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Accessible summary: What is known on the subject?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide.Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety.The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents.This research highlights the various ways in which stigma impacts residents, their families and care home staff.This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice?: There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. Introduction: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. Aims: To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. Methods: A qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. Results: The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. Discussion: Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. Implications for Practice: Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There have been some studies on the experience and community life of mental health clients receiving integrated community mental health service (ICMHS).Evaluation of ICMHS suggests that the service could have positive clinical and social outcomes, but the results are inconclusive. What does the paper add to existing knowledge?: Research studies have focused on clients and/or staff of the ICMHS, while in this study, the experiences and perspectives of family members are also explored. More comprehensive knowledge about the work for, and community life of, people previously under the services of ICMHS is added to the existing knowledge.This study found that with "timely support" and "family presence," people who had received the services of ICMHS continued to engage in more social activities ("expanding social networks"), had "better family relationships," were "letting go" of thinking too much and more able to relax, and had "better self‐efficacy and self‐caring" in the community.Professional contact after ICMHS through continuous conversations (e.g. home visits and follow‐up calls) and social activities are essential for both clients and their families to carry on living with the illness.Timely support, family presence, support to family members in the community and better social networks are key experiences of ICMHS clients. What are the implications for practice?: Although the ICMHS' resources are limited, better promotion is urgently needed for the public to realize the services and to support mental health clients.Mental health professionals may develop practice models through exploratory and confirmatory factors analyses of the themes identified from this study as the outcome measures. The cost‐effectiveness of services and relapse rates over time should also be evaluated for future practice development.Further studies for practice on the difference that family support can make to the community life of former ICMHS clients are warranted. This may be achieved through research designs that compare people with, and without, family members. Introduction: More comprehensive understanding, from the experiences and multiple perspectives of the clients, families and staff, about the community life of former clients of the integrated community mental health service (ICMHS) is scarce. Aim: To explore the community life experiences of people after their discharge from the ICMHS. Method: A qualitative approach with an interpretative phenomenological analysis was utilized for this study. Data were collected through individual semi‐structured interviews of 37 participants, including people discharged from an Integrated Community Centre of Mental Wellness, their family members and staff members. Results: Six themes emerged from the analysis: "timely support," "family presence," "better family relationships," "expanding social networks," "letting go" and "better self‐efficacy and self‐care," under the main theme of "walking with the illness and life." Discussion: Over and after the ICHMS, with timely support and family presence, there was a positive trend in the experiences of clients in expanding social networks, having better family relationships, letting go of thinking too much and being more able to relax, and improving self‐efficacy and self‐caring. Implications for practice: The study provides a more comprehensive understanding of the experiences of clients, family and staff about the community life of people post‐ICMHS, providing insights and clearer directions for research and practice development. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study exploring and comparing the experience of men and women with colorectal cancer at diagnosis and during surgery. Background. Men have higher incidence and mortality rates for nearly all cancers and frequently use health behaviours that reflect their masculinity. There has been minimal investigation into the influence of gender on the experience of a 'shared' cancer. Methods. From November 2006 to November 2008, a qualitative study was conducted involving 38 individuals (24 men, 14 women) with colorectal cancer. Data were generated using semi-structured interviews at four time points over an 18-month period. This paper reports the participants' experience at diagnosis and during surgery (time point 1) with the purpose of examining the impact of gender on this experience. Findings. In general, men appeared more accepting of their diagnosis. The majority of females seemed more emotional and more affected by the physical side effects. However, there was variation in both gender groups, with some men and women portraying both 'masculine' and 'feminine' traits. There was also individual variation in relation to context. Conclusions. It appears that many men may have been experiencing side effects and/or psychological distress that they were reluctant to discuss, particularly as some men portrayed typical 'masculine' traits in public, but felt able to open up in private. Nurses should not make assumptions based on the traditional view of masculinity, and should determine how each man wants to deal with their diagnosis and not presume that all men need to 'open up' about their illness. [ABSTRACT FROM AUTHOR]

