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Challenge for theory and practice in elderly care: intertwining forces
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-2646-8715
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-1588-135X
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aim: Investigating into the possible disparity between theory and practice in caring by analysing nurses’ lived experience of the understanding of caring theory in practice in the context of municipal elderly care.

Background: Caring theories are the description and conceptualization of the care that is given in caring practise by nurses and other professional caregivers with the aim of verbalizing and communicating caring phenomena. Intermittently, a theory –practice gap is given expression- that theory does not go along with clinical practice in caring.

Method: Hermeneutical phenomenology was the research approach used to explore the lived experience of caring science theories in caring practice from the perspective of 12 nurses working in municipal care for elderly.

Findings: A detachment to caring theory was enunciated, but when describing their caring intentions, the nurses’ relationship to theory became apparent, and even confirmed their practice. As such, a seedbed exists for caring theory to be reflected on and cultivated in caring praxis. However, as the nurses describe, the caring theory must be sensitive enough for the nursing practitioners to accept. The gap revealed itself on an organisational level, as the nurses’ commission in municipal care did not correspond with their caring intention.

Conclusion: We believe it is important to seriously consider what we want to achieve as a caring profession. We have to reflect on our responsibility as culture carriers and knowledge developers. We must make the disparate forces of intention and organisation become one intertwining force.

Keyword [en]
Theory-practice, elderly care, phenomenological hermeneutics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-63683OAI: oai:DiVA.org:liu-63683DiVA: diva2:382156
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2016-08-31Bibliographically approved
In thesis
1. Expanding Caring: Theory and Practice intertwined in municipal elderly care
Open this publication in new window or tab >>Expanding Caring: Theory and Practice intertwined in municipal elderly care
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Swedish Agency for Higher Education evaluated in 2007 the nursing programs at Swedish Universities, and confirmed that several programs lacked definition of the main subject of the discipline;- namely caring- and/or nursing. The caring science disciplines showed indications of increasing signs of fragmentation, in that sub-disciplines were evolving. There is a unique foundation of theoretical knowledge that is specific for the caring professions grounded in caring theory and philosophy. For some reason the theoretical foundation and contexture of providing care seems to fade off with time in clinical practice, as well as an explicated theory-practice gap; that theory does not go along with clinical practice. An assumption in this thesis is that caring theory somehow seems to evaporate; as nurses become clinically active- caring theory does not seem to be much reflected upon.The overall aim was to investigate into the meaning of caring to nurses in municipal elderly care, and into their explicit and implicit understanding of caring theory in their daily practice.The theoretical perspective was caring science, while the epistemological frame was of a phenomenological hermeneutical life world approach. Data was gathered by interviews with nurses working in elderly care and analyzed to grasp the structure of the phenomenon of caring in theory and practice. The thesis comprises four studies of which three empirical was consolidated with a Jean Watson’s specific caring theory, ending up in a better understanding of the approach of caring in nursing and the role of theory in practice.

The findings of the studies show that the lived experience of caring as narrated by the participating nurses comprises both implicit and explicit theoretical foundation to existential caring theory. The explicit use of theory or certain theoretical affiliation was not obvious; rather what may be theoretical inputs was expressed as the importance of being present and the necessity of having a health perspective in caring. By illuminating caring and concepts from caring theory, the meaning of caring in their professional lived experience, the primary intention or choice of working as nurses became apparent again. There seems to be different perspectives related to caring theory, but as the empirical findings shows, there is a consensus behind what caring is, both in theory and in practice. As a result from the analysis the aim of caring itself may be more salient and focused if based on existential phenomenological caring concepts and theory, as this corresponds with the nurses understanding of holistic intentional caring with a health perspective.

A gap exists, but is more related to organizational restrictions such as role constraints and time pressure than to the meaning of caring in theory and practice.

Mediating care is a concept that embraces the implications of all the outcome concepts of the analysis and it has the possibility of being the expression of immanent and transcendent dimensions in caring. Mediating care represents the expression of our understanding of life, our values and norms. It is given expression through the insights into, and the ways we connect to one another, our ability as carers (nurses) to reach out to another in his or her being, as well the understanding of ones own being in caring. Theoretical and practical reflection and cultivation of clinical sensibility has the opportunity of inspiring for an expanded caring consciousness, manifested in the mediation of care.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 63 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1217
Keyword
Caring in theory and practice, municipal elderly care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-63685 (URN)978-91-7393-277-6 (ISBN)
Public defence
2011-01-14, Aulan K1, Kåkenhus, Campus Norrköping, Linköpings universitet, Linköping, 09:11 (Swedish)
Opponent
Supervisors
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2016-08-31Bibliographically approved

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Ranheim, AlbertineKärner, AnitaBerterö, Carina

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