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We aimed to survey the findings of phenomenological studies built up in the field of diabetes care in Sweden. This is a meta-synthesis of phenomenological studies on experiences related to diabetes in Sweden focusing on learning to live with diabetes. We proceeded by reference to the seven phases of Noblit & Hare. We examined papers from seven phenomenological studies on learning to live with diabetes in Sweden. From the papers, which describe the experience of living with diabetes, three overarching themes were selected—perception and awareness of the body; integration and responsibility; and presence of others who provide support. From those describing the expert's experience, an overarching theme emerged—encouraging reflection in persons with diabetes. We interpreted each of these themes in phenomenological terms and compared them with theories in Japan. Persons with diabetes take responsibility for coping with a range of things brought on by the illness and learn to live with diabetes. Experts support these persons so they can see their world objectively and critically scrutinize it. By building a model of diabetes care in Japan that references Scandinavian human science, it will be possible to find new approaches that support learning at the existential level. [ABSTRACT FROM AUTHOR]

Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before. [ABSTRACT FROM AUTHOR]

Purpose: This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them. Methods: A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach. Results: The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants' experiences. Conclusions: Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum Depression (PPD) --a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. Methods: Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. Results: The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes--psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme--afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two subthemes-- limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes--better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). Conclusions: PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-- including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support. [ABSTRACT FROM AUTHOR]

The aim was to explore existential loneliness in different long-term care contexts as narrated by older people. A qualitative secondary analysis was performed of 22 interviews with older people in residential care, home care, and specialized palliative care. The analysis started with naive reading of interviews from each care context. As these readings showed similarity with Eriksson's theory of the suffering human being, the three different concepts of suffering were used as an analytic grid. Our result indicates that suffering and existential loneliness are interrelated for frail older people. Some situations and circumstances that trigger existential loneliness are the same in the three care contexts while others differ. In residential and home care, unnecessary waiting, not feeling at home and not being encountered with respect and dignity can trigger existential loneliness while seeing and hearing others suffering can give rise to existential loneliness in residential care. In specialized palliative care, feelings of guilt and remorse are prominent in relation to existential loneliness. In conclusion, different healthcare contexts have various conditions for providing care that meet the existential needs of older people. Hopefully our results will be used as a basis for discussions in multi-professional teams and among managers. [ABSTRACT FROM AUTHOR]

Adolescents' school performance is influenced by several factors and meaningful leisure time, especially organized activities, has great potential to impact academic results. Therefore, this study aimed to gain a greater understanding of how community actors perceive meaningful leisure time and how they work to create meaningful leisure time with the intention of increasing the chances for more adolescents completing upper secondary school. Semistructured interviews with 14 informants, representing nine different community actors in a middle-sized city in Sweden, were conducted and analysed using content analysis. Results suggest that meaningful leisure time positively impacts adolescents' mental health through social relations, support, and guidance. Leisure is believed to have spillover effects on reducing stress, manage school demands and performance. Nevertheless, leisure time activities and school performance must be balanced with time and effort. Community actors work proactively with availability, individual approaches, and offering activities to create meaning. From a societal perspective, places to hang out with supportive adults, in particular structured activities, should be regarded as a social investment in adolescents' health and prospects, especially in deprived areas where fewer activities are available. Finally, ensuring meaningful leisure time is in line with the Convention on the Rights of the Child. [ABSTRACT FROM AUTHOR]

Purpose: To address the consequences of living with supraventricular tachycardia and to improve the quality of treatment, there is a need to highlight patient experiences of treatment with catheter ablation. Therefore, the aim was to describe the phenomenon of catheter ablation, as it is experienced by patients being treated awake. Methods: A descriptive design was applied based on a reflective lifeworld research founded on phenomenological epistemology. Interviews were conducted between December 2021 and Mars 2022 with seven women and five men, three to twelve months after they underwent catheter ablation. Results: Patients undergoing catheter ablation while awake during treatment, which includes experiences of relying on others expertise, being actively passive, and striving to be cured. It entails experiences of having a foreign object moving in one's body and heart and can be endured through strategies of mainly shifted one's mental focus. Conclusions: The effort of undergoing a catheter ablation procedure is worthwhile as the confirmation of a physical curable condition that opens a future with possibilities instead of the obstacle in daily life that tachycardia entails. For the patients, an informative and caring conversation was needed that would have provided the support they lacked before and during the ablation. [ABSTRACT FROM AUTHOR]

