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  • 1.
    Arman, Maria
    et al.
    Karolinska Institute, Sweden.
    Ranheim, Albertine
    Malardalens University, Sweden.
    Rydenlund, Kenneth
    Forens Psychiat Regional Clin, Sweden.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Rehnsfeldt, Arne
    Stord Haugesund University of Coll, Norway.
    The Nordic Tradition of Caring Science: The Works of Three Theorists2015In: Nursing Science Quarterly, ISSN 0894-3184, E-ISSN 1552-7409, Vol. 28, no 4, p. 288-296Article in journal (Refereed)
    Abstract [en]

    The Nordic tradition of caring science has had a significant influence on healthcare research, healthcare education and clinical development in the Nordic countries from 1990 to the present. Theoretical contributions from the professors and scientists Katie Eriksson, Kari Martinsen and Karin Dahlberg form the basis for this paper. The tradition has established a paradigm of ethics, ontology and epistemology for the caring science domain. Short introductions present the scientific background of Eriksson, Martinsen, and Dahlberg, and show how interpretive teamwork has led to the formation of an intertwining of the essential qualities of the theories. The synthesis emphasizes caring science as a human science, and views caring as a natural phenomenon where the patients world, vulnerability, health, and suffering are primary. In the art and act of caring, relationships and dialogue are essential; they provide parameters where caring becomes visible in its absence.

  • 2.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed)
    Abstract [en]

    This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

  • 3.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Council, Jönköping, Sweden.
    Wärdig, Rikard
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences.
    The borderline between life and death: Mental healthcare professionals' experience of why patients commit suicide during ongoing care2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 9-10, p. 1623-1632Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore mental health professionals' experiences in regard to circumstances that cause the patient to take their own life during ongoing care.

    BACKGROUND: Suicide is a worldwide health problem, and of those who take their own life, nearly 20% have had contact with a psychiatric unit. Mental health professionals may have extended intuitive knowledge that has not been made visible. Mental health professionals' experiences can contribute knowledge that can complement suicide risk assessments and can be helpful in developing approaches and strategies where the hope is to identify and draw attention to people at risk of taking their own life.

    DESIGN: A reflective lifeworld research.

    METHODS: Twelve interviews with mental health professionals with experience of working in caring relationships with patients that had taken their life during the period of care. The study was performed in accordance with COREQ (see Supporting Information Data S1).

    RESULTS: Mental health professionals' experiences regarding circumstances that cause the patient to take their own life are related to the patient's life circumstances that led to a loss of dignity, and finally beyond retrieval. Mental health professionals share patients' struggle to choose between life and death, the darkness of their life and their hopeless situation. This shared experience also makes the mental health professionals wish to relieve patient's suffering but also gives them an understanding of why patients take their own life.

    CONCLUSIONS: The mental health professionals experience how the patient loses the possibility of living a worthwhile life, recognise darkness within the patient and see how the patient's life is fragile. Suicide described as logical and expected, based on their life and life circumstances, has not been found in previous research. Bearing this in mind, should psychiatric care focus on a proactive approach and act when these circumstances are identified?

    RELEVANCE TO CLINICAL PRACTICE: The Mental health professionals' tacit knowledge may be used to strengthen uncertain suicide assessments.

    The full text will be freely available from 2019-12-27 08:59
  • 4.
    Rytterström, Partrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Arman, Maria
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Aspects of municipal culture in care for the elderly: a hermeneutic documentary analysis of reports of abuseManuscript (preprint) (Other academic)
    Abstract [en]

    Introduction: Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations which go beyond the everyday routine, such as cases of mistreatment. In Sweden, health care professionals are obliged  to document and report any suspected bad conditions.

    Aim: To understand aspects of the municipality’s care culture for the elderly, in the light of reports of suspected mistreatment.

    Design and methods: A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four-stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective, which is the theoretical basis for this study.

    Findings: It was found that care of the elderly in the municipality was based on a social culture which placed residents' needs at the centre. Following routines were considered important in preventing mistreatment, and were intended to ensure that all patients were treated fairly and equally. Care was described as task-oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was shown that in the municipality’s care of the elderly there was a focus on elderly people’s freedom at the expense of the vulnerability aspects of well being.

    Conclusion: Raising awareness of the values underlying care could help to understand care practice. Change is only possible when we reflect on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring. This will provide the basis moving towards a caring culture based on the meaning and values that promote humanistic care.