Aim: To explore young adults' experiences of living with type 1 diabetes in the transition to adulthood, including experiences of the transfer from paediatric to adult care. Design: A qualitative approach was used. Method: Ten young adults, six women and four men, aged 19–29 years, participated. Participants were recruited at their regular diabetes clinic from spring 2021 to spring 2022. Semi‐structured interviews were transcribed and analysed using qualitative content analysis. Findings: Dreaming of being nurtured towards self‐reliance was the overarching theme. Personal experiences of the transition to adulthood, including the transfer from paediatric to adult care, were described in terms of struggling to find balance in daily life, dealing with feelings of being different, being gradually supported to achieve independence, and wishing to be approached as a unique person in healthcare. Conclusion: In healthcare, it is important to emphasize not only diabetes‐related factors but also emotional and psychosocial aspects of life connected to the transition to adulthood, including the transfer to adult care. The young adults wished to be seen as unique persons in healthcare during their emerging adulthood and should therefore be supported to achieve self‐reliance through personal preparations for new challenges and for the consequences of transitioning to adulthood. Specialist nurses can provide appropriate knowledge and leadership. Implications for the Profession: These findings can guide nurse specialists in support for emerging adults to achieve self‐reliance and indicate the importance of person‐centred care when experiencing transition and transfer. Reporting Method: The study adhered to EQUATOR guidelines, and the COREQ checklist for qualitative studies was used as the reporting method. [ABSTRACT FROM AUTHOR]

Aims and objectives: Explore the parent and child/young person experience of difficult venous access and identify ideas and preferences for changes to clinical practice. Background: Peripheral intravenous catheter insertion is one of the most common invasive procedures in hospitalised paediatric patients. Multiple insertion attempts in paediatric patients are common and associated with pain and distress. Little research has explored the parent and child/young person experience of difficult venous access nor sought to identify their suggestions to improve clinical practice. Design: Qualitative description. Methods: A purposive sampling approach was used to identify children and young people with experience of difficult venous access and their parents. Semi‐structured interviews were conducted, with sample size based on data saturation. Transcripts were analysed using thematic analysis. Results: There were 12 participants, seven parents and five children/young people (five parent/child dyads and two individual parents). Analysis of the data revealed three main themes: (1) Distress—before, during and after (2) Families navigating the system: the challenging journey from general clinician to specialist and (3) Difficult venous access impacts both treatment and life outside the hospital A pre‐determined theme, (4) Recommendations for good clinical practice is also described. Conclusions: Multiple attempts to insert a peripheral intravenous catheter are a source of substantial distress for children/young people, leading to treatment avoidance. Effective interpersonal skills, providing choice and avoiding frightening language are important to minimise distress. Clinicians without specialist training should assess each child's venous access experience and consider immediate referral to a specialist if they have a history of difficult venous access. Cultural change is required so clinicians and healthcare services recognise that repeated cannulation may be a source of psychological distress for children/young people. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study exploring the lived experiences and emotional responses of female patients learning to perform clean intermittent self-catheterisation (CISC). Background. There is general consensus that CISC should be considered in preference to in-dwelling catheterisation wherever feasible. Published literature has tended to focus on quality of life issues and technical and physical aspects. There has been less investigation into patients' initial perceptions of CISC and into their subsequent experiences of learning the technique. Design. This qualitative study used a phenomenological research design. Method. A series of semi-structured, in-depth interviews were held with a purposive sample of adult female patients performing CISC aged 34-64 years. Interviews were tape recorded and transcribed verbatim. Data were analysed using the 'Framework' method. Results. This study identified six recurrent themes: grief and loss, lack of knowledge (regarding female anatomy, bladder dysfunction and catheters), negative associations and stigma, psychological aversion and embarrassment, nursing approaches and coping mechanisms. Conclusion. Loss of normal bladder function may represent a devastating event and trigger emotional responses associated with grief and loss. Patients may experience a range of reactions whilst learning CISC, including embarrassment and aversion, which may not dissipate over time. However, psychological distress is not inevitable and varies enormously between individuals. The nursing approach is vital, as individualised, empathic care is recognised and valued. Relevance to clinical practice. This study adds to an emerging body of knowledge providing an enhanced understanding of the lived experiences of patients learning CISC. Nurses need to be alert to a range of potential emotional responses. This will facilitate the adoption of individualised teaching and learning strategies, designed to optimise the patient's assimilation of CISC into their lifestyle, promoting physical health, psychological wellbeing and independent living. [ABSTRACT FROM AUTHOR]

