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Öhlén J, Friberg F. Empirical Phenomenological Inquiry: Guidance in Choosing Between Different Methodologies. Glob Qual Nurs Res 2023; 10:23333936231173566. [PMID: 37215583 PMCID: PMC10196530 DOI: 10.1177/23333936231173566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/05/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Empirical phenomenological inquiry and analyses are of high relevance and applicability for nursing and health care. Phenomenology has clear roots in philosophy, which needs to be brought into an empirical phenomenological inquiry. However, all study of phenomena and experience does not qualify as phenomenological inquiry. The aim of this article is to provide guidance for how to relate different empirical phenomenological methodologies that are in play in the broader field of healthcare research, and thus support healthcare researchers in navigating between these methodologies. For pedagogical purposes, we present commonalities and differences as related to descriptive and interpretive phenomenological inquiries throughout the research process. The merits and criticisms of empirical phenomenological inquiry are commented on.
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Affiliation(s)
- Joakim Öhlén
- Institute of Health and Care Sciences and
Centre for Person-Centred Care (GPCC), and Sahlgrenska University Hospital, Palliative
Centre, University of Gothenburg, Gothenburg, Sweden
| | - Febe Friberg
- Faculty of Health Sciences, Stavanger,
University of Stavanger, Norway
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Helde Frankling M, Klasson C, Björkhem-Bergman L. Successful Strategies and Areas of Improvement-Lessons Learned from Design and Conduction of a Randomized Placebo-Controlled Trial in Palliative Care, 'Palliative-D'. Life (Basel) 2021; 11:life11111233. [PMID: 34833109 PMCID: PMC8619948 DOI: 10.3390/life11111233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/17/2022] Open
Abstract
Clinical trials in palliative care are challenging to design and conduct. Burden on patients should be minimized, while gatekeeping by professionals and next-of kin needs to be avoided. Clinical deterioration due to disease progression affects attrition unrelated to intervention, and different care settings complicate comparisons and reduce the generalizability of the results. The aim of this review is to provide advice for colleagues planning to perform clinical trials in palliative care based on our own experiences from performing the Palliative-D study and by a thorough literature review on this topic. The Palliative-D study was a double-blind trial with 244 randomized patients comparing the effect of vitamin D3 to placebo in patients with advanced or metastatic cancer in the palliative phase of their disease trajectory who were enrolled in specialized palliative home care teams. Endpoints were opioid and antibiotic use, fatigue, and QoL. Recruitment was successful, but attrition rates were higher than expected, and we did not reach targeted power. For the 150 patients who completed the study, the completeness of the data was exceptionally high. Rather than patient reported pain, we choose the difference in the mean change in opioid dose between groups after twelve weeks compared to baseline as the primary endpoint. In this paper we discuss challenges in palliative care research based on lessons learned from the "Palliative-D" trial regarding successful strategies as well as areas for improvement.
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Affiliation(s)
- Maria Helde Frankling
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo Floor 7, SE-141 83 Huddinge, Sweden; (C.K.); (L.B.-B.)
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, Solna, SE-171 64 Stockholm, Sweden
- Correspondence:
| | - Caritha Klasson
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo Floor 7, SE-141 83 Huddinge, Sweden; (C.K.); (L.B.-B.)
- Stockholms Sjukhem, Palliative Medicine, Mariebergsgatan 22, SE-112 19 Stockholm, Sweden
| | - Linda Björkhem-Bergman
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo Floor 7, SE-141 83 Huddinge, Sweden; (C.K.); (L.B.-B.)