  • 5.
    Rytterström, Partrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Arman, Maria
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Care culture as a meaning-making process: a study of a mistreatment investigation2013In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 9, p. 1179-1187Article in journal (Refereed)
    Abstract [en]

    Culture might offer significant insights into the circumstances under which mistreatment occurs. Our aim with this study was to understand and explore institutional mistreatment from a care culture perspective. We used a case study with a triangulating methodology. It involved 12 individual interviews, one focus group interview with four people, a 2-day field study, and a document study. The case was a mistreatment situation that had occurred in municipal care, in which residents had been locked in their rooms at night. Two different care cultures were identified that could give a richer contextual understanding of the motives behind the institutional mistreatment. The service culture was need-oriented and emphasized freedom in care provision. The motherhood culture was characterized by protection and safeguarding of the vulnerable residents. Both cultures showed traces of caring values, but when important caring values were absent, this created a seedbed for mistreatment.

  • 6.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Teachers’ Experiences of Hope Using Eye Gaze-Controlled Computers2017In: Harnessing the Power of Technology to Improve Lives / [ed] Peter Cudd, Luc de Witte, IOS Press, 2017, Vol. 242, p. 1089-1094Conference paper (Refereed)
    Abstract [en]

    Technology to control a computer with eye gaze is a fast growing field and has promising implications for people with severe disabilities. 11 school staff was interviewed about teaching using an eye gaze computer for pupils with severe disabilities. The eye gaze computer creates opportunities for the teachers to get a glimpse of emotions and knowledge that is “inside” the pupil's trapped body and creates hope concerning the pupil's future possibilities. The implementation of the eye gaze computer create new imaginations for the future for the pupil and when the teachers are exposing themselves to the uncertainty, hope becomes a source of motivation and behavior.

  • 7.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Tradition och horisont: vårdkulturens betydelse för vårdens praxis2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The main aim of this thesis was to illuminate and understand aspects of care culture as a meaning–making process that influences the care praxis. In health care there is increasing recognition of the impacts on organizational culture of health-related matters. Although the factors studied affect care and nursing care, there has been little research from a caring science perspective. Care culture is understood from a hermeneutic perspective as a meaning-making process related to tradition, horizon and “bildung”. These three concepts give care a meaning cohesion that helps caregivers to orient themselves and acquire a care praxis.

    Study I was an interview study with seventeen nurses working on different wards. Study II was a focus group study, and included three focus groups with 24 nurses and a secondary qualitative analysis of interviews from study I. Both studies I and II used a phenomenological-hermeneutic approach. Study III was a hermeneutic documentary analysis conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. Study III was a hermeneutic documentary analysis conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. Study IV was a case study involving 12 individual interviews and one focus group interview that included four participants. All participants were working at various levels in the municipal organization and were directly or indirectly connected to a mistreatment situation. This research also included a two-day field study and a document study. The individual interviews and focus group interviews were analyzed using a phenomenological hermeneutic approach.

    The findings show that care culture can be experienced as positive and enabling of good care but also as defective and an obstacle to good care. Three different care cultures were identified: a service, a social and a motherhood culture. All cultures showed traces of caring values, but from a caring theory perspective, none of them fully demonstrated understanding of the notion of existential caring revealed as the integration of freedom and vulnerability. By studying the underlying traditions and the caregivers’ horizon, the care culture can be illuminated and understood through its expression in praxis. From gaining a comprehensive understanding, a caring ideal could open up and reflect the care culture´s boundaries. This means that ideals can have different interpretations depending on the conditions the care praxis is based on. The gap between care theory and praxis can therefore be understood to mean that the care culture does not use Bildung as a process of alienation and appropriation, resulting in no transformation of the prevailing tradition.

    Care culture could be distinguished from three different perspectives. They are referred to in this thesis as the prevailing, the visionary and the critical perspective. Developing a hermeneutic concept of culture, understood as the care culture´s critical perspective, could serve as an opportunity for a reinterpretation of nursing theory´s meta-paradigm concept of environment.

    List of papers
    1. Care and caring culture as experienced by nurses working in different care environments: A phenomenological-hermeneutic study
    Open this publication in new window or tab >>Care and caring culture as experienced by nurses working in different care environments: A phenomenological-hermeneutic study
    2009 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 5, p. 689-698Article in journal (Refereed) Published
    Abstract [en]

    Aim: The aim is to understand and develop the concept of care and caring Culture and to do so based on the empirical/phenomenological standpoint of nurses lived experiences of working in different environments.

    Background: Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the caring culture as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means.

    Method: A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working oil different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses I year later for validation of the findings.

    Findings: Thematic analyses revealed five themes: you have to adapt to the existing care Culture: seeing the invisible: being Yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as "homelike", nurses may act in a way that reflects their own values.