sanders c., carter b. & goodacre l. (2011) Searching for harmony: parents' narratives about their child's genital ambiguity and reconstructive genital surgeries in childhood. Journal of Advanced Nursing 67(9), 2220-2230. Abstract Aim. This paper is a report of a narrative study of parents' experiences of their child's genital ambiguity and the place reconstructive surgeries have in their lives. Background. Increasingly, the use of early reconstructive genital surgery has come under criticism. Few studies have explored parents' inclusion in the surgical decision-making process, their experiences of their child's surgeries or of parenting a child born with ambiguous genitalia. Method. Narrative interviews about parents' experiences of having and caring for a child of uncertain gender and their rationale for reconstructive surgeries were conducted with 15 parents between October 2004 and February 2006. Interviews were recorded, transcribed verbatim and analysed in a narrative analysis framework. Results. Narrative analysis resulted in three increasingly contextual and conceptual levels of stories. Connections between stories gave the basis for the synthesis of the data; interpretation identified three elements of shock, protection and anxiety, which influenced the parents. The parents identified the need for early and ongoing support from healthcare professionals. The parents expected professionals to be knowledgeable about the dilemmas surround disorders of sex development and have experience in managing care for themselves and their child. Conclusion. For the parents seeking a sense of harmony between their child's genital ambiguity and gender during childhood was important. Searching for this harmony became a dynamic and evolving process, which was built on their knowledge and increasing willingness to engage with professionals, negotiate their social worlds, emotional responses and belief systems. [ABSTRACT FROM AUTHOR]

Forsberg A, Lindgren E, Engström Å. International Journal of Nursing Practice 2011; : 110-116 People who have been cared for in intensive care units (ICUs) are transferred between different levels of care and hospitals. The aim with this study was to describe peoples' experiences of being cared for in an ICU and transferred to a ward. An inductive, descriptive qualitative study was performed with qualitative individual interviews with 10 participants. The interviews were transcribed verbatim and subjected to qualitative thematic content analysis which resulted in one theme; searching for the known in the unknown, and five categories. The findings showed the importance of being prepared for the transfer and knowing what was going to happen. Some participants felt secure in the ICU and excluded on the ward, others appreciated leaving the stressful environment in the ICU for a more peaceful ward. Feelings of anxiety and exposure were experienced during the transfer and it was helpful if staff involved were known to the participants. Better information and patients' involvement concerning the transfer from ICUs to general wards are suggested as means of improving nursing care. Further studies are needed to improve continuity of care for critically ill people. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore how excellent nurses in hospitals take into account patient preferences in nursing decision‐making in the evidence‐based practice towards personalised care. Background: In evidence‐based practice, nursing decision‐making is based on scientific evidence, evidence of best practice and individual patient preferences. Little is known about how nurses in hospitals take into account patient preferences in nursing decision‐making. Design: Qualitative grounded theory. Methods: Data collection entailed 27 semi‐structured interviews with nurses designated by their colleagues as excellent caregivers, followed by 57 hours of participant observation. Data analysis was conducted using three‐level coding with constant comparison and theoretical sampling. The COREQ checklist for qualitative research was followed. Results: A main finding was that participants used three implicit tools to discover patient preferences: establishing a connection, using antennae and asking empathic questions, thus instantly reassuring patients from the very first contact. Their starting point in care was the patient's perception of quality of life wherein they shifted towards their patient's perspective: "Teach me to provide the best care for you in this situation." During the observations, it was confirmed that the excellent nurses behaved as they had described before. Conclusion: Excellent nurses actively turn towards patients' expectations and experienced quality of life by carefully blending individual sensitive and situation specific patient preferences with scientific evidence and evidence of best practice. In doing so, they are able to balancing more equally patient preferences in to the equation called evidence‐based practice, thus leading to wise decision‐making in personalised nursing care. Relevance to clinical practice: Patient preferences become a fully fledged part of nursing decision‐making in EBP when in education and practice, the implicit knowledge of excellent nurses about how to take into account patient preferences to provide personalised care is more valued and taught. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore patients and carers' experience and perceptions of different modalities of long‐term enteral feeding. Background: With an ageing population in Singapore, there is a concomitant increase in number of patients with dysphagia and hence increase in prevalence of enteral feeding. It is essential to understand experiences of patients and home carers with long‐term home enteral feeding and perceptions of different modalities to better provide support. Design: A qualitative descriptive approach fulfilling the COREQ checklist criteria (See File S1). Nine patients who were receiving long‐term enteral feeding and nine carers were recruited over the period of August to December 2017. One‐to‐one interviews were conducted and audio‐recorded. An inductive content analysis approach, with open coding, creation of categories and abstraction of data, was adopted. Results: Three themes were generated: (a) factors influencing choice of mode of enteral feeding; respondents narrated factors such as need to "conceal" illness, need to be independent and previous bad experience with alternative modality (b) identified informational, emotional and physical needs. Respondents reported the need for support in terms of information on the different modalities, and training on how to self‐care or provide care and (c) individual perception and attitude towards life with enteral feeding. Most respondents portrayed a positive outlook to life, despite that they could no longer participate in communal eating. Conclusion and Relevance to clinical practice: Understanding patients and carers' experience and perceptions will inform the development of strategies to empower future patients and carers in choice of modality for enteral feeding. Patients with percutaneous endoscopic gastrostomy (PEG) found it easier to integrate enteral tube feeding into daily lives. Carers played a pivotal role in choice of modality, as well as in care of patients on enteral feeding. [ABSTRACT FROM AUTHOR]