Previous research has widely recognized the challenges uniformed police officers face in their working lives. However, little is known about the overall lifestyles of police officers, including what they do in private life. We interviewed 17 officers and used reflexive thematic analysis to explore their experiences. The study sheds light on how uniformed police officers navigate the intersection between their private and professional lives, as well as how their professional role impacts their day-to-day doings and private life roles. The key findings relate to how the demands of their professional role impact their private life, such as the profession becoming a way of life. Furthermore, they highlight the challenges of avoiding certain environments where they might be recognized as police officers. It also entails balancing energy levels in work and private life, as well as how their profession's unpredictability affects their daily routines and roles. The findings also show how their personal choices in private life are frequently influenced by their professional role. The study's findings have theoretical as well as practical implications, contributing to a better understanding of uniformed police officers' challenges and resources for a sustainable and healthy lifestyle. [ABSTRACT FROM AUTHOR]

Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients' experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one's healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation. [ABSTRACT FROM AUTHOR]

The article focuses on the paper of Jonathan A. Smith, a reader of Psychology in Birkbeck University of London, England to be presented at the 4th Nordic Interdisciplinary Conference in Sweden. The paper discusses theory and practice between various aspects of hermeneutic theory and data from empirical studies in health psychology. Empirical illustrations are drawn from studies that explore chronic illness and psycho-social aspects of the new genetics.

The article focuses on the paper of Marcia Sá Cavalcante Schuback, an associate philosophy professor at Södertörns University College to be presented at the 4th Nordic Interdisciplinary Conference in Sweden. The paper discusses the experience of attention from a phenomenal point of view. The paper argues that attention is not only a condition for knowledge but a condition of possibility for a new experience of knowledge itself.

The purpose of this study was to describe experiences of being a manager in the municipal sector in rural northern Sweden. Semi-structured interviews were performed with 15 managers working in the municipal sector. The interviews were subjected to inductive qualitative content analysis. The managers' experiences were interpreted in the main theme, Striving for stability on shaky ground. They struggled within slimmed-down organizations with substitute shortages and reduced means. They expressed being burdened by conflicting demands, a work overload, work conflicts and a requirement to be present. They had to endure the negative consequences of working in small municipalities, and handling health and family life impairments. The managers expressed the importance of being strengthened by inner and outer resources, such as being motivated, having social support and finding strategies to cope. They also expressed benefits of working in small municipalities, such as great opportunities to influence and efficiency in decision-making. This study illuminates managers' adverse psychosocial working conditions, insights into working in a small municipality in the rural context and also the importance of organizational support. Future studies could focus on applying adapted workplace support interventions among managers in the municipal sector in rural northern Sweden. [ABSTRACT FROM AUTHOR]

The aim of the study was to describe the loss of a family member by suicide, based on the lived experience of suicide survivors. A phenomenology study with a Reflective Lifeworld Research approach was conducted, consisting of sixteen interviews with eight suicide survivors. The essence of losing a family member by suicide encompasses experiences of involuntary and existential loneliness, life suffering, and additional burdens in a life that is radically transformed, comprising prolonged and energy-intensive attempts to understand. Life for the family member encompasses a constant fear of being judged and an ambiguous silence, where this silence can both lead to involuntary loneliness and be a source of support and fellowship. Support mechanisms inside the family fall apart, and it becomes obvious that the survivors' experiences affect others. The loss also implies an active endeavour to maintain the memory of the deceased. Based on these results, it is important for professionals to accept the survivors as suffering human beings early—from the point of the notification of death—and consider them as patients in need of compassionate care. Such support might reduce life suffering, counteract stigma and involuntary loneliness, and work simultaneously as suicide prevention. [ABSTRACT FROM AUTHOR]

Families arriving in Sweden after being forced to flee their home need health care. Communication is a key component to establishing good care relations and becomes difficult when there are language barriers between families and healthcare professionals. In the context of neonatal care, communication is carried out with parents. The aim of the study was to describe parents' experiences of communication with neonatal healthcare professionals and using pictorial support when language barriers exist. The study takes a qualitative approach based on seventeen interviews with parents who had experienced neonatal ward. Qualitative content analysis was used. The parents needed to communicate through supports, which caused distress and misunderstanding. The relationship between parents and the healthcare professionals affected the communication. Pictorial support was used to different degrees. Four categories were identified from the data analysis: Communicating through supports, Facing barriers in communication, Facing external influences and The need for a good healthcare relationship. The present study is the first to describe parents' experience with using the pictorial support developed in the project KomHIT Refugee and therefore fulfils the function of being a first evaluation of the pictures from parents' perspective. [ABSTRACT FROM AUTHOR]

Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44–89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. Under the main theme of Suffering Through Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both health and family lives of employees, and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization. [ABSTRACT FROM AUTHOR]

