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  • 1.
    Arman, M.
    et al.
    Karolinska Institute, Section of Nursing, SE-141 83 Huddinge, Sweden, Karolinska Institute, Stockholm, Sweden.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Hälsa - utbildning - välfärdsinstitutioner (HUV) .
    The 'tittle extra' that alleviates suffering2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 3, p. 372-384Article in journal (Refereed)
    Abstract [en]

    Nursing, or caring science, is mainly concerned with developing knowledge of what constitutes ideal, good health care for patients as whole persons, and how to achieve this. The aim of this study was to find clinical empirical indications of good ethical care and to investigate the substance of ideal nursing care in praxis. A hermeneutic method was employed in this clinical study, assuming the theoretical perspective of caritative caring and ethics of the understanding of life. The data consisted of two Socratic dialogues: one with nurses and one with nursing students, and interviews with two former patients. The empirical data are first described from a phenomenological approach. Observations of caregivers offering 'the little extra' were taken to confirm that patients were 'being seen', not from the perspective of an ideal nursing model, but from that of interaction as a fellow human being. The study provides clinical evidence that, as an ontological response to suffering, 'symbolic acts' such as giving the 'little extra' may work to bridge gaps in human interaction. The fact that 'little things' have the power to preserve dignity and make patients feel they are valued offers hope. Witnessing benevolent acts also paves the way for both patients and caregivers to increase their understanding of life. © 2007 SAGE Publications.

  • 2.
    Arman, Maria
    et al.
    Department of Nursing, Karolinska Institute, Huddinge, Sweden.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Hälsa - utbildning - välfärdsinstitutioner (HUV) .
    How can we research human suffering?2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 239-240p. 239-240Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 3. arman, maria
    et al.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Living with breast cancer - a challenge of expansive and creative forces2002In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 11, no 4, p. 290-296Article in journal (Refereed)
  • 4. arman, maria
    et al.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    The hidden suffering among breast cancer patients - a qualitative metasynthesis2003In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 13, no 4, p. 510-527Article in journal (Refereed)
  • 5. arman, maria
    et al.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    The Presence of Love in Caring2006In: Nursing forum, ISSN 0029-6473, Vol. 41, no 1Article in journal (Refereed)
  • 6. arman, maria
    et al.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Vittnesbördet som etisk grund i vårdandet2003In: Gryning II, Klinisk Vårdvetenskap / [ed] Katie Eriksson; Unni Å Lindström; Åbo akademi, Vasa: Institutionen för Vårdvetenskap , 2003, p. 109-123Chapter in book (Other academic)
  • 7. Arman, Maria
    et al.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Vårdande som lindrar lidande -Etik i vårdandet2006 (ed. 1)Book (Other academic)
    Abstract [sv]

    När livet förändras eller hotas av sjukdom eller olycka aktualiseras en mängd etiska frågor. Hur hanterar man människor i livsavgörande skeenden? Hur kan man som vårdpersonal i sådana situationer se, bli delaktig i och lindra lidandet? Vårdande som lindrar lidande tar upp dessa viktiga frågor.Läs merMed nya vårdvetenskapliga teoriansatser, inspirerade av Katie Eriksson, omsätter författarna det abstrakta vårdtänkandet till ett mer praktiskt vårdande. Läsaren får också ta del av människors berättelser om lidande och bemötande inom vården. Alla som kommer i kontakt med lidande människor har nytta av boken. Den är framför allt givande för studenter och yrkesverksamma inom hälso- och sjukvården.Om författarnaMaria Arman är leg. sjuksköterska, leg. barnmorska, doktor i vårdvetenskap och biträdande universitetslektor i omvårdnad vid Karolinska Institutet, Stockholm. Arne Rehnsfeldt är leg. sjukskötare, docent i vårdvetenskap och universitetslektor vid Hälsouniversitetet, Linköpings universitet.

  • 8.
    Arman, Maria
    et al.
    Karlskrona.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Carlsson, Marianee
    Uppsala universitet Uppsala.
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Indications of change in life perspective among women with breast cancer admitted to complementary care2001In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 10, no 3, p. 192-200Article in journal (Refereed)
    Abstract [en]

    In this study, qualitative content analysis was used in order to understand the reported changes of life perspective in interviews with 59 women with breast cancer who were admitted to complementary care. The aim of this research was to study women's perceived consequences as well as perceived causes of breast cancer and to explore aspects of importance to the women. The material was collected in semistructured interviews from women with breast cancer at different stages of the disease. The women received complementary care at an anthroposophic clinic in Sweden. Findings showed that these women's view of their relationships with others grew more valuable. Their self-confidence and experience of strength improved, and they regarded life as being more enriched. A change in their disposition towards becoming more fragile and low-spirited was experienced as a hardship by the women. An interesting finding was that the patients described the aetiology of the disease from several interacting perspectives, which also affected their ideas of how to achieve well-being and health. The findings support the view that changes of both benefit and harm are present in the experience of breast cancer.

