Tid för vårdande möten : att vidmakthålla och utveckla vårdandet med patientperspektivet i fokus

Sammanfattning: Aim: The overall aim is to examine how a patient perspective, grounded in caring science, can be preserved and developed in the context of hospital care. Methods: The first study examines attitudes towards caring science in a clinical practice. Data were collected through focus group interviews with seven nurses, three head nurses and four senior preceptors. An interpretive approach guided the study. The results called for collaboration between clinical praxis and the academy, according to how caring science can be preserved and developed. Study II–III functioned in accordance with this goal and were conducted in collaboration with a hospital ward for people over seventyfive years of age. In an attempt to develop care the patients were invited to attend a team meeting. The data in these studies were collected using interviews and observations. Fifteen patients (study II) and nine nurses (study III) who had experienced patient participation in a team meeting participated. In these studies, a reflective lifeworld approach guided the research process. Study IV is presented as a general structure and philosophical examination in the light of Heidegger and Merleau-Ponty’s philosophies. Main Findings: To preserve and develop a patient perspective is strongly connected to existential issues, such as lived time, intersubjectivity and a meaningful existence. For the patients, vulnerability is exposed and increased when the need for hospital care arises. The team meeting is experienced as an emotional situation where existential dimensions need to be recognized. The nurses desire to develop caring is challenged by organizational and economic demands. Time presents both a possibility for an encounter as well as a threat to excellent care. Conclusions: There is a need to challenge narrow processes in modern health care that value the staffs’ work and the patients’ vulnerability in quantifiable measures of efficiency. The challenge is to take into account something that is invaluable - human existence.