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Caring or uncaring - meanings of being in an oncology environment.
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
Umeå University, Faculty of Medicine, Nursing.
2006 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 55, no 2, 188-197 p.Article in journal (Refereed) Published
Abstract [en]

AIM: This paper reports a study illuminating meanings of being in the physical environment of an oncology centre as narrated by patients, significant others and staff. BACKGROUND: The physical environment of hospitals can convey different messages. For example, landscape pictures, plants and comfortable chairs can convey positive messages, while sparsely decorated and run-down environments can convey negative values. Traditional healthcare environments may be experienced as unfamiliar, strange and alienating, fostering feelings of stress and vulnerability. The majority of research on care environments has employed experimental designs to test different environmental variables, for example sound, colour and architecture, in relation to patient outcomes such as recovery, pain and blood pressure. There is, however, little research-based understanding of the meanings of being in these environments. METHODS: A phenomenological hermeneutic approach was applied to analyse 17 interviews with patients, significant others and staff carried out during the spring of 2004 at an oncology centre in Sweden. FINDINGS: The physical environment was found to influence experiences of care in four ways: first, by being a symbol expressing messages of death and dying, danger, shame and stigma, less social value and worth; second by containing symbols expressing messages of caring and uncaring, life and death; third, by influencing interaction and the balance between being involved and finding privacy; and fourth, by containing objects that could facilitate a shift of focus away from the self: being able to escape the world of cancer, and finding light in the midst of darkness. The comprehensive understanding illuminates the physical environment as not merely a place for caring, but as an important part of caring that needs to be accounted for in nursing care. CONCLUSION: To promote well-being among patients, we need to ask ourselves if the environment imposes rather than eases suffering. Our findings also suggest the importance of not limiting our conceptions of nursing to nurse-patient relationships, but of using the therapeutic potential of the total environment in nursing care.

Place, publisher, year, edition, pages
2006. Vol. 55, no 2, 188-197 p.
Keyword [en]
Adult, Aged, Aged; 80 and over, Attitude to Health, Existentialism, Female, Health Facility Environment, Humans, Male, Middle Aged, Neoplasms/*psychology, Oncologic Nursing, Privacy/psychology, Professional-Patient Relations, Self Concept, Symbolism
URN: urn:nbn:se:umu:diva-6762DOI: 10.1111/j.1365-2648.2006.03900.xPubMedID: 16866811OAI: diva2:146432
Available from: 2007-12-17 Created: 2007-12-17 Last updated: 2009-11-11Bibliographically approved
In thesis
1. Atmosphere in care settings: Towards a broader understanding of the phenomenon
Open this publication in new window or tab >>Atmosphere in care settings: Towards a broader understanding of the phenomenon
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the study is to understand and describe the phenomenon ‘atmosphere in care settings’ as experienced by patients, significant others and health care staff. The study consists of four papers, each of which illuminates various aspects of the phenomenon. Data consisted of observations and interviews with patients, significant others and staff (n=126) within a hospice, a geriatric, a medical and an oncology setting, and community care settings for older people. Narrative analysis, grounded theory, and phenomenological hermeneutics were used in a triangular fashion to analyse the data.

The findings illuminate the phenomenon ‘atmosphere in care settings’ as being constituted by two interacting and interwoven dimensions: the physical environment and people’s doing and being in the environment. The physical environment is the first dimension, and five aspects were illuminated, namely the physical environment as a symbol; as containing symbols; as influencing interaction; as facilitating a shift of focus from oneself to the environment, and; as containing scents and sounds influencing experiences of at-homeness or alienation. People’s doing and being in the environment is the other dimension, and five aspects were illuminated, namely the experience (or absence of experience) of a welcoming; of seeing and being seen; of a willingness to serve; of a calm pace; and of safety. It was understood that people’s doing and being influences experiences of the physical environment and that the physical environment influences experiences of people’s doing and being. The comprehensive understanding illuminated that the phenomenon is not merely subtle qualities of the place for care, but an active part of care. Both the physical environment and peoples doing and being conveys messages of caring and uncaring. The atmosphere of a care setting can at best support experiences of at-homeness in relation to oneself, others and the surrounding world.

Place, publisher, year, edition, pages
Umeå: Omvårdnad, 2005. 189 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 941
Nursing, Narrative analysis, Grounded Theory, Phenomenological hermeneutics, Symbols, At-homeness, Environment, Omvårdnad
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Research subject
omvårdnadsforskning med samhällsvetenskaplig inriktning
urn:nbn:se:umu:diva-406 (URN)91-7305-807-6 (ISBN)
Public defence
2005-02-04, Aulan, Vårdvetarhuset, Umeå universitet, Umeå, 13:00 (English)
Available from: 2005-01-11 Created: 2005-01-11 Last updated: 2009-11-11Bibliographically approved

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