  • 9.
    Arman, Maria
    et al.
    Finland.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Bröstcancerpatienters upplevelser av komplementär vård vid en antroposofisk klinik - en fallstudie2002In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 22Article in journal (Other (popular science, discussion, etc.))
  • 10.
    Arman Rehnsfeldt, Maria
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Lindholm, L
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
    Eriksson, Katie
    Institutionen för Vårdvetenskap Åbo Akademi, Vasa, Finland.
    Suffering related to health care: a study of breast cancer patients' experiences.2004In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 10, no 6, p. 248-256Article in journal (Refereed)
    Abstract [en]

    A previous study indicated that patient narratives include experiences of suffering caused or increased by health-care encounters. The aim of this study was to interpret and understand the meaning of patients' experiences of suffering related to health care from an ethical, existential and ontological standpoint. Sixteen women with breast cancer in Sweden and Finland took part in qualitative interviews analysed with a hermeneutic, interpretive approach. The outcome showed that suffering related to health care is a complex phenomenon and constitutes an ethical challenge to health-care personnel. The women's experiences of suffering related to health care tended to be of similar seriousness as their experiences of suffering in relation to having cancer. In an ethical, existential and ontological sense, suffering related to health care is basically a matter of neglect and uncaring where the patient's existential suffering is not seen and she is not viewed as a whole human being.

  • 11. Isovaara, Sten
    et al.
    Isovaara, Sten
    Arman, Maria
    Arman, Maria
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Family suffering related to war experiences: An interpretative synopsis review of the literature from a caring science perspective2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 241-250Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to conduct a synopsis review of findings from families' experiences related to combat and war events and to interpret these findings from the perspective of theories of suffering. The method used in the study was a synopsis review of 12 articles dealing with family suffering related to war or combat experiences and an interpretation of the articles from a caring science perspective. Findings from the synopsis review were that the dominant part of the articles viewed suffering in general and post-traumatic stress disorders (PTSD) in particular from a medical, psychiatric or psychologically behaviouristic perspective. PTSD and other distress-related conditions were mainly described in terms of their symptoms and dealt with in terms of pathology. The interpretation of the articles from a caring science perspective generated three significant themes: first, interdependence as a spiritual dimension of dependence, secondly, familial communion as sharing moral and spiritual values and thirdly, familial suffering visualized by compassion. The study's conclusion is that, from a caring science perspective, the appearance of family suffering should be comprehended in terms of expressed compassion and that any disturbance within familial communion is likely to have an emotional impact on all of the family members, as a result of their interdependence. © 2006 The Authors.

  • 12.
    Lindholm, Lisbet
    et al.
    Åbo Akademi Vasa.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Arman, Maria
    Åbo Akademi Vasa.
    Hamrin, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology.
    Significant others' experience of suffering when living with women with breast cancer2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 248-255Article in journal (Refereed)
    Abstract [en]

    This is an inquiry into how significant others experience being close to a woman suffering from breast cancer. In order to find this out, theme interviews were arranged with 17 women and 16 significant others from four different caring cultures in Sweden and Finland. A phenomenological case study methodology was adopted and in the analysis of the data a scientific teamwork model was employed, based on ideas developed at the Vancouver School of Doing Phenomenology. The findings show that the significant others experience deep often unrelieved suffering. They consider themselves prisoners of a situation of uncertainty and powerlessness when standing by the woman. They are torn between their own suffering and their desire to alleviate the woman's suffering. A vicious circle of mutual protection intensifies the suffering of the significant other, while actively sharing the suffering brings relief. The gravity of the situation creates an ethical urge in the significant other to assume responsibility for life in common with the woman.

  • 13.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Begreppen integration och problembaserat lärande granskat ur ett vårddidaktiskt perspektiv2004In: Vårdvetenskapens didaktik : caritativ didaktik i vårdandets tjänst / [ed] Dahly Matilainen & Katie Eriksson, Vasa: Åbo Akademi, Institutionen för Vårdvetenskap , 2004, p. 135-147Chapter in book (Other academic)
  • 14.
    Rehnsfeldt, Arne
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Existentiellt Livsmöte under Existentiellt Traumatisk Livshändelse1991In: Vårdteologi. Vårdforskningsrapport / [ed] Katie Eriksson & António Barbosa da Silva, Vasa: Åbo Akademi, Institutionen för vårdvetenskap , 1991, p. 96-115Chapter in book (Other academic)
  • 15.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Möte och Livsmening under Existentiellt Traumatiska Livshändelser (Lic.dissertation)1994Book (Other academic)
  • 16.
    Rehnsfeldt, Arne
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Mötet med patienten i ett livsavgörande skeende. (Doctoral Thesis). (The encounter with the patient in a life-changing process, English summary)1999Book (Other academic)
  • 17.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    Skapande av livsmening i gemenskap i ett livsavgörande skede (creating meaning in communion in a period of decisive importance to life)2000In: Gryning : en vårdvetenskaplig antologi / [ed] Katie Eriksson, Unni Å. Lindström, Vasa: Åbo Akademi, Institutionen för Vårdvetenskap , 2000, 1, p. 95-115Chapter in book (Other academic)
  • 18.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies.
    The relevance of the ethics of understanding of life in nursing2005In: International journal for human caring, ISSN 1091-5710, Vol. 9, no 4, p. 39-44Article in journal (Refereed)
  • 19.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Hälsa - utbildning - välfärdsinstitutioner (HUV) .
    Arman, M.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Huddinge, Sweden.
    A pilgrimage on the road to understanding of life in experiences of cancer and burnout syndrome2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 2, p. 275-283Article in journal (Refereed)
    Abstract [en]

