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.