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The present study is part of a series of qualitative studies focusing on dialogic practice in southern Norway. In this article, we present a qualitative study of a network meeting focusing on the interplay between the participants' inner and outer dialogues. The network meeting is between an adolescent boy, his mother and two network therapists, the same adolescent case discussed previously in this journal by Boe et al. (2013). The aim of this study is to explore how the interplay between inner and outer dialogues contributes to significant and meaningful moments for the interlocutors. A multiperspective methodology is used that combines video recordings of a network meeting and participant interviews with text analysis. Our research found the interplay has an important role in understanding the emergence of significant and meaningful moments in therapy. A one-sided focus on participants' utterances or inner dialogues was insufficient to explain their significance and meaning to the interlocutors. A dialogical approach provides a theoretical frame and concepts that are useful in investigations of therapeutic conversations.

The aim of this study is to describe the experience of time as it presents itself at the place being situated when living with severe incurable disease and receiving palliative care. The empirical data consist of 26 open-ended interviews with 23 patients receiving palliative care at home, at a palliative day care; in a palliative bed unite in hospital or in a nursing home in Norway. A common meaning of a shifting space for living emerged from the analysis and was revealed through three different aspects: (i) Transition from a predictable to an unpredictable time: To live with severe incurable disease marks a transition to a changed life involving an ongoing weakened and altered body with bothersome symptoms making experience of time different and unpredictable. (ii) Transition between a safe and unsafe time: When time is unpredictable, feeling safe is revealed as essential to how time is experienced at the place being situated. (iii) To be in transition from a homely to a homeless existence. In a time of increased bodily weakness, unpredictable ailments and displacements the sense of belonging to the place is revealed as significant to the experience of time. Not knowing where to be in a time of change is like an existential cry of distress where the foothold in existence is lost. The findings are discussed and interpreted as an embodied experience originating from the passage of time continually affecting life sometimes so fundamentally that it marks a transition to a changed space of life that is reflected in the experience of time. acceptedVersion

Women ( n = 87) at women’s shelters in Norway, a country of high welfare and gender equality, reported a multitude of severe threats and actual acts of physical, sexual and psychological violence. An individual threatening to kill his partner represented a significant increased risk for experiencing serious acts of violence, especially when the threats were repeated. A self-administered questionnaire was sent to all the women’s shelters. Experiences of violence were measured by The Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI).

The aim of the study was to identify and describe spouses'/cohabitants' experiences of living with a partner with bipolar affective disorder over time. Qualitative research interviews were conducted with eight spouses/cohabitants. Transcribed interviews were analysed structurally based on Ricoeur's phenomenological hermeneutics as described by Lindseth and Norberg. The participants' shared lives ranged from 6 to 51 years, and the study found three major aspects that characterized their experience along this time-dimension; experience formed part of a cumulative process containing up to 14 experiences. Each experience created a preunderstanding that affected how subsequent experiences were perceived, and mastered. These three major aspects had a reciprocal influence on the following 14 experiences over time: Fear and the incomprehensible. Accusations. Self-doubt and doubt about own powers of judgement. Care and information vs. being overlooked or turned away by health personnel. Stigmatization and loss of social network. Uncertainty, powerlessness and hope. Loneliness. Anger and despair. The persistent threat. Own health problems. Grief over loss. Dawning acceptance. Reconciliation. New hope. A theoretical understanding using gestalt therapy theory suggests that burdensome experience can be seen as an inner imbalance in the spouse/cohabitant when she/he cannot find meaning in their experiences. When only parts of the whole are perceived, an incomplete gestalt is formed in the person's lived-experience that counteracts the equilibrium of the organism. Insight and meaning can protect them against burdensome experiences and nurses can empower them through care, health-promoting education and guidance. Nursing research should develop methods of education and guidance sensitive enough to help each spouse/cohabitant, regardless of where they are in their cumulative process.

This article aims to illustrate how Antonovsky's salutogenic theory and its central concept of sense of coherence can be operationalized into salutogenic therapy principles and an intervention program for promoting a sense of coherence, coping, and mental health among people with mental health problems. The intervention is based on the following five basic components or therapy principles: (1) the health continuum model; (2) the story of the person; (3) health-promoting (salutary) factors; (4) the understanding of tension and strain as potentially health promoting, and (5) active adaptation. The program is a talk therapy group intervention and consists of 16 group meetings and homework. The intervention may serve as a guide to mental health nursing practice when coping is the main target.

Objective Although the theory of salutogenesis provides generic understanding of how coping may be created, this theoretical perspective has not been explored sufficiently within research among people suffering from mental health problems. The aim of this study is to investigate the effect of talk-therapy groups based on salutogenic treatment principles on coping with mental health problems. Method In an experimental design, the participants (residents in the community) were randomly allocated to a coping-enhancing experimental group (n = 59) and a control group (n = 47) receiving standard care. Coping was measured using the sense of coherence (SOC) questionnaire. Results Coping improved significantly in the experiment group (+6 points) compared with the control group (−2 points). The manageability component contributed most to this improvement. Conclusion Talk-therapy groups based on salutogenic treatment principles improve coping among people with mental health problems. Practice implications Talk-therapy groups based on salutogenic treatment principles may be helpful in increasing coping in the recovery process among people with mental health problems and seem to be applicable to people with various mental health problems.