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Aim and objectives: To explore patients' lived experiences of daily life and coping with recovery after transcatheter aortic valve implantation (TAVI). Background: Transcatheter aortic valve implantation is increasingly used to treat older patients with severe aortic stenosis with high surgical risk. This novel treatment has been shown to be effective in relieving symptoms, improving survival and prognosis, but its impact on patients' daily life has been sparsely explored. Design: Qualitative design. Methods: Qualitative interviews were conducted in a purposeful sample of ten patients three‐four months after TAVI. A phenomenological hermeneutical approach comprised an epistemological stance and Ricoeur's work inspired the qualitative methodological foundation. The study adhered to the COREQ guidelines. Results: This study is illuminating patients' perception of recovery after TAVI. The patients experienced a transformation of bodily sensations, a changed bodily attention and enhanced physical possibilities to cope with life. Undergoing TAVI changed the pre‐treatment symptoms that limited daily activities, allowing the patients to resume or participate in activities that were previously impossible. TAVI gives patients the feeling that they can do more than before, which strengthens their faith in the body's possibilities and means that they can live a more self‐reliant and independent life. Conclusion: For older patients, TAVI can serve to bolster a sense of trusting their own body again. A clear distinction between pre‐ and post‐TAVI is recognised. Patients may be able to resume everyday activities following TAVI. The recovery process, however, must take into account the individual patient's own resources. Relevance to clinical practice: The impact of TAVI on daily life activities should be communicated to the patient in decision‐making. Recovery depends on the patient's own effort, why identification of the patients who need support for recovery after TAVI as well as differentiated rehabilitation is required. Walking as a parameter should be integrated in the recovery trajectory. [ABSTRACT FROM AUTHOR]