    The preunderstanding for this study is that progression of a person's suffering can be seen as movement from unbearable to the bearable. This study aims to examine the development of understanding of life in people with cancer and burnout syndrome in relation to nursing care. Our method entailed clinical application research in the design and collection of data, which consisted of qualitative interviews with 16 former patients in conventional and anthroposophic health care, nine with cancer diagnoses and seven with burnout syndrome. The main theme of our findings is 'a pilgrimage on the road to understanding of life'. The pilgrimage is the person's own inner decision to reach new insights and meaning. When suffering from cancer, the struggle is related to threat of death, while persons with burnout syndrome struggle with a threatening nothingness. Walking alone on the pilgrimage without being met in an understanding of life creates increased suffering, while having a companion on the pilgrimage was seen as adding dignity to the suffering human being. The implications for nursing care are that even patients with burnout syndrome need a caring hermeneutic dialogue, where time and space is shared with a caregiver during the pilgrimage. © 2008 Nordic College of Caring Science.

  • 20.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Arman, M
    Livsförståelseetik2003In: Gryning II: klinisk vårdvetenskap / [ed] Katie Eriksson och Unni Å. Lindström, Vasa: Åbo Akademi: Institutionen för vårdvetenskap , 2003, p. 97-109Chapter in book (Other academic)
  • 21.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Arman Rehnsfeldt, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Livsförståelseetik och vittnesbörd - vårdetiska aspekter2005In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 25, no 3, p. 19-23Article in journal (Refereed)
  • 22.
    Rehnsfeldt, Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV).
    Eriksson, Katie
    Åbo Akademi.
    The progression of suffering implies alleviated suffering2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, no 3, p. 264-272Article in journal (Refereed)
    Abstract [en]

    There is a lack of research focusing directly on both patients' suffering and alleviated suffering in relation to care. The aim of this paper was to investigate the progression of suffering in relation to the encounter between the suffering person and the caregiver from the perspective of an understanding of life. The progression of suffering is assumed to be an existential 'sign' of the development of understanding of life as an ontological or spiritual entity, which demands a meaning-creating encounter between the patient and caregiver. The concept 'existential caring encounter' was used to describe how the encounter between patient and caregiver can create meaning in communion and thereby alleviate suffering by making it bearable. The study was carried out using an interpretive, hermeneutic approach. The study as a whole comprises three parts, and these include letter-writing and interviews. The findings are described by the following main theses: (a) a darkness in life understanding is existentially experienced as unbearable suffering and requires an encounter involving attentive care and confrontation, (b) the turning point means that the struggle of suffering begins, and (c) the encounter involves being meaningcreating in a communion in the struggle of suffering. An understanding of the patterns of unbearable and bearable suffering can be of help to the caregiver in caring for the patient by serving as a basis for meaning-creation in communion. This may thereby be a way of alleviating the patient's suffering by making it bearable during the progression of suffering.

  • 23.
    Roxberg, A.
    et al.
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    Eriksson, K.
    Department of Caring Science, Åbo Academy, Vasa, Helsinki University, Central Hospital, Helsinki, Finland.
    Rehnsfeldt, Arne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Hälsa - utbildning - välfärdsinstitutioner (HUV) .
    Fridlund, B.
    School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
    The meaning of consolation as experienced by nurses in a home-care setting2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 8, p. 1079-1087Article in journal (Refereed)
    Abstract [en]

    Aims and objective. The aim of this study was to illuminate nurses' experiences of consolation and how these experiences relate to suffering and care. Background. Consolation is commonly associated with the relief of suffering. The question of consolation in terms of its definition and relevance for care has, however, been a matter of discussion among nurse researchers. The question raised concerns about the nature of consolation, its place and its role in relation to care and the caring sciences. Design. An explorative qualitative interview study with 12 participants, six registered and six enrolled nurses, was carried out in a home-care context. Methods. A phenomenological-hermeneutic method inspired by the French philosopher Paul Ricoeur was used for the text analysis. Results. Two main aspects of consolation appeared: 'the present consolation', which is flexible, sustaining and opening and 'the absent consolation', which conceals the suffering and is incapable of consoling. The result was interpreted from a philosophical-ethical perspective, based on the works of Levinas and Lögstrup. Conclusions. Consolation appears as a complex phenomenon, both in terms of its existence and its absence consolation, constituting a caring and non-caring consolation. A caring consolation entails meeting the other as different and being present in a way that gives the other space to be the one he or she really is. It requires acceptance, accepting the sufferer and his/her way of suffering as unique. Relevance to clinical practice. The clinical nurse is involved in complex care situations, which entails both reflecting upon and using intuition when consoling. A caring consolation is a contradictory phenomenon that requires a nurse to be capable of both reflecting upon and acting intuitively on the unique suffering of the other. © 2008 Blackwell Publishing Ltd.

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