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Biomedical subjects

K Dahlberg

Publications and source records attributed to K Dahlberg.

At least 19 recordsLinked to original sources
PubMed2001

Pre-understanding and openness - a relationship without hope?

Pre-understanding and openness - a relationship without hope? In all research, quantitative as well as qualitative, we have to deal with our presuppositions in order to remain open throughout the whole process of inquiry. If we fail to do so the findings might be little more than a reflected image of something already existing in our understanding. The question dealt with in this paper is: how can we gain increased openness by being more aware of our presuppositions. The aim was to investigate the intentional structure of pre-understanding and its effects upon data-collection as well as data-analysis and conclusions in research. The question of pre-understanding is central in Gadamer's philosophy, even if he is not the first one to discuss this concept. Gadamer further developed the philosophy of understanding. According to him pre- understanding is an intentional structure of feelings and thoughts, which is activated when we regard something as something. By studying the structure of pre-understanding we became more aware of its effect upon understanding. In this paper, theoretical frameworks within cognitive and social psychology as well as psychoanalytic object-relation-theory were compared with Gadamer's philosophy concerning the conditions of human understanding. Finally the possibility of increased openness in the process of research was discussed. (Such openness is related to knowledge about the structure of pre-understanding.)

Attitude of Health Personnel↗
PubMed2001

Swedish midwives' care of women who are at high obstetric risk or who have obstetric complications.

OBJECTIVE: to describe how midwives experience the care of women who are at high obstetric risk or who have an obstetric complication during pregnancy, childbirth and early parenthood. DESIGN: a qualitative approach using a phenomenological method. PARTICIPANTS: 10 Swedish midwives, recognised as highly skilled clinicians with at least five years of clinical experience in the studied context, from four different hospitals. FINDINGS: the essence of midwifery when caring for women at high obstetric risk or with a manifested complication was defined as 'a struggle for the natural process'. Women's transition, physically as well as emotionally, during pregnancy, childbirth and early parenthood, was described as a genuinely natural process. The midwives' struggle consisted of encouraging and preserving this process within each woman. It was based on embodied knowledge and included a balancing between the medical and natural perspectives. Prerequisites, and therefore part of the struggle for the natural process, were sensitivity to the spontaneous, mutual interaction with the woman and enduring presence. KEY CONCLUSIONS AND IMPLICATION FOR PRACTICE: the midwives' responsibility is to promote the natural process during pregnancy, childbirth and puerperium within every woman at high obstetric risk or with obstetric complications. The findings could serve as a basis for reflection on the professional role of midwives, and on the organisation of modern maternity care.

Adaptation, Psychological↗
PubMed2001

A meaningful relief from suffering experiences of massage in cancer care.

The experience of massage in an oncology ward was the focus of this study. Eight female cancer patients were given massage for 10 consecutive days and then interviewed using phenomenology as a theoretical framework. The essential meaning of getting massage as part of the daily care for female cancer patients was described as getting a meaningful relief from suffering. The findings identified five themes: the relief is meaningful because it offers the patient an experience of being "special." The massage contributes to the development of a positive relationship with the personnel, to feeling strong, and to a balance between autonomy and dependence. The massage also brings about a meaningful relief from suffering because it just "feels good." The findings of this study can be of use to health care professionals as it shows that the relatively short period of massage can result in physical and emotional benefits for cancer patients.

Activities of Daily Living↗
PubMed2000

Lip rejuvenation.

BACKGROUND: The management of the senile lip remains a dilemma. Allogenic fillers often feel unnatural, lip resurfacing is not adequate, and fat transfers may disappear. OBJECTIVE: To develop a more reliable step-by-step approach to lip augmentation. METHOD: Lips were divided into types: (1) the simple senile lip that had lost its fullness-treated with fat augmentation; (2) the lip with rhagades-treated with fat augmentation and laser resurfacing; and (3) the duckbill lip-treated with lip advancement, fat augmentation, and laser resurfacing. Tattooing to increase the degree of redness was performed on all types of lips. RESULT: If there had been a previously full lip, it was possible to rejuvenate the lip by simple augmentation with autologous fat transfer. The average number of fat transfer sessions to generate this pleasing lip was two to three. The lip with rhagades required fat filling, with laser resurfacing to achieve a new contour. The duckbill lip required a lip advancement along with lipofilling and laser resurfacing. All types benefited from lip tattooing. CONCLUSIONS: It was possible with fat augmentation and/or laser resurfacing to generate a pleasing lip in type 1 and 2 lips. Lip type 3 required a lip advancement along with fat augmentation and laser resurfacing. Lip tattooing accentuated all the lip types.

Adipose Tissue↗
PubMed2000

Context and methodological decontextualization in nursing research with examples from phenomenography.