- Stockholms Sjukhem, Palliative Medicine, Mariebergsgatan 22, SE-112 19 Stockholm, Sweden
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Madsen R, Uhrenfeldt L, Birkelund R. Transition experiences during courses of incurable cancer from the perspective of patients. Eur J Oncol Nurs 2019; 38:13-20. [DOI: 10.1016/j.ejon.2018.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
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Cowley A, Evans C, Bath-Hextall F, Cooper J. Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence. ACTA ACUST UNITED AC 2018; 14:134-166. [PMID: 27846123 DOI: 10.11124/jbisrir-2016-003168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Esophagogastric cancer is the fifth most common malignancy and its incidence is increasing. The disease progresses quickly and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence on the most effective service models to support esophagogastric cancer patients. OBJECTIVES The overall objective of this systematic review was to synthesize the best available evidence on the experiences and perceptions of patients and health professionals with regard to the care of people diagnosed with palliative esophagogastric cancer. INCLUSION CRITERIA TYPES OF PARTICIPANTS The review considered studies that included patients diagnosed with palliative esophagogastric cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting. PHENOMENA OF INTEREST The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people. CONTEXT Studies that were carried out in any setting, including in-patient and outpatient areas, specialist cancer and non-specialist palliative care services and those were any patient were in receipt or had experiences of palliative care services were considered. All types of health practitioners delivering palliative care to esophagogastric cancer patients were considered. TYPES OF STUDIES Studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and narrative approaches were considered. Mixed methods studies were considered in the review only if qualitative findings were reported separately. SEARCH STRATEGY A three-step search strategy was utilized. A total 11 databases were searched for studies from 2000 onward, followed by hand searching of reference lists. METHODOLOGICAL QUALITY Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical appraisal tool (JBI-QARI). DATA EXTRACTION Qualitative findings were extracted using the JBI-QARI data extraction Instrument. DATA SYNTHESIS Qualitative research findings were pooled using a pragmatic meta-aggregative approach. RESULTS The review included two publications. There were 46 findings which were aggregated into four categories and one overall synthesized finding: "In addition to support for physical needs, patients need support that takes into account changing life situations to achieve the best quality of life." CONCLUSIONS The review shows that patients value services and support that addresses their complex, fluctuating and highly individual needs. No evidence was uncovered regarding how these services should be designed and delivered.
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Affiliation(s)
- Alison Cowley
- 1Nottingham University Hospitals NHS Trust, Nottingham, UK 2School of Health Sciences, University of Nottingham 3The Nottingham Centre for Evidence-based Healthcare: a Joanna Briggs Institute Centre of Excellence, Nottingham, UK
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Recruiting participants to a randomized controlled trial testing an intervention in palliative cancer care – The perspectives of health care professionals. Eur J Oncol Nurs 2017; 31:6-11. [DOI: 10.1016/j.ejon.2017.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/01/2017] [Accepted: 09/22/2017] [Indexed: 11/23/2022]
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Olsson M, Lundberg T, Fürst CJ, Öhlén J, Forinder U. Psychosocial Well-Being of Young People Who Participated in a Support Group Following the Loss of a Parent to Cancer. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2017; 13:44-60. [PMID: 28140778 DOI: 10.1080/15524256.2016.1261755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite the evidence of unmet support needs among young people who have lost a parent to cancer, only a few support group initiatives have been reported. This observational prospective study explored the psychosocial well-being of young people who participated in support groups at a Swedish specialist palliative care setting. On three occasions, 29 participants, aged 16-28 years, answered questionnaires covering characteristics of the participants, circumstances of the losses, psychosocial well-being of the young people, and their own assessment of the support groups. The support groups attracted mostly young women who were often unprepared for the loss. The living arrangements differed between younger and older participants; however, the loss-related variables did not differ. Significant positive changes were found regarding a sense of meaning in their future life and life satisfaction. The helpfulness of the group was assessed as high/very high and the group brought a valuable fellowship with others in a similar situation. Universality and beneficial interactions were reported and strengthened psychosocial well-being developed over time. This change, according to the young people themselves, may be attributed to the group support. The findings are useful for planning interventions to support young people in bereavement in order to enhance their psychosocial well-being.
