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Background: The need for dignity and compassion in healthcare is enshrined in policy, but is often difficult to enact in practice and what is precisely meant by these concepts is unclear. In this paper, we have explored theoretical underpinnings which form the basis of a lifeworld‐led approach which was used in a research study to support the humanity of service providers and users alike. Aim: In this article, we share our analysis of what we have learnt after undertaking an innovative appreciative action research project with patients and staff in a stroke ward with the aim of exploring if a novel phenomenologically driven and philosophically derived humanising framework could be applied in health care. Following the research, we wanted to develop a theoretical understanding of the processes occurring during the research in order to provide a framework and language which could be used to support practical lifeworld developments in the future. We analysed the approach through Participatory and Appreciative Action Reflection. Findings: As researchers, we found that the approach was underpinned by four key existential principles. The first principle was recognising a mutually arising reality rather than a reality 'out there'. The second was recognising a reality which was constantly changing rather than 'fixed'. The third was recognising that we needed to work from within, as part of a human living system rather than trying to control reality from the 'outside'. Finally, we recognised that this reality could only be accessed through human knowing, including embodied knowing rather than intellectual knowing alone. These principles challenged many of the usual ways of thinking and working within research and healthcare contexts. Conclusion: Understanding the processes and reality in this way gave new perspectives; enhancing our understandings and views of ourselves, what is important and most importantly what is possible in caring systems. [ABSTRACT FROM AUTHOR]

The experience of physical activity is influenced by social relations and gendered roles. Group-based lifestyle interventions are considered effective in promoting physical activity, yet the experiences of being active with others are unknown among individuals with severe obesity. To explore how individuals with severe obesity experience being with others during physical activity. A qualitative hermeneutic phenomenological study of repeated single-gender focus group interviews was conducted with adults living with severe obesity during group-based lifestyle intervention. Three themes were developed: 1) 'Enjoying safety, kinship and belonging among peers'; 2) 'Feeling like a failure is shameful: A sense of aversion'; and 3) 'Striving to feel at home in physical activity: Needing distance from others.' The themes were drawn into an overall meaning 'Achieving wellbeing may always be a challenge: not feeling at home in the group or in body.' Intersubjective and spatial dimensions of experiences are central and influence how individuals with severe obesity can feel wellbeing and 'at home' in physical activity. Physiotherapists should be aware of the individuals' vulnerability regarding feelings of failure, aversion, and shame as well as awareness of gendered norms and roles. [ABSTRACT FROM AUTHOR]

Despite substantial reorganisation of stroke unit provision in the United Kingdom, limited qualitative research has explored how stroke survivors experience the acute stroke unit. This hermeneutic phenomenological study used accounts from four stroke survivors who experienced one of two acute stroke units. Through detailed analysis, the acute stroke unit emerged as a meaningful space, in two distinct but interconnected forms. As holding space, the unit was understood to offer protection and safe haven, as the stroke survivors looked to cope and respond to the temporal, bodily, biographical disruption and significant vulnerability brought about by stroke and by being in hospital. Holding was fulfilled by different people (including their fellow stroke survivors) and reflected a human response to human need and existential vulnerability. This space, and the practices within it, functioned to hold them intimately but also at a distance from their prestroke lifeworld. As such, the acute stroke unit holding space was intertwined with how it supported, encouraged or provoked transition. In the transitional space of the acute stroke unit, stroke survivors described how they survived the hospital‐healthcare space, stroke unit and poststroke space. This paper articulates how transition was meaningfully signified through its absence or presence, as they transformed, relinquished or re‐asserted their 'self', and in one case, recovered whilst 'in there'. The findings of this study provide phenomenological insight into stroke survivors' lived experience, the meaningful holding and transitional contribution of the unit, and how these spatial forms were intertwined. These insights are discussed in relation to the existing evidence base and stroke unit provision. [ABSTRACT FROM AUTHOR]

Background: In-depth understanding of the experiences of both well-being and suffering in relation to being severely obese and becoming active through lifestyle intervention is lacking. Aim: to explore and describe adults' existential experiences of being active, when living within a large body—before and during a lifestyle intervention. Methods: A longitudinal design of repeated individual interviews with 16 adults with BMI ≥40, based on hermeneutic phenomenology, existential philosophy and a theory of well-being was performed. The study was approved by the Danish health authorities. Results: Two dimensions of experiences were found; "Living within a downward spiral" and "Striving for enjoyment and settlement". The themes describing suffering were: 'Sense of being thwarted and defeated ' and "Tackling energy depletion and impact of sense of self". The themes describing well-being were: "Hoping for renewal and energised resoluteness" and "Enduring discomfort and feeling safe". Conclusions: Interacting existential experiences can be facilitators or barriers for physical activity. It seems relevant for health care providers to address the individual's lifeworld experiences of well-being, lack of well-being and suffering. Well-being as a sense of feeling "at home" when physically active may break down an inactivity spiral. Promoting well-being is a legitimate aim of lifestyle intervention. [ABSTRACT FROM AUTHOR]

In this paper, we draw on a phenomenological-philosophical foundation to clarify the meaning of dignity as a coherent phenomenon. Consistent with an evocation of its central meanings, we then introduce and delineate seven kinds of dignity that are intertwined and interrelated. We illustrate how these kinds of dignity can provide a useful template to think about its qualities, its 'rupture' and its 'restoration' in human life, particularly in relation to health and social care contexts. We then consider the implications of these relational and experiential views for current debates about the notion of dignity: Is dignity a useless concept? Is dignity objective or subjective? What are the useful ways of characterizing different varieties of dignity? We conclude by pointing to a metaphor that may hold the sense and meaning of our deepest human dignity: The gathering of both value and vulnerability, in which human value does not depend on the eradication of human vulnerability, but occurs within its very context. [ABSTRACT FROM AUTHOR]

