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Background This study aims to investigate the lived experience of well-being among older patients and their relatives in the transition from hospital to home after early discharge. Research has shown that the transition brings severe challenges to their everyday lives. However, to date, there has been a lack of research focusing on the lived experiences of well-being during this process. Methods The data collection and analysis followed the phenomenological approach of Reflective Lifeworld Research. Ten in-depth interviews with older patients and their relatives were conducted in Austria up to 2–5 days after hospital discharge. Results The essential meaning of the phenomenon of well-being in the transition from hospital to home is marked by security and confidence to face the challenges following the discharge. Four constituents emerged: being calm and in alignment with the homecoming, being in familiar surroundings at home—a sense of belonging, striving towards independence—continuity of life and having faith in the future. Conclusion Our findings point to the importance of recognizing the vulnerability associated with the transition from hospital to home, as it impacts the existential aspects of space and time. Facilitating a sense of continuity and belonging can foster well-being during this critical period.

Phenomenology was introduced to the field of nursing in late ‘70s in the US and Scandinavia. Since then, phenomenology has developed as a commonly used approach within nursing research. However, during the past two to three decades, phenomenological nursing research has come under attack from scholars outside the field of nursing who question the credibility and usefulness of phenomenological nursing research. The aim of this discussion paper is twofold: 1) to illuminate why phenomenology was introduced by nurse scholars to develop theory and as a framework for empirical research in the US and Scandinavia; and 2) to discuss the legitimacy of applying a phenomenological approach in nursing research and practice today. The rationale behind advocating the integration of a phenomenological approach into nursing practice was to defend, apprehend and articulate the essence of caregiving in theory building within nursing. We claim these arguments are maybe even more important today. Using three examples of empirical phenomenological studies, we illustrate how these studies provide theoretically informed insights into existential aspects of care that guide caring practice and accordingly humanise practice. We argue that phenomenology provides the nursing profession with a humanly sensitive approach that challenges the current tendency within healthcare to emphasise an evidence-based, standardised approach to patient care that inclines to neglect each patient’s uniqueness. Nursing profession may lose its very raison d'être, i.e. to deliver humanly sensitive care, if nursing research ceases to address existential aspects of being a human. Thus, it is evident that phenomenological nursing studies have legitimacy and are important for developing theoretically informed insights that promote the discipline of nursing. Consequently, the value of phenomenological nursing research should be assessed based on the findings it provides that promote such knowledge. Hence, credibility and usefulness of phenomenological nursing research must be determined by the discipline itself.

Background: Early hospital discharge is rising internationally. Hence, homecoming is a significant event that has a severe impact on the well-being of older adults and their relatives. Evidence suggests that adapting to this unfamiliar situation requires a concerted effort to strive towards independence. This study describes the meaning of striving towards independence as experienced by older adults and their close relatives during the first month after early discharge from hospital to home and examines how this process relates to their experiences of well-being. Methods: Data was gathered through 18 dyadic phenomenological in-depth interviews with ten older adults discharged from three hospitals in Austria and their relatives. Results: The essential meaning of striving towards independence after early discharge is characterised by being at ease and further articulated in the three constituents: walking a tightrope between push and support, steady improvement as an opportunity for new possibilities and returning to cherished habits as a source of joy in life. Conclusion: Our study highlights the dynamic process of striving towards independence, which encompasses acceptance, trust and identification with the condition, and is intertwined with existential dimensions of temporality, inter-subjectivity and identity. Facilitating trust in the future between the older adult and their carers, as well as helping them regain former habits, supports the strive towards independence after early hospital discharge and contributes to the experiences of well-being of older adults and relatives. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the lived experience of well-being among older patients and their relatives in the transition from hospital to home after early discharge. Research has shown that the transition brings severe challenges to their everyday lives. However, to date, there has been a lack of research focusing on the lived experiences of well-being during this process. Methods: The data collection and analysis followed the phenomenological approach of Reflective Lifeworld Research. Ten in-depth interviews with older patients and their relatives were conducted in Austria up to 2–5 days after hospital discharge. Results: The essential meaning of the phenomenon of well-being in the transition from hospital to home is marked by security and confidence to face the challenges following the discharge. Four constituents emerged: being calm and in alignment with the homecoming, being in familiar surroundings at home—a sense of belonging, striving towards independence—continuity of life and having faith in the future. Conclusion: Our findings point to the importance of recognizing the vulnerability associated with the transition from hospital to home, as it impacts the existential aspects of space and time. Facilitating a sense of continuity and belonging can foster well-being during this critical period. [ABSTRACT FROM AUTHOR]