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Affiliation(s)
- Mariann Olsson
- a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden
- b Stockholms Sjukhem Foundation , Stockholm , Sweden
| | - Tina Lundberg
- a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden
- c Palliative Research Centre , Ersta Sköndal University College , Stockholm , Sweden
- d Department of Social Work , Karolinska University Hospital , Stockholm , Sweden
| | - Carl Johan Fürst
- e Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Joakim Öhlén
- f Institute of Health Care Sciences, University of Gothenburg Centre for Person-Centred Care , University of Gothenburg , Gothenburg
| | - Ulla Forinder
- a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden
- d Department of Social Work , Karolinska University Hospital , Stockholm , Sweden
- g Department of Social Work and Psychology , Gävle University , Gävle , Sweden
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Hughes ND, Locock L, Simkin S, Stewart A, Ferrey AE, Gunnell D, Kapur N, Hawton K. Making Sense of an Unknown Terrain: How Parents Understand Self-Harm in Young People. QUALITATIVE HEALTH RESEARCH 2017; 27:215-225. [PMID: 26369673 DOI: 10.1177/1049732315603032] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Self-harm is common in young people, and can have profound effects on parents and other family members. We conducted narrative interviews with 41 parents and other family members of 38 young people, aged up to 25, who had self-harmed. Most of the participants were parents but included one sibling and one spouse. This article reports experiences of the parent participants. A cross-case thematic analysis showed that most participants were bewildered by self-harm. The disruption to their worldview brought about by self-harm prompted many to undergo a process of "sense-making"-by ruminative introspection, looking for information, and building a new way of seeing-to understand and come to terms with self-harm. Most participants appeared to have been successful in making sense of self-harm, though not without considerable effort and emotional struggle. Our findings provide grounds for a deeper socio-cultural understanding of the impact of self-harm on parents.
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Pettersson ME, Öhlén J, Friberg F, Hydén LC, Carlsson E. Topics and structure in preoperative nursing consultations with patients undergoing colorectal cancer surgery. Scand J Caring Sci 2016; 31:674-686. [DOI: 10.1111/scs.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 05/30/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Monica E. Pettersson
- Institute of Health and Care Sciences and Centre for Person-Centred Care; Sahlgrenska Academy at the University of Gothenburg; Göteborg Sweden
- Vascular Department; Sahlgrenska University Hospital/Sahlgrenska; Göteborg Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and Centre for Person-Centred Care; Sahlgrenska Academy at the University of Gothenburg; Göteborg Sweden
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
| | - Febe Friberg
- Institute of Health and Care Sciences and Centre for Person-Centred Care; Sahlgrenska Academy at the University of Gothenburg; Göteborg Sweden
- Department of Health studies; Faculty of Social sciences; University of Stavanger; Stavanger Norway
| | - Lars-Christer Hydén
- Department of Health and Medical Sciences; Linköping University; Linköping Sweden
| | - Eva Carlsson
- Institute of Health and Care Sciences and Centre for Person-Centred Care; Sahlgrenska Academy at the University of Gothenburg; Göteborg Sweden
- The Colorectal Unit; Sahlgrenska University Hospital; Göteborg Sweden
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Patients' experiences of care and support at home after a family member's participation in an intervention during palliative care. Palliat Support Care 2016; 15:305-312. [PMID: 27748224 DOI: 10.1017/s1478951516000729] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Patients who receive palliative home care are in need of support from family members, who take on great responsibility related to caregiving but who often feel unprepared for this task. Increasing numbers of interventions aimed at supporting family members in palliative care have been described and evaluated. It is not known whether and how these interventions actually affect the care or support provided to a patient, even though it has been suggested that family members would be likely to provide better care and support and thus allow for positive experiences for patients. However, this has not been studied from the perspective of the patients themselves. The objective of our study was to explore patients' experiences of care and support at home after family members' participation in a psychoeducational intervention during palliative care. METHOD Our study took a qualitative approach, and interviews were conducted with 11 patients whose family members had participated in a psychoeducational intervention during palliative home care. The interviews were analyzed employing interpretive description. RESULTS Patients' experiences were represented by three themes: "safe at home," "facilitated and more honest communication," and "feeling like a unit of care." Patients felt that their needs were better met and that family members became more confident at home without risking their own health. Patients felt relieved when family members were given the opportunity to talk and reflect with others and hoped that the intervention would contribute to more honest communications between themselves and their family members. Further, it was of great importance to patients that family members receive attention from and be confirmed and supported by healthcare professionals. SIGNIFICANCE OF RESULTS Our findings show how an intervention targeted at family members during palliative home care also benefits the patients.