To explore communication and engagement in everyday situations between persons with young-onset dementia (YOD) living in a nursing home (NH) and the caregivers. The study draws on ethnographic methods aligned with participatory design. Three residents with YOD living in a NH and eight staff members were recruited. A narrative approach was used for data collection and analysis. Three narrative vignettes were developed representing everyday situations in which communication and engagement was enacted among residents and caregiver staff: (a) waiting for something to happen, (b) tensions about everyday communication, and (c) negotiating a combined living + working environment. The findings stress a paradoxical tension rooted in the NH as residence and workplace as well as place of calm and place of boredom. The everyday situations are interpreted differently from the perspective of the residents and staff. The identified paradox of planned and spontaneous situations influences communication and engagement in everyday life, and the potentiality for active engagement embedded in contexts of units for residents with YOD. The degree to which everyday activities and encounters are redefined and renegotiated is an important part of caregiving practices in NH settings for residents with YOD. [ABSTRACT FROM AUTHOR]

Zero separation is a family-centred approach where newborns should be accompanied by their parents, regardless of the type of birth or health status. To our knowledge, few studies have described the way this approach is realized in clinical practice. This study describes situations of separation between mother/partner and newborn after birth on the labour ward, maternity ward and at the neonatal unit. An observation study was conducted during four months at a Swedish hospital. All caregivers at the three units were given the task of collecting the data. A semantic thematic analysis was performed with an inductive approach. Six themes emerged from the analysis. Two themes were common to all three units, one theme was common to two units and three themes emerged at only one unit. The themes describe various causes of separation, such as organizational and economic barriers, clinical routines, parents' own decisions, shortage of collaboration within and between units, as well as a shortage of interprofessional communication. Our study shows that there is still a gap between the latest evidence-based knowledge of the importance of zero separation and current practice in newborn care. There is a need for continuous collaboration between all units responsible for the care of mother and newborn. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines intergenerational, interdependent and contextual aspects of wellbeing and acculturative stress in refugee families during resettlement. Particular focus is placed on how children influence their parents. Method: The study is based on interviews with and diary notes from Middle Eastern parents and children residing in Sweden. Results: Analyzes of the narratives show how the direct and indirect influence of the child affects the parents in both negative and positive ways. Acculturative stress follows from unexpected and undesired migration outcomes, such as parent-child conflicts and low school achievement. Such strains add to other hardships refugee families face, for instance, unemployment, welfare dependence, poor housing, and insufficient mastery of the majority language. However, acculturative stress can be alleviated by the children's educational success, and reciprocal practices of love and caring including helping out with chores and supporting each other in different ways. Conclusions: Children's agency has significant effects on parents' wellbeing, as wellbeing is accomplished in and through relationships with others. [ABSTRACT FROM AUTHOR]

Purpose: Falls are the most common cause of injury in all ages and are especially difficult to prevent among residential care residents. Compliant flooring that absorbs energy generated within the fall, has been proposed as a measure to prevent fall-injury, however little is known regarding the implementation aspects in clinical settings. The aim of this study is to explore the experiences of falls, the risk of fall-injury, prevention in general and specifically compliant flooring as an injury preventative measure amongst frail elderly people living in a residential care facility with compliant flooring. Through this, generate a theory that further explains the underlying barriers of active prevention amongst elderly people. Method: We used the grounded theory method and conducted semi-structured in-depth interviews with eight elderly people in residential care (data collected between February and December 2017). Results: The identified categories were Falling as a part of life, Fearing the consequences and A wish to prevent falls and injuries. Through the results it was clear that There is more to life than risk avoidance, permeated the interviews, therefore forming the grounded theory. The interviewees viewed falls as something common and normal, and were uninterested in focusing on the risk of falls. Although they wanted to prevent falls, it was often difficult to integrate preventative measures into their everyday life. They embraced the idea of an injury-reducing compliant flooring, however their main interests lay elsewhere, preferring to focus on social interaction and issues concerning daily activities. Conclusions: The theory generated in this paper proposes explanations on the obstacles of implementing fall prevention measures in an elderly frail population. The findings give insights as to why interest and compliance for active fall prevention measures are low. We conclude that complaint flooring, from the perspective of the residents, can work well in residential care. [ABSTRACT FROM AUTHOR]

The relationship between architectural space and resident-centred care is poorly understood, even though architectural space is indicated as an important factor in the quality of care. This paper aims to address this gap in existing research by putting resident-centred care in the theoretical context of relationality and emergence in which space is a co-producing component. This qualitative case study includes two housing alternatives, which are compared: one assisted living and one extra-care housing residence, which differ in their legal status and architecturally. Similar fieldwork was carried out in the two residences. Individual interviews with staff and residents, as well as observations—direct and shadowing—were the main data collection methods. The concept of assemblage was used for the analysis of how resident-centred care and architectural space co-evolved. The findings show that resident-centred care appears in similar but also diverse and sometimes contradictory ways in different spaces in the two housing alternatives, suggesting that resident-centred care is situated, volatile and emergent. Although architecture has strong agency, space and care need to be considered together—a caring architecture—in order to understand the nuances and rich conceptual palette of resident-centred care. [ABSTRACT FROM AUTHOR]

