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Being dependent on homecare potentially threatens a person's integrity and autonomy, particularly when people are dependent on help to manage basic bodily functions that involve intimacy and nudity, making the person vulnerable despite being in his or her own home. As the population continues to age and live longer, more people are expected to be dependent on homecare. The aim of this study was to investigate the phenomenon of dependence on homecare among people ageing at home. Individual in-depth interviews were used to explore 15 Danish and Norwegian homecare receivers’ experiences of dependence on homecare. Interview records were transcribed and analysed in a hermeneutical phenomenological process described by van Manen. First and foremost, the experience of dependence on homecare is a question of adaption. The older people in this study struggled to get used to their deteriorating body and at the same time they continuously had to negotiate to get care in accordance with their values. Being dependent on care could be experienced as being reduced to a task or a problem to be solved though the participants had a significant need for undivided mental attention. The presence of homecare staff in the participants’ homes could entail a change where the participants experienced that they lost control over the surroundings. According to the voices of the older people in this study, future homecare should be accommodated in an organisational set-up that gives priority to stability and continuity in the relation between the homecare receiver and the homecare staff. Also it is significant that homecare staff do not have a task-oriented approach to their job and are sensitive to the values of the homecare receivers.

Autonomy is a key aspect for elderly patients associated with experiences of personal integrity and dignity. However, studies indicate that their self-determination can be threatened when they receive home care nursing. The purpose of the present study was to describe elderly patients’ lived experiences of autonomy in relation to home care nursing. Based on a phenomenological-hermeneutic approach, six interviews were conducted with patients aged between 77- 88 years. All patients were living at home and dependent on home care nursing. The findings revealed four themes: 1) The handing over of tasks to the nurse, 2) The influence of everyday routines, 3) Resisting or giving up, 4) Having to adapt to a regulating organization. The study concludes that autonomy is embedded in complex power relations at both individual and organizational levels, especially as patients experience both normal everyday routines and the nature of the organizational framework itself as overpowering and undermining their autonomy. Keywords: autonomy, self-determination, home care nursing, phenomenological hermeneutic approach.

International studies show that veterans with PTSD experience severe physical, psychological and social challenges in their everyday life, but only a few Danish studies have been carried out. The aim of this study was to gain insight and understanding of the challenges veterans with PTSD experience in their everyday life. Three veterans participated in the study. Data were collected through semi-structured interviews and analysed using the guidelines for meaning interpretation as described by Kvale and Brinkmann. The findings show that the veterans struggled to realize and accept their PTSD, and that they struggled to become reintegrated in their everyday life. Although this is a main condition for their recovery, they were in need of support during this process. The study concludes that veterans can be supported during this process by psychiatric nursing based on the Tidal Model.

Older people may face many challenges and experience insecurity after discharge from hospital to home. To bridge the potential gap between general hospital and home, the concept ‘Intermediate Care’ (IC) was developed at the beginning of 2000. IC aims to safeguard older people from being discharged to their home before they have sufficiently recovered, but knowledge within this area is sparse. In particular the experience of older people is yet to be explored. The aim of this study was to explore older people’s experiences of being back home after a stay in an IC unit. Data were drawn from 12 interviews. Transcripts were analysed using a phenomenological approach. The essential meaning of being back home after a stay in an IC unit was characterised by ‘uncertainty’. Four constituents emerged: ‘in a state of shock about coming home’, ‘dependence on informal helpers’, ‘a sense of isolation’, and ‘fear of losing functional ability permanently’.Key words: intermediate care, older people, discharge, interview, phenomenology

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Aims and objectives The aim of this study was to explore caregivers’ experience of assisted feeding. Background Assisted feeding presupposes a technical and creative coordination of the behaviour of the caregiver and the person who needs assistance. To achieve this, the two parties must be able to perceive and interpret each other's verbal and non-verbal behaviour and respond. Design A qualitative approach using in-depth semi-structured interviews conducted with caregivers was used. Methods Twelve caregivers with different educational background (nurses and care assistants) were interviewed during 2010. Transcriptions of interviews were analysed using the phenomenological guidelines by Dahlberg and colleagues. Results The essence of assisted feeding among caregivers was identified to be a healing activity creating a basis for recovery. The constituents of the essence were as follows: with simulated calmness, with the nutritional aspect in mind, with relatives as source and resource, with work experiences and personal preferences as reference points and with inconsistent reactions to patient behaviours. Conclusion When performing assisted feeding, caregivers adjust their care to the individual patient drawing on their personal knowledge and empathy. They mainly focus on the nutritional aspect of assisted feeding but also take their own beliefs and societal norms around eating into consideration. There seems to be a tension between the importance caregivers assign to the nutritional aspect of assisted feeding and the low status this task holds, not only in the hierarchy of hospital activities but also among caregivers. Relevance to clinical practice An overriding guideline for assisted feeding should be formulated, so that the activity will be less dependent on the individual caregiver's personal beliefs, time pressure and the character of the surroundings.

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Artiklen beskriver uddrag af interview med 16 patienter og refleksioner over patienternes udsagn. Artiklen er baseret på en ph.d.-afhandling, og konsekvensen for praksis er, at accelererede operationsforløb fordrer særlig opmærksomhed på asymmetriske magtforhold og patientens autonomi, og at støtte til patientens egenomsorg indebærer langt mere end faktuel information baseret på sikker-viden.

The aim of this study was to explore patients’ lived experiences of participating in a fast-track programme after colonical surgery within a phenomenological framework. 16 patients suffering from colonic cancer were interviewed twice. Transcriptions of the interviews were analysed using Reflective Lifeworld Research.Participating in the programme involved facing several dilemmas. It was not always easy for the patients to find the strength, courage, and will to comply with the daily regimen because discomfort and vulnerability could undermine their abilities to follow the recommendations. In this process, support from professionals or relatives was a decisive factor. After discharge, the professional recommendations were included in the patients’ daily routines to the extent which suited the individual patient’s everyday life. The findings show that these aspects are of great importance to the way in which the patients act and cope with the programme at the hospital and at home.

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Udgivelsesdato: 07-10

Udgivelsesdato: Jan

The purpose of this study was to obtain knowledge about patients’ experience of fast track colonic surgery. Applying Van Manen’s phenomenological- hermeneutical approach, the present study is based on 6 in-depth interviews. The analysis led to one dominating theme: Introduction to a programme and living up to this programme, and four subthemes: mobilizing willpower, balancing on the brink of one’s capacity, lack of influence, and the need for attention. Although patients wanted to contribute actively to their restitution by living up to the demands of the regimen, they felt pushed to – or beyond – the limits of their willpower and stamina. Patients experienced both an asymmetry between their degrees of responsibility and their degrees of influence, and a power related asymmetry in relation to the professional staff. Therefore, the study recommends an increased degree of ethical reflections within the practise of fast track surgery.