Previous research has shown that movement quality may be described as offering a general impression of a whole unified person, understood as a relation between postural stability, free breathing and awareness, which combined produce a refinement of movement as well as enhancing well-being. The phenomenon could further be structured in terms of four movement dimensions: structural, physiological, psychological/relational and a purely human dimension. So far we have little knowledge about these dimensions. The aim of this study is to deepen the understanding of the phenomenon of movement quality through close observation of Greek sculpture, reflection and literature studies relating to Greek sculpture. The aim was to see if these methods could be a tool for achievement of a deeper understanding of movement quality, in clinical observation and reasoning. A phenomenological method was used to study the essence of the phenomenon of movement quality. A study of Greek sculpture was chosen because of the way ancient Greek sculptors sought to express several dimensions of human existence. The results show that close observation, reflection and literature studies of Greek sculptures deepened the knowledge of the four dimensions of movement quality and provided a way in which this knowledge could be expressed in words. These methods may represent a tool for achieving a deeper understanding of movement quality in clinical observation and reasoning.

Quality of movement is frequently referred to as a phenomenon in the European movement tradition, underlining the close connection between outer expression and inner, lived experience. Within physical therapy little is clarified about the phenomenon from the point of view of lived experience. A case study has been undertaken focusing on the lived experience of the phenomenon, searching for basic elements and dimensions. An interpretive phenomenological approach was the method chosen for research. A qualitative interview was conducted involving one movement expert with an understanding and knowledge of the phenomenon. Analysis of the data revealed three levels of views on the quality of movement: basic elements and dimensions, functional use and personal integration. The phenomenon could be understood by the relation between three key elements, postural stability, free breathing and awareness; all contributing to a refinement in movement as well as a greater experience of well-being. The key elements were considered prerequisites to a four-dimensional therapeutic approach involving personal integration of bodily and mental aspects in movement. The basic element and dimensions of the phenomenon of quality of movement can be regarded as a starting point for research in this area.

The main issue is the connection between physical outfit and meaning in life after treatment in a stroke unit. The purpose is to provide knowledge about patients in the first period after getting the disease. Such information can be valuable when it comes to understanding the situation of elderly patients with stroke after they have left the hospital or stroke unit. 70 woman and men — aged between 55 and 95 participated, interviews were carried out and the instruments Barthel Index (ADL), Purpose in Life (PIL), and research questions were used. The main variables are activities of daily living and purpose in life. (The connection between physical outfit and meaning in life). The patients show a weakening of physical outfit and altogether 43 patients had an unsure score or reduced meaning in life. The results show a positive connection between physical outfit and meaning in life. There are gender differences that are clear, more men get stroke and they are also clinically more vulnerable (stronger connecti...

The aim of this study was to gain a deeper understanding of the experience of time when living with severe incurable disease. A phenomenological and philosophical approach of description and deciphering were used. In our modern health care system there is an on-going focus on utilizing and recording the use of time, but less focus on the patient's experience of time, which highlights the need to explore the patients' experiences, particularly when life is vulnerable and time is limited. The empirical data consisted of 26 open-ended interviews with 23 participants receiving palliative care at home, in hospital or in a nursing home in Norway. The theoretical frameworks used are mainly based upon K. Martinsens philosophy of care, K. E. Løgstrup phenomenological philosophy, in addition to C. Saunders' hospice philosophy, L. Feigenberg's thanatology and U. Qvarnström's research exploring patient's reactions to impending death. Experience of time is described as being a movement that moves the individual towards death in the field of opposites, and deciphered to be a universal, but a typical and unique experience emerging through three integrated levels: Sense of time; where time is described as a movement that is proceeding at varying speeds. Relate to time; where the awareness of limited life changes the understanding of time to be more existential. Being in time; where limited time seems to clarify the basic living conditions and phenomena of life. The existence of life when the prospect of death is present is characterized by emotional swings that move within polarizing dimensions which is reflected in the experience of time illustrated as the moves of the pendulum in a grandfather clock. The diversity of the experience of time is oscillating between going fast or slow, being busy or calm, being unpredictable but predictable, safe or unsafe and between being good or bad, depending on the embodied situation of the individual.

