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Olsman E, Versteeg A. Happiness in Hospice Care in The Netherlands: A Case Study Design. JOURNAL OF RELIGION AND HEALTH 2024; 63:1538-1553. [PMID: 38421565 DOI: 10.1007/s10943-024-02011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
Happiness is central in spirituality but has hardly been explored in palliative care. The objective of this study is to explore happiness in hospice care in the Netherlands. A case study design consisting of participatory observations and semi-structured interviews was used. Happiness was associated with all dimensions of health. Patients spoke about a growing receptivity and a deepening of connections with themselves and others. Hospice staff related their happiness to feeling a true connection and their work supported them in appreciating their own lives in new ways. This study suggests that happiness can be found in settings that are frequently associated with suffering.
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Affiliation(s)
- Erik Olsman
- Section of Chaplaincy Studies, Department of Community & Care, Protestant Theological University, Janskerkhof 12, 3512 BL, Utrecht, The Netherlands.
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Crowe M, Manuel J, Carlyle D, Lacey C. Experiences of psilocybin treatment for clinical conditions: A qualitative meta-synthesis. Int J Ment Health Nurs 2023. [PMID: 36779424 DOI: 10.1111/inm.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/14/2023]
Abstract
There is increasing clinical interest in the use of psilocybin. There is emerging evidence of the efficacy of psilocybin for the treatment of a range of clinical conditions. Mental health nurses have a unique set of skills for caring for people who are hallucinating. To expand these skills to meet the developing clinical interest in the therapeutic use of psilocybin, it is helpful to understand the experience from the perspective of the person being treated with psilocybin. A qualitative meta-synthesis was conducted to examine how those with psilocybin described their experiences to identify whether its effects are similar across different health conditions. Ten studies were included in the review. The health conditions studied were cancer, depression, HIV, substance use disorder, smoking cessation and trauma. The synthesis of findings identified three themes that were common across the studies despite the health condition: acceptance, connection and transformation. The review provides helpful insights into how people experience psilocybin and its effects on their health condition.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jenni Manuel
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Dave Carlyle
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Gerlach C, Ullrich A, Berges N, Bausewein C, Oechsle K, Hodiamont F. The Impact of the SARS-CoV-2 Pandemic on the Needs of Non-Infected Patients and Their Families in Palliative Care—Interviews with Those Concerned. J Clin Med 2022; 11:jcm11133863. [PMID: 35807148 PMCID: PMC9267922 DOI: 10.3390/jcm11133863] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 02/05/2023] Open
Abstract
During humanitarian crises, such as a pandemic, healthcare systems worldwide face unknown challenges. This study aimed to explore and describe the effect of the SARS-CoV-2 pandemic on the needs of non-infected patients and family caregivers in specialist palliative care, using qualitative, semi-structured interviews. Data were analyzed using inductive content analysis, following the framework approach. Thirty-one interviews were conducted with patients/family caregivers (15/16) in palliative care units/specialist palliative home care (21/10) from June 2020 to January 2021. Well-known needs of patients and family caregivers at the end of life remained during the pandemic. Pandemic- dependent themes were (1) implications of the risk of contagion, (2) impact of the restriction of social interactions, (3) effects on the delivery of healthcare, and (4) changes in the relative’s role as family caregiver. Restriction on visits limited family caregivers’ ability to be present in palliative care units. In specialist palliative home care, family caregivers were concerned about the balance between preserving social contacts at the end of life and preventing infection. Specialist palliative care during a pandemic needs to meet both the well-known needs at the end of life and additional needs in the pandemic context. In particular, attention should be given to the needs and burden of family caregivers, which became more multifaceted with regards to the pandemic.
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Affiliation(s)
- Christina Gerlach
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
- Department of Palliative Care, Heidelberg University Hospital, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-(0)-6221-56-310-683
| | - Anneke Ullrich
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
| | - Natalie Berges
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
| | - Claudia Bausewein
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
| | - Karin Oechsle
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (A.U.); (K.O.)
| | - Farina Hodiamont
- Department of Palliative Medicine, LMU University Hospital, 81377 Munich, Germany; (N.B.); (C.B.); (F.H.)
