Matka serkamolaiseen teatteriin : kohti sanatonta kerrontaa

A travelogue to serkamoan theater deals, just like its name implies, with the molding process of one theater opinion. It has been influenced by both Aristotle's poetry and Bertold Brecht's epic theater. Side by side with theater goes dance, whose development the thesis also considers briefly. Of today's theater makers, Päivi Ketonen (playback theater), Juha Hurme and Nigel Charnock (dance theater) have had a definitive impact on the Serkamoan theater view. Their relation to theater and dance is clarified in the interviews conducted by the writer, which can be found in their entirety among the appendices of this thesis. Serkamoan theater has also been influenced by the writer's studies in Portuguese theater school in 2004. In Portugal the writer had a chance to work a theater piece in a new cultural environment where, for example, a novel and paintings were used as inspiration. The strongest legacy from Portugal however was the desire to do theater that can be understood without words. Serkamoan theater considers the combinations of theater and dance in performing arts, agreeing with, among others, Pina Bausch's footsteps. Serkamoan theater ladles its inspiration from theater, dance, human being, human body and movement. It is theater that cannot be understood through intellect but through the heart.

Maahanmuuttajaoppilaat erityiskouluissa

Immigrant Pupils in Special Education Schools The study focused on the opinions of immigrant pupils in the 1st–9th grades of basic education in four special education schools of the City of Turku and in need of special support about the following: 1. Their difficulties in going to school in general education before the transfer to a special education school. 2. Their opinions about the transfer process to special education and the changes in their school practice after being transferred to a special education school. 3. Their experiences about their school and coping in special education school. The study strengthened the idea that immigrant pupils need positive special treatment, linguistic support, individual guidance, small teaching groups and operating models that promote well-being on their integration and education path. The central educational idea of inclusive education is based on deconstructing the power structures concerning gender, ethnicity and “race” and approval of differences in the pupils. Shifting the emphasis from the pupil to working on the learning environment has resulted in special education no longer being primarily separate special education tied to a certain place, but directing the teaching more towards individuality. The central dimension of intercultural competence of a teacher working in a