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Enabling sense-making for patients receiving outpatient palliative treatment: A participatory action research driven model for person-centered communication. Palliat Support Care 2015; 14:212-24. [PMID: 26235481 DOI: 10.1017/s1478951515000814] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES In clinical palliative cancer care, the diversity of patient concerns over time makes information provision a critical issue, the demands of information-seeking patients presenting a challenge to both the communicative and organizational skills of the health provider. This study puts forward a practice model for communication between patients, their family members, and professional health providers during ongoing palliative chemotherapy; a model which supports the providers in enabling person-centered communication. METHOD A constant comparative analysis adapted to participatory action research was applied. The model was developed step-wise in three interrelated cycles, with results from previous studies from palliative cancer care processed in relation to professional health providers' experience-based clinical knowledge. In doing this, focus group discussions were carried out with providers and patients to develop and revise the model. RESULTS The Enabling Sense Making model for person-centered communication gave rise to three domains (which are also the major communicative actors in palliative care): the patient, the family, and the provider. These actors were placed in the context of a communicative arena. The three respective domains were built up in different layers discriminating between significant aspects of person-centered communication, from the manifest that is most usually explicated in dialogues, to the latent that tends to be implicitly mediated. SIGNIFICANCE OF RESULTS The model intends to facilitate timely reorientation of care from curative treatment or rehabilitation to palliation, as well as the introduction of appropriate palliative interventions over time during palliative phases. In this way the model is to be regarded a frame for directing the awareness of the professionals, which focuses on how to communicate and how to consider the patient's way of reasoning. The model could be used as a complement to other strategic initiatives for the advancement of palliative care communication. It needs to be further evaluated in regard to practice evidence.
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Melin-Johansson C, Öhlén J, Koinberg I, Berg L, Nolbris MJ. The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden. Glob Qual Nurs Res 2015; 2:2333393615595965. [PMID: 28462312 PMCID: PMC5342296 DOI: 10.1177/2333393615595965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/03/2015] [Accepted: 06/23/2015] [Indexed: 11/18/2022] Open
Abstract
The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs.
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Affiliation(s)
| | - Joakim Öhlén
- University of Gothenburg, Göteborg, Sweden
- Ersta Sköndal University College, Stockholm, Sweden
| | - Ingalill Koinberg
- University of Gothenburg, Göteborg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Berg
- University of Gothenburg, Göteborg, Sweden
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Karlsson M, Friberg F, Wallengren C, Öhlén J. Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: a life-world phenomenological study. BMC Palliat Care 2014; 13:28. [PMID: 24936149 PMCID: PMC4059734 DOI: 10.1186/1472-684x-13-28] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 05/15/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Many people around the world are getting cancer and living longer with the disease. Thanks to improved treatment options in healthcare, patients diagnosed with advanced gastrointestinal cancer can increasingly live for longer. Living with cancer creates existential uncertainty, but what does this situation mean for the individual? The purpose of the study is to interpret meanings of existential uncertainty and certainty for people diagnosed with advanced gastrointestinal cancer and receiving palliative treatment. METHODS This study is part of a larger project in which 7 men and 7 women aged between 49 and 79 participated in a study of information and communication for people with advanced gastrointestinal cancer. A total of 66 interviews were conducted with participants who were followed up over time. The narrative interviews were transcribed verbatim and the texts were analysed in three steps: naive reading, structural analysis and interpreted whole by utilizing a phenomenological life-world approach. RESULTS THIS STUDY HAS IDENTIFIED DIFFERENT SPHERES IN WHICH PEOPLE DIAGNOSED WITH ADVANCED GASTROINTESTINAL CANCER VACILLATE BETWEEN EXISTENTIAL UNCERTAINTY AND CERTAINTY: bodily changes, everyday situations, companionship with others, healthcare situations and the natural environment. Existing in the move between existential uncertainty and certainty appears to change people's lives in a decisive manner. The interview transcripts reveal aspects that both create existential certainty and counteract uncertainty. They also reveal that participants appear to start reflecting on how the new and uncertain aspects of their lives will manifest themselves -a new experience that lays the foundation for development of knowledge, personal learning and growth. CONCLUSIONS People diagnosed with advanced gastrointestinal cancer and receiving palliative care expressed thoughts about personal learning initiated by the struggle of living with an uncertain future despite their efforts to live in the present. Their personal learning was experienced through a changed life for themselves and having to confront their own pending death and develop self-insight regarding finality of life. Healthcare professionals can try to support people receiving palliative treatment for cancer by diversifying avenues for their personal growth, thus helping them manage their existential uncertainty and gravitate towards greater existential certainty.