The article presents several qualitative studies to be presented at the 4th Nordic Interdisciplinary Conference on May 18-20, 2006 in Sweden. They include qualitative study of how spinal cord injury patients recreate meaning during rehabilitation period by Sanne Angel, parents' experience of having a child with autism and intellectual disabilities living in a group home by Ylva Benderix and conceptions of xerostomia among health care professionals by Solgun Folke.

Sweden has tried to speed up the process of early cancer detection by standardization of care. This increased focus on early cancer detection provides people with a conflicting norm regarding the importance of recognizing possible cancer symptoms and the responsibility of not delaying seeking care. Based on existing norms about patients' responsibility and care seeking, this study explores how patients experience encounters with primary care physicians when they seek care for symptoms potentially indicating cancer. Thirteen semi-structured interviews were conducted with patients receiving care for symptoms indicative of cancer in one county in northern Sweden. Data was analysed with thematic analysis. The common notion of describing patients as customers in a healthcare context does not sufficiently capture all aspects of what counts as being a person seeking care. Instead, people interacting with primary care face a twofold role in where they are required to take the role not only of customer but also of seller. Consequently, people shift between these two roles in order to legitimize their care seeking. Standardization oversimplifies the complexity underlying patients' experience of care seeking and interaction with healthcare. Hence, healthcare must acknowledge the individual person within a standardized system. [ABSTRACT FROM AUTHOR]

Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden; moreover, many support needs of the carers are not met, leading to confusion, disappointment and frustration. We conducted an interview study to clarify the meaning of support given and received by informal carers to relatives with chronic obstructive pulmonary disease or chronic heart failure. We purposively selected and recruited informants via participants in another study, thereby conducting interviews over the phone from June 2016 to May 2017. In total, we conducted 14 interviews with 12 informants. All interviews were transcribed verbatim and the content was analysed using a phenomenological hermeneutical approach. Our comprehensive understanding of the meaning of support for these carers is twofold: it is a self-evident struggle for the good life of their relatives and that they want to be carers in partnership. The healthcare system must recognize the efforts of carers and include them in the strategic planning and operational stages of care and treatment for people with long-term illness. [ABSTRACT FROM AUTHOR]

Nurses often work alone in complex environments with ambiguous responsibilities and need ensured access to supervision.Online supervision has become common and has potential to support supervision in rural areas. To explore the experiences of registered nurses (RNs) learning online to be a supervisor in professional supervision in nursing. A longitudinal qualitative design was used. A total of six focus group discussions, with 15 RNs divided in two groups, were conducted before, during, and after the training. Data underwent qualitative content analysis. Results showed that the participants experienced learning to be a supervisor online as a personal and professional journey, and learning online was an advantage rather than a disadvantage. Initially, they focused on themselves, then on themselves within the group, and finally on themselves and the group. Both the group and the internet environment were described as safe places. Online tutoring needs to include the creation of a social presence within the group. [ABSTRACT FROM AUTHOR]

The birthing room is a major workplace for midwives but how it influences them in practice is not enough investigated. Purpose: This study aimed to explore midwives´ experiences of how the birthing room affects them in their work to promote a normal physiological birth. Methods: A phenomenological reflective lifeworld research approach was used and included individual interviews with 15 midwives working at four different hospitals in western Sweden, and of which two also assisted at homebirths. The analysis focused on the meanings of the study phenomenon. Results: A birthing room can by its design either support a normal physiological birth or support a risk approach to childbirth. Four opposing constituents complete the essential meaning of the birthing rooms, and to which the midwives need to relate in their roles as guardians for normal birth: i) a private or a public room; ii) a home-like or hospital-like room; iii) a room promoting activity or passivity; iv) a room promoting the midwife´s presence or absence. Conclusions: The birthing room mirrors a pathogenic-oriented care approach. A presupposition for the work to keep the birth bubble intact is to protect the mother from disturbing elements both inside and outside the room. [ABSTRACT FROM AUTHOR]

