Biomedical subjects

Carola Skott

Publications and source records attributed to Carola Skott.

8 recordsLinked to original sources

PubMed2006

Patients' existential situation prior to colorectal surgery.

AIM: The aim of this paper is to present a hermeneutic phenomenological study illuminating patients' existential situation prior to colorectal surgery. The intention was also to explore the value of the encounter between patient and nurse. BACKGROUND: Patients waiting for major surgery experience multifarious reactions. Emotions of anxiety, fears of the unknown, anaesthesia, cancer diagnosis and death can arise. Several earlier studies have reported the importance of information, coping strategies and the need to reduce anxiety and stress in relation to surgery. However, there is a lack of studies focusing on patients' existential situation in the preoperative phase. METHODS: Conversational interviews were conducted with 28 patients 1 week before their surgery during autumn 2002. Analysis of the data was influenced by van Manen's existential themes: lived space/spatiality, lived body/corporeality, lived time/temporality and lived relation/relationality. FINDINGS: Participants expressed either hope of increased spatiality or fear of restricted spatiality, according to whether they had a benign or malign diagnosis. Statements about lived time were also related to the diagnosis. Patients waiting for surgery for a benign diagnosis could use the time to relax and gather energy, while malignancy gave them high levels of anxiety and stress. Lived body experiences showed the ambivalence felt in entrusting one's body to professionals. Statements about lived relations drew attention to the need for considerate caregivers to enhance feelings of security and continuity. CONCLUSION: The existential situation of patients in a preoperative context was shown to be a state of uncertainty with regard to lived space, body, time and relation. The significance of meeting and talking to the nurse did not appear in the statements. The nurse was invisible. If nurses were to employ the existential themes proposed by van Manen in preoperative encounter with patients, their need for care might be more clearly identified and affirmed.

Adult↗

PubMed2006

An interpretive phenomenological method for illuminating the meaning of caring relationship.

This study is a part of a larger project in which the aim is to illuminate the meaning of the caring relationship between patients and nurses in daily nursing practice. Empirical studies in this area inspired from the interpretive phenomenological method are not commonly used. The aim of this paper is to describe how an interpretive phenomenological method was used to illuminate the meaning of the phenomenon caring relationship in daily nursing practice. Data were collected during 16 nursing care proceedings using participant observation with field notes, and in addition to that two interviews, one patient and one nurse. The interpretation moved back and forth between the whole and the parts in a dialectic process. Initial interpretive understanding of interviews and field notes, meaning units and comprehensive understanding were presented. Themes from the patient's interviews were competence, lack of continuity, strain and vulnerability. Themes from the nurse's interviews were competence and striving. Themes from the field notes were interactions towards a goal. The use of interpretive phenomenology offered an opportunity for learning to understand the meaning of the phenomenon caring relationship in daily nursing practice with both strengths and limitations. This study gave an understanding of the phenomenon through the illumination of the patient's and the nurse's thoughts, feelings and actions in the nursing care proceedings that led to a more profound knowledge about how they together create an encounter through their unique competence.

Attitude of Health Personnel↗

PubMed2005

Developing clinical knowledge through a narrative-based method of interpretation.

The results of research using a narrative analysis provide new clinical knowledge, but the methods used are unknown to many readers. In this paper we present an example of how an analysis may be performed in practice. The purpose of the interpretation of this specific story was to develop clinical knowledge of how it is to live with chronic heart failure from a daily life perspective. The steps in the interpretation process, within the framework of Paul Ricoeur's Interpretation theory, were: (1) general or naïve reading, (2) distancing, (3) examination of discourse, (4) conjectures and questions, and (5) reflection over the whole. The demonstrated interpretation of the interview resulted in a theme called: "Struggling to comprehend medical information". This systematic way of working with narratives makes implicit assumptions about the relationship between meaning and language explicit. These themes can be used in everyday practice as clinical tools. Because of the interpretative nature of human understanding the experienced health professional will be capable of integrating evidence-based research findings and individual illness experience.

Adaptation, Physiological↗

PubMed2005

Interpreters' experiences of general practitioner-patient encounters.