Aims To explore the impact of the diagnosis of polycystic ovary syndrome on health/ill health identity, how women experience this diagnosis and their health beliefs. Background Polycystic ovary syndrome is a common and heterogeneous condition, giving rise to a wide range of different health concerns. Previous research on polycystic ovary syndrome has been dominated by the medical perspective and less is known about the experiences and needs of women. Design A qualitative study of 32 premenopausal adult women with polycystic ovary syndrome (diagnosis confirmed by Rotterdam criteria), aged between 18 and 45 years, recruited from a primary and secondary care setting. Methods Thematic analysis of transcripts from 11 focus groups conducted between 2013-2015. Results/Findings Women identified a range of concerns affecting personal and reproductive identity, health knowledge and beliefs: (1) delays and barriers to diagnosis; (2) general lack of empathy by the medical profession; (3) difficulty in accessing specialist referral; (4) lack of information from professionals; (5) inconsistent and sometimes unsatisfactory experiences with medications; (6) insufficient help and advice regarding in/fertility; (7) relative lack of awareness or concern about longer term risks such as diabetes; and (8) significant discrepancies between the beliefs of women with polycystic ovary syndrome and how they experienced the attitudes of healthcare professionals. Conclusions There appears to be a divergence between women's experience and attitudes of healthcare professionals. The diagnosis, support and lived experience of women with polycystic ovary syndrome could be enhanced by better professional recognition of these concerns, improved knowledge and communication about polycystic ovary syndrome and better access to support and specialist advice. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this exploratory research was to understand how men experience their advanced cancer in relation to their perceptions of masculinity. Background There are differences in the way men and women experience illness and health care. There are inequalities in incidence and morbidities of many diseases as well as differences in rates of help-seeking behaviours. Theories on masculinity offer some explanation towards this. Men's experiences of advanced cancer in relation to masculinity are under reported, published literature suggests that there are certain issues or men dealing with advanced disease that justify investigation. Design A Qualitative approach using a Husserlian Phenomenological design was conducted. Sample Eight men (aged 26-68) all with advanced cancer, defined as advanced or metastatic disease for which the patient had exhausted all standard therapeutic options. Methods In-depth interviews were conducted to capture narratives of the experiences of men. Data were analysed using Colaizzi's seven stage framework. Results Themes included thwarted ambition, changing expectations, protection and provision, stoicism and coping, images of illness versus images of masculinity, importance of being a fighter and loss. Conclusion Findings showed that the experiences of these men were complex and should be handled sensitively. Ideas for gender-specific interventions and further research were developed from the findings in relation to current literature. Relevance to clinical practice A better understanding and awareness of this in this context will help nurses to consider more subtle challenges that these patients may be dealing with that in turn could affect how they cope with the burden of cancer. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore how Iranian patients with coronary heart disease experience their lives. Background Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease. Design Qualitative study using grounded theory for the data analysis. Methods Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised. Results The main categories of the transition from acute phase to a modified or 'new normal' life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages. Conclusion Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations. Relevance to clinical practice By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences. [ABSTRACT FROM AUTHOR]

Aim To explore if young people with higher and lower levels of metabolic control of type 1 diabetes have different perceptions about their lives and illness. Background Adolescence through emerging adulthood is a developmental stage made more challenging when the person has type 1 diabetes. Little research has investigated if individuals with high and low levels of metabolic control in this age group perceive their disease differently. Design Qualitative descriptive. Methods In this study, 14 participants, ages 11-22 years were interviewed in 2008 about their perceptions of living with type 1 diabetes. Through a process of induction, major themes were identified. Results/findings Participants with high and low metabolic control levels reported similar themes related to reactions of others, knowledge about type 1 diabetes, and believed healthcare providers used authoritarian interactions. However, high metabolic control level participants believed type 1 diabetes would be cured; had negative initial responses to being diagnosed; rarely received parental support in managing their diabetes; and were negligent in self-care activities. Participants with low metabolic control levels did not believe a cure was imminent or have negative responses to being diagnosed; received parental support in managing diabetes; and were diligent in self-care activities. Conclusion Nurses should give information to young people with type 1 diabetes beyond initial diagnosis and help and support this age group learn appropriate ways to manage their disease, develop positive relationships with healthcare professionals, and participate in interactions with others their age successfully managing type 1 diabetes. [ABSTRACT FROM AUTHOR]

Aims and objectives To illuminate the meaning of living with alcohol dependency as a woman. Background The number of women suffering from alcohol dependency is increasing. Today there are shortcomings in knowledge about the lived experiences of being a woman with alcohol dependency; knowledge which might be of importance for meeting these women's specific needs of care. Design The study has a qualitative design. Fourteen women with alcohol dependency participated in open in-depth interviews. Method Data were analysed according to a phenomenological-hermeneutic method, and interpreted by help from gender and caring perspectives as well as results from previous research of alcohol dependency. Results In relation to the women's senses of well-being, four main gender formations were found; An unstable self involving continual and rapid swings between emotional and bodily reactions. Ambivalence - meaning ambiguous feelings towards themselves as human beings and how they lead their lives. Introspectiveness - involving reflections, pondering and being introverted. Attempts to perform normality - covering - dealing with life through various strategies and facades to live up to the expectations of how to behave as a woman. Conclusion Living with alcohol dependency as a woman constitutes of a rapid shifting everyday life resulting in senses of alienation as well as private introspection leading to self-degradation, and to a lesser extent meaningfulness and hope. It also constitutes of managing to perform normality. Relevance to clinical practice When supporting women with alcohol dependency towards wellbeing, professionals need to work towards approaching the woman's inner thoughts, share them and reflect over them together. To support these women to find balance in life, caregivers need to cooperate with the women to find out how best to live a life adjusted to the woman's abilities and wishes. [ABSTRACT FROM AUTHOR]

