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Beroende av vård: innebörden av fenomenet som det visar sig genom patienters, deras anhörigas och vårdares berättelser
Umeå University, Faculty of Medicine, Department of Nursing.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2002. , 76 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 768
Keyword [en]
dependency, care, interview, phenomenological-hermeneutics
Keyword [sv]
Sjuksköterska-patientrelationer, Omvårdnad, Omvårdnadsforskning
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-94104ISBN: 91-7305-163-2 (print)OAI: oai:DiVA.org:umu-94104DiVA: diva2:764443
Public defence
2002-01-25, Vårdvetarhuset, Aulan, Umeå universitet, Umeå, 09:00
Opponent
Supervisors
Projects
digitalisering@umu
Note

Diss. (sammanfattning) Umeå : Umeå universitet, 2002

Available from: 2014-11-19 Created: 2014-10-03 Last updated: 2016-02-01Bibliographically approved
List of papers
1. Struggling to be/show oneself valuable and worthy to get care: One aspect of the meaning of being dependent on care--a study of one patient, his wife and two of his professional nurses
Open this publication in new window or tab >>Struggling to be/show oneself valuable and worthy to get care: One aspect of the meaning of being dependent on care--a study of one patient, his wife and two of his professional nurses
2002 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, 43-51 p.Article in journal (Refereed) Published
Abstract [en]

Dependency on care has commonly been described negatively and as a problem that needs to be addressed. From a larger data material, interviews with an old, hospitalized man with a chronic disease, his wife and two of his professional nurses was selected to study. The aim was to illuminate the meaning of being dependent on care, when it appears "negative". A phenomenological-hermeneutic approach was used to interpret the material. The interpretation shows that dependency on care is reluctantly shown although it is expected to be expressed and/or respected as it is shown. This makes dependency on care camouflaged and the space to be dependent is limited. The meaning of being dependent on care is understood as a two-dimensional struggle for existence. One dimension of the struggle is about to be/show oneself worthy to get care, as dependency on care holds a fear to be abandoned. The other dimension of the struggle is about to be/show oneself valuable as a human being, as identity is built upon being able to manage oneself and be strong. The interpretation if reflected on can open up possibilities to improve the quality of life for patients who are dependent on care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2002
Keyword
chronic disease, dependency, care, interview, phenomenological-hermeneutics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32259 (URN)10.1046/j.1471-6712.2002.00053.x (DOI)11985748 (PubMedID)
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2017-12-12Bibliographically approved
2. An exemplar of a positive perspective of being dependent on care
Open this publication in new window or tab >>An exemplar of a positive perspective of being dependent on care
2000 (English)In: Scholarly inquiry for nursing practice, ISSN 0889-7182, Vol. 14, no 4, 327-346; discussion 347-353 p.Article in journal (Refereed) Published
Abstract [en]

This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger data set derived from 10 patients, interviews with one severely ill patient, her daughter and two of her professional nurses were selected to illuminate a "positive" meaning of being dependent on care. The interviews were tape-recorded and transcribed verbatim and followed by interpretation of transcripts using a phenomenological-hermeneutic approach inspired by Paul Ricoeur's philosophy. The interpretation discloses the meaning of being dependent on care as balancing between being free and negotiating when receiving care. Whether or not dependency on care is negotiated about seems to be about how the power that lies in the existing differences in ability is used. When ability, that is, power, is used to compensate inability, the patient appears free to be dependent on care. Dependency on care is accepted for what it is, when it is. When dependency on care is negotiated about, the differences in ability, that is, power, risk setting limits for what dependency on care is to be. There is a risk that dependency on care will be limited within the frame of what is regarded as polite, appealing and pleasing.

Keyword
Sense of coherence (SOC), Very old age, Health in old age, Social support, Mortality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32257 (URN)11372190 (PubMedID)
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2016-02-01Bibliographically approved
3. Being overwhelmed by the feeling of having a home and family: One aspect of the meaning of being dependent on care. A study of one patient and two of his nurses.
Open this publication in new window or tab >>Being overwhelmed by the feeling of having a home and family: One aspect of the meaning of being dependent on care. A study of one patient and two of his nurses.
2001 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 5, 717-727 p.Article in journal (Refereed) Published
Abstract [en]

RATIONALE: This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger body of data, interviews with one patient and two of his nurses were selected to study. AIM: The aim was to deepen understanding of the meaning of being dependent on care when this appears desirable for the patient. METHODS: A phenomenological-hermeneutic approach was used to interpret the material. Interviews were recorded and transcribed verbatim. FINDINGS/DISCUSSION: The interpretation discloses the meaning of being dependent on care as an overwhelming, unfamiliar feeling of having a home and family. The patient is beguiled into believing he is the ruler in an established relationship and his dependency on care gives him an opportunity to be surrounded by loving, altruistic, helpful people. Being dependent on care is overwhelming and irresistible, i.e. coveted, but simultaneously it is like walking on thin ice, i.e. treacherous. The irresistible desire concerns being unconditionally cared about. The danger is that this 'family membership' will not last. It is brought to the patient because of his dependency on care and it is based on his terms. There is reflection about the patient being unprepared for dealing with his own world of loneliness.

