounding the birth. However, they also experience negative attitudes from other people about their decision to give birth at home, and challenges because of worries about how they and their baby will cope. During the birth women feel a sense of connection to their own body, which they trust to tell them what to do. They experience great happiness on successfully giving birth and feel connected to nature and the circle of life. Being able to celebrate with family members and be pampered by them after the birth made the women feel 'like queens'. CONCLUSIONS: women's experience of childbirth at home is one of having control over the birthing process and its environment. The main challenge is exposure to negative attitudes from others, including health care professionals. Overall, the experience was full of happiness and good feelings. We conclude that more attention should be paid to the quality of birth experiences and women's individual needs and wishes within maternity care provision.

Researching Lived Experience of Drugs and Crime: A Phenomenological Study of Drug-Dependent Inmates.

This study identified the main components of the drugs and crime experience of a sample of 25 drug-dependent inmates interviewed in prison. Text analyses were conducted using a phenomenological method. The sample was characterized by a disruptive childhood in multi-problematic families and deviant social contexts where drug use and crime were considered normal since early adolescence. Drug initiation involved recreational use of dance drugs and/or cocaine, and the pleasure experienced was identified as the cause of subsequent persistent use. Three pathways that led to dependence were identified: The narcissistic pathway was defined as involving uncontrolled cocaine and amphetamines to feel powerful and limitless. The posttraumatic pathway was defined as involving post-trauma self-destructive drug use, while the pain relief pathway was defined as involving multiple substances to relieve pain. The second and third pathways were more directly associated with crime aimed at sustaining drug use.

Participation in siblings׳ birth at home from children׳s viewpoint.

BACKGROUND: partners often participate in childbirth, and the effects on both partners have been intensively investigated, but children׳s participation is rare in western countries and less studied. Thus, the aim of this study was to explore and construct a comprehensive structure of meaning of Finnish children׳s experiences of participating in birth of a sibling at home. DESIGN: a phenomenological study based on analysis of open-interview transcripts by Colaizzi׳s approach and drawings. PARTICIPANTS: seven children aged five to 17 years who participated in birth of a sibling at home. FINDINGS: the children׳s experience of participating in a sibling׳s birth was multifaceted. Their feelings varied from joy to worry, they helped their mother and learned from the experience. They chose to participate. They experienced overwhelmingly strong and positive feelings, but were also worried about the well-being of other family members during the birth. Further, younger children were frustrated, especially if the birth took a long time and they were not allowed to do all they wanted, such as going to a birthing pool. It was important for the children to be able to help their mother and support younger siblings. They learned a lot about childbirth from their participation and information given by the adults. The children regarded home as safe, cosy and a better place to give birth than a hospital. The older children also regarded a home birth as a possible choice for them in the future. They celebrated the baby׳s arrival and remembered the birth day as being joyful and happy. Participation in the sibling׳s birth made relationships between the children closer and warmer. Children felt hurt when people outside the family were suspicious when told that the baby was born at home. CONCLUSIONS: the children׳s experience of participating in a sibling׳s birth at home included varying feelings, learning from their experience and helping mother. The findings could be utilised in parent education if they are going to have their children with them during the childbirth.

Older people's experiences of their free will in nursing homes.

BACKGROUND: Older people in institutional care should be allowed to live a meaningful life in a home-like environment consistent with their own free will. Research on actualisation of older people's own free will in nursing home context is scarce. OBJECTIVES: The purpose of this study was to describe older people's experiences of free will, its actualisation, promoters and barriers in nursing homes to improve the ethical quality of care. RESEARCH DESIGN: Fifteen cognitively intact older people over 65 years in four nursing homes in Southern Finland were interviewed. Giorgi's phenomenological method expanded by Perttula was used to analyse the data. ETHICAL CONSIDERATIONS: Chief administrators of each nursing home gave permission to conduct the study. Informants' written informed consent was gained. FINDINGS: Older people described free will as action consistent with their own mind, opportunity to determine own personal matters and holding on to their rights. Own free will was actualised in having control of bedtime, dressing, privacy and social life with relatives. Own free will was not actualised in receiving help when needed, having an impact on meals, hygiene, free movement, meaningful action and social life. Promoters included older people's attitudes, behaviour, health, physical functioning as well as nurses' ethical conduct. Barriers were nurses' unethical attitudes, institution rules, distracting behaviour of other residents, older people's attitudes, physical frailty and dependency. DISCUSSION: Promoting factors of the actualisation of own free will need to be encouraged. Barriers can be influenced by educating nursing staff in client-orientated approach and influencing attitudes of both nurses and older people. CONCLUSION: Results may benefit ethical education and promote the ethical quality of older people's care practice and management.

Supporting and Sharing-Home Birth: Fathers' Perspective.

The planned home birth has provoked discussion around the world. Home birth has been described as a positive experience, but results regarding the safety of home birth are controversial. To date, the phenomenon has mainly been examined from the mother's point of view, and there is only one previous study reporting fathers' perspective. The purpose of the present phenomenological qualitative interview study was to investigate fathers' experiences of planned home birth. Eleven fathers were interviewed, and the data were analyzed using Colaizzi's phenomenological method. The fathers followed the woman's wish in choosing the birthplace and set aside their own views. Furthermore, hospital birth was not an option for the fathers due to their own prior negative experiences of hospital births such as disturbing the natural progress of birth. The fathers' experience of home birth included sharing the responsibility, supporting the woman, and participating in the home birth process. The experience was challenging; fathers had to take the role of a midwife, and no support or information on organizing home birth was offered by public health services. The fathers felt that the home birth connected them as family, and the experience was empowering. Our study results suggest that the health care professionals need more education and information on home birth and that the families (including fathers) interested in home birth need greater support from health care professionals. There is a need for proper national home birth guidelines, while family-and client-centered care has to be improved in birthing hospitals.