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Affiliation(s)
- Magdalena Karlsson
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden, Box 457, Gothenburg SE- 405 30, Sweden
- Sahlgrenska University Hospital, Per Dubbsgatan, Gothenburg SE- 413 45, Sweden
| | - Febe Friberg
- University of Gothenburg Centre for Person-Centred Care, Box 457, Gothenburg SE- 405 30, Sweden
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger 4036, Norway
| | - Catarina Wallengren
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden, Box 457, Gothenburg SE- 405 30, Sweden
- University of Gothenburg Centre for Person-Centred Care, Box 457, Gothenburg SE- 405 30, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden, Box 457, Gothenburg SE- 405 30, Sweden
- University of Gothenburg Centre for Person-Centred Care, Box 457, Gothenburg SE- 405 30, Sweden
- Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden
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Communicating bodily changes: physicians' ways of enabling patient understanding in gastrointestinal cancer consultations. Palliat Support Care 2014; 13:661-71. [PMID: 24784141 DOI: 10.1017/s1478951514000352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations. METHOD Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001). RESULTS Two overarching communicative strategies were identified: (1) "visualizing strategies," with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) "contrasting strategies," with the dimensions: contrasting subjective experiences and contrasting between the patient and other people. SIGNIFICANCE OF RESULTS The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner.
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Borimnejad L, Mardani Hamooleh M, Seyedfatemi N, Tahmasebi M. Human relationships in palliative care of cancer patient: lived experiences of Iranian nurses. Mater Sociomed 2014; 26:35-8. [PMID: 24757399 PMCID: PMC3990400 DOI: 10.5455/msm.2014.26.35-38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 02/15/2014] [Indexed: 11/19/2022] Open
Abstract
Background: cancer patients require palliative care. Aim: the purpose of this study was to explore the experiences of nurses, who provide palliative care for cancer patients, within the context of Iranian culture. Methods: we conducted a hermeneutic phenomenological study. Semi structured in-depth interviews with 10 nurses were audio taped and transcribed. The transcriptions were then analyzed by Van Manen’s method. Results: one of the most important themes that emerged was “human relationships”, which also contained the subthemes of “comprehensive acceptance” and “psychological support”. Conclusions: the results provide deep understanding of human relationships in palliative care of cancer patients in Iran.
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Affiliation(s)
- Leili Borimnejad
- Department of Nursing, Center for Nursing Care Research, Iran University of Medical Sciencs, Tehran, Iran
| | - Marjan Mardani Hamooleh
- Department of Nursing, Nursing Education Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Naimeh Seyedfatemi
- Department of Nursing, Center for Nursing Care Research, Iran University of Medical Sciencs, Tehran, Iran
| | - Mamak Tahmasebi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Affiliation(s)
- Joakim Öhlén
- Palliative Research Centre, Ersta Sköndal University College, Sweden; Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care, Sweden
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