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Carmont H, McIlfatrick S. Using virtual reality in palliative care: a systematic integrative review. Int J Palliat Nurs 2022; 28:132-144. [PMID: 35452268 DOI: 10.12968/ijpn.2022.28.3.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Recently, healthcare services have witnessed an exponential increase in the use of immersive and non-immersive virtual reality (VR) technology to improve health-related outcomes. However, the use of VR in palliative care remains relatively unexplored. AIMS To review and synthesise evidence regarding the experiences of patients, families and healthcare professionals in palliative care who have engaged with immersive/non-immersive VR technology. METHODS A systematic integrative review using pre-defined MeSH search terms to identify eligible studies from five electronic databases (Cochrane Library, CINAHL, OVID Medline, Pubmed and Scopus) between April 2020 and February 2021. FINDINGS In total, 1066 articles were reviewed, 55 articles were considered eligible and subject to further analysis and a total of 16 articles met the inclusion criteria and were subject to critical appraisal. Rigorous analysis of eligible articles resulted in the identification of five overarching and interconnected themes: connection, VR as an emergent technology, perceptual change, safety, and future research. CONCLUSION This review identified that VR could support patients, families and healthcare professionals in palliative care. As a result of the COVID-19 pandemic, the findings could prove particularly significant for facilitating connection. However, further research is necessary to explore the full scope of VR use in this speciality.
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Affiliation(s)
| | - Sonja McIlfatrick
- Head of School of Nursing and Professor of Nursing and Palliative Care, Ulster University, UK
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Caregiver bereavement outcomes in advanced cancer: associations with quality of death and patient age. Support Care Cancer 2021; 30:1343-1353. [PMID: 34499215 PMCID: PMC8426162 DOI: 10.1007/s00520-021-06536-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022]
Abstract
Purpose We investigated relationships between domains of quality of dying and death in patients with advanced cancer and their caregivers’ bereavement outcomes and the moderating effect of patient age at death. Methods Bereaved caregivers of deceased patients with advanced cancer who had participated in an early palliative care trial completed measures of grief (Texas Revised Inventory of Grief [TRIG]), complicated grief (Prolonged Grief Inventory [PG-13]), and depression (Center for Epidemiologic Studies-Depression [CESD-10]). They also completed the Quality of Dying and Death measure (QODD), which assesses patients’ symptom control, preparation for death, connectedness with loved ones, and sense of peace with death. Results A total of 157 bereaved caregivers completed the study. When patient age × QODD subscale interactions were included, greater death preparation was related to less grief at patient death (past TRIG: β = − .25, p = .04), less current grief (present TRIG: β = − .26, p = .03), less complicated grief (PG-13: β = − .37, p = .001), and less depression (CESD-10: β = − .35, p = .005). Greater symptom control was related to less current grief (present TRIG: β = − .27, p = .02), less complicated grief (PG-13: β = − .24, p = .03), and less depression (CESD-10: β = − .29, p = .01). Significant patient age × connectedness interaction effects for current grief (present TRIG: β = .30, p = .02) and complicated grief (PG-13: β = .29, p = .007) indicated that, with less connectedness, younger patient age at death was associated with greater caregiver grief. Conclusion Better end-of-life death preparation and symptom control for patients with cancer may attenuate later caregiver grief and depression. Less connectedness between younger patients and their families may adversely affect caregiver grief.
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Kim GL, Berall A, Gardner S, Brookes J, Natadiria M, Perri GA. The COVID-19 pandemic and palliative care units: A cross-sectional survey of the informational needs of caregivers. Palliat Med 2021; 35:627-631. [PMID: 33482701 DOI: 10.1177/0269216321989562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ginah Lee Kim
- Baycrest Health Sciences Centre, Toronto, ON, Canada.,Division of Palliative Care, Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Anna Berall
- Baycrest Health Sciences Centre, Toronto, ON, Canada
| | - Sandra Gardner
- Baycrest Health Sciences Centre, Toronto, ON, Canada.,Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | | | - Giulia-Anna Perri
- Baycrest Health Sciences Centre, Toronto, ON, Canada.,Division of Palliative Care, Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, ON, Canada
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Neufeld E, Freeman S, Spirgiene L, Horwath U. A Cross-Sectoral Comparison of Prevalence and Predictors of Symptoms of Depression Over Time Among Older Adults in Ontario, Canada. J Geriatr Psychiatry Neurol 2021; 34:11-20. [PMID: 32133916 DOI: 10.1177/0891988720901790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Late-life depression, a common mental health issue, poses a significant burden of illness globally. We investigated factors associated with symptoms of depression among older adults across 3 health sectors in Ontario, Canada. METHOD Electronic health assessment data on older adults aged 60 years+ in home care (HC; N = 359 217), long-term care (LTC; N = 125 496), and palliative care (PC; N = 29 934) were examined. Change in symptoms of depression, measured using the interRAI Depression Rating Scale (DRS), over time was examined, including predictors of the development of depression. RESULTS At baseline, symptoms of depression were observed in 19.1% (HC), 24.2% (LTC), and 11.9% (PC). This increased to 20.6% (HC), 33.8% (LTC), and 13.2% (PC) at follow-up. For most older adults, DRS scores remained the same across sectors over time. Three independent variables emerged consistently across sectors as the main risk and protective factors for symptoms of depression. CONCLUSION Although variations in the risk and protective factors for late-life depression were demonstrated across each sector, some commonalities emerged including unmanaged pain, symptoms of depression at baseline, social connectedness, and activity.