jonas-simpson c., mitchell g.j., carson j., whyte c., dupuis s. & gillies j. (2012) Phenomenological shifts for healthcare professionals after experiencing a research-based drama on living with dementia. Journal of Advanced Nursing 68(9), 1944-1955. Abstract Aim. The aim of this article is to report research findings describing phenomenological shifts, that is, changes in patterns of lived experience, for healthcare professionals who attended a performance of a research-based drama, called I'm Still Here. Background. The research drama, based on six studies, was created to help change the ways persons understand, think about and relate with persons living with dementia. Methods. In 2006-2007, 50 healthcare professionals from various disciplines and eight nursing students participated in this study. Participants were recruited from four Canadian cities in the province of Ontario where focus groups were held before and after engaging in a live performance of I'm Still Here. Findings. Analysis of focus group transcripts showed shifts in patterns of lived experience for the healthcare professional participants as evident in the participants' descriptions. The phenomenological shifts reflected a move from descriptions of 'diminishing humanness to discerning humanness', from 'disengaged care/mundane relating to reflexive relating in the now', and 'terrifying portrayals of loss to awakening to hopeful possibility'. The shifts described herein are supported with examples from the focus group transcripts. Conclusions. Findings reveal the power of drama as a vibrant and meaningful means of shifting understandings, images and intended actions of healthcare professions which have the potential to affect the lived experiences, relationships and quality of life of persons with dementia. [ABSTRACT FROM AUTHOR]

Aim. To explore the experiences of patients with coronary heart disease in China. Background. The morbidity and mortality rates of people with coronary heart disease have been growing rapidly in the past decades in China, yet little is known about the experiences of Chinese patients with the disease. Design. A qualitative descriptive study. Methods. Face-to-face semi-structured interviews were employed in this study. Using a purposive sample, 11 participants who had been diagnosed with coronary heart disease for at least one month were recruited. A content analysis was used to identify themes. Results. Three themes were identified from the data: experiencing a life-threatening illness, strategies for adapting to living with coronary heart disease and help-seeking behaviour. Conclusion. Chinese patients with coronary heart disease experienced the disease as a life-threatening illness related to chest pain. Chinese culture, values and beliefs influenced their adaptation strategies and help-seeking behaviour. Their misconceptions about coronary heart disease and the information needs for lifestyle changes were evident in this study. This study highlights the need for health education to support coronary heart disease patients in China. Relevance to clinical practice. The findings provide useful information for Chinese health professionals to develop interventions for Chinese patients with coronary heart disease. [ABSTRACT FROM AUTHOR]

sitvast j.e., abma t.a. & widdershoven g.a.m. (2011) Living with severe mental illness: perception of sickness. Journal of Advanced Nursing 67(9), 2170-2179. Abstract Aim. This article is a report of a study on how participation in photo groups influenced the perception of the impact of sickness on daily life. Background. Living with severe mental illness can have a strong impact on daily life and the experience of self. In combination with self-stigmatization, this can lead to a sense of being no more than a patient. Method. A mixed-methods design was used to measure the perception of sickness impact. Consumers of psychiatric services participated in photography groups that aimed at integration of illness and developing new goals in life. These groups were conducted by nurses and data were collected between the years 2005 and 2009. The Sickness Impact Profile (SIP) questionnaires were completed by the respondents before and after intervention. The SIP was used to differentiate between respondents who perceived less impact of illness on their daily lives after following a photogroup and those who did not perceive so or remained the same. A sample of these three groups was used to complement the quantitative findings with in-depth interviews with consumers and mentor nurses. Results. Findings indicated absence of important changes in the sickness impact scores except in the domain of mobility. Consumers did, however, show signs of progress in terms of increasing openness, understanding of their feelings and situation and abilities to cope with them. Conclusion. Participating in photo groups can help patients get along with their life and make it more bearable. No signs of demoralization and self-stigmatization were found. [ABSTRACT FROM AUTHOR]

