AIM: This paper is a report of a study of the immediate lived experiences of victims and relatives of the 2004 tsunami disaster. BACKGROUND: Disasters serve to remind us of our frailty and vulnerability and raise existential questions. From the perspective of caring sciences, suffering is regarded as a natural source for change in patients' understanding of the world and the meaningfulness of their lives. METHOD: A phenomenological hermeneutic study was conducted, using in-depth interviews with a convenience sample of 19 informants in 2006-2007. Ricoeur's theory of interpretation served as a guiding principle for interpreting the interview texts. FINDINGS: The immediate lived experiences of the tsunami survivors and their relatives revealed a comprehensive picture, described as different acts of the drama. These acts were: 'experiencing the very core of existence', 'a changed understanding of life' and 'the power of communion'. Confronting our frailty and vulnerability makes us more authentic to ourselves, to our relatives and to life itself. The first step towards progression involves an act where the suffering is seen and validated by another person. Reshaping the suffering together with the family adds a valuable dimension to life. Availability and presence by the family opened up for communion. CONCLUSION: The immediate lived experiences of the tsunami disaster from an existential and ontological perspective constitute an important aspect of understanding the whole phenomenon. Concepts such as communion, understanding life and progression of suffering can help us construct an image of this previously unresearched dimension.
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.
BACKGROUND: Becoming autonomous is an important aspect of teenagers' psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support. OBJECTIVE: The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes. DESIGN AND METHOD: Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis. PARTICIPANTS: Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes. FINDINGS: The lived experiences of the transition towards autonomy in self-management were characterized by the over-riding theme "hovering between individual actions and support of others". The findings indicate that individual self-reliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme "confirmation of others" showed that parental encouragement increased the certainty of teenagers' standpoints; peers' acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers' self-esteem. CONCLUSION: In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations.