Background

Childhood functional constipation, a common concern within child healthcare, necessitates oral and rectal medical treatments, that are mostly administered by parents in the home environment. It is important to gather children’s perspectives in child- and family-centred care. The private nature of toileting, bowel movements, and faecal incontinence are areas of taboo and stigmatisation. Research is scarce on how children perceive this common but private situation of oral and rectal constipation treatment.

Objective

To explore children’s experiences of functional constipation and its treatments.

Design

A qualitative interview study with a constructionist epistemology and a predominantly experiential orientation.

Setting

Individual interviews were conducted in the child’s home, in the child’s familiar outpatient clinic, or on university premises. Open and permissive conversations about bowel habits, constipation, medical treatments, faecal leakage, and related feelings were digitally recorded and transcribed.

Participants

Twenty children (thirteen boys and seven girls) with functional constipation, aged 6–14 years, from four different outpatient clinics in southeast Sweden, who had experiences of oral and rectal medical treatments, were purposively recruited. Exclusion criteria were anorectal malformation or prior rectal surgery.

Methods

Transcripts were analysed using reflexive thematic analysis by Braun & Clarke.

Findings

This study provides a deeper understanding of why children choose not to go to the toilet. It explains how children perceive constipation treatment as simultaneously good and bad, and describes how faecal incontinence is strongly associated with the fear of exposure. The study also outlines the hopes and prospects of a cure. Four themes were created: 1) Procrastinating toilet visits – focus elsewhere, 2) Dreading exposure in a vulnerable position, 3) Enemas, a nightmare and a relief, 4) A doubtful hope during the treatment journey.

Conclusions

Care providers must acknowledge and validate the child’s perspective in constipation treatment situations. Our study provides an understanding of this perspective, which should be incorporated into clinical conversations with children about their diagnosis and proposed constipation treatment regimen. Adopting an approach that acknowledges children’s views based on this new information may enhance collaboration between care providers, parents, and children during constipation care.

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in-depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co-occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self-governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.

Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life.

Aim

To explore parents´ experiences of living with a child with FC and its impact on everyday family life.

Method

A qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC.

Findings

Shame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame.

Conclusion

FC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed.

Practice implications

Healthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.

Background Research in forensic psychiatric care focusing on person-oriented care is ambiguous about matters of quality. The encounters between a healthcare professional (HCP) and patient could influence how connections and relations emerge between the caregiver and the patient. Objectives To better understand caring aspects, this study explores significant encounters in forensic psychiatric care from the perspective of HCPs. Method This study is based on 34 written narratives from HCPs from two forensic psychiatric hospitals in Sweden. The narratives concern significant encounters with a patient. These narratives were analysed according to methodologies developed by phenomenological and reflective lifeworld research. Findings The essence of a significant encounter is a temporal extended phenomenon that both precedes as well as is a consequence of the actual encounter as it occurs. The encounter is unforeseeable and being open to an encounter also means to be vulnerable as it is not predetermined how someone will respond. The significant encounter is an act of sharing, and HCPs may come to understand more about their patients as well as about themselves. Moreover, these encounters seem to create repercussions and hope for the future care. Conclusions The everyday activities of forensic psychiatric care are not trivial activities. Rather, they are important aspects of health care as these everyday encounters can deepen the relationship between the HCPs and their patients and help both the HCPs and their patients develop a sense of hope for the future.

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.

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.

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.

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.

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.

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.