The study aimed to describe how patients with epilepsy perceive living with epilepsy. Epilepsy signifies a medical diagnosis as well as a social label. Persons living with epilepsy have more psychosocial problems compared with the general population, and stigma is often experienced. Few studies address patients' life situations as a whole, and there are no studies on how patients perceive living with epilepsy. This was a qualitative interview study where 19 outpatients were purposively chosen and interviewed. A phenomenographic approach was used for interviewing and for analysing the interviews. Living with epilepsy was perceived in two different ways depending on the person's feelings towards the condition. A positive feeling signified 'Living with epilepsy means living a normal life - gaining and maintaining control' with the descriptive categories: 'Accepting the person with epilepsy', 'Taking responsibility' and 'Appreciating the good things'. A negative feeling signified 'Living with epilepsy means living with focus on the condition - conflict and avoidance or resigning to fate' with the descriptive categories: 'Struggling with feelings of stigma, prejudices and loss of control' and 'Giving up hope of recovery, accepting loss of control'. The findings indicate that patients' perceptions of living with epilepsy are closely related to their feelings towards the condition. There is a need for further exploration of the relationship between perceptions of epilepsy as a phenomenon, perceptions of living with epilepsy and feelings related to the condition. The findings demonstrated how important feelings and perceptions are to how patients with epilepsy regard themselves. This knowledge is essential for nurses when helping patients to better understand underlying reasons for their reactions to various situations. Forming interventions to help patients with epilepsy to find coping strategies that enhance self-esteem and self-value is another area of relevance. [ABSTRACT FROM AUTHOR]

The implantation of defibrillators should not be studied simply on the basis of clinical improvement or quality of life: it is also important to understand the significance, which the recipients attach to the defibrillator and their experiences with it. The aim of this work was, therefore, to determine the experience of Spanish implantable defibrillator recipients. A qualitative phenomenological study. Purposeful sampling of male implantable defibrillator recipients older than 18 years of age attended at the defibrillator consultancy at the Hospital Fuenlabrada or belonging to the Heart Patients' Association (Asociación de Pacientes Coronarios, APACOR). A secondary, theoretical sampling was also carried out to gain a more in-depth understanding of certain aspects identified in the first sampling, such as living with the discharges and difficulties during sexual activity. Data were collected using unstructured and semi-structured questionnaires and applying a question guide, field notes and the recipients' personal diaries/letters. Data collection was terminated once theoretical saturation was reached. Data were analysed using the Giorgi method. Finally, the seven themes, which showed what it means to be an implantable cardioverter-defibrillator recipient, were described. The defibrillator is perceived positively and is considered to be a form of life insurance, whereas the discharges are a limiting factor. The recipient's outlook on life changes. Acceptance of the changes resulting from the implant leads to the development of strategies to facilitate everyday life. An understanding of the significance attached by recipients to their disease, diagnosis and treatment allows their behaviour and expectations to be understood. Provide the basis for nursing assessment after discharge, understand the effects of the device in the recipient and track the process of adapting the recipient to daily life. [ABSTRACT FROM AUTHOR]

To explore the perceptions of loneliness according to people with early-stage dementia, living in community and long-term care and also the views of their family carers. Research that specifically explores the influence of loneliness on dementia is limited and indicates the prevalence of loneliness and the negative relationship between loneliness and cognitive decline. There is a paucity of research that explores loneliness from the perspective of the person with dementia. A descriptive exploratory qualitative approach was used. Data were collected through semi-structured audio-taped interviews. A purposive sample of 70 people with a diagnosis or probable dementia and 73 family carers were recruited from community and long-term care from South East Queensland, Australia. Four themes were identified: staying connected to others; losing the ability to socially engage; experiencing loneliness; and overcoming loneliness. The results emphasise the importance of familiar human relationships in reducing the feelings of loneliness in people experiencing dementia. People with dementia are at risk of loneliness, but placing them with unfamiliar people and environments may not improve their situation. Better refinement of care that takes into account the potential for loneliness and an understanding of premorbid social tendency may assist in the implementation of individualised and evidence-based strategies to assist people with dementia to lead a better quality of life. To maintain well-being, the social needs of the person with dementia as well as the family need to be considered. [ABSTRACT FROM AUTHOR]