Primary hyperhidrosis (PH) is a disease characterized by focal and excessive sweating. Purpose: The aim of this study was to describe the experiences of men and women with PH when seeking help for their condition. Method: A qualitative interview study with 30 men and women diagnosed with PH was conducted. Data was inductively analysed using manifest and latent content analysis. Results: The analysis resulted in a theme: Navigating in the fog, based on the categories doubtful encounters with health care professionals, helpful encounters with health care professionals, delays due to inadequate knowledge, and supported urge for help. Conclusions: Deficient knowledge and understanding about PH create a sense of resignation in individuals, resulting in delay of seeking treatment. Support from others, life-changing events, and finding information about PH were important motivating factors in seeking help and demanding access to treatment. A holistic approach towards patients with PH is important to reduce stigma and acknowledge the problems that are encountered in their daily lives. Educating health care professionals and students so that patients can be identified and assessed without delay and making information available about PH in schools and pharmacies could improve the general knowledge and facilitate obtaining treatment for individuals with PH. [ABSTRACT FROM AUTHOR]

Despite evidence that older persons want to be involved in care, little is known about how frail older people with significant care needs living at home experience participation in care provided by different stakeholders. This study investigates the experiences of participation in care by older people following their involvement in an intervention of a health care model called Focused Primary care (FPC). Individual semi-structured interviews were conducted with 20 older persons in five municipalities in Sweden. The results show that older persons highlighted opportunities and limitations for participation on a personal level i.e., conditions for being involved in direct care and in relation to independence. Experiences of participation on organizational levels were reported to a lesser degree. This included being able to understand the organizational system underpinning care. The relational dimensions of caregiving were emphasized by the older persons as the most central aspects of caregiving in relation to participation. Primary care should involve older persons more directly in planning and execution of care on all levels. An ongoing connection with one specialized elderly team and a coordinating person in Primary care who safeguards relationships is important for providing participation in care for frail older persons with significant care needs living at home. [ABSTRACT FROM AUTHOR]

Purpose: Although the relation between health and well-being is deemed conceptually important, it is diverse and intractable. The aim of this small-scale study is to reveal different possible relations of the concepts of health and well-being, interrelation of these relations and consequences of implied normative expectations in the relations. Method: Primary data originate from course literature in Swedish health education. Additional data included scientific articles and website content (collected from WHO and via Google) and were analysed with objective hermeneutics. Results: Congruent, complementary and coincident relations were found. In congruence, health and well-being are synonyms. Complement relations contain: "quality" with well-being as overall aim, "plurality" with health as umbrella term, "well-being as positive health", "enhancement" with health and well-being potentially boosting each other and "subjectivity/objectivity" with objective health complemented by subjective well-being. In coincidence, health and well-being are counter-intuitively regarded unlinked, which may challenge expectations concerning health promotive activities. Independent and affiliated relations were identified. Conclusion: In congruence and complement, health and well-being are mostly aligned whereas in coincidence, their quality may be decoupled. In the discursive climate of second modernity, the relation of health and well-being tends to conflict and ambiguous coincidence, demanding ambiguity tolerance as key skill. [ABSTRACT FROM AUTHOR]

Purpose: Long-term pain is a public health problem but few studies have focused on experiences among women with CWP. This study aimed to explore women's experiences of the impact of CWP on daily life. Method: The participants were 19 women between 45–67 years old, who had developed CWP between 1995 and 2016. Individual interviews were conducted and analysed with qualitative content analysis. Results: Daily life with CWP was expressed in the main theme "Moving between living in the shadow of pain or living a life with the pain in the shadows" including three themes and eight subthemes; 1) living with invisible challenges by feeling neglected as a person and feeling lonely among other people; 2) struggling with limitations by moving between ability and inability, stress and worries, and being dependent on others; and 3) encountering daily life with varying degrees of flexibility by standing still and giving up, moving back and forth by adapting and striving forward with resistance. Conclusions: Women experienced different ways of how CWP influenced their daily life with challenges, limitations, and flexibility. Daily life with CWP entails moving between living in the shadow of pain and living a life with the pain in the shadows. [ABSTRACT FROM AUTHOR]

Purpose: Organized care in specialist stroke units is fundamental for achieving better outcomes for persons with stroke. Although the importance of the physical environment for health and well-being is well recognized, research regarding how environmental features can influence stroke care is limited. The aim was to elucidate healthcare professionals' experiences of the physical environment in newly built stroke units with respect to stroke care.Methods: Healthcare professionals (n = 42) representing eight professions participated in semi-structured, face-to-face interviews. Qualitative content analysis was used.Results: The physical environment both facilitated and restricted the professionals' ability to provide stroke care. Five categories were identified: "Working towards patient engagement in single rooms", "Hampered rehabilitation in an environment not always adapted to patients' difficulties", "Addressing patients' psychosocial needs in the environment", "Ensuring patient safety by using the environment in accordance with individual needs", and "Collaboration and task fulfilment—a challenge due to care unit design".Conclusions: The healthcare professionals viewed the physical environment mainly in relation to stroke patients' specific needs, and several environmental features were considered poorly adapted to meet these needs. The physical environment is essential to high-quality care; thus, the process of planning and designing stroke units should be based on existing evidence. [ABSTRACT FROM AUTHOR]

