In this article, we identify some worrying problems in the contemporary practice of qualitative research, such as the confusion regarding content and meaning in content analysis, the frequent use of standardized methods that avoids philosophy, as well as the description/interpretation dichotomy in empirical research. Since they all arise from a failure to understand the concept of meaning, we return to the question of meaning as the axis that qualitative research pivots around. We examine the meaning of meaning, and how meaning differs from content, and we then ask what consequences this has for research. Even though our analysis is rooted in phenomenological philosophy, we argue that that the ideas that we present are valid for any qualitative research approach. The question of understanding and relating to meaning, we argue, is a momentous issue for qualitative research, where we either continue safeguarding the very essence of qualitative research as dealing with human phenomena, or give it up in favor of more pragmatic and clear-cut methods that seemingly does away with the question of meaning.

Being able to describe how research findings become evidence is crucial in providing a justification for all kinds of research findings. However, qualitative researchers in health care, including those who conduct phenomenological research, are usually fairly modest when it comes qualifying their research findings as such. We advocate a view of evidence for phenomenological research, an approach that is rooted in philosophy of science, including perspectives of ontology, epistemology, and methodology. We suggest that phenomenology can become an exemplar for how qualitative research can make convincing arguments and thus can be better appreciated. In this article, we present a philosophical foundation for phenomenological evidence by exploring the notions of objectivity, validity, and generalizability in terms of openness, meaning, and essence.

The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew. Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it.

The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault’s historical-philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-)caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault’s historical-philosophical work. The philosophical examination presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care.

This study describes the phenomenon of caring touch from the patients' perspective in an anthroposophic clinical context where caring touch is often used to promote health and alleviate suffering. The aim of the study was to explore and phenomenologically describe the phenomenon of caring touch from the patients' perspectives. The study has been carried out with a Reflective Lifeworld Research approach in order to understand and describe human existential phenomena. Ten female patients were interviewed in an anthroposophic clinic in Sweden. The findings show how caring touch has multifaceted meanings and makes the patients' feel present and anchored in a meaningful context. The patients' feel that they are seen, accepted and confirmed. Furthermore, touch creates a caring space where the patients become receptive for care and has the power to alleviate the patients' suffering, as well as to frighten and cause or worsen the suffering. In order to take advantage of the caring potential, the patient needs to be invited to a respectful and sensitive form of touch. An interpersonal flexible space is necessary where the touch can be effective, and where a dynamic interplay can develop. In conclusion, caring touch is an opportunity for carers to support well-being and health. The carers need to approach their patients in both a sensitive and reflective way. A caring science perspective can serve as a help to further understand touch as a unique caring act.

Our focus in this article is research interviews that involve two languages. We present an epistemological and methodological analysis of the meaning of qualitative interviewing with an interpreter. The results of the analysis show that such interviewing is not simply exchanging words between two languages, but means understanding, grasping the essential meanings of the spoken words, which requires an interpreter to bridge the different horizons of understanding. Consequently, a research interview including an interpreter means a three-way coconstruction of data. We suggest that interpreters be thoroughly introduced into the research process and research interview technique, that they take part in the preparations for the interview event, and evaluate the translation process with the researcher and informant after the interview.

Introduction: Out-of-hospital cardiac arrest (OHCA) is a lethal health problem thataffects between 236,000 and 325,000 people in the United States each year. As resuscitationattempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services(EMS) personnel often face the needs of bereaved family members.Problem: Decisions to continue or terminate resuscitation at OHCA are influenced byfactors other than patient clinical characteristics, such as EMS personnel’s knowledge,attitudes, and beliefs regarding family emotional preparedness. However, there is littleresearch exploring how EMS personnel care for bereaved family members, or how theyare affected by family dynamics and the emotional contexts. The aim of this study is toanalyze EMS personnel’s experiences of caring for families when patients suffer cardiacarrest and sudden death.Methods: The study is based on a hermeneutic lifeworld approach. Qualitative interviewswere conducted with 10 EMS personnel from an EMS agency in southern Sweden.Results: The EMS personnel interviewed felt responsible for both patient care and familycare, and sometimes failed to prioritize these responsibilities as a result of their ownperceptions, feelings and reactions. Moving from patient care to family care implied amovement from well-structured guidance to a situational response, where the personnelwere forced to balance between interpretive reasoning and a more direct emotionalresponse, at their own discretion. With such affective responses in decision-making, thepersonnel risked erroneous conclusions and care relationships with elements of dishonesty,misguided benevolence and false hopes. The ability to recognize and respond to people’sexistential questions and needs was essential. It was dependent on the EMS personnel’sbalance between closeness and distance, and on their courage in facing the emotionalexpressions of the families, as well as the personnel’s own vulnerability. The presence offamily members placed great demands on mobility (moving from patient care to familycare) in the decision-making process, invoking a need for ethical competence.Conclusion: Ethical caring competence is needed in the care of bereaved family membersto avoid additional suffering. Opportunities to reflect on these situations within a frameworkof care ethics, continuous moral education, and clinical ethics training are needed.Support in dealing with personal discomfort and clear guidelines on family support couldbenefit EMS personnel.Bremer A, Dahlberg K, Sandman

The discharge process (DP) is full of well-known risks, and a comprehensive and well-executed DP is especially important for older people with multiple health problems and continuing care needs, as well as for their relatives. Few studies focus on the experiences with the DP by older people in need of home care nursing and their relatives. Therefore, the aim was to deepen the understanding of the DP as a phenomenon described by older people, their relatives, and care professionals. The method is an excursus of the findings of two previously published research studies. By using the Reflective Lifeworld Research approach, the empirical findings were further interpreted with lifeworld theory. The results describe the essential meaning of the phenomenon of DP in relation to healthcare needs. The illness and the DP can be viewed as a course of action where the familiar becomes unfamiliar for older people and their relatives, entailing an insecure future existence characterized by the experience of being in-between. The DP is marked by bodily and existential needs. The older persons and their relatives are lost in the hospital context and trying to influence life and adapt to life circumstances, while being relentlessly dependent on care professionals. Care professionals work from both an organizational and a medical approach. Disharmony and disagreement seem to arise easily among the professionals regarding the planning negatively affecting the patients and their relatives. More efforts are needed in the DP to empower older people and their relatives to go on with their life at home. The caring practice needs to more clearly meet and address the individual needs of older people and their relatives and their understanding of their illness. It needs to give them lifeworld and life goals to alleviate their suffering and to help them adjust to their new situation.