This article aims to describe the phenomenon of learning at a university-based nursing student–run health clinic, as experienced by student nurses and lecturers. The study is based on a reflective lifeworld research approach founded on continental philosophy. Eight group interviews were conducted with 38 student nurses and 5 lecturers. The data were explored and analysed for meaning. The results show that learning is supported by a permissive learning environment that builds on both individual and common learning as well as equal relationships within the student group, in relation to the visitors at the health clinic and, to a certain extent, in relation to the lecturers. The most significant finding is that reflective, development-oriented learning takes place when the students, supported by each other and their lecturers, reflect on how to relate to problems and situations. A situation-based learning approach is thus shown to create the prerequisites for lecturers being nearby, reflective dialogue partners but also supervisors in situations where the students ask for support and guidance.

Purpose: A patient is vulnerable and exposed due to illness, relies on and surrender to other people. In caring this means a special dependency. The aim of this study was to describe the origin of the concept ‘exposed’, to elucidate how the definition of this term has changed over time, and to outline its relevance in caring science. Method: A semantic concept analysis in two phases was conducted. Results: The findings show that over time, the degree of binding of the following synonyms has become stronger; unprotected/defenseless, naked/bare, pressed/jostled and unsafe/unprotected and can easily be transferred to a clinical nursing context. Conclusions: This study provides a deeper understanding of the concept 'exposed' semantically. Being exposed is a profound experience for patients who need to be seen as the person they really are. A life-world led care has an existential power that can support professionals, strengthen patients’ health processes, and alleviate the patient’s suffering.

Patients are vital for student learning. However, research has primarily focused on student nurse learning from a student or supervisor perspective; few studies have investigated patient perspectives. This study examines student care practice for patients in acute psychiatric day care. The aim was to describe patients’ experiences of care by student nurses in a psychiatric education unit, a collaboration between the clinic and academia. Data were collected through 17 lifeworld interviews with patients, of which 10 also included observations. Data have been analysed for meanings using reflective, lifeworld research (RLR). The findings reveal that the encounters involve an interactive process of giving and receiving, providing students with both health opportunities and risks. The findings can further be described by the following constituents: exposed and vulnerable; responsibility to support; the importance of accessibility; reciprocity; and engagement that evokes the desire to live a life with dignity. In a patient–student community, there are prerequisites for proper caring. Patient health seems to be positively affected when patients are involved in both their own care and student learning.

Background

Caring and learning in clinical educational contexts is characterized by an encounter between lived experiences of the patient and the student’s knowledge and understanding. In other words, it is an encounter between two lifeworlds, which has the potential to create a fruitful tension to develop deep knowledge about the patient’s world that can give direction for practice. We will argue that a particular kind of Caring science knowledge becomes an important tool to support this caring and learning process where the goal is to intertwine lived experiences of health and illness with professional knowing and scientific knowledge. From this perspective is even caring and learning an intertwined phenomenon, and it is this intertwining that enables lifeworld led care.

Aim

This paper presents a study that illustrate how caring and learning is intertwined from the students’ view in an educational clinical context.

Method/design

The study was carried out using Reflective Lifeworld Research (RLR) with a phenomenological approach. Lifeworld interviews were conducted with students after their clinical placement on a Dedicated Education Unit (DEU).

Result

The result shows that the essential meaning of the intertwined phenomenon is a movement where caring and learning fall into place which appears in an atmosphere filled with appealing challenges, but has to be sensitive to the students’ readiness. The atmosphere depends on their sense of security and how they experience confirming and affirming responses. Encountering the patient means that the students can gain a sense of the whole and the theory falls into place. The results also highlight how the student, in this atmosphere, has a desire to find a new role in a personal style.

Conclusions

On the basis of this study a challenge to the curriculum is presented, that is, to develop didactics and supervision models that use a holistic approach and adopt a reflective attitude upon caring and learning as intertwined and not separated.