    Discussion: The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring Culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.

    Keywords
    Care culture, Caring culture, Phenomenological-hermeneutic method, Nursing, Adaptation, Ethos, Ward
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-18031 (URN)10.1016/j.ijnurstu.2008.12.005 (DOI)
    Available from: 2009-05-04 Created: 2009-05-04 Last updated: 2019-06-28Bibliographically approved
    2. The significance of routines in nursing practice
    Open this publication in new window or tab >>The significance of routines in nursing practice
    2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 23-24, p. 3513-3522Article in journal (Refereed) Published
    Abstract [ar]

    Aim. The aim of this study was to illuminate the significance of routines in nursing practice.

    Background. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action.

    Design. A qualitative design using a phenomenological-hermeneutic approach.

    Method. Data collection from three focus groups focused on nurses’ experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as ‘qualified nursing pool’ nurses.

    Result. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient’s integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it.

    Conclusions. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice.

    Relevance to clinical practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine.

    Place, publisher, year, edition, pages
    Wiley, 2011
    Keywords
    culture, lifeworld, nursing practice, phenomenological-hermeneutic method, routine, ward
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-67272 (URN)10.1111/j.1365-2702.2010.03522.x (DOI)000297864500027 ()
    Note
    Article first published online: 12 Oct. 2010Available from: 2011-04-07 Created: 2011-04-07 Last updated: 2019-06-28Bibliographically approved
    3. Aspects of municipal culture in care for the elderly: a hermeneutic documentary analysis of reports of abuse
    Open this publication in new window or tab >>Aspects of municipal culture in care for the elderly: a hermeneutic documentary analysis of reports of abuse
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Introduction: Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations which go beyond the everyday routine, such as cases of mistreatment. In Sweden, health care professionals are obliged  to document and report any suspected bad conditions.

    Aim: To understand aspects of the municipality’s care culture for the elderly, in the light of reports of suspected mistreatment.

    Design and methods: A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four-stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective, which is the theoretical basis for this study.

    Findings: It was found that care of the elderly in the municipality was based on a social culture which placed residents' needs at the centre. Following routines were considered important in preventing mistreatment, and were intended to ensure that all patients were treated fairly and equally. Care was described as task-oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was shown that in the municipality’s care of the elderly there was a focus on elderly people’s freedom at the expense of the vulnerability aspects of well being.

    Conclusion: Raising awareness of the values underlying care could help to understand care practice. Change is only possible when we reflect on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring. This will provide the basis moving towards a caring culture based on the meaning and values that promote humanistic care.

    Keywords
    Care culture, Caring, Document analysis, Elderly care, Hermeneutic, Municipal
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72229 (URN)
    Available from: 2011-11-23 Created: 2011-11-23 Last updated: 2019-06-28Bibliographically approved
    4. Care culture as a meaning-making process: a study of a mistreatment investigation
    Open this publication in new window or tab >>Care culture as a meaning-making process: a study of a mistreatment investigation
    2013 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 9, p. 1179-1187Article in journal (Refereed) Published
    Abstract [en]

    Culture might offer significant insights into the circumstances under which mistreatment occurs. Our aim with this study was to understand and explore institutional mistreatment from a care culture perspective. We used a case study with a triangulating methodology. It involved 12 individual interviews, one focus group interview with four people, a 2-day field study, and a document study. The case was a mistreatment situation that had occurred in municipal care, in which residents had been locked in their rooms at night. Two different care cultures were identified that could give a richer contextual understanding of the motives behind the institutional mistreatment. The service culture was need-oriented and emphasized freedom in care provision. The motherhood culture was characterized by protection and safeguarding of the vulnerable residents. Both cultures showed traces of caring values, but when important caring values were absent, this created a seedbed for mistreatment.

    Place, publisher, year, edition, pages
    Sage Publications, 2013
    Keywords
    case studies; health care; culture of; hermeneutics; lived experience; phenomenology
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72230 (URN)10.1177/1049732312470760 (DOI)000323312000003 ()
    Available from: 2011-11-23 Created: 2011-11-23 Last updated: 2019-06-28Bibliographically approved
  • 8.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Arman, Maria
    Karolinska Institute, Stockholm, Sweden.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Aspects of care culture in municipal care for elderly people: a hermeneutic documentary analysis of reports of abuse2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 354-362Article in journal (Refereed)
    Abstract [en]

    Introduction:  Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations that go beyond the everyday routine, such as cases of abuse. In Sweden, health care professionals are obliged to document and report any suspected bad conditions. Although the reports have the potential to communicate underlying values and assumptions about the care culture, such studies have not been performed.