Purpose: Becoming widowed is a stressful health-threatening event causing major life changes. We explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood. Methods: A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results: Six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. Conclusion: The circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe patient experiences of received primary care for low back pain (LBP) according to the BetterBack Model of Care (MoC) with a focus on illness beliefs and self-management enablement. Methods: Individual interviews were conducted with 15 adults 4–14 months after receiving treatment according to the BetterBack MoC for LBP in primary care in Sweden. Data were analysed using content analysis. Results: When analysing the data, the following theme emerged; "Participant understanding of their treatment for low back pain and self-management strategies—a matter of support systems", comprising the following categories: "Knowledge translation", "Interaction and dialogue", "The health care professional support" and "Form organization". Participants experienced that they had better knowledge about their LBP and received tools to better manage their health condition. The participants expressed good communication with the treating physiotherapist and provided suggestions to further improve the treatment of LBP. Conclusions: Participants experienced that they had gained new knowledge about their health problems and after the treatment they had the tools to handle their back problems. This suggests that the BetterBack MoC may be used as a basis for a support system to provide valuable tools for self-management for patients with low back pain. [ABSTRACT FROM AUTHOR]

This paper explores the impact of self-chosen arts-based recreational activities, as opposed to the traditional arts therapy activities, on the well-being of healthcare providers. Three qualitative case studies of programs in which arts-based activities were used to work with healthcare providers, lasting for 10 weeks each, are phenomenological-hermeneutically evaluated using interviews and focus groups. The findings show what we refer to as an “ecological” ripple of effects: (1) the arts-based activities helped to reduce individual stress and to enhance mood over time, (2) the activities helped to transform workplace relationships within wards, and (3) the arts humanized the overall work climate in the healthcare setting. These effects go beyond those of using the art production as a strategy for stress reduction and imply potential for a more encompassing role for the arts within healthcare. [ABSTRACT FROM PUBLISHER]

The aim of this study was to actively integrate expertise of persons living with spina bifida, to explore conditions embedded in their everyday life. This was important because young adults with spina bifida risk not being able to fully participate in the community on equal terms and in accordance with their own preferences. Photovoice, a community-based participatory research approach, was utilized to engage participants through dialogue and photography. An exhibition was created to share results with community and stakeholders. An overarching theme that characterized the experiences of the group was, "an adaptation for us, but it works for no one". Findings are presented as: "Accessibility—a never-ending project," "Tensions of a normative view," and "Power to influence." Findings integrated everyday life metaphors photographically depicted by broken elevators, unsafe transportation, closed doors and not experiencing real opportunities of involvement. Tensions in everyday life experienced by persons living with spina bifida can inform conditions relevant and necessary to support community participation, particulary among persons living with disability. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore lived experiences with working life from the perspective of people with deafblindness due to Usher syndrome type 2 (USH2). Background: A limited number of studies have explored working life of people with Usher syndrome. One study of individuals with USH2 showed that work active reported significantly better psychological health compared to non-working individuals. Methods: Seven participants aged 38–50 years with USH2 participated in interviews analysed by interpretative phenomenological analysis. Results: The analyses yielded four themes showing that work is a source of satisfaction and a commitment that needs to be balanced. It is also associated with facing limitations and feelings of uncertainty. Conclusion: Based on the psychology of work model we have demonstrated that work is associated with social connectedness, self-determination and a source of improved health outcomes. There are however also potential health hazards in people with USH2, indicating a need for balance between individual needs and resources, and an adapted environment, for maintaining or regaining health for actively working people with USH2. [ABSTRACT FROM AUTHOR]

Purpose: Stress and achievement pressure constitute factors affecting young people's mental health, especially among girls. Leisure participation holds the potential to be a collective space where young people can respond to stressors together. This study explores how girls collectively construct responses to daily stressors within the context of leisure participation. Methods: Nine focus groups were conducted with 16 girls aged 14–21 who were active members in two sport organizations in northern Sweden. Data was collected by using participatory observations and photo-elicited focus group discussions. Results: Our findings from the inductive thematic analysis were interpreted by combining the stress process model with social practice theory, resulting in three subthemes or responses: sharing sites of responsibility, resisting norms related to (gendered) youth and focused distraction. The subthemes were abstracted into the central theme of trustful belonging as a resource for collective responses, representing what pre-conditions need to be in place to make the responses possible. Conclusion: Leisure participation is an important relational space for young people to respond to stressors by making use of everyday routines, and the agency these social practices hold. However, the effort needed to respond to these stressors brought additional pressure in terms of responsibilities, and achievements. [ABSTRACT FROM AUTHOR]