OBJECTIVE: To study interpreters' experiences of problems in cross-cultural communication with special regard to the general practitioner (GP)-patient encounter. DESIGN: A focus-group interview with authorized interpreters was carried out. A phenomenographic method was used in the analysis. SETTING: Primary health care. RESULTS: The interpreters displayed a number of problems mainly related to the difficulty in balancing the triad relation (GP-patient-interpreter), the role of the interpreter in relation to other healthcare staff, the time aspects of the translation procedure, and the problems of diverse health beliefs and cultural inequalities. CONCLUSION: The interpreters notice a set of difficulties that need to be highlighted in order to improve consultations with cross-cultural GP-patient encounters.

Adult↗

PubMed2005

Clinical caring--the diary of a nurse.

AIMS AND OBJECTIVES: The aim of this study was to explore the content of individual acts of nursing care and to discuss how these context-specific acts relate to the concept of caring. DESIGN AND METHODS: The point of departure was a diary kept by a nurse on an oncology ward over a period of six months. Hermeneutic interpretation, including content analysis of verb phrases, was carried out to inspire reflection and discussion rather than to generalize. RESULTS: The verbs that occurred in the diary text represented three categories of acts: physical care, speech and reflection. CONCLUSIONS AND DISCUSSION: The diary text expresses the carer's acts as situated in a specific space and time through her presence, communication and reflection. The absence of bodies in this text points to the discourse of nursing as subjected to dualism and to the medical rules of knowledge. Caring emerges as experience-near action that through history is connected to situated knowledges, actual discourse and universal human condition. Relevance to clinical practice. This study demonstrated that caring acts are situated and conditioned and that they should therefore be researched in relation to the carers' acts and thoughts. This confirms the need for cooperation between researchers and clinical nurses in the quest of deepening our understanding of caring.

Adaptation, Psychological↗

PubMed2003

Storied ethics: conversations in nursing care.

The purpose of this article is to discuss narration of ethical themes in nursing care. The text represents part of the findings of an ethnographic study aimed at description of everyday work on an oncology ward. Nurses on this ward are constantly involved in ethical care issues and narratives are told to share experiences. Of vital importance in ethical decision making is the perpetual creation of a mediating moral world constituted by daily experience. The need for making space in nursing for a continual learning conversation is expressed and in this I include writings of nursing theorists.

Adaptation, Psychological↗

PubMed2002

Expressive metaphors in cancer narratives.

This article presents and interprets illness narratives, told by patients treated for cancer. The aim is to discuss the meaning of cancer metaphors. The interpretation focuses on the relationships of metaphors to bodily experience and to social and cultural levels. The experience of cancer and cancer therapy obviously involve the patient's body. To comprehend what is happening is a process full of uncertainty and obscurity. Metaphors, such as cancer "eating," are widespread and persistent while the meaning of that metaphor today mirrors new scientific and lay explanations of cancer and cancer treatment. Personal newly created metaphors express threatening experiences in which fear of losing oneself and fear of death are involved. Ambivalent hope in relation to treatment and caregivers is expressed. Creating new metaphors involves imaginatively using the available concepts and metaphors. Narrative communication gives access to patients' experiences of an unwanted and painful physiologic process leading to forced embodiment of sickness. Patients want consolation and must overcome solitude by articulating experience, being listened to, and, in this way, recreating and strengthening identity.

Adult↗

PubMed2002

Being in a lived retreat--embodied meaning of alleviated suffering.

Meanings of alleviated suffering in persons living with life-threatening cancer are explored in this life-world phenomenologic study. In repeated conversations, 16 patients with cancer who were receiving palliative care shared their embodied experiences in personal narratives. When interpreting the narratives, the following meanings of experiencing alleviation of suffering were disclosed: an endurable body being independent and feeling at home, feelings of connectedness, taking a long view of the suffering, being lifted out of the suffering, and an inner peace. Movements that were found in alleviation were dampening the suffering, arousing a zest for life, and focusing on both the present and the patient's dignity. As an interpreted whole, alleviation of suffering was found to be an embodied experience of "being in a lived retreat." This is a symbolic place owned by the person and is experienced in either the company of others or solitude. This lived retreat can provide a feeling of being at home, creating peace, rest, confidence, and breathing space in the person's suffering. It means coping with the altered lived body and feeling dignified. This is a personal experience that is both intersubjectively created and dependent. The importance of openness and responsibility in palliative care is emphasized in the findings and the notion of control of suffering in palliative care is accordingly rejected.

Aged↗