Vårdande och icke-vårdande tröst

The aim of the thesis is, from a caring science perspective including a caring theology perspective, to illustrate the meaning of the phenomenon consolation and howconsolation relates to suffering and care. Two studies were completed where staff and elderly care receivers were interviewed and a third study focused on an analysis of consolation as it is presented in the Book of Job in the Old Testament. These studies deal with carers' experiences of consolation and consoling, elderly care receivers' experiences of consolation, and Job's experience of consolation. Phenomenology and hermeneutics form the basis for the methodological approach. A phenomenological- hermeneutic method, inspired by Paul Ricoeur, has been used for the text analyses. The thesis also covers significant aspects of poetical and religious texts. The metaphors that occur in the interview studies with the carers and the elderly are analysed in order to take care of the excess of meaning that, according to Ricoeur, can be expressed in metaphors. The result showfive overall meanings: The contradictory consolation, The bonding consolation, The mute and rigid consolation, The uncontrolled consolation and The restful consolation. A caring consolation is contradictory in the sense that it entails that the sufferer on the one hand passes on his or her suffering to someone else and on the other hand that the suffering can be returned to be suffered. Consolation can thus entail suffering. The bonding consolation is present, i.e. is with the sufferer and is based on that person's suffering. This consolation is characterised by a close fellowship, a feeling of being understood at a deeper level. The results also reveal a consolation that is mute and rigid. This consolation does not respond to the sufferer's experience of his or her suffering, is shapeless and therefore unable to follow the suffering. An example of a mute, rigid and non-caring consolation is the consolation of the friends in the Book of Job. This consolation is not capable of consoling because it does not correspond to where Job is, i.e. in his experience of his suffering. A caring consolation is also uncontrolled because it is on the one hand spontaneous and on the other hand helps the sufferer to lose control over the suffering. To lose control entails, amongst other things, the sufferer giving up trying to understand suffering and instead lets that which is incomprehensible be incomprehensible. A consoling and health-bringing rest in or from the struggle with suffering presents itself by giving up what in various ways is tied to the suffering. The result as a whole is interpreted from a caring science perspective with the following important concepts: caring relationship, faith, health and sacrifice. Consolation as health is considered on the basis of a theoretical model inspired by Katie Eriksson's ontological health model. The research is also illustrated from a philosophical-ethical perspective, mainly based on the work of Emmanuel Levinas. The findings are discussed in relation to previous research and also to caring science, society and care.

Generic and professional caring in a Chinese setting: an ethnopraphic study

The objective of the present study is to describe the cultural care practices, meanings, values and beliefs which form the basis of caring in a Chinese context. The research has its starting point in a caring science perspective and a qualitative research approach with interpretative ethnography as methodological guideline. The theoretical perspective is formed by elements of the theory of caritative caring, developed by Eriksson, and the theory of Culture Care Diversity and Universality, developed by Leininger. Previous research of suffering, culture and caring is described and also a presentation of actual transcultural nursing research as well as a presentation of the social structure dimensions of Chinese culture is included in the theoretical background. The empirical part includes patients and relatives, nurses and Hu Gongs as informants. The data collected are analysed based on Geertz’s idea of forming “thick descriptions” through examining the “what, how and why” of people’s actions. The findings show that the family has a prominent position in Chinese caring practices. The patient plays an unobtrusive role and a mutual dependence between the patient and the family members is evident. The professional nursing care is an extended act which includes the family in the caring relationship. The care practices of the Chinese nurse are characterized by great professional nursing skills. Suffering is described by the informants as being caused by disease, pain and social circumstances. “Social suffering” is described as worse than physical or mental suffering. Culturally competent and congruent care is a prerequisite for avoiding cultural pain, imposition and blindness when caring for the suffering human being. The findings of the present study necessitate a broadening in caring theory to include the family in the caring relationship. A further conclusion is that a broadening in our perception and understanding of culture would promote the delivery of culturally competent and congruent care. Suffering need to be seen as enclosed in cultural patterns of how it is expressed, interpreted, understood and relieved. Care and caring need to be seen as embedded in culture and the care practices values and beliefs have to be congruent with the cultural patterns where the care is provided.