Although user participation and shared decision-making in formal statutory coordinated care planning are described as central, they remain to be implemented. The aim of this study is to explore how collaboration and shared decision-making in the social services can be realized in formal care planning activities with people with mental disabilities. We conducted eight workshops with 12 users and 17 caregivers to investigate existing barriers to and possible solutions for participation in coordinated care planning. Workshop formats and techniques from participatory design generated rich research materials illustrating challenges currently experienced by users and caregivers in care planning work, as well as a large variety of solutions to these challenges. They also illustrated differences in how participation is understood and the conditions required to realize shared decision-making between users and caregivers. An improved coordinated individual plan (CIP) process emerged, based on the active participation of users and caregivers. This process is a familiar and transparent process for users and caregivers, reflecting the needs and preferences of users at all stages. It requires careful preparation and collaboration with the users, as well as caregiver flexibility. [ABSTRACT FROM AUTHOR]

Purpose: Spouses are in a vulnerable situation when caring for a frail partner late in life. Exploring their existential loneliness can be a way to understand more about their existential needs. Method: A hermeneutic approach was used. Multistage focus group interviews were conducted with two groups consisting of five spouses, respectively, who met three times each. To work with the text, an approach was adapted where quotations are converted into poems in a linguistic manner. Results: Existential loneliness can be understood as the following: 1) being in a transition from us to merely me, 2) being forced to make decisions and feeling excluded, 3) navigating in an unfamiliar situation and questioning oneself, and 4) longing for togetherness but lacking the energy to encounter other people. The main interpretation is that existential loneliness emerges when one is in moments of inner struggle, when one is forced to make impossible choices, when one is approaching and is in limit situations, and when one is experiencing the endless loss of the other. Conclusion: For health care professionals to achieve a holistic picture, person-centeredness can be a way to make the spouses' existential needs visible and to provide support based on their needs. [ABSTRACT FROM AUTHOR]

Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient's empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care. Purpose: The specific aim in this study was to describe patients' experiences of group-based education using the Taking charge of one's life with type 2 diabetes model. Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books. Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others' experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning. Conclusion: The results showed that from the patients' perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning. [ABSTRACT FROM AUTHOR]

In Sweden, according to law, adolescents with extensive psychosocial problems, substance abuse or criminal behaviour can be cared for in institutions. The two-fold aim of these institutions (to rehabilitate and incarcerate) puts special demands to their socio-spatial context. Purpose: To elucidate adolescents' lived experiences of the socio-spatial environment at special youth homes run by the Swedish National Board of Institutional Care (SiS) in Sweden. Methods: Data collected through Photovoice and analysed employing a phenomenological hermeneutical method. Fourteen adolescents (age 15–19) were asked to photograph their environment, and this was followed up by in-depth interviews. Results: Two themes emerged from the material: the dense walls of institutional life and create and capture the caring space. The socio-spatial environment can be seen as an additional "other" that distances the adolescents and the staff from one another. Negotiating with their behaviour, the adolescents strive to present themselves as worthy of increased degrees of freedom and ultimately access to the desired outside life. Conclusions: In an institutional setting dominated by a security and criminal justice logic, words appear to have less impact than the environment. The adolescents appear to understand themselves through the socio-spatial other, causing reinforced feelings of social exclusion. [ABSTRACT FROM AUTHOR]

Girls face gendered violence on an everyday basis, and this may have severe health consequences. Purpose: The aim of this study was to learn about gendered violence facing girls in rural Sweden in their everyday life, as it is experienced by the girls themselves. Method: Using the photovoice method, we worked with 35 girls in an upper secondary school, aged between 16 and 20, to explore how they navigated social spaces and developed strategies for increased safety. Results: Thematic analysis revealed two main themes (constant fear and strategies) and four sub themes (fear of being raped, fear of being labelled and excluded, being "appropriately" sexually active, and appearance and performance for increased feelings of safety). Conclusion: We considered how gendered violence facing girls led to fear and marginalization in a range of situations and interactions. Consequently, girls occupied significantly smaller social spaces compared to boys, and we argue that this was reproduced and upheld through everyday practices informed by hegemonic masculinity and performativity. [ABSTRACT FROM AUTHOR]