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Affiliation(s)
| | - Shannon Freeman
- School of Nursing, 6727University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lina Spirgiene
- Department of Nursing and Care, Medical Academy, 230647Lithuanian University of Health Sciences, Kaunas, Lithuania
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Vasileiou K, Smith P, Kagee A. "The way I am treated is as if I am under my mother's care": qualitative study of patients' experiences of receiving hospice care services in South Africa. BMC Palliat Care 2020; 19:95. [PMID: 32611344 PMCID: PMC7330936 DOI: 10.1186/s12904-020-00605-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 06/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Research on the patient experience of receiving palliative care across a number of settings is increasing, but the majority of these investigations are situated within the context of developed countries. There is limited research from resource-limited countries, especially with regard to patients with cancer who receive hospice care. The present study explored the lived experience of attending hospice care facilities in South Africa to develop a bottom-up understanding from the perspectives of patients themselves. Methods A qualitative cross-sectional study was designed to examine how patients experienced receiving hospice care We conducted in-depth, semi-structured interviews with thirteen, purposively selected patients living with terminal cancer and receiving in-patient or day care palliative services from a hospice organisation in South Africa. We used inductive thematic analysis to analyse the data. Results We identified three themes that reflected a process of transformation that was experienced by participants during their engagement with the hospice services. The first theme describes participants’ initial reluctance to be linked to the hospice as a result of the stereotypic perceptions of hospice as being associated with death and dying. The second theme presents the perceived positive impact on patients’ physical and psychosocial wellbeing which resulted from the highly valued interactions with staff and other patients as well as patients’ engagement with creative activities. The final theme delineates the transformation of hospice into a second ‘family’ and ‘home’ and the restoration of an identity that expands beyond the ‘sick’ role. Conclusions Receiving hospice care that sensitively attends to patients’ psychosocial and physical needs helps people to re-create a sense of homeliness within the world, re-orient themselves toward a meaningful life and re-configure their relationship with self. Patient experience of receiving hospice care in South Africa does not appear dissimilar to that reported by patients in resource-rich countries, suggesting underlying commonalities. There is a need for raising awareness and educating the public about what palliative care can offer to those in need. Public health campaigns could help reduce the stigma attached to palliative care, deflect negative perceptions, and communicate the benefits for patients, families and communities in culturally sensitive ways.
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Affiliation(s)
- Konstantina Vasileiou
- Department of Psychology, University of Bath, 10 West Building, Bath, BA2 7AY, UK.,Department of Social Work, University of West Attica, 12241, Athens, Greece
| | - Paula Smith
- Department of Psychology, University of Bath, 10 West Building, Bath, BA2 7AY, UK.
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
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Guerrero-Torrelles M, Monforte-Royo C, Rodríguez-Prat A, Porta-Sales J, Balaguer A. Understanding meaning in life interventions in patients with advanced disease: A systematic review and realist synthesis. Palliat Med 2017; 31:798-813. [PMID: 28498025 DOI: 10.1177/0269216316685235] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Among patients with advanced disease, meaning in life is thought to enhance well-being, promote coping and improve the tolerance of physical symptoms. It may also act as a buffer against depression and hopelessness. As yet, there has been no synthesis of meaning in life interventions in which contextual factors, procedures and outcomes are described and evaluated. AIMS To identify meaning in life interventions implemented in patients with advanced disease and to describe their context, mechanisms and outcomes. DESIGN Systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and realist synthesis of meaning in life interventions using criteria from the Realist And Meta-narrative Evidence Syntheses: Evolving Standards project. DATA SOURCES The CINAHL, PsycINFO, PubMed and Web of Science databases were searched. RESULTS A total of 12 articles were included in the systematic review, corresponding to nine different interventions. Five articles described randomized controlled trials, two were qualitative studies, two were commentaries or reflections, and there was one pre-post evaluation, one exploratory study and one description of a model of care. Analysis of context, mechanisms and outcomes configurations showed that a core component of all the interventions was the interpersonal encounter between patient and therapist, in which sources of meaning were explored and a sense of connectedness was re-established. Meaning in life interventions were associated with clinical benefits on measures of purpose-in-life, quality of life, spiritual well-being, self-efficacy, optimism, distress, hopelessness, anxiety, depression and wish to hasten death. CONCLUSION This review provides an explanatory model of the contextual factors and mechanisms that may be involved in promoting meaning in life. These approaches could provide useful tools for relieving existential suffering at the end of life.