Purpose Eating difficulties cause reduced food intake and poor quality of life among adolescents and young adults (AYAs) with cancer. Therefore, next-of-kin eating support is crucial. The purpose of this study was to explore the lived experiences of being close to AYAs with cancer in the context of eating when they are at home between high-emetogenic chemotherapy (HEC) sessions. Method In-depth interviews were conducted with 12 next-of-kin to AYAs (15–29 years old) with oncological or haematological diseases, treated with HEC. Van Manen’s hermeneutic-phenomenological approach guided the design. Results The essential meaning of the next-of-kin experiences is reflected in the overarching theme “Utilizing meals as an action-opportunity” consisting of two subthemes: ’Being on constant alert’ and “Walking a tightrope to maintain usual everyday life.” Conclusions Findings revealed that utilizing meals as an action-opportunity towards AYAs’ food intake involved existential feelings including fear of losing their loved ones. Next-of-kin experienced that providing support through and with food was their only avenue of action. However, this sparked feelings of frustration and powerlessness.

Background and aim: Communication is a key factor in intraprofessional collaboration between hospital nurses and homecare nurses in hospital‐to‐home transitions of older patients with complex care needs. Gaining knowledge of the nature of cross‐sectoral communication is crucial for understanding how nurses collaborate to ensure a seamless patient trajectory. This study explores how cross‐sectoral electronic health records communication influences collaboration between hospital nurses and homecare nurses when discharging older patients with complex care needs. Method: The study is based on qualitative group interviews with six hospital nurses and 14 homecare nurses working at different hospitals and municipalities across Denmark. Data were analysed using reflexive thematic analysis, as described by Braun and Clark. Findings: The themes Collecting pieces for the 'puzzle': Losing the holistic picture of the patient; Working blindfolded: limited provision of and access to critical information; and Bypassing the 'invisible wall': dialogue supports cohesion illustrate the impact of organisational structures within electronic health records have on hospital nurses' and homecare nurses' intraprofessional collaboration across sectors. Challenges with predefined and word‐limited elements in digital communication, and inadequate and limited access to significant medical information were identified. To compensate for the inadequacy of the electronic health records, direct contact and dialogue were emphasised as ways of fostering successful collaboration and overcoming the barriers created by electronic health records. Conclusion: Despite hospital nurses' and homecare nurses' desire to conduct holistic patient assessments, their ability to collaborate was hindered by failures in electronic health record communication resulting from restrictive organisational structures across sectors. Thus, it became necessary for hospital nurses and homecare nurses to bypass the electronic health record system and engage in dialogue to provide holistic care when discharging older patients with complex care needs. However, by hospital nurses and homecare nurses compensating for counter‐productive organisational structures, problems brought about by the electronic health record system paradoxically remain invisible. [ABSTRACT FROM AUTHOR]

Abstract Aim To gain in-depth knowledge of mothers’ and fathers’ experiences of the whole trajectory of an early in-home care programme supported by video consultations with a neonatal nurse. Design A qualitative interview study. Methods Data were collected through dyadic semi-structured interviews with mothers and fathers participating in virtual early in-home care programmes and were subjected to inductive content analysis. Findings The mothers and fathers were anxious about mastering the care of their premature infants at the start of the early in-home care phase but gradually developed confidence by the completion of the early in-home care programme. Being at home during the early in-home care programme gave the mothers and fathers an opportunity to test their decision making concerning the care of the infant while having the ability to obtain support from nurses when needed. Conclusion Our findings indicate that the trajectory of early in-home care programmes combined with video consultations contributes to parents’ increased confidence as mothers and fathers. Trial registration Clinical trial registration: REG-113-2014 and SJ-431 .

Abstract Aim This study examined how communication between nurses and families in video consultations in a neonatal early in‐home care program unfolded in the context of parents' homes. Design A qualitative study based on focused observations supported by audio‐recorded video consultations. Methods The data were collected through nine video consultations between nurses and families in an early in‐home care program. The transcribed material was examined using inductive content analysis. Findings The analyses revealed the following themes: “Setting the scene,” “Weight as a point of reference” and “The pros and cons of technology.” The video consultations unfolded in a relaxed atmosphere, but also as one‐way communication dominated by nurses, with the infant's weight as the focus. The study finds that a focus on training in video communication is needed to take full advantage of video consultations' potential.