Scientific knowledge is characterized by abstract descriptions and structures, which are not identical to the lived reality. Scientific knowledge cannot directly be applied on the lived existence, without being transformed and adjusted to the individual’s very complex lifeworld. Learning in caring contexts is an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. Lifeworld didactics are built on an approach about learning as an individual process and that learning takes its point of departure in the learner’s previous experiences, which accompanies the learning process. The challenges within lifeworld didactics are to be open and sensitive to the learner’s lifeworld and with tact support the development of a reflective attitude in the learning process. Lifeworld didactics strategies are of crucial importance in different caring contexts. This symposium presents three lifeworld led phenomenological research projects that have focused on acquiring caring science knowledge in caring contexts, more precisely it is the encounter between caring science and the lifeworld. The research is within the framework of lifeworld didactics, but the three projects each have a special focus.

To support care for patients in an adequate way, Caring science theory and nursing practice need to be intertwined to bridge problematic dualisms such as mind and body, sense and sensibility, theory and practice, learning and caring. The overall aim in caring is to support wellbeing and to strengthen health and how this is achieved has been discussed extensively. However ways of overcoming such dualistic understandings are needed to pave the way for a care that is up to the task of responding to human possibilities and vulnerabilities within the complexity of existence.

In supporting patients, we argue that a range of aspects, inter-relational, intellectual, emotional and embodied need to be evoked and reflected upon by students as a beginning foundation for the incorporation of, and the intertwining of Caring science theory and practice. This intertwining draws on knowledge for ‘the head’, ‘the heart’, ‘the hand’ (Galvin & Todres, 2013) and can develop and support a particular sensibility and sensitivity both of which are needed within clinical and learning contexts.

In this presentation we will show the importance of a solid theoretical foundation drawn from Husserl’s lifeworld theory and theory of intentionality, Merleau-Ponty’s later philosophy concerning how everything is intertwined in existence, as well as Gadamer’s ideas about shared understandings and Gendlin’s work on embodied relational understanding. While we have drawn from all these phenomenological perspectives, we will show how they serve as a coherent direction for overcoming the dualistic consequences of ‘splits’ such as, between human and world, illness and well-being , caring and technology, learning and caring, youth and old age, life and death and so on (Dahlberg et al., 2009).

Such existential ways of understanding and well considered ‘didactic tools’ are needed to support this concern. We will share a number of illustrations from the lifeworld led care and education theme within EACS to contribute to such developments:

• Embodied interpretations shared as poems (Galvin & Todres, 2011)
• Using films to support the understanding of Caring science theory and practice (Hörberg, Ozolins & Ekebergh, 2011; Hörberg & Ozolins, 2012)
• Learning through students’ creating poems from their responses to film (Hörberg, Ozolins & Galvin)
• The intertwining of caring and learning in clinical settings illustrated through two examples: firstly, a ‘developing and learning care unit’ (Ekebergh, 2009, 2011; Holst & Hörberg, 2012, 2013) and secondly, as a student led health clinic (Ozolins & Elmqvist & Hörberg, 2013) both supported by structures specifically from the lifeworld perspective.

This paper could serve reflection on how to integrate Caring science theory with practice in order to develop new curricula and practice to take care of the pending dualisms and other obscuring influences, such as 21st century organisational structures and demands that are problematic in research, learning and caring.

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.

Background: Clinical studies in nursing education ought to create conditions for the students to link theory to praxis.Previous research in this field focuses on the gap between theory and practice, learning environments, supervision andreflection connected to caring and learning. In addition there are studies that propose the concept of learning and caring asintertwined. The aim of this study is to describe how caring and learning is intertwined from a student perspective.Methods: The study was carried out using Reflective Lifeworld Research (RLR) with a phenomenological approach.Lifeworld interviews were conducted with students after their clinical placement on a Dedicated Education Unit (DEU).Results: The essential meaning is a movement where caring and learning fall into place which appears in an atmospherefilled with appealing challenges, but has to be sensitive to the students’ readiness. The atmosphere depends on their senseof security and how they experience confirming and affirming responses. Encountering the patient means that the studentscan gain a sense of the whole and the theory falls into place. The results also highlight how the student, in this atmosphere,has a desire to find a new role in a personal style.Conclusions: The study emphasizes the importance of supporting the students in understanding learning and caring asintertwined and not separated. A dualistic approach could harm the students’ aim to get the knowledge embodied. Thisholistic perspective requires a reflective attitude on caring and learning and has to be further developed in the didactics andsupervision.