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Affiliation(s)
- Mariona Guerrero-Torrelles
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Josep Porta-Sales
- 3 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,4 Palliative Care Service, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Albert Balaguer
- 3 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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Tornøe KA, Danbolt LJ, Kvigne K, Sørlie V. The challenge of consolation: nurses' experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study. BMC Nurs 2015; 14:62. [PMID: 26609281 PMCID: PMC4658768 DOI: 10.1186/s12912-015-0114-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A majority of people in Western Europe and the USA die in hospitals. Spiritual and existential care is seen to be an integral component of holistic, compassionate and comprehensive palliative care. Yet, several studies show that many nurses are anxious and uncertain about engaging in spiritual and existential care for the dying. The aim of this study is to describe nurses' experiences with spiritual and existential care for dying patients in a general hospital. METHODS Individual narrative interviews were conducted with nurses in a medical and oncological ward. Data were analyzed using a phenomenological hermeneutical method. RESULTS The nurses felt that it was challenging to uncover dying patients' spiritual and existential suffering, because it usually emerged as elusive entanglements of physical, emotional, relational, spiritual and existential pain. The nurses' spiritual and existential care interventions were aimed at facilitating a peaceful and harmonious death. The nurses strove to help patients accept dying, settle practical affairs and achieve reconciliation with their past, their loved ones and with God. The nurses experienced that they had been able to convey consolation when they had managed to help patients to find peace and reconciliation in the final stages of dying. This was experienced as rewarding and fulfilling. The nurses experienced that it was emotionally challenging to be unable to relieve dying patients' spiritual and existential anguish, because it activated feelings of professional helplessness and shortcomings. CONCLUSIONS Although spiritual and existential suffering at the end of life cannot be totally alleviated, nurses may ease some of the existential and spiritual loneliness of dying by standing with their patients in their suffering. Further research (qualitative as well as quantitative) is needed to uncover how nurses provide spiritual and existential care for dying patients in everyday practice. Such research is an important and valuable knowledge supplement to theoretical studies in this field.
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Affiliation(s)
- Kirsten Anne Tornøe
- Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway ; MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway
| | - Lars Johan Danbolt
- MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway
| | - Kari Kvigne
- Department of nursing, Faculty of Public Health, Hedmark University College, P.O. Box 400 2418, Elverum, Norway ; Department of nursing Nesna University College, Nesna, 8700 Norway
| | - Venke Sørlie
- Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway
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Thoresen L, Öhlén J. Lived Observations: Linking the Researcher's Personal Experiences to Knowledge Development. QUALITATIVE HEALTH RESEARCH 2015; 25:1589-1598. [PMID: 25711845 DOI: 10.1177/1049732315573011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
As researchers in palliative care, we recognize how involvement with seriously ill and dying persons has an impact on us. Using one's own senses, emotional and bodily responses in observations might open intersubjective dimensions of the research topic. The aim of the article is to highlight how phenomenological theories on intersubjectivity can be useful to develop rich and transparent data generation and analysis. We present three field note examples from observation in a hospice ward, which illuminate how researcher awareness of aspects of intersubjectivity can add valuable insights to data and analysis. Out of the examples, we elaborate on three arguments: (a) how the researcher's lived experience of time and space during fieldwork triggers new research questions, (b) how observations as an embodied activity can bring new insights and open new layers of meaning, and (c) the value of observations in gaining insight into relational aspects in a hospice.
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Affiliation(s)
| | - Joakim Öhlén
- Ersta Sköndal Högskola and Ersta Hospital, Stockholm, Sweden University of Gothenburg, Gothenburg, Sweden
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