Place, publisher, year, edition, pages
John Wiley & Sons, 2001
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32258 (URN)10.1046/j.1365-2648.2001.01904.x (DOI)11529974 (PubMedID)
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2017-12-12Bibliographically approved
4. Meaning of dependency on care as narrated by 10 patients
Open this publication in new window or tab >>Meaning of dependency on care as narrated by 10 patients
2003 (English)In: Research and Theory for Nursing Practice, ISSN 1541-6577, E-ISSN 1945-7286, Vol. 17, no 1, 65-84 p.Article in journal (Refereed) Published
Abstract [en]

This article is part of an ongoing study that aims to illuminate the meaning of dependency on care. The aim of this particular study is to disclose the meaning of dependency on care as narrated by patients. We conducted interviews with patients (six men and four women) who had been in medical or surgical wards for at least 14 days. Seven of the patients were also interviewed one week after discharge. The participants ranged in age from 41 to 84 years old. The interviews were tape-recorded and transcribed verbatim. A phenomenological-hermeneutic approach was used to interpret the resulting text. The results show that to be dependent on care is to face the inevitability of not being able to manage by oneself--it is being attached to the nurses and bound to the care they offer. Being dependent on care involves a struggle to get care without treading on the nurses' toes. The nurses are one's lifelines and getting care is essential, no matter what. It is better to receive any form of care, good or bad, than to receive nothing. Being dependent on care is to be exposed and subjected to a nurse's ability and benevolence. One comprehensive understanding of the meaning of dependency on care is simply that "one does not saw off the branch one is sitting on." Furthermore, dependency on care involves a struggle to move forward in a life that hurts. Patients lose much of their freedom of choice in daily life and grieve their loss of ability and value. Patients may be able, however, to see things they would have never noticed earlier in life. Dependency on care is understood as one kind of "limit situation." Patients who are dependent on care may reevaluate their potential in life and gain another perspective on life.

Keyword
Caregiving, dependency
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32261 (URN)10.1891/rtnp.17.1.65.53170 (DOI)12751886 (PubMedID)
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2017-12-12Bibliographically approved
5. Meaning of dependency on care as narrated by nurses
Open this publication in new window or tab >>Meaning of dependency on care as narrated by nurses
2003 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 1, 84-91 p.Article in journal (Refereed) Published
Abstract [en]

This article is part of an ongoing study aimed at illuminating the meaning of dependency on care. The aim of this particular study is to illuminate the meaning of the phenomenon 'dependency on care' as narrated by nurses. Interviews with 20 nurses were conducted, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic approach was used to interpret the data. The meaning of dependency on care is revealed as laborious for both patients and nurses. The nurses' text discloses that for patients, dependency on care is a miserable loss of self-determination and self-worth. Nurses appear to be moved by dependents' difficult life and want to do whatever they can for the dependent. Dependency on care is a burdensome responsibility for nurses. For nurses dependency on care is revealed as evoking feelings of guilt and insufficiency and of being constantly concerned and worried. It is to struggle to be patient and understanding, having the arduous task of putting oneself into the dependent patients' shoes in order to cope with the demanding task of balancing between helping and not helping too much. The interpretation discloses, however, that nurses distinguish between easy and trying dependency on care. The understanding indicates that when they meet 'good' patients, nurses reappraise the situation, transform it into something new and meaningful, that is dependency on care is disclosed as 'easy to take'. When coming across'difficult' patients dependency on care is disclosed as trying. It seems that within the unique nurse-patient relationship patients may participate in such a way as to facilitate or inhibit nurses in finding meaning in the immediate caregiving situation. Nurses' evaluations of what constitutes a 'good' or a 'difficult' patient, respectively, seem to play an important role in distinguishing between dependency on care that is easy and that which is trying. The result is viewed through an existential paradigm and there is also reflection about what nurses perceive as valuable qualities in patients which might influence the quality of care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2003
Keyword
dependency, carenurse–patient relationship, interview, phenomenological-hermeneutics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-32260 (URN)10.1046/j.1471-6712.2003.00213.x (DOI)12581300 (PubMedID)
Available from: 2010-03-05 Created: 2010-03-05 Last updated: 2017-12-12Bibliographically approved

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