Our general purpose is to show how a philosophically oriented theoretical foundation, drawn from a lifeworld perspective can serve as a coherent direction for caring practices in education. We argue that both caring and learning share the same ontological foundation and point to this intertwining from a philosophical perspective. We proceed by illustrating shared epistemological ground through some novel educational practices in the professional preparation of carers. Beginning in a phenomenologically oriented philosophical foundation, we will first unfold what this means in the practice of caring, and secondly what it means for education and learning to care in humanly sensitive ways. We then share some ways that may be valuable in supporting learning and health that provides a basis for an existential understanding. We argue that existential understanding may offer a way to bridge the categorisations in contemporary health care that flow from problematic dualisms such as mind and body, illness and well-being, theory and practice, caring and learning. Ways of overcoming such dualistic splits and new existential understandings are needed to pave the way for a care that is up to the task of responding to both human possibilities and vulnerabilities, within the complexity of existence. As such, we argue that caring and learning are to be understood as an intertwined phenomenon of pivotal importance in education of both sensible and sensitive carers. Lifeworld led didactics and reflection, which are seen as the core of learning, constitute an important educational strategy here.

Background: Managers in clinical education units (CEUs) have the responsibility to facilitate evidence-based environments for both caring and learning. Promoting such environments might be challenging in times of financial constraints and organisation changes.

Objective: The purpose of this study was to describe how managers experience their responsibility to support the caring and learning environments in CEUs.

Methods: The study method followed the principles of Reflective Lifeworld Research (RLR) grounded in a phenomenological approach. The study was conducted at a hospital in Southern Sweden. Ten first- and second-line managers responsible for CEUs were interviewed. The interviews were conducted as reflective dialogues using an open, and bridled approach.

Results: The results show that clinical education unit managers regard the responsibility to support caring and learning environments as a challenging experience, elucidated in three themes: (1) to have or to take responsibility; (2) cooperation that supports and challenges; and (3) bringing it all together— a daily struggle.

Conclusions: In conclusion, the managers of CEUs need to be aware of the importance of common theoretical grounds for caring and learning. Caring and learning are more likely to be intertwined when responsibility is taken, when collaboration between actors is characterised by respect and when an awareness of the importance of reflection is present. Awareness of the importance of creating opportunities for reflection and mutual collaboration among the different actors involved could lead to improvements in nursing education and, therefore, improved patient care.

Background

In research the relationships between parents and their adolescent daughters have been viewed from problem oriented perspectives, usually exploring negative effects and health-related problems. Health and well-being are complex phenomena and knowledge is needed on how parents can support the health and well-being of their daughter.

Objectives

The aim of this study was to illuminate parents’ experiences of supporting the health and well-being of their adolescent girls.

Methods

A descriptive design with a phenomenological approach including interviews, individually or in group with ten mothers and five fathers was conducted.

Results

Supporting the health and well-being of adolescent girls was experienced as challenging. The parents needed to altering the parenting role: from being the one who had previously set the limits they needed to rethink and be available for support. In this process interplay, communication and trust were important to support the health and well-being of the girls in an efficient way. This meaning was further illuminated by four constituents: Balancing the need for control, maintaining a trusting relationship, interplay to facilitate their daughters’ transition to independence, and an ambiguous parenting role.

Conclusions

This study highlights the importance of parents being involved in the everyday life of their adolescent daughter to support her health and well-being. The parents’ ability to contribute to the health and well-being of their girl seemed in this study dependent on their ability to communicate and alter the parenting role with sensitivity to the lifeworld of the adolescent girl.

Supervising student nurses in clinical praxis entails dealing with both caring and learning aspects. There is a dearth of research focusing on both the caring and learning aspects in supervision. The present study describes how caring and learning is intertwined in supervision. The study was performed with a Reflective Lifeworld Research approach and analyzed phenomenologically for meanings. Eight interviews were conducted with supervisors on an orthopedic-dedicated education unit. The findings reveal how supervisors constantly move in order to be either close to or standing back, adjusting to the students’ and the patients’ needs. This is described in more detail via the constituents: handling responsibility in constant movement, participating in a new and different way, coexisting with students creates meaning and development. The findings show that a reflective attitude in supervision, clear structure for daily activities, and a lifeworld-led didactics can promote a learning and caring environment. Supervisors’ demanding task requires pauses in order to maintain motivation among supervisors. A mutual link between supervisors, students and patients is crucial in order to create an environment where caring and learning are intertwined.

Background

It is crucial for patients to be met by understanding in their vulnerability, to be treated by competence that ensure adequate care and met with an encouraging attitude to participate in their health process. They meet professional careers as well as students, but nevertheless the aim for caring is the same: to provide good and secure care for the patients, all in line with a caring science approach. A limit amount of studies illuminate patients’ experiences of receiving care from student nurses.

Aim

The aim was to describe how patients perceived being cared for by student nurses, in a clinical context

Method

The study has been performed with a Reflective Lifeworld Research approach founded on phenomenology. 11 lifeworld interviews were conducted with patients, recently discharged from an orthopedic Dedicated Education Unit. Data have been analyzed for meanings.

Results

Patients perceive that they are being carried along on the students' learning process like a journey together. This is characterized by a fluctuation between stable and unstable care from the students. Along this journey, patients are in need of a mutual invitation to participation, of genuine encounters, and essential support.