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: 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: Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study.

Aim: To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs.

Material and methods: Twelve women, 27–54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used.

Results: One theme ‘catching a glimpse of and momentarily capturing well-being’ and four categories were identified: ‘Photographing moments of well-being visualizes well-being’, ‘Using photographs could either facilitate or complicate the narrative’, ‘Changing perspective in everyday life’ and ‘Creating recollections of well-being’.

Conclusions and significance: Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

Background: Stress-related mental health illnesses are increasing in all ages. Be-WellTM is a health-promoting intervention intended for primary healthcare. Be-WellTM involves 12 sessions based on photo-supported conversations. Patients use their mobiles to photograph situations about well-being, and the photos are used as a starting point for dialogues with their therapist. Aim: The aims of this study are to evaluate the feasibility of Be-WellTM, and to compare the outcomes concerning health and well-being in the intervention group with those of a control group. Method: This ongoing study is conducted in Swedish primary healthcare. A total of 70 patients in working age, living with stress-related disorders will be recruited. The intervention group receive the intervention Be-WellTM in addition to care as usual, and the controls only receive care as usual. Prior to and directly after the intervention, and after 6 months, the participants complete questionnaires and take part in qualitative interviews about stress and well-being in their present life-situation and experiences from participating in Be-WellTM. Non-parametric and qualitative analysis will be used. Results: Twenty-nine of 35 participants have been recruited to the intervention and 28 of 35 participants to the control group. We will present the research design and preliminary outcomes from the baseline and follow-up data.Conclusion: If the intervention Be-WellTM is found to be feasible with positive outcomes, the health-promoting intervention Be-WellTM can be useful as a complementary intervention in primary healthcare for patients with stress-related illness. Implications for Caring in a changing world: Probably, photo-supported conversations may promote well-being to other patients in different life situations, but future research is warranted.

Background: Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well™) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stressrelated illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation.

Methods/Design: This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20–67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of wellbeing and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology.

Discussion: The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention.

Caring science didactics is the framework of a supervision model that includes students learning process, from a lifeworld perspective, in an encounter with patients, supported by supervision in pair of students. A challenge in nursing education is to bridge the gap between theory and praxis. Reflection and a model for learning and supervision enable students to learn in meeting patients and to get a deeper understanding of their lifeworld. The aim of this study was to describe the learning process of students, in an encounter with a patient, when supported by supervision given to pair of students. Data were collected through interviews and diary entries, interviews in pair of students, and diary entries in private. The analysis was based on reflective lifeworld research approach, founded on phenomenology. Results show that security and insecurity in pair of students, environmental conditions and attitude of health care professionals have influence on students’ learning process. Meeting patients is described as important for the student learning process, but also as indiscernible and that supervised reflection serves to bridge the gap between theoretical and practical knowledge. Structured supervision is shown to be supportive for nursing students when developing in their learning process.

Keywords: caring science; learning; lifeworld; nursing students; phenomenology; reflection

Background: Clinical studies have an important position in Nursing Education, it is thus important to develop the learning strategies of students in order to facilitate their learning process during the clinical practice. The aim of the study is to describe the process of students’ learning towards their profession, when supported by supervision in pairs.

Methods: Data has been collected through interviews of students during their clinical studies. The study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on phenomenological traditions. The clinical settings are based on the model of the Developing and Learning Care Unit that has a structure that supports students in their learning towards becoming nurses.

Results: Results show that structured supervision is favourable for students learning, where pair of students, space and time play a significant role. The results are illustrated in following themes: The significance of responsibility for learning, the strength and sensitivity in pairs of students, the focus on doing, the significance of the attitude of the supervisor, the vulnerability and potential of the learning environment and Reflection as a possibility and a pre-requisite.

Conclusions: The study shows that the conduct of supervising in pair of students is of great importance for students’ learning and it is thus important to develop a reflective supervising approach and also knowledge of how to support students’ learning.