Purpose: Digitalization and e-health have potential to generate good quality, equal health, well-being and to develop and strengthen individuals' resources with the goal of increased independence and participation in society. The implementation of welfare technology requires knowledge of digitalization, as well as an awareness of its meaning in terms of ethical principles and ethical analysis. The purpose of this study was to describe ethical analysis concerning the implementation of welfare technology, in terms of both strategies and tools, within areas of social services in a Swedish municipality. Method: We followed a working model that focused on increased knowledge and experience in the implementation of welfare technology from an ethical perspective. In the data collection were observations, a questionnaire with open-ended questions and focus group discussions used. Results: The analysis showed that when welfare technology was introduced and implemented within the area of social services in a municipality, ethical awareness resulting from the conflicts between various interests and values had to be addressed. Conclusions: The ethical analysis improved implementation of strategies and tools in terms of facts and values, and invisible underlying values to the concept of well-being. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to describe young women's (16–25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others. Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns. Results: The results show the essential meaning of the phenomenon of "existential concerns" that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one's vulnerability. Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore and describe experiences of the dental care system among adolescent dental patients with a recent history of missed dental appointments at public dental clinics (PDCs) in a Swedish county. Methods: Twelve adolescent girls participated in the study. Data were collected by individual, semi-structured, open-ended interviews and analysed with qualitative content analysis. Results: The study findings could be summed into the theme "Triggers for adolescent girls to take on or not take on adult responsibility for dental care". The experience of free dental care could be summarized in five main categories: Pain and discomfort; Attractive and healthy teeth; Feeling safe and secure; Taking on the responsibility; and Free of charge. These five categories consisted of 15 subcategories. Conclusions: The results of this study should increase the knowledge on how to meet and treat adolescent girls in dental care. Knowing what will happen during the dental visit was highlighted by the participants as decisive to whether or not they would attend their dental appointments. Therefore, we should as far as possible ensure that our patients feel safe at their dental visits and by trying to avoid painful treatments. [ABSTRACT FROM AUTHOR]

Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient's needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses' experiences working with BA related to patients with emotional instability and self-harm. Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis. Results: Four main categories emerged regarding nurses' experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient's health and empowers the patient. The nurse's role shifted from "handling problems" to establishing caring relationships with a focus on the person's health and possibilities for recovering instead of psychiatric symptoms. Conclusions: Previous studies on patients' perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to describe Swedish Healthcare Direct (SHD) and its features as a complex system. Methods: Qualitative interviews were conducted with 20 SHD telenurses, covering their experiences and skills when encountering and advising callers with mental illness. Complexity science was used as an a priori theoretical framework to enhance understanding of the complex nature of telenursing. Results: SHD was described as a complex system as nurses were constantly interacting with other agents and agencies. During these interactions, dynamic processes were found between the agents in which the nurses adapted to every new situation. They were constantly aware of their impact on the care-seekers, and perceived their encounters with callers with psychiatric illness as "balancing on a thin line". SHD was also described as both an authority and a dumping ground. The openness of the system did not give the nurses possibility to control the number of incoming calls and the callers' intentions. Conclusions: These new insights into SHD have important implications for organization developers and nursing management in terms of overcoming linear thinking. [ABSTRACT FROM AUTHOR]

Purpose: Vitamin D deficiency is a complex topic in human health and ill-health and has been studied in a variety of contexts and populations. Few studies examine Vitamin D deficiency among non-western immigrant women and even fewer examine women's perspective on daily life while living with low vitamin D levels after childbirth and undergoing vitamin D treatment. The aim was, therefore, to explore health and ill-health among non-western immigrant women living with low vitamin D levels after childbirth and reaching normalized levels after one year of vitamin D treatment. Method: An explorative qualitative study using qualitative content analysis. Six women aged 25 to 38 years, diagnosed with low 25-hydroxyvitamin D levels during pregnancy, were recruited after having undergone vitamin D treatment. Results: The women told about living a restrained life which gradually transformed into an experience of recaptured vitality. They also experienced a need for continuity in medication, as an interruption of treatment meant returning symptoms. Conclusion: In this study, non-western immigrant women described benefits in everyday life, increased strength, relieved pain and improved sleep quality. The findings can provide valuable knowledge for healthcare providers meeting women with physical weakness, musculoskeletal pain and/or poor sleep quality after childbirth. Further studies using a longitudinal design and larger samples are warranted. [ABSTRACT FROM AUTHOR]

The article focuses on the paper of Marit Kirkevold, Professor of Nursing Science at the University of Oslo and Aarhus University to be presented at the 4th Nordic Interdisciplinary Conference in Sweden. The paper discusses on the significant contribution of qualitative research in the development of evidence concerning the practice towards human health disciplines. It emphasized the various evidence provided by qualitative studies, and the application of clinical knowledge to patients.

The article focuses on the paper of Donald Polkinghorne, Emeritus Professor of Education at the University of California to be presented at the 4th Nordic Interdisciplinary Conference in Sweden. The paper proposes investigations and instructions in the skills and dispositions needed by qualitative research practitioners. Concerns about the quality of qualitative research are expressed while attention to the development of researcher virtues are recommended.