    Aim:  The aim of this study was to understand how elderly care abuse in institutions could be understood from a care culture perspective.

    Design and methods:  A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four-stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective.

    Findings:  The care of the elderly in the municipality was based on a social culture that placed residents’ needs at the centre. Following routines were considered important in preventing mistreatment and were intended to ensure that all patients were treated fairly and equally. Care was described as task oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was interpreted that in the municipalities’ care of the elderly, there was a focus on elderly people’s freedom at the expense of the vulnerability aspects of well-being.

    Conclusion:  Raising awareness of the care culture underlying abuse could help to improve understanding of care practice. Change may be only possible when reflected on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring.

  • 9.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Borgestig, Maria
    Orebro Univ, Sweden.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Stockholm Univ, Sweden.
    Hope and Technology: Other-Oriented Hope Related to Eye Gaze Technology for Children with Severe Disabilities2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 10, article id 1667Article in journal (Refereed)
    Abstract [en]

    Introducing advanced assistive technology such as eye gaze controlled computers can improve a persons quality of life and awaken hope for a childs future inclusion and opportunities in society. This article explores the meanings of parents and teachers other-oriented hope related to eye gaze technology for children with severe disabilities. A secondary analysis of six parents and five teachers interview transcripts was conducted in accordance with a phenomenological-hermeneutic research method. The eye gaze controlled computer creates new imaginations of a brighter future for the child, but also becomes a source for motivation and action in the present. The other-oriented hope occurs not just in the future; it is already there in the present and opens up new alternatives and possibilities to overcome the difficulties the child is encountering today. Both the present situation and the hope for the future influence each other, and both affect the motivation for using the technology. This emphasises the importance of clinicians giving people opportunities to express how they see the future and how technology could realise this hope.

  • 10.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Borgestig, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Teachers’ experiences of using eye gaze-controlled computers for pupils with severe motor impairments and without speech2016In: European Journal of Special Needs Education, ISSN 0885-6257, E-ISSN 1469-591X, Vol. 31, no 4, p. 506-519Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to explore teachers’ experiences of using eye gaze-controlled computers with pupils with severe disabilities. Technology to control a computer with eye gaze is a fast growing field and has promising implications for people with severe disabilities. This is a new assistive technology and a new learning situation for teachers. Using a reflective lifeworld approach, 11 teachers were interviewed twice. The essence of the phenomenon of teaching pupils who use an eye gaze-controlled computer is to understand what the pupil does with the computer and relate this to what the pupil wants to express through the computer. The pupils have emotions, wishes and knowledge that are trapped in their own bodies. The eye gaze computer creates opportunities to get a glimpse of these thoughts to others, and creates hope concerning the pupil’s future possibilities. The teacher’s responsibility to try to understand what is inside the pupil’s trapped body is a motivating factor to integrate the computer in everyday classroom activities. The results give directions for teaching and for implementation of eye gaze computers in the school system, and also suggest improvements that could be made to computers.

  • 11.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Cedersund, Elisabet
    Linköping University, Department of Social and Welfare Studies, Äldre - vård - civilsamhälle (ÄVC) . Linköping University, Faculty of Arts and Sciences.
    Arman, Maria
    Karolinska Institutet, Stockholm.
    Care and caring culture as experienced by nurses working in different care environments: A phenomenological-hermeneutic study2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 5, p. 689-698Article in journal (Refereed)
    Abstract [en]

    Aim: The aim is to understand and develop the concept of care and caring Culture and to do so based on the empirical/phenomenological standpoint of nurses lived experiences of working in different environments.

    Background: Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the caring culture as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means.

    Method: A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working oil different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses I year later for validation of the findings.

    Findings: Thematic analyses revealed five themes: you have to adapt to the existing care Culture: seeing the invisible: being Yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as "homelike", nurses may act in a way that reflects their own values.

    Discussion: The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring Culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.

  • 12.
    Rytterström, Patrik
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Arman, Maria
    Dept of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute.
    The significance of routines in nursing practice2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 23-24, p. 3513-3522Article in journal (Refereed)
    Abstract [ar]

    Aim. The aim of this study was to illuminate the significance of routines in nursing practice.

    Background. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action.

    Design. A qualitative design using a phenomenological-hermeneutic approach.

    Method. Data collection from three focus groups focused on nurses’ experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as ‘qualified nursing pool’ nurses.

    Result. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient’s integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it.

    Conclusions. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice.

    Relevance to clinical practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine.

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