A Developing and Learning Care Unit is a learning environment in clinical practice designed to integrate theory and practice by using lifeworld didactics in order to support pairs of students in their professional development. Lifeworld didactics is based on a lifeworld led learning approach, which focuses on each student’s experiences and knowledge and supports each individual student and the students as a pair. The aim of this study is to explain and create an understanding of the phenomenon “learning space” that occurs in the interaction between patient, pairs of students and supervisors, during clinical practice. This hermeneutic study is based on a Reflective Lifeworld Research approach. The analysis is based on observations and interviews with patients, pairs of student nurses and supervisors at Developing and Learning Care Units. The result shows that the patient, pairs of students and supervisors are placed in the learning space, and are therefore related to each other. The relationships that arise in the learning space are enhanced through responsibility and the respect shown to each other. A relationship that appears to be supportive is characterized by: thoughtfulness, understanding of each other and enabling to ask questions. This creates an interplay of dynamic movements that are directed toward a common goal and thus provide opportunities to give and receive support. A balance between the patient, pairs of students and supervisor should thus be recognized to facilitate a favorable learning environment.

The aim of this study was to describe how supervisors’ support nursing students learning in pairs, during their clinical practice. The research is based on a Reflective Lifeworld Research approach founded in phenomenology. The analysis is based on seven individual interviews with head supervisors and four group interviews with base supervisors at Developing and Learning Care Units. There is a total of eleven Developing and Care Units in both somatic and psychiatric care. This learning environment is designed to integrate theory and practice through lifeworld didactics in order to support pairs of students in their professional development. The results show that supporting students’ learning in pairs is based on interpersonal meetings and entails focusing on learning in pairs, where both each individual student and the pair of students as a unit are given space. Being the ultimate support for students’ learning is a major challenge that requires flexibility towards the pair of students. Supporting students’ learning is also characterized by being present for the students with a reflective supervising approach, at the same time as supporting means to take a step back in relation to not be too prominent. The learning support, which is characterized by structure and reflection, is also challenged by the competing “reality of the nursing situation”, which is shown in a balancing act between the demands of the “reality of the nursing situation” and the space needed for reflective learning.

The purpose of this study is to describe how supervisors experience supporting nursing students' learning in pairs on a Developing and Learning Care Unit in Sweden. The present study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on phenomenology. A total of 25 lifeworld interviews were conducted with supervisors who had supervised pairs of students. The findings reveal how supervisors support students' learning in pairs through a reflective approach creating learning space in the encounter with patients, students and supervisors. Supervisors experience a movement that resembles balancing between providing support in learning together and individual learning. The findings also highlight the challenge in supporting both the pairs of students and being present in the reality of caring. In conclusion, the learning space has the potential of creating a relative level of independency in the interaction between pairs of students and their supervisor when the supervisor strives towards a reflective approach.

Purpose: Previous research shows that the learning space is significant for students’ learning in pairs in clinical practice but does not explain the meaning of the phenomenon. The aim of this study is thus to explain and understand the learning space that occurs in the interaction between the patients, the pairs of nursing students, and the supervisors on a developing and learning care unit in Sweden. 

Method: The study has been carried out with a Reflective Lifeworld Research (RLR) approach founded on hermeneutics. A total of 39 informants, consisting of 16 patients, five pairs of students (10 students), and 13 supervisors, were observed and interviewed. 

Results: The results reveal that an interpersonal linkage between the patients, the students, and the supervisors is created within the learning space. A learning space, based on respect towards each other, creates the prerequisite for beneficial and supportive interactions that contribute to a deeper relationship. 

Conclusion: The phenomenon is complex due to its expandable nature and due to the fact that the learning space cannot be isolated from the surrounding environment. In order to exploit the potential of the learning space it is of importance to understand and consider the learning space as a whole.

The aim was to describe and gain a greater understanding of the phenomenon “caring-learning space” based on the perspectives of patients, nursing students, and supervisors in clinical practice contexts.

A general structure of the phenomenon “caring-learning space” was created based on essential structures from five empirical studies. The analysis is based on a reflective lifeworld research approach (RLR).