Den etiske akten : den caritative etikken når pasientens fordringer er av eksistensiell art

The purpose of this thesis is to develop a theory model about some core concepts and phenomena within caritative ethics when patients' demands are existential. There are two research questions, (A) Which realities represent concepts such courage, responsibility, and sacrifice within the caritative ethics. (B) Which phenomena of ethical significance are made current and applicable when patients¿ demands are existential. This study takes as its point of departurecertain chosen theoretical perspectives that discuss some perspectives of the concepts of courage, responsibility, and sacrifice in terms of their significanceto the research questions A. This represents the study¿s theoretical data. The empirical data provide answers to the research question B. In the end, the thesis discusses synthesis of these two accesses of knowledge in order to formulate theses and create a theory model. Løgstrup's contribution and description of the ethical claim helps in understanding and interpreting the links between the substance of the caritative ethic and the concrete reality in the encounter with existential issues. This thesis is a study within the field of Caring Science. The nursing profession provides empirical data and reflects the study topic, by addressing issues of relevance to the application of the knowledge of Caring Sciencein light of the nursing profession's various daily challenges. This study proceeds from the basic assumption: "Caring relationships form the meaningful contextfor caring and derive from the ethos of love, responsibility, and sacrifice, i.e. a caritative ethics" (Eriksson 2001). This study attempts to explore and prove this statement in the light of theoretical and empirical data, in the light ofthe caring scientific perspective which is here linked particularly to the viewof man as a unity of body, mind, and soul, and to the ontological health model. Hermeneutics is the overall perspective for the interpretations proposed in this thesis. Through conversation and hermeneutic observations, I try to understandthe challenges of nursing performance in the encounter with existential issues. This constitutes the empirical data that was gathered on a ward treating cancerpatients. The discussion proceeds sequence by sequence, first by discussing theconditions of the caritative ethics when meeting the existential claims in the light of the concepts of courage, sacrifice, and responsibility. Then a thesis is formulated concerning the caritative ethics in the light of Caring Science. This is the foundation of the creation of the theory model. The resulting theses concern the chosen concepts and phenomena which promote caritative ethics when patients' claims are existential: Freedom is the hallmark of caritative ethics. Freedom is the basic category of caring. When attending to the patient's existential claims, it is of vital importance to secure human relationships as caring interpersonal communions, created by responsible persons who have shown courage and sacrifice. Courage and sacrifice constitute the ethos of caring communities (communions). Courage and sacrifice are then a part of the collective ethos of caring communities, because the patient is confirmed as the unity of body, mind, and soul.

Makt som fullmakt : ett vårdvetenskapligt perspektiv

The aim of this study is to deepen understanding and knowledge of the concepts and phenomenaof power and authority from the standpoint of caring science. The overall questions of the research are: What is power? What is authority? How do power and authority manifest themselves in the context of caring? How are power and authorityto be understood as caring science concepts? The overall research inception is determination of the concepts in accordance with the hermeneutic approach based on Eriksson's model. The process of understanding follows Gadamer's (1999) hermeneutics. The thesis consists of three part studies. An ontological determinationof the character of the concepts is carried out where a hermeneutic interpretation is made of texts in the Old and the New Testaments in the Bible. The pragmatic features of the concepts are studied on the basis of nurses' written stories of authority and patients' written stories of power and authority. Beside the review of literature concerning power and authority a qualitative meta-analysis ofthe concept and the phenomenon of empowerment are made. The ontological determination shows how a human being's power is the authority to hold every living thing in trust, to tend and care life. To anyone using this authority, serving onesfellow-being is the purpose. Understanding the pragmatical features of authority in the stories of nurses reveals the life-giving nature of serving. By serving the nurse draws near her true mission as a human being, her authority to care for life with love. The service of the nurse and her ability to see and confirm the patient's otherness creates confidence and results in her authority. The nursedoes not abandon the responsibility associated with authority. When the patientdoes not entrust the nurse with authority the nurse employs her inherent authority to alleviate the suffering of the patient. The pragmatical features of the concepts of power and authority in the patients' stories indicate how the nurse puts her power to an improper use if she only makes use of the authority conferred by the hierarchy of power in the organisation, assumes all power and fails to use her faculty for loving care. Patients feel that their existence is threatened when the nurse tries to deprive them of their authority; they experience homelessness, despair and impotence. Patients' struggle for existence and absolute dignity deprives their health processes of strength, and their suffering becomes unbearable. Patients recognize their vitality when encountering a nurse who uses her authority to alleviate the patients' suffering. The power of compassion is strong, and the patients' dignity is recreated when they are able to serve fellowpatients or nurses. The purpose of human life can be understood as the use of one's own inner power and strength. Love.

Undersökning, om Nyland och Tavastehus län, i anseende til dess, läge, vidd, climat, våhr-floder, sjöar och vatuleder, naturs förmåner och brister, näringar, folkrikhet, politie och cameral författningar. Andra delen : ... under ... Pehr Adrian Gadds inseende, utgifven och försvarad för lagerkrantsen af Samuel Gabriel Mellenius norr finne. I Åbo Acad. öfre lärosal före m. den [ ] Junii 1789.

Dedicated to: Helena Marg. Lybecker, née Hising.