The Humanised Care Assessment Tool (HCAT) was collaboratively developed in the UK with input from theory, patients, relatives, and staff. HCAT contains 109 items providing an in-depth understanding of the values considered when assessing whether care is practiced in a humane manner. This study's objective was to provide a linguistically valid and reliable Danish version of the HCAT suitable for primary healthcare settings. We report on the process of translation and adaptation, resulting in the Danish pilot version with 83 items within the eight original dimensions. The Danish pilot HCAT is the first Danish questionnaire intended to serve as both a reflective tool and a measurement instrument for assessing how workplace culture fosters or impedes humane caregiving behavior. The next step is to investigate the validity, reliability and responsiveness of the instrument as well as its value as a tool for reflection in primary healthcare. [ABSTRACT FROM AUTHOR]

Background: Collaboration is a key factor influencing the quality and safety in patients transition between sectors. However, specific collaborative practices may give rise to conflict between hospital nurses and community nurses. Aims: To gain a deeper understanding of collaborative practices which have the potential to fuel tension in collaboration between hospital nurses and community nurses during discharge of older patients from hospital to homecare. Methods: A meta-ethnography approach was used in this study and a systematic literature search was conducted in 2022. Results: Five themes were identified in the analysis. These themes revealed how uncertainty, limited confidence in information and personal attitude in communication may fuel tension between hospital nurses and community nurses. Tensions arising from a negative loop emerged because of uncertainty, causing a growing rift between hospital nurses and community nurses, leaving them as opponents rather than collaborators. The authors suggest that policy makers and managers can break this loop by underpinning shared policies and awareness of common objectives. [ABSTRACT FROM AUTHOR]

Abstract Background Doyne honeycomb retinal dystrophy (DHRD)/malattia leventinese (ML) is an autosomal dominant, progressive retinal disorder characterized by massive central retinal drusen often partly coalescent forming a characteristic honeycomb‐like pattern. Debut of vision loss often occurs in early to mid‐adulthood, and the degree varies. A single variant in EFEMP1: c.1033C>T (R345W) has been identified as the cause in all cases. Methods Following DNA isolation, exome sequencing was performed in seven genes associated with flecked retina. Direct sequencing was used for variant verification. Results We report the first Scandinavian case of molecular genetically verified DHRD/ML: a 57‐year‐old woman debuting with vision loss and metamorphopsia. On both eyes, ophthalmological findings included massive hard drusen in the macular region and nasal to the optic disc as well as macular hyperpigmentation. Secondary choroidal neovascularizations were identified on both eyes, and anti‐vascular endothelial growth factor was administered, without effect. Conclusion Molecular genetic investigation revealed heterozygosity for the known pathogenic missense variant in EFEMP1: c.1033C>T (R345W) previously reported in relation to DHRD/ML. Family history revealed no other cases of similar visual impairment suggesting a de novo mutation. Furthermore, there was no correlation between the unique DHRD/ML haplotypes reported in the literature and our patient.

Abstract Background CABP2‐related non‐syndromic hearing loss have only been reported in a few families worldwide (Iran, Turkey, Pakistan and Italy). The hearing loss was in these cases described as prelingual, symmetrical, and moderate to severe. Methods Following DNA isolation, exome sequencing was performed in 123 genes related to non‐syndromic hearing loss. Variant verification and carrier testing were performed by direct sequencing. Results We report the first Northern European individual with CABP2‐related hearing loss: an 8‐year‐old Danish Caucasian boy with non‐syndromic, prelingual, and sensorineural hearing loss, who is homozygous for the splice site variant CABP2: c. 637+1G>T previously found in three Iranian families and in one Pakistani family. Both parents are of Danish Caucasian origin with no known history of consanguinity. This is in contrast to the four reported Middle Eastern families, who all were consanguineous. However, loss of heterozygosity in a 3.2 Mb area on chromosome 11 including CABP2 was observed, suggesting a common parental ancestor. Conclusion We report the first case of CABP2‐related autosomal recessive hearing loss in Northern Europe. The index is of Danish Caucasian origin and found to be homozygous for the splice site variant c.637+1G>T.

In this paper, we discuss “the slow in the fast” related to care situations in a “fast-track” hospital setting were the length of patients’ stay has been reduced significantly. The discussion is based on a narrative created from observations made in a postoperative care unit where patients are intensively observed and cared for during a very short time span. We found that within the phenomenological notions of lived time, lived space and lived illness, it is possible to create an imaginative space in time – to make a time warp. Despite being in a setting where the objective time measure dominates, the nurse can create a rhythm of her own in the room. Thus, acting slow in the quick meeting means that nurse-patient relationship is characterized by calmness and quietness, the nurse’s engagement in the patient’s suffering and her help to the patient to endure the present and hold the now.