Understanding the ''insider'' perspective has been a pivotal strength of qualitative research. Further than this, within the more applied fields in which the human activity of ''caring'' takes place, such understanding of ''what it is like'' for people from within their lifeworlds has also been acknowledged as the foundational starting point in order for ''care'' to be caring. But we believe that more attention needs to be paid to this foundational generic phenomenon: what it means to understand the ''insiderness'' of another, but more importantly, how to act on this in caring ways. We call this human phenomenon ''caring for insiderness.'' Drawing on existing phenomenological studies of marginal caring situations at the limits of caring capability, and through a process of phenomenologically oriented reflection, we interrogated some existential themes implicit in these publications that could lead to deeper insights for both theoretical and applied purposes. The paper provides direction for practices of caring by highlighting some dangers as well as some remedies along this path. [ABSTRACT FROM AUTHOR]

A person's sense of dignity is a complex phenomenon and is intertwined with their sense of feeling human and being respected as a human being. In 2010, the School of Health and Social Care developed a collaborative lifeworld led transprofessional curriculum for health and social work disciplines harnessing technology to connect learners to a wider view of evidence based practice. The purpose was to increase use of technology-enhanced learning, introduce lifeworld-led philosophy to the curriculum, release staff potential, and expose students to research undertaken within the School. Delivered to undergraduate students the Exploring Evidence to Guide Practice Unit was facilitated by a number of resources including lectures, group work and a variety of web-based learning materials. Central to the unit were seventeen web-based case studies which included the human experience of the impact of specific illnesses (such as stroke and living with dementia) and more general experiences (such as social isolation and homelessness). Each case study provided stories and poems, qualitative and quantitative research and policy and practice issues related to specific topics. At the heart of the philosophy underpinning the unit was an opportunity for students to integrate understandings about different kinds of knowledge for practice, conventional evidence, understandings about the person's or service user's experience and the student's own insights that came from imagining 'what it was like' for the person experiencing a condition or situation and encountering human. The project built on the successful development of Wessex Bay, a virtual community of case scenarios, used as problem-based triggers to engage students in learning activities relating to residents. This paper discusses the development of the web-based case studies and how they integrated visual and audio materials with the aim of enhancing the lifeworld experience of students and helping to show the importance of humanising healthcare. [ABSTRACT FROM AUTHOR]

Aim: This paper introduces the notion of ‘Caring science’ as a way to delineate and develop particular kinds of knowledge relevant to caring practices in critical care. Relevance for practice: Firstly, one particular development of person centred care, lifeworld led care is offered. Its relevance for critical care nursing is analysed by pointing to examples of studies which describe temporality, spatiality, intersubjectivity and embodiment and how they may manifest with reference to the person as ‘body object/body subject' and the matter of technology in critical care environments. Secondly, by use of an imagined practice scenario, the challenge of expanding our traditional notions of evidence to encompass ways of knowing that are more intimately embodied and practice related is discussed. Such knowledge, referred to as ‘embodied relational understanding’ is particularly relevant to a conception of caring for persons' in a holistic way. Conclusion: The paper concludes by pointing to the potential for caring science, grounded in lifeworld led care, to offer some integrating ideas that legitimate the full range of resources, ‘head’, ‘hand’ and ‘heart’, that nurses can draw upon in everyday holistic critical care practice. [ABSTRACT FROM AUTHOR]

Background: Mobile devices have become increasingly important to young people who now use them to access a wide variety of health-related information. Research and policy related to the integration of health information and support with this technology do not effectively consider the viewpoint of a younger patient. Views of young people with type 1 diabetes are vital in developing quality services and improving their own health-related quality of life (HRQOL), yet research on their lifestyle and use of Web and mobile technology to support their condition and in non-health-related areas is sparse. Objective: To develop insight into young people with type 1 diabetes and their current use of Web and mobile technology and its potential impact on HRQOL. This can be achieved by constructing an in-depth picture of their day-to-day experiences from qualitative interviewing and exploring how they make use of technology in their lives and in relation to their condition and treatment. The goal was then to build something to help them, using the researcher's technical expertise and seeking users' opinions during the design and build, utilizing sociotechnical design principles. Methods: Data were collected by semistructured, in-depth qualitative interviews (N=9) of young people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto NVivo for theme identification. Data analysis was undertaken during initial interviews (n=4) to locate potential ideas and enhancements for technical development. Latter interviews (n=5) assisted in the iterative sociotechnical design process of the development and provided additional developmental ideas. Results: Six themes were identified providing an understanding of how participants lived with and experienced their condition and how they used technology. Four technological suggestions for improvement were taken forward for prototyping. One prototype was developed as a clinically approved app. A number of ideas for new mobile apps and enhancements to currently existing apps that did not satisfactorily cater to this age group's requirements for use in terms of design and functionality were suggested by interviewees but were not prototyped. Conclusions: This paper outlines the nonprototyped suggestions from interviewees and argues that young people with type 1 diabetes have a key role to play in the design and implementation of new technology to support them and improve HRQOL. It is vital to include and reflect on their suggestions as they have a radically different view of technology than either their parents or practitioners. We need to consider the relationship to technology that young people with type 1 diabetes have, and then reflect on how this might make a difference to them and when it might not be a suitable mechanism to use. (JMIR Mhealth Uhealth 2013;1(2):e12) [ABSTRACT FROM AUTHOR]