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Different understandings of the phenomena health and disease may have consequences for the clinical nurse. Evidence-based medicine (EBM) has a strong foothold in nursing. Practical knowledge, proficiency, and judgment acquired by the individual clinicians through clinical experience are no longer reliable sources of knowledge. There is an element of risk attached to not following the best available, external clinical evidence from systematic research. Also, there may be some risk involved if the clinical judgment does not see risk as an opportunity to interact. David Sackett, one of the pioneers of evidence-based medicine (EBM), reminds clinicians of the importance of integrating individual expertise and best external evidence. If clinical practice is guided by research activity alone, and if practical intuition and clinical judgment are ignored, the practice will become too generalized, and not enough attention will be paid to what is unique for each individual case.
This article explores, how patients experience the meaning of fellow patients in Joint Care tracks, based on four qualitative interviews. Applying van Manens phenomenological- hermeneutical approach one dominating theme appears: Joining a fellowship and living up to this. And three subthemes: To be known in an unknown world, to be understood by peers and to balance between selfishness and charity. The patients felt a unique contact to fellow patients and felt safe with the known fellow patients. According to this the understanding among patients made the natural modesty insignificant, which points out, in respect to nursing, that privacy in the shared space needs a review. As well as the fellowship was a positive experience, the patients experienced that they were seen as a team and not as individuals which could make them feel overlooked. Therefore the study recommends an increased reflection on the view of patients in Joint Care tracks.
This article discusses how nurses offering CAM (Complementary and Alternative Medicine) understand their own holistic approach. Empirical data were collected from field work among registered nurses who choose to offer CAM. Due to cultural science, CAM is a part of the New Age movement. Holism is considered to be a core concept in both nursing and the New Age movement and is used to describe CAMpractice in contrast to conventional bio-medicine. Results are categorized in three main issues: 1. Holism emphasize relations and connections. 2. Holism describes a unity between man and nature, and 3. Holism emphasizes spiritual aspects in health care. This discussion is focusing on the diffuse connection between CAM, nursing, and the New Age movement and shows how holism is both applauded and rejected in nursing, especially when it comes to the spiritual aspects. The conclusion is that holism is understood in different ways, and that there is a blurred connection between CAM, nursing, and the New Age movement. The connection between health and spirituality needs further investigation.
Objective. To report 1-year results of newly developed method, Guided Self-Determination (GSD), applied in group training (GSD-GT) for Type 1 diabetes patients with persistent poor glycaemic control. Methods. GSD was designed on the basis of qualitative research to help patients develop life skills with diabetes using worksheets filled in at home and coached by nurses in mutual reflection. We randomized 18-49 year-old adults at a Danish university hospital to either 16-hour GSD-GT in 2001 or to similar training 1 year later. Inclusion criteria: mean A1C ≥ 8.0% for at least two years, disease onset ≤ 40 years and insulin treatment from onset.
Results. Thirty GSD-GT patients and 20 controls completed the study. GSD-GT patients did better than control patients in terms of a) increased autonomy support perceived from health professionals (p<0.01); b) higher frequency of self-monitored blood glucoses (p<0.001); c) increased perceived competence in managing diabetes (p<0.01); d) fewer diabetes-related problems (p<0.05); and e) improved glycaemic control (p<0.01).
Conclusion. GSD was effective in improving life skills with diabetes, including A1C, over a period of 1 year.
Practice Implications. GSD is a worthy candidate for further research. We consider it adjustable to people with type 2 diabetes and other chronic conditions.
Background: Quantitative research has been the primary approach when investigating fast-track colonic surgery. The patient perspective is sparsely represented in research, despite requirement of user involvement.
Aim: To gain insight into patients’ experience of conventional and accelerated colorectal treatment courses respectively.
Method: Three focus group interviews from patients in two conventional treatment courses and one from a fast-track regime. The analysis was performed in a hermeneutic perspective and by using the template style.
Results: Eight themes were identified, of which five had existential character, and among them, the phenomena of trust, anxiety and security were recognized. The themes emerged independently of the treatment course, and the study suggests that the temporal perspective is particularly important to the patients.
Conclusion: The patients’ experiences relate to other phenomena than the core categories in the fasttrack regime for colonic surgery. The study confirms the need to include qualitative evidence and the patient perspective in the development of fast-track surgery and rehabilitation.
The study is based on the assumption that a valuable interpersonal encounter between helper and helpee (patient/client) requires that the helpee is recognized, i.e. that their perception of both self and reality is confirmed.
The purpose of the study is to seek a deeper understanding of recognition as a phenomenon, by investigating its constitution.
The method used is qualitative interviews within a phenomenological-hermeneutical tradition.
Result: The stories of the informants is about „being seen“ and thus be recognized as an individual, or about being overlooked, and thus not being recognized as a specific human being.
Conclusion: The experiences of „visibility“ or „invisibility“ leads to some fundamental theoretical insights. But more important are the practical insights: to understand – and thus recognize the other, the helper has to draw upon their own experience and their understanding of themselves.