In both human science and nursing research the concept of context is important. However, context can be understood in different ways. The aim of this article is to elucidate, discuss and problematize context, decontextualization and recontextualization in some health care-related phenomenographical studies. A further aim is to problematize the concept of context in a wider perspective of human science, in order to gain a better understanding of phenomenographical research related to nursing care. Our analysis indicates that the complex phenomena which characterize nursing research demand a broad contextual understanding. Both the local or immediate context and the global or mediated context must be considered, as they are dialectically related. This includes the informants' experiences of the phenomenon of interest as well as the socio-cultural discourse. A balance between openness and pliability to the phenomenon is suggested. Reflection is considered an important tool in this process. Within phenomenography, the interest is directed towards conceptions of certain aspects of the world. Thus, context in a wider sense is given a subordinate role. Accordingly, phenomenography is considered to have limited applicability in nursing research when complex phenomena are to be studied.

Clinical Nursing Research↗
PubMed1999

Neck rejuvenation by combining Jessner/TCA peel, dermasanding, and CO2 laser resurfacing.

BACKGROUND: One of the greatest challenges facing facial cosmetic surgeons today is the simultaneous rejuvenation of the neck and face. Laser resurfacing of the face using the carbon dioxide (CO2) laser or the erbium:yttrium-aluminum-garnet (Er:YAG) laser has enjoyed widespread popularity, but the neck and chest are often avoided. It would be quite helpful to rejuvenate the neck at the same time the face is being resurfaced. This would diminish lines of demarcation and help reduce the signs of aging of the neck. There would be a better match between the new skin of the neck and face. OBJECTIVE: To develop a safe and effective method to rejuvenate the neck. METHOD: A step-by-step skin care program was instituted. The patients preconditioned their face and neck skin with vitamin A/glycolic skin conditioning lotions for 6-8 weeks prior to surgery. Following this the chest and neck area was treated with the Jessner-trichloroacetic acid (TCA) peel. Then the middle section of the neck was sanded with 150 grit sandscreen. Finally, the central area was resurfaced with the UltraPulse CO2 laser using reduced power settings. Usually two passes was adequate to shrink the skin of this central section of the neck. A petrolatum-based ointment was applied during the initial 7-day postoperative period. After reepithelialization a sunscreen-moisturizer was used during the day and hydrocortisone moisturizer was applied at night. RESULTS: The neck skin was able to tolerate this step-by-step skin rejuvenation. The blending from the décolleté area to the hairline produced a rejuvenation without a line of demarcation. There were no examples of scarring in the 12 cases that were evaluated for 6 months. Two cases developed persistent erythema that responded to silicone gel sheeting. Although no patients complained of hypopigmentation, a decrease in pigment was found using special UV photography. CONCLUSION: It is possible with this gradient, step-by-step method to produce a rejuvenation of the neck. An improved texture of the neck developed without visible scarring.

Chemexfoliation↗
PubMed1999

Disappointing results following resurfacing of facial skin with CO2 lasers for prophylaxis of keratoses and cancers.

BACKGROUND: With the development of the short-pulse CO2 laser it was hoped that this resurfacing would prevent recurrent actinic keratoses and basal cell cancers similar to resurfacing with dermabrasion, laser abrasion, and deep chemical peel. However, we have begun to see patients that are developing keratoses and cancers within months following laser resurfacing. OBJECTIVE: To document the problems of recurrent keratoses and basal cell cancers in patients following CO2 laser resurfacing. METHODS: Thirty-five patients with extreme sun damage were seen at 3, 6, and 12 months following CO2 laser resurfacing for repeat color and ultraviolet photography and clinical examination to look for erythematous dyskeratotic lesions or papules with pearly borders. RESULTS: Five of our patients (14.3%) who had undergone recent CO2 resurfacing developed actinic keratoses and basal cell cancers. CONCLUSION: CO2 laser resurfacing is not as effective as dermabrasion, chemabrasion, and deep chemical peel for the prophylaxis of actinic keratoses and basal cell cancers, especially in Fitzpatrick type I and II patients.

Adult↗
PubMed1998

Women's experience of pain during childbirth.

OBJECTIVE: To describe women's experience of pain during childbirth. DESIGN: A qualitative study using a phenomenological approach. Data were collected by tape-recorded interviews. SETTING: An Alternative Birth Care Centre at a university hospital in Sweden in 1995. PARTICIPANTS: Nine women, four primiparous and five multiparous who were two to four days post delivery. KEY FINDINGS: Four themes were identified in the meanings of experience: (1) pain is hard to describe and is contradictory; (2) trust in oneself and one's body; (3) trust in the midwife and husband; and (4) transition to motherhood. The essential structure of the studied phenomenon was described as 'being one's body', which includes a non-objectifying view of the body, a presence in the delivery process, and a meaning connected to the transition to motherhood. IMPLICATIONS FOR PRACTICE: The women felt that pain was a natural part of the delivery process, and that the strength and power to cope with it came from within the women. A conclusion is that midwives can help birthing women to find their own ability to cope, and should interfere only if the woman asks or if the natural process is disturbed, e.g. by complications. The experience of pain during childbirth, together with the experience of strength during childbirth, gives meaning to the transition to motherhood.

Adaptation, Psychological↗
PubMed1998

A phenomenological study of women's experiences of complicated childbirth.