Treatment with deep brain stimulation for Parkinson’s disease, leads to a rapid improvement in mobility, which may challenge patients and spouses when adjusting to everyday life. An intervention, developed to support the adjustment to everyday life with DBS, demonstrated that individualized meetings with a specialized nurse was experienced as important and fruitful by both patient and spouses. Purpose: The aim was to gain a deeper understanding of how the meetings contributed to the adjustment process. Method: 38 audio-recorded meetings and six written summaries from eight couples participating in the intervention, were analyzed in a hermeneutic process. Results: The analysis revealed four themes: A relational triad of co-creating personal knowing. Sharing and listening in an atmosphere of trust and openness. Unveiling the couple’s everyday life, coping strategies and expectations. Supporting adjustment through knowing their personal story. Conclusion: The triadic dynamics in the meetings were quite particular. The main focus was the patients’ and spouses’ stories, individually and as a couple. The DBS nurse pursues solutions based on professional and specialized knowledge of Parkinson’s disease and the couple’s everyday life. Thus, the intervention meetings offered tailored, individualized and specialized care in supporting adjustment to DBS for PD both individually and as couples.

Purpose The purpose of this study is to illustrate a theoretical value framework for humanisation of healthcare, a lifeworld-led care that has the potential to support nurses in acute medical units in addressing and meeting both challenges and care needs expressed by patients suffering from alcohol use disorders. Providing care to these patients means working with a very divergent and complex group of patients. When hospitalised in an acute medical unit, nurses are often these patients' first encounter, which gives a unique opportunity to initiate and establish a successful care alliance. Method The present study is a qualitative study based on an amplified secondary analysis of 25 pre-conducted interviews. Following a hermeneutic approach, the analysis was structured in accordance with the conceptual value framework for humanisation of care, drawing on the recognition of the patients' lifeworld as an aspect of importance. Findings The study showed that while there were examples of humanising care guided by the patients’ lifeworld present, there were also situations of care that were dehumanising. Conclusion: When letting the patients’ perspective of well-being be the centre of care, the patients’ experience of meaningfulness and sincerity within the provided care was nurtured, and they felt more humanly met.

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. [ABSTRACT FROM AUTHOR]

Purpose: During the transition from ingesting milk to ingesting solid food, infants substantiate their eating habits. The present study focuses on this transition. Specifically, it aimed to explore first-time parents’ lived experiences of their infants’ transition from milk to solid foods. Method: The study is based on the descriptive phenomenological approach Reflective Lifeworld Research (RLR). Ten mothers and ten fathers were interviewed twice; when the infants were aged four to five months and again at seven to eight months of age. Data were analysed according to RLR principles. Results: The findings show that the transition from milk to solid food is a demanding in-between phase. The physically intimate feeding situation is replaced by unfamiliar situations in which parents and infant are physically separated and new types of food are introduced. The process of feeding requires parents’ full attention and sensitivity towards the infant’s reactions. Conclusion: The study highlights how shared parental experiences were reflected in frames for how a meal should normally proceed, including parents’ desire to create healthy eating habits and uphold harmony duringfamily meals We suggest for health professionals to present parents with a wider frame of normality, especially as concerns the concept of what constitutes “normal” eating patterns.

The increasing need for energy storage technology has led to a massive interest in novel energy storage methods. The energy geomembrane system is such a novel energy storage method. The concept of the system is briefly introduced, and a holistic numerical model of the system is presented. The model uses advanced finite-element techniques to model the energy storage system using fluid cavity elements. The developed geomembrane energy system is modelled with different constitutive models to represent the soil behaviour: a linear elastic model, a nonlinear Mohr-Coulomb model, and a hypoplastic constitutive model. The consequences of these different models on the results are studied. Hereby, the focus is the first inflation and deflation cycle of the system.

This study explores the lived experience of losing a leg as described by the patients themselves post-discharge. Studies have documented that regardless of aetiology patients are faced with severe physical as well as psychosocial challenges post-amputation. However, only few studies explore in-depth the patients’ perspective on the various challenges following the loss of a leg. The study uses the phenomenological approach of Reflective Lifeworld Research (RLR). Data were collected from 24 in-depth interviews with 12 Danish patients. Data analysis was performed according to the guidelines given in RLR. The essential meaning of losing a leg is a radical and existential upheaval, which restricts patients’ lifestyle and irretrievably alters their lifeworld. Life after the operation is associated with despair, and a painful sense of loss, but also with the hope of regaining personal independence. The consequences of losing a leg gradually materialize as the patients realize how the loss of mobility limits their freedom. Patients experience the professional help as primarily directed towards physical care and rehabilitation. The findings show that the loss of a leg and, subsequently, the restricted mobility carry with them an existential dimension which refers to limitation of action space and loss of freedom experienced as an exclusion from life. Our findings demonstrate a need for complementary care and stress the importance of an increased awareness of the psychosocial and existential consequences of losing a limb.