In this article the concept «mental suffering» is discussed as a possible anomaly from the point of view of nursing science. Based upon a review of central concepts common to nursing science the concept «suffering» is elucidated with regard to the concept's content, source, character and power. «Mental suffering» has been predominately used as a concept connected to disease. In such a context the concept may be regarded as reductionistic since «suffering» is perceived to be a comprehensive concept having spiritual, cultural, psychological, social and physical dimensions. It may seem unnecessary, and frankly even misleading, to couple the concepts «mental» and «suffering» since suffering, in itself, is predominately mental. The Health Service must surely meet suffering human beings by focusing on the uniqueness of each individual and not just on the diagnosis of the person involved.

Background In recent years, physical therapists have paid greater attention to body awareness. Clinicians have witnessed the benefits of supporting their patients' learning of movement awareness through the promotion of their movement quality. Objective The aim of this study was to investigate how physical therapist experts promote movement quality in their usual clinical settings. Design A phenomenological research design that included a sampling strategy was devised. Using specific criteria, 6 lead physical therapists nominated a group of physical therapist experts from the fields of neurology, primary health care, and mental health. Fifteen informants, 5 from each field, agreed to participate. Methods In-depth interviews were conducted with a semistructured interview guide. The informants were invited to simply describe what they had experienced to be successful therapeutic processes for promoting movement quality. Each interview was audiotaped and transcribed. The data analysis was based on a multistep model. Results Three main themes emerged from the data. First, the physical therapists' embodied presence and movement awareness served as a precondition and an orientation for practice. Embodied presence is a bodily felt sense, a form of personal knowing that evokes understanding and fosters meaning. Second, creating a platform for promoting movement quality revealed implementation of psychological attitudes. Third, action strategies for promoting movement quality suggested a movement awareness learning cycle and components for clinical use. Conclusions This study demonstrated specific attitudes and skills used by physical therapist experts to promote movement quality in their clinical practice. These results may serve as a therapeutic framework for promoting movement quality in clinical physical therapy, although further research is needed.

Movement quality is a phenomenon frequently used by physiotherapists in oral language, written text, and clinical practice, with little clarification. The purpose was to investigate the lived experiences of a group of expert physiotherapists, searching for essential features and characteristics of the phenomenon. A phenomenological study, using in-depth interviews was chosen. Ten copies of Fine Art were used to stimulate the description of the phenomenon. The informants were 15 peer-designated physiotherapists, five from each field of neurology, psychosomatic/psychiatry and primary health care. They were nominated by physical therapist leaders in the region. The interviews were audiotaped and transcribed. Giorgis' recommendation concerning analysis of the interview data was followed. Four main themes were developed, seeing movement quality as biomechanical, physiological, psycho-socio-cultural, and existential, all interacting processes. Each theme includes preconditions to movement quality and movement characteristics. Movement quality in general was seen as a unifying phenomenon, representing a synthesis of the four themes. The outcome of the study is the Movement Quality Model (MQM) illuminating essential features and characteristics of the phenomenon. Further research is needed for clarification and application in clinical practice.

The study addresses the following two questions: 1) Do the patients and staff at psychiatric hospitals hold similar or divergent views with regard to what is good care? 2) Does gender influence how patients and staff at psychiatric hospitals rank the importance of what is good care? The study was carried out by a survey design. Four hospitals in western Norway with a total of 65 patients and 79 staff took part. A revised version of the Care Q instrument was used. The results show that both groups rank human interaction between patients and staff as the most important care procedure. Physical nursing and monitoring functions were considered the least important care procedures by both groups. The results also show a statistically significant difference between patients and staff with regard to 15 out of 50 individual statements. As an example the statement «is honest about your mental problems», and «gets to know the patient as an individual person» was ranked as much more important by patients than by staff. The study also indicates that the gender of patients and staff may influence how they rank the importance of care procedures.

During the last years there has been a wide reduction in institution places in psychiatric health care. The purpose of this study was to present how psychiatric patients experience their situation at home, and in what situations they need help from the psychiatric community nurses. Data were gathered from eleven qualitative interviews with eight patients. A hermeneutical approach and method was used in the study. The main focus was on the quality of life of the patients. The patients expressed a need of having an informal contact with the nurses and that the nurses focused on motivation and practical action. Three main factors showed out to be the causes related to the need of help. The first factor was the experience of psychological pain. The second factor was the experience of loneliness, and the third factor was related to the tendency of passivity. The patients need for help and guidance was therefore often related to emotional support, social contact and activities.

The purpose of this study is to identify central aspects of feelings in relation to the experience of being a brother or sister of someone who suffers from schizophrenia. The study makes use of a hermeneutical method for the collection of data as well as for the systemizing and interpretation of data. The participants in the study were 16 siblings of persons with diagnosed schizophrenia. In total 80 interviews were done, with an average length of 50 min. A theory of interrupted feelings was developed within the tension between empirical data and preunderstanding. Mixed feelings of grief, hope, anger, guilt and shame are interrupted by four interrelated factors: ambiguous loss, the fluctuating nature of the illness, an inner prohibition of feelings and the tendency of others to invalidate the feelings. The interruption may lead to a lonely and painful experience which is difficult both to process for oneself and to share with others.