Vårdandets symfoni Fenomenet vårdrelation i skenet av två världsbilder

Sammanfattning: This thesis 'The Symphony of Care' consists of four studies focusing on care relationships between patients and professional caregivers.Care relationships are central to the health process and a fundamental element in caregiving. The term care relationship is widely used in caring science but lacks a clear definition, which can create misunderstanding and can constitute an obstacle when attempting to optimize care relationships.The aim of this thesis is to describe the phenomenon of care relationships in order to add to the body of knowledge in caring science.The main research questions are:• What is a care relationship within the caring science field?• How can a care relationship be optimized to improve its caring function, in order to promote health?The ontological foundation of this thesis is caring science. Phenomenology and Lifeworld theory are used as its epistemological bases. Reflective Lifeworld Research is used as a methodological approach.The four studies were conducted in different contexts and cultures- the first two empirical studies were performed in China and the remaining two, a metasynthesis and a secondary analysis, were carried out in a Swedish context.The results show that care relationships are temporary intentional relationships between a person who needs help and a helper. The purpose of this relationship is to support the patient in his/her dynamic health process, which is unique for each person in different times and contexts. Care relationships are fragile because the patient is vulnerable and the demand on the helper is great. It is an inter-human relationship between equals, which can at the same time be an asymmetric relationship due to the professionalism with the caregiver and the vulnerability with the patient. A care relationship is not independent, but is affected by internal factors such as the two individuals' lifeworlds and external factors such as health policies, organization, economics, health culture and environment. To optimize the effectiveness of caring, the relationship and its surrounding need to be in harmony. The view of care relationships should be broadened to include the external resources in order to optimize their caring potential.