A phenomenological hermeneutical method for researching lived experienceThis study describes a phenomenological hermeneutical method for interpreting interview texts inspired by the theory of interpretation presented by Paul Ricoeur. Narrative interviews are transcribed. A naïve understanding of the text is formulated from an initial reading. The text is then divided into meaning units that are condensed and abstracted to form sub-themes, themes and possibly main themes, which are compared with the naïve understanding for validation. Lastly the text is again read as a whole, the naïve understanding and the themes are reflected on in relation to the literature about the meaning of lived experience and a comprehensive understanding is formulated. The comprehensive understanding discloses new possibilities for being in the world. This world can be described as the prefigured life world of the interviewees as configured in the interview and refigured first in the researcher's interpretation and second in the interpretation of the readers of the research report. This may help the readers refigure their own life.Keywords: phenomenological hermeneutics, interview, lived experience, method, text. Submitted 14 July 2003, Accepted 8 January 2004 Researching lived ethicsFrom time to time nurses and physicians experience ethically difficult situations in the care work. They are able to talk about them, but they are not usually able to explain their ethical thinking. This is connected with the fact that human beings live and act out of their morals, i.e. internalized norms, values and attitudes, without necessarily knowing about them. For this reason you cannot just ask people what morals they have. Often they will not be able to answer. So if you want to investigate the morals of physicians and nurses, the object of investigation is not just openly there, ready to be observed. To gain access to this 'object', you may ask the nurses and physicians to tell stories about situations involving regrettable conduct, something they have done themselves, actions they have participated in or witnessed. This question will lead to exciting stories (1, 2). The situation related often happened years previously, but the interviewee may have talked very little about it. Sometimes, the telling is accompanied by tears. Thus it is possible to collect an interesting material that reveals the morals and the ethical thinking of physicians and nurses, but of course, these morals are not explicitly spelled out. So the challenge for the researcher is to analyse the material and make the morals and the ethical thinking visible. Searching for a suitable methodIn 1989 we decided to investigate how nurses and physicians reason in ethically difficult care situations. We wanted to do research within the field of ethics. Ethics in this context means moral theory, i.e. a perspective on morals, or a moral teaching. Morals then signify the internalized norms, values, principles and attitudes we live by in relation to other people, but do not necessarily refl...

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.

The spontaneous variation of catheter life, i.e. the time in days between catheter changes, was observed in 20 long-stay geriatric inpatients with initially short catheter lives. The study ran for 6 months. The catheter regimen was standardized throughout the study. The intra-individual and inter-individual catheter lives showed considerable variation. Each patient retained his individual pattern of catheter life. It is concluded that, despite the variation of isolated catheter lives, the median value of repeated observations of catheter life provides a reliable parameter of catheter function.

Different concepts have been presented which denote driving forces and strengths that contribute to a person's ability to meet and handle adversities, and keep or regain health. The aim of this study, which is a part of The Umeå 85+ study, was to describe resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health in a sample of the oldest old. The study sample consisted of 125 participants 85 years of age or older, who ranked themselves on the Resilience Scale, Sense of Coherence Scale, Purpose in Life Scale and Self-Transcendence Scale and answered the SF-36 Health Survey questionnaire. The findings showed significant correlations between scores on the Resilience Scale, the Sense of Coherence Scale, the Purpose in Life Test, and the Self-Transcendence Scale. Significant correlations were also found between these scales and the SF-36 Mental Health Summary among women but not among men. There was no significant correlation between perceived physical and mental health. The mean values of the different scales showed that the oldest old have the same or higher scores than younger age groups. Regression analyses also revealed sex differences regarding mental health. The conclusions are that, the correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults. Another conclusion is that the dimensions that constitute mental health differ between women and men.