Undersökning, om Nyland och Tavastehus län, i anseende til dess, läge, vidd, climat, våhr-floder, sjöar och vatuleder, naturs förmåner och brister, näringar, folkrikhet, politie och cameral författningar. Tredje delen : ... under ... Adrian Gadds inseende, utgifven och försvarad för lagerkrantsen af Carl Bergman, nylenninge, kongl. stip. I Åbo Acad. öfre lärosal förr mid. den 22 Junii 1789.

Dedicated to: Carl Ulner, Adam Ulner, Carolus Bergman.

Historisk och oeconomisk beskrifning öfwer sjö-staden Ekenaes : ... under ... Pehr Kalms inseende, ... utgifwen och til allmän granskning öfverlämnad i Åbo Academiens öfra läro-sal för middagen den 4. Augusti 1760. Af Carl Bergman. Nylänninge.

Dedicated to: Anders Anton von Stiernman, Olof von Dalin, Borgmästare och Råd i sjö-staden Ekenaes.

Sednare delen, om Gamle Carleby, ... : Utgifwen af praeses Jacob Chydenius Jac. son, och som et academiskt prof, allmän granskning understäld i Åbo Academies öfre sal den 7. Dec. efter middagen 1754, af respondens Samuel Fabrell, norr finne.

Dedicated to: Thomas Holmstedt, Wilhelm Ehrnstolppe, Friedrich Grönhage, Henric Dahlman, Christlieb Lebr. Carpelan, Axel Germund Lilliegren, Johan Haxen, Pehr Granroth.

Geographisk, physico-economisk och historisk beskrifning öfwer Birckala socken uti Åbo höfdingedöme : af Daniel Hall, commissions landmätare i Finland.

Offprint from: Samling af rön och afhandlingar, rörande landtbruket, som till Kongl. Wetenskaps Academien bilfwit ingifne, tom. 4.

Oeconomisk beskrifning öfwer Åbo stad, : med wederbörandes tilstädielse, under professorens i naturkunnigheten, ... Carl Fridric Mennanders inseende, som et academiskt prof. framgifwen i Åbo den [ ] Octob. 1749. af Niclas Wasström, studiosus medicinae.

Dedicated to: Carl Gustaf Tessin, Jean Georg Lilljenberg & Johan Browallius, Algot A. Scarin & Johan Leche & Jonas Synnerberg & Joachim Schultz.

Historisk och oeconomisk beskrifning öfwer Cajanaborgs-län : ... under ... Pehr Kalms inseende ... til almänt ompröfwande framgifwen i Åbo Academ. öfre sal, den 13. Junii 1754. Af Eric Castrèn, österbotninge.

Dedicated to: Lars Henric Backman, Jacob Salmen, Abraham Frosterus, Johan Frosterus, Simon Appelgren.

Afhandling om hushållningens upkomst och tilväxt i Österbotten : Första delen, med philosophiska facultetens bifall utgifven och försvarad af Hans Petter Winge, phil. mag. och Jacob Abraham Strömmer, Österbottningar. I Åbo Academies öfre lärosal den 22 Februarii 1797, på vanlig tid förmiddagen

Bound in: Dissertatio historica de paroecia Alandiae Lemland, eique annexa Lumparland / Daniel Ferdinandus Mallén. Aboae : typis Frenckellianis, [1792]

Academisk afhandling och oeconomisk beskrifning öfwer Kulsiala församling i Tavastehus län, ... : under ... Pehr Adrian Gadds anförande, utgifwen och förswarad af Lars Palander, Gabr. S. Tawast-Finne. I Åbo Academiens öfre lärosal den 25 Junii 1767. På wanlig tid, förr middagen.

Dedicated to: Otto Ernst Boije, Anders Boije, Eric Johan Andersin, Gustaf Lewander.

Förra delen, om Gamle Carleby, ... : ... under ... Pehr Kalms inseende ... och almen granskning understäld i Åbo Academies öfre sal, den 19 Julii efter m. 1754, af Jacob Chydenius, Jac. son, österbotninge.

Dedicated to: Jacob Chydenius.

Försök til en historisk, geometrisk och physico-oeconomisk beskrifning öfwer Pedersöre sokn i Österbotn : Första delen : Öfwer sjö-staden Jacobsstad : ... under ... Pehr Kalms inseende ... förswarad af Hans Henric Aspegren, österbotninge. Den 1 Julii 1763, för midd. i Åbo Acad. öfre lärosal.

Dedicated to: Pontus de la Gardie, Ephraim Otto Runeberg, Johan Billmark, Carl Joh. Bäckman, Lars Blom, Nathanael Häggström, Matths Nyman, Anders Biring, Anders Winstefn, Petter Teliin, Carl Malm.