Conclusion

The patient-student-supervisor relationship is of importance for patients’ experience of being cared for by student nurses in a clinical setting. Genuine encounters between patient and student must be identified and can be stimulated by didactic support and reflection grounded in caring science with a lifeworld perspective. Supervisors have to support to both students and patients in order to create a safe environment in which caring and learning are intertwined. Students require patients in their learning process but patients’ vulnerability, need for participation, genuine encounters and essential support, must be taken into account.

The purpose of this study is to describe how patients perceive being cared for by student nurses, in a clinical context in the form of a Dedicated Education Unit (DEU). The study has been performed with a Reflective Lifeworld Research (RLR) approach grounded in phenomenology. Lifeworld interviews were conducted with patients who had received care from student nurses on an orthopaedic dedicated education unit (DEU) and data have been analysed for meanings. The findings reveal how patients experience to be carried along as a part of the students' learning process. This is described in more detail via the constituents: a mutual invitation to participe, the importance of genuine encounters, and essential support. Patients experience both a stable and a less stable care in a learning environment and it is thus essential for them to be invited to be a part of both the students’ learning process and their own health process. The findings also highlight the key role of the supervisors for patients’ sense of security. Finally there are indications that concepts such as DEU with a lifeworld-led didactic, based on reflection on both the patients’ stories and the students’ experiences, can create learning environments that support patients’ health processes and also students’ learning processes.

The aim of the present study is to explore interpersonal dimensions of the presence of older patients at team meetings.The theoretical foundation of the study is grounded in caring science and lifeworld phenomenology. The results from two empirical studies, that indicated the need for a more in-depth examination of the interpersonal relationships when an older patient is present at a team meeting, were further explicated by philosophical examination in the light of Heidegger and Merleau-Ponty’s philosophy. The empirical studies were performed in a hospital ward for older people, where the traditional rounds had been replaced by a team meeting, to which the patients were invited. The analysis of the general structure and philosophical examination followed the principles of reflective lifeworld research. The philosophical examination is presented in four meaning structures: mood as a force in existence; to exist in a world with others; loneliness in the presence of others;and the lived body as extending. In conclusion, professionals must consider patients’ existential issues in the way they are expressed by the patients. Existence extends beyond the present situation. Accordingly, the team meeting must be seen in a larger context, including the patients’ life as a whole, as well as the ontological and epistemological foundations on which healthcare is based.

This chapter gives a Swedish perspective of the Dedicated Education Unit as a learning environment where caring and learning are united in ‘reflective tutoring’ at the University of Borås. The author discusses the overall purpose and structure of the Borås Dedicated Education Units, their scientific and philosophical bases and their focus on patient-centred student learning, reflection and research. She explains the key tutoring roles within the Borås Dedicated Educational Units, the lifeworld perspective of caring science that forms a frame of reference for learning and tutoring there and strategies that affirm and clarify the fundamental principle that caring and learning are parallel and common phenomena. She also describes the challenge for Borås Dedicated Education Units to focus on active patient care development through research, reflects on what is needed for successful tutoring, explains how Dedicated Education Units contain rich possibilities for concretising caring theory into practice and outlines six themes that characterise a Dedicated Education Unit from the students’ and tutors’ perspectives. The chapter concludes with the results of research evaluating the effectiveness of the DEUs as student clinical learning environments and suggests strategies for future development of the Borås Dedicated Education Units. © Springer Science+Business Media Dordrecht 2014.

Learning in caring contexts could be illustrated as an encounter between the scientific knowledge of caring and thelearner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start anintertwining process with the lifeworld that creates embodied knowledge. The aim of this article is to illustrate themeaning of this encounter with help of a theoretical foundation and two examples of research projects with a reflective lifeworld research approach (RLR) founded on phenomenology. Both examples describe the student nurses’ perspective.One illustrates promoting learning through lifeworld-led supervision in pairs of students. The other illustrates learning environments that bridges the gap between theory and practice. These two examples show how the intertwining of caring science theory with lived experience required a certain learning and caring atmosphere that is open and sensitive for the lifeworld. In conclusion, lifeworld-led learning is more than learning per se. Lifeworld theory as a basis for supporting students’ learning could provide both a broadened and deepened understanding of the meaning of learning and also a greater understanding of how to support students’ learning.

BackgroundThe environment of an intensive care unit (ICU) is, in general, stressful and has an impact on quality of care in terms of patient outcomes and safety. Little is known about nurses' experiences, however, from a phenomenological perspective with regard to the critical care settings as a place for the provision of care for the most critically ill patients and their families. AimThe aim of this study was to explore nurses' lived experiences of ICU bed spaces as a place of care for the critically ill. Design and methodsA combination of qualitative lifeworld interviews and photos-photovoice methodology-was used when collecting data. Fourteen nurses from three different ICUs participated. Data were analysed using a phenomenological reflective lifeworld approach. FindingsAn outer spatial dimension and an inner existential dimension constitute ICU bed spaces. Caring here means being uncompromisingly on call and a commitment to promoting recovery and well-being. The meanings of ICU bed spaces as a place of care comprise observing and being observed, a broken promise, cherishing life, ethical predicament and creating a caring atmosphere. Conclusions and relevance to clinical practiceThe architectural design of the ICU has a great impact on nurses' well-being, work satisfaction and the provision of humanistic care. Nurses need to be involved in the process of planning and building new ICU settings. There is a need for further research to highlight the quality of physical environment and its impact on caring practice.