OBJECTIVE: To describe women's experiences of a complicated childbirth. DESIGN: A qualitative study using a phenomenological approach. Data were collected by tape-recorded interviews. SETTING: Sahlgrenska University Hospital, Göteborg, Sweden in 1995. PARTICIPANTS: 10 women, eight primiparous and two multiparous, who were interviewed two to five days post delivery. KEY FINDINGS: The essential meaning of women's experiences of complicated childbirth is the desire to be recognised and affirmed as a genuine subject. If this happens they feel accepted as childbearing women and as mothers-to-be, even if obstetric interventions are necessary and high technology is used. IMPLICATIONS FOR PRACTICE: By understanding and respecting every women as an individual the caregivers support women giving birth and make them feel accepted, thus paving the way for them to gain control over the situation. Through a true dialogue resulting in a trustful relationship, the women can manage even emergency situations. Separation of the mother and her baby should be avoided if possible.

Adolescent↗
PubMed1997

A lifeworld paradigm for nursing research.

This article is a companion to an earlier article entitled "Challenging a Reductionistic Paradigm as a Foundation for Nursing," which appeared in the December 1995 issue of the Journal of Holistic Nursing. The authors discuss how five concepts-encounter, openness, immediacy, uniqueness, and meaning-which constitute their philosophy for nursing practice, also comprise a foundation for human sciences research. In the first article, encounter was presented as the core concept for practice. In the present work, openness is the central idea in a lifeworld research paradigm, with encounter, immediacy, uniqueness, and meaning as supporting concepts. Openness is explicated with the notions of open-mindedness, open-heartedness, phenomenological questioning, and preunderstanding. A lifeworld paradigm for research is based on phenomenological philosophy and the understanding that the conduct of research is guided by the researcher's openness to the phenomena of the everyday world.

Humans↗
PubMed1996

Intersubjective meeting in holistic caring: a Swedish perspective.

Intersubjectivity is a central notion in nursing which describes the important relationship between nurse and patient. The aim of this article is to analyze the concept of intersubjective meeting and to examine its meaning in light of selected works by nursing and nonnursing authors who have addressed the phenomenon. Intersubjective meeting is posited here as a true and meaningful confirming dialogue. Thus, three elements of this construct will be adduced for further elaboration: a true and meaningful meaning, a confirming meeting, and the meeting as dialogue. For caregivers to engage in such an intersubjective meeting, they must exercise knowledge of self and have access to care for the caregiver.

Communication↗
PubMed1995

Qualitative methodology as caring science methodology.

Interest in the use of qualitative methodology is increasing among researchers within the field of caring sciences. Several reasons might account for this growing interest: disappointment from experiences with quantitative methodology in this field; interest in caring issues which do not lend themselves to quantitative analysis; and, simply, an emerging appreciation of qualitative methodology. There is a need for additional clarity about the applications of qualitative methodology in explication of caring. The major questions concern the suitability of qualitative methodology to the study of caring and the scientific status of qualitative methodology. This paper advocates qualitative methodology as a methodology of choice for scientific exploration in the field of caring.

Empathy↗
PubMed1995

Challenging a reductionistic paradigm as a foundation for nursing.

Historically, nursing practice has been grounded in the objective, analytic philosophy of the natural sciences. Over the past decades, caring--a humanistic concept--has been espoused as the essence of nursing. Paradoxically, practice based on the theme of caring remains aligned with the philosophy of the natural sciences and continues to use tools such as nursing process and nursing diagnosis, products of the natural sciences paradigm. The authors have outlined the foundation for a philosophy of caring. The encounter between caregiver and patient is the central aspect of this philosophy and is elaborated with the related concepts of openness, nonreductionism, immediacy, and meaning. In addition, holistic nursing practice requires attention by caregivers to their own self-awareness and the personal growth that is necessary for the demands of encountering patients. Practice based on such a philosophy maintains the primacy of the caregiver-patient relationship and permits the incorporation of analytic tools without depersonalizing effects.

Empathy↗
PubMed1994

The collision between caring theory and caring practice as a collision between feminine and masculine cognitive style.

In the Swedish education of nurses, teaching should be focused in a way that the students develop a holistic view of caring. Swedish health care and medical care should be carried out in a way that promotes a holistic view. It seems that the education of nurses has prerequisites to develop, and often does present, a holistic view to the students, but this view is not always carried over to practice. Student nurses think they have a theoretical understanding of a holistic view, but they cannot manage to transform their knowledge to practice. It is proposed that this failure to transfer knowledge of holistic care principles into practice is partly based on the fact that medical and technological thought dominate practice in the caring disciplines. This article explores some factors influencing caring theory and praxis and possible causes for the gap between these areas. The question of gender is proposed as a reason for the identified difference between theory and praxis. From a gender theoretical perspective, the difference can be understood as a collision between feminine and masculine cognitive styles. It is proposed that the caring ideals of holism are emphasized by the woman-dominated nursing schools, but these ideals are not able to influence practice of the caring professions, which are dominated by men.

Cognition↗