To investigate how spinal cord injured patients struggle with their rehabilitation and how they feel that the professionals influence this process.
Rehabilitation after a spinal cord injury is a long and arduous process during which the patient needs much support. Some patients lack adequate support from the professionals. This makes it pertinent to investigate the processes patients go through to get on with their lives and the influence professionals have.
A phenomenological-hermeneutic study with a narrative approach using Ricoeur's theory.
A purposeful and consecutive sample of 12 newly injured, adult Danish-speaking patients previously living a normal life were observed 7-12 times and interviewed six or seven times over two years.
The patients regained meaning and got on with life through resolute fighting for a meaningful life. We found three patterns of fight; the patients fought with themselves together with the professionals (pattern I). If consensus about the goals and pathway broke down and was not re-established, this fight could turn into a fight against the professionals (pattern II). This would, in turn, cause the patients to fight against themselves. A third pattern (III) was that the patients turned away, either going their own way or suppressing themselves by adapting to the professionals' views. In either case, the patients would feel being left on their own.
When the patient and professionals agreed on the way forward, the patient experienced the professionals as supportive. However, if the patient's goals were not consistent with the professionals' views, the patient felt that the professionals withdrew their support.
If the professional were able to maintain consensus with the patient, they contributed to the patient's process of regaining meaning.
Comment In: Evid Based Nurs. 2012 Jan;15(1):30-121949280
The article demonstrates a process analysis for therapeutic conversations, highlighting four styles of therapeutic communication and its relational patterns, and illustrates the use of two educational tools in learning the languages of therapy that shape therapeutic conversations.
The purpose of this study is to contribute to an understanding on how home health caregivers experience engagement in their work, and specifically, how aspects of home healthcare work create meaning associated with employee engagement. Although much research on engagement has been conducted, little has addressed how individual differences such as worker orientation influence engagement, or how engagement is experienced within a caregiving context. The study is based on a qualitative study in two home homecare organisations in Denmark using a think-aloud data technique, interviews and observations. The analysis suggests caregivers experience meaning in three relatively distinct ways, depending on their work orientation. Specifically, the nature of engagement varies across caregivers oriented towards being 'nurturers', 'professionals', or 'workers', and the sources of engagement differ for each of these types of caregivers. The article contributes by (i) advancing our theoretical understanding of employee engagement by emphasising meaning creation and (ii) identifying factors that influence meaning creation and engagement of home health caregivers, which should consequently affect the quality of services provided home healthcare patients.