The aim of this paper is to discuss in the light of phenomenological philosophy, whether it can be argued that men and women have different lifeworlds and how this may legitimize the segregation of men and women in empirical nursing research. We analyzed peer-reviewed papers from 2003-2012 and scrutinized the arguments used for dividing men and women into separate groups in empirical nursing studies based on phenomenology. We identified 24 studies using gender segregation and posed the following questions: 1. What is the investigated phenomenon as explicated by the authors? 2. What arguments do the authors use when dividing participants into gender specific groups? The analysis showed that a variety of phenomena were investigated that were all related to a specific medical condition. None appeared to be gender-specific, though the authors argued for a sole focus on either women or men. The most common argument for segregating men and women were reference to earlier studies. A few studies had references to methodology and/or philosophy as argument for a segregation of men and women. Arguments for gender segregation in empirical nursing studies based on a phenomenological approach tend to build on the conviction that experiences of health related phenomena are gendered. However, it seems to be difficult to identify conclusive arguments for this division within phenomenological philosophy. Therefore we recommend that segregation should be used with caution. Otherwise other research approaches may be more suitable.

Many persons with leg amputations experience that using a prosthesis enriches their quality of life. However, there is an ongoing concern with underuse and non-use of artificial limbs in lower limb prosthetic rehabilitation. Studies have identified an initial critical stage among potential prosthetic users. The aim of this study was to explore the lived experience of becoming a prosthetic user as seen from the perspective of patients. The study is based on the phenomenological framework of Reflective Lifeworld Research (RLR). Data were collected through three in-depth interviews with each of the eight participants during the first year post-amputation. Data were analyzed according to the guidelines given in RLR. The findings showed that the participants found themselves in a state of in-between existence. They felt disconnected from their usual lives and not yet integrated in a new and different life. In this in-between existence, the participants oscillated between experiences of victory and defeat. The study adds to increased understanding of the initial critical stage of becoming a prosthetic user by showing that this in-between existence is inherent in the process of becoming a prosthetic user. To become a prosthetic user requires a high degree of stamina and resilience as this in-between existence takes its toll on patients’ recovering process.

What happens when designer dreams meet business reality? This paper illustrates how a group of professional designers experienced emotional tensions and conflicts of personal and professional identity during an eight-week voluntary course on business and entrepreneurship for the creative professions. The designers' discourse, which revolved around ideals of commitment towards artistic integrity, aesthetics and design clashed with the hard core discourse of business which highlighted practical concerns relating especially to market considerations and the necessity of adapting designs to existing means of production. Intellectually, the designers agreed on the need to develop business skills to improve their financial situation and enhance their employability. Emotionally, however, their choice of discourse, metaphors and framing strategies reflected a series of professional and personal conflicts and struggles of identity. The study illustrates the oscillating nature of designers' identity negotiations between business and design but offers no one-size-fits-all solution to business training for the creative professions. The data reflect that identity negotiations do not take the form of a liniar process in which logic, material concerns and business sense will eventually prevail. To facilitate the potential incorporation of business thinking into the professional identity of designers, the data indicate that business related training targeting the creative professions would benefit from paying increased attention to the influence of professional discourse and sensemaking patterns on the construction of personal and professional selves.

The creative processes of understanding patients’ experiences in phenomenological research are difficult to articulate. Drawing on life philosophy as represented by the Danish philosopher K.E. Løgstrup (1905–1981), this article aims to illustrate Løgstrup's thinking as a way to elaborate the creation of cognition and understanding of patients’ experiences. We suggest that Løgstrup's thoughts on sensation can add new dimensions to an increased understanding of the creative process of phenomenological research, and that his thinking can be seen as an epistemological ground for these processes. We argue with Løgstrup that sense-based impressions can facilitate an flash of insight, i.e., the spontaneous, intuitive flash of an idea. Løgstrup stresses that an “flash of insight” is an important source in the creation of cognition and understanding. Relating to three empirical phenomenological studies of patients’ experiences, we illustrate how the notions of impression and flash of insight can add new dimensions to increased understanding of the creative processes in phenomenological research that have previously not been discussed. We illustrate that sense-based impressions can facilitate creative flash of insights that open for understanding of patients’ experiences in the research process as well as in the communication of the findings. The nature of impression and flash of insight and their relevance in the creation of cognition and understanding contributes to the sparse descriptions in the methodological phenomenological research literature of the creative processes of this research. An elaboration of the creative processes in phenomenological research can help researchers to articulate these processes. Thus, Løgstrup's life philosophy has proven to be valuable in adding new dimensions to phenomenological empirical research as well as embracing lived experience.