The “caring-learning” space shows itself in terms of interpersonal relationships between patients, students, supervisors, and other actors in the care environment. It is first when the learning space is accepted as a part of caring, that a “caring-learning space” is created. A flexibility and a receptivity are seen where the learning is allowed to become visible and be integrated in the caring processes when caring and learning to interact.

A caring-learning space is established by the patient being the focal point, but also a co-creator in caring as well as learning regardless of her/his health status. This entails that the ”caring-learning space” exists when patients, students, supervisors and other healthcare professionals interact based on their ability and role in the space.KEYWORDS:

An increasing number of older people with severe mental illness (SMI) poses additional challenges to healthcare and social services. This scoping review aimed to investigate the life situation of older people living with severe mental illness and identify the research gaps in the existing literature. The current review followed the methodological framework for conducting scoping reviews by Arksey and O'Malley, consisting of five main stages: (1) identifying the research question (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarising, and reporting the results. An optional sixth stage, a consultation exercise, has also been used in this study: The scoping review was conducted in accordance with the PRISMA extension for scoping reviews PRISMA-ScR, and the databases PsychINFO Scopus, Cinahl, Web of Science and PubMed were used. A total of 24 studies were included in the review. The thematic analysis focused on: (1) the perspective of older people with SMI, (2) the perspective of healthcare professionals supporting older people with SMI, and (3) the perspective of informal carers supporting older people with SMI. The results describe the life situation of older people living with SMI, especially in relation to the older peoples' experiences of suffering and well-being. The staff and the informal carers need adequate knowledge to provide support to the older people with SMI. To gain greater knowledge about the life situation and support needed by older people with SMI, we strongly advocate additional research focusing on their own experiences.

To be sentenced to care in the forensic psychiatric services can be seen as one of the most comprehensive encroachments society can make on a person's life and being, as it entails a limitation of the individual's freedom but with no time limit. The aim of this dissertation is to describe caring in forensic psychiatry based on how it is experienced by those who perform the caring and by those are cared for in a maximum secure unit. A reflective lifeworld approach, based on phenomenological philosophy, has been applied. The data has been collected in interviews that have been analyzed by use of a meaning analysis searching for the essence of the phenomenon. The results of the research are presented in two empirical studies and a general structure based on the empirical findings. The dissertation also contains an excursus, a philosophical intermediate chapter containing further analysis of the results of the studies.

The results show how the forensic psychiatric care is experienced as being non-caring by the patients with only small "pockets" of good care. Caring consists of corrective techniques that are unreflected and contradictory, where the conditions are determined by the caregivers and the ward culture. The correcting takes place through the modification of the patients' behaviour with the aim of the patients having to adapt themselves to the terms of the care provision. This care results in the patients trying, by use of different strategies, to adapt them-selves to the demands of the caregivers in order to gain privileges. At the same time the patients long to get away from the care system and are lacking real, meaningful and close relationships. To be the subject of care entails struggling against an approaching overwhelming sense of resignation and to care entails experiencing both power and powerlessness in performing the care. A destructive power struggle is being waged within forensic psychiatric care that suppresses the caring potential and true caring is thus elusive.

The characteristics of forensic psychiatric care, based on the results of the research, are clarified in the dissertation's excursus. These include the corrective and disciplinary nature of forensic psychiatric care, its power and how this is materialized in care situations as well as the influence of tradition on current forensic psychiatric care in the light of the work of the French philosopher Michel Foucault.

The dissertation shows that if the caring potential is to be able to be developed and form a caring nucleus for forensic psychiatric care then education levels need to be further developed. A caring culture and caring environment is needed where true caring can gain a foothold. In order for this to become a possibility the current caring culture and environment must be clarified, questioned and examined. The prevalent fundamental ideas in forensic psychiatric care have to be "jeopardized" and challenged by new scientifically based ideas on what constitutes true caring in this context.

PURPOSE: This study aimed to discuss how caring science can contribute and provide a theoretical foundation for the development of caring within forensic psychiatric care.

