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ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and Patient Care Impact Reporting Method Patient or Public Contribution To explore Registered Nurses' experiences and perceptions of using the National Early Warning Score in the U.K. as part of the recognition and management of acute adult patient deterioration.Hermeneutic Phenomenological design.Sixteen Registered Nurses from a U.K. NHS hospital were interviewed using an interpretative phenomenological approach (2019–2020).Registered Nurses' use of NEWS highlighted 3 risk areas: delegation of vital sign monitoring to unregistered staff leading to uncertainty and delayed escalation, junior nurses' over‐reliance on NEWS and deference to expertise, and senior nurses' self‐management of deteriorating patients. The workplace culture revealed frequent compromises and limited learning opportunities.When using NEWS, failure to recognise associated risks threatens patient safety. Wrong decisions at the three ‘pinch points’ may lead to missed chances in preventing deterioration. Incorrect judgements may lead to unrecognised patient deterioration or inappropriate management leading to preventable adverse events.The way in which NEWS is used by healthcare professionals brings inherent patient safety risks. Addressing education gaps and fostering a supportive culture in nursing, valuing and enhancing nurses' clinical judgement, is crucial for mitigating these risks and ensuring patient safety.The study deepens understanding of nurses' use of NEWS and identifies components affecting the recognition of patient deterioration.Adherence to the EQUATOR guidelines SRQR confirmed.Service user involvement was included within the design of the study and ethical approval. [ABSTRACT FROM AUTHOR]

Aim(s) Design and methods Results Conclusion Implications for the profession Impact Reporting method Patient or public contribution To discuss the methodological aspects of participatory design, arguing for a three‐phase approach and the suitability of situating participatory design within a phenomenological–hermeneutical tradition in health science.Methodological discussion based on participatory design theory, epistemology and research studies.The epistemological and methodological discussions show how the core values and key elements of participatory design align with the phenomenological–hermeneutical approach. In addition, examples of participatory design studies are provided to illustrate how it can be conducted in health science.Participatory design is a flexible framework based on genuine participation, defined by three core values: having a say, mutual learning and democratization. The iterative processes allow for adjustments in alignment with the core values and the scientific stance that defines the choice of methods, tools and techniques. A phenomenological–hermeneutic approach in participatory design studies is relevant and aligned with the core values of participatory design. Thus, this paper argues for a close integration between the participatory design methodology and the phenomenological–hermeneutic scientific approach within health science.Participatory design is a powerful methodology with core values that can co‐design sustainable health technologies with potential to impact patient care and the clinical practice of nurses. When combined with qualitative research methods, patients' lived experiences serve as the foundation for improving clinical nursing practice. Discussing the epistemological aspects of participatory design provides nurse researchers with a coherent methodological understanding, essential for the continual development of nursing research. This paper discusses the research methodology of participatory design within health sciences. It aims to address the lack of understanding of the methodology, particularly within a specific scientific stance. The main finding is the elaboration on participatory design and the relevance of a phenomenological–hermeneutical approach. The paper has the potential to impact researchers, master's and PhD students, as well as others engaged in participatory design or other methodologies related to user involvement within health science. No available EQUATOR guidelines were applicable to this methodological paper, as no new data were created or analysed.There was no direct patient or public contribution, as this is a methodological paper. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To explore from the perspective of women the nature of basic existential conditions while living with systemic lupus erythematosus. Background: Systemic lupus erythematosus has an unpredictable disease course and is documented to cause an existential rearrangement of life. The significance of changes in existential conditions and related experiences are unclear in the context of nursing and women with systemic lupus erythematosus. Design: A qualitative design guided by Van Manen's hermeneutic‐phenomenological methodology. Method: Individual in‐depth interviews with 15 women diagnosed with systemic lupus erythematosus and of various ages, disease durations and severities were undertaken from September 2013 ‐ October 2015. Data were analysed following van Manen's phenomenological approach and using drawing as an interpretive tool. Findings: The main existential experience was interpreted as a person “moving with the waves of systemic lupus erythematosus” constituted by the themes “oscillating between presence and absence of systemic lupus erythematosus,” “recognizing space and bodily possibilities and limitations” and “being enriched through relationships and activities.” When systemic lupus erythematosus was flaring, well‐being was threatened and a laborious time to escape the feeling of a setback‐in‐life persisted long after the disease was medically under control. Conclusion: Daily life with systemic lupus erythematosus is conditioned by a prominent need to be in existential motion, related to the absence and presence of systemic lupus erythematosus. The experience of a setback‐in‐life by illness might challenge well‐being and indicates that periods of disease flares or disturbing symptoms are critical time points to provide support. [ABSTRACT FROM AUTHOR]