CONCLUSIONS: It is not only a challenge but also a great opportunity to use caring science theory within forensic psychiatric care when caring for the patients and supporting their health processes.

PRACTICE IMPLICATIONS: There is a need for more knowledge about, understanding of, and willingness to care for patients within forensic psychiatric settings in a “true caring”way. In order to achieve this, a caring culture is required, one that supports carers and provides them with opportunities to further develop a caring attitude.

Den 7 mars disputerade jag med min avhandling Att vårdas eller fostras. Det rättspsykiatriska vårdandet och traditionens grepp, vid institutionen förvårdvetenskap och socialt arbete, Växjö universitet. Fem års forskarutbildning och arbete med avhandlingen innebär att det funnits många tillfällen för reflektion och problematisering över det egna arbetet.

Vårdrelatoner är både en möjlighet och en förutsätning för at kunna förstå och möta patenten och en möjlighet för at uppnå delaktghet. Det handlar om at försöka möta och förstå patenten som människa och den person hen är. Psykiatrisjuksköterskan och forskaren Ulrica Hörberg från Linnéuniversitetet refekterar över dialog och partnerskap som förutsätning och möjlighet i psykiatrisk omvårdnad.

Patients in forensic psychiatric clinics are a vulnerable and exposed patient group due to suffering from a severe mental disorder, having committed a crime and being cared for against their will in an institutional environment with a high level of security. The art of understanding in forensic psychiatric care is discussed from a caring science perspective, based on a lifeworld approach. The aim is to contribute knowledge that can support staff, who daily meet patients on forensic psychiatric wards, in applying a caring attitude.

Being healthcare professionals in the complex field of forensic psychiatry care (FPC) seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer’s philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient’s care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one’s own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family’s resources.

The Mental Health Care reform in Sweden aimed, among other things, to improve the possibilities for persons with mental illnesses to experience companionship and participation in society. The aim of the study was to describe how persons suffering from mental illness perceive their relationships with nursing staff in local authority psychiatric services. Data were collected through semi-structured recorded interviews with 17 strategically chosen clients. A qualitative approach inspired by phenomenography was used to analyse the data. The analysis resulted in four main categories and 13 subcategories. The main categories were: security, companionship, confirmation and development.

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.

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.

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.

Introduction and Aim: There is limited scientific knowledge about older people with severe mental illness and the support they receive in municipal housing and home care. Greater knowledge of their life situation can contribute to the development of support and care interventions for the target group. The aim was to describe how older people with severe mental illness experience their life situation and the support they receive in their daily lives in ordinary housing or care homes.

Method and Results: The project is a part of an EU project “Innovatedignity” focusing on sustainable and dignified care for older people. Thirteen lifeworld interviews were conducted with older people (11 women and 2 men), between 65 to 81 years of age, with severe mental illness who receive support and care from municipal care staff in their own home or in special housing in the municipality. The interviews were conducted in the older people’s homes, lasting between 40 to 60 minutes. The interviews were characterized by openness and flexibility towards the phenomenon of the study “the life situation and support in everyday life and in the home”. The opening questions were: “Can you tell me about a usual day in your life?” and “How do you experience the support you receive from municipal care staff in your everyday life and in your home?” The data was analyzed with a phenomenological meaning analysis based on a Reflective Lifeworld Research (RLR) approach.All of the older people with severe mental illness had experiences of being treated or cared for in mental hospitals or psychiatric care homes earlier in their lives. Preliminary findings indicate that their everyday life was characterized by routines, such as eating, receiving help with cleaning and personal hygiene, and going for walks, watching television, or smoking. The older people in special housing talk of there being some members of staff who they feel they can trust and who they feel understand them, but they have little contact or connection with the other residents. Their contact with other residents was minimal because they do not have a sense of companionship with them or have the same interests. The older people in ordinary housing receive less support from municipal care staff, and most of this support was for cleaning and purchasing food and other supplies.

Conclusion: To conclude, the result is characterized by a sense of loneliness and a lack of belonging, even though the majority lived in housing together with others. There is a challenge for the municipalities to create accommodation for elderly people with severe mental illness that can feel like a home and not an institution with locked doors and long corridors.