Aims This article discusses the ways researchers may become open to manifold interpretations of lived experience through thematic analysis that follows the tradition of hermeneutic phenomenology. Background Martin Heidegger's thinking about historical contexts of understandings and the notions of 'alētheia' and 'techne' disclose what he called meaning of lived experience, as the 'unchanging Being of changing beings'. While these notions remain central to hermeneutic phenomenological research, novice phenomenologists usually face the problem of how to incorporate these philosophical tenets into thematic analysis. Design Discussion paper. Data sources This discussion paper is based on our experiences of hermeneutic analysis supported by the writings of Heidegger. Literature reviewed for this paper ranges from 1927 - 2014. We draw on data from a study of foreign domestic helpers in Hong Kong to demonstrate how 'dwelling' in the language of participants' 'ek-sistence' supported us in a process of thematic analysis. Data were collected from December 2013 - February 2016. Implications for Nursing Nurses doing hermeneutic phenomenology have to develop self-awareness of one's own 'taken-for-granted' thinking to disclose the unspoken meanings hidden in the language of participants. Understanding the philosophical tenets of hermeneutic phenomenology allows nurses to preserve possibilities of interpretations in thinking. In so doing, methods of thematic analysis can uncover and present the structure of the meaning of lived experience. Conclusion We provide our readers with vicarious experience of how to begin cultivating thinking that is aligned with hermeneutic phenomenological philosophical tenets to conduct thematic analysis. [ABSTRACT FROM AUTHOR]

udo c., danielson e. & melin-johansson c. (2013) Existential issues among nurses in surgical care - a hermeneutical study of critical incidents. Journal of Advanced Nursing 69(3), 569-577. doi: 10.1111/j.1365-2648.2012.06032.x Abstract Aims. To report a qualitative study conducted to gain a deeper understanding of surgical nurses' experiences of existential care situations. Background. Existential issues are common for all humans irrespective of culture or religion and constitute man's ultimate concerns of life. Nurses often lack the strategies to deal with patients' existential issues even if they are aware of them. Design. This is a qualitative study where critical incidents were collected and analysed hermeneutically. Methods. During June 2010, ten surgical nurses presented 41 critical incidents, which were collected for the study. The nurses were first asked to describe existential care incidents in writing, including their own emotions, thoughts, and reactions. After 1-2 weeks, individual interviews were conducted with the same nurses, in which they reflected on their written incidents. A hermeneutic analysis was used. Findings. The majority of incidents concerned nurses' experiences of caring for patients' dying of cancer. In the analysis, three themes were identified, emphasizing the impact of integration between nurses' personal self and professional role in existential care situations: inner dialogues for meaningful caring, searching for the right path in caring, and barriers in accompanying patients beyond medical care. Conclusion. Findings are interpreted and discussed in the framework of Buber's philosophy of the relationships I-Thou and I-It, emphasizing nurses' different relationships with patients during the process of caring. Some nurses integrate their personal self into caring whereas others do not. The most important finding and new knowledge are that some nurses felt insecure and were caught somewhere in between I-Thou and I-It. [ABSTRACT FROM AUTHOR]

morgan p., merrell j., rentschler d. & chadderton h. ( 2012) Uncertainty during perimenopause: perceptions of older first-time mothers. Journal of Advanced Nursing 68(10), 2299-2308. Abstract Aim. This article is a report of a study exploring older first-time mothers' perceptions of health during their transition to menopause. Background. Increasing numbers of women world-wide are delaying motherhood, yet little is known about the unique phenomenon created when midlife motherhood is closely followed by the transition to menopause. A literature search revealed that the effect of these overlapping life transitions on women's health was unknown. Design. A hermeneutic phenomenological approach utilizing Gadamer's philosophical underpinnings guided the study. Method. A purposive sample of thirteen women aged 45-56 years who were mothering children aged 12 years or younger and experiencing symptoms of perimenopause was recruited. Two in-depth interviews were conducted with each woman and meaning was mutually negotiated through participative dialogue with the women, ongoing construction and thematic analysis of data collected between 2004 and 2007. Findings. The key theme 'Perimenopause as a State of Uncertainty' is an interpretation of older first-time mothers' perceptions of health during perimenopause and is the focus of this article. Hermeneutic interpretation culminated in the construct 'uncertainty' as theoretical embodiment of the women's lived experience. An uncertain temporality, projection of the lifespan and valuing health as precious enabled these women to transform uncertainty into opportunities for health promotion to 'be there' for their children. Conclusion. Nurses, nurse practitioners and midwives will increasingly be caring for midlife mothers and need to understand the unique issues of older mothers to offer education and health promotion that support healthy transitions to menopause. [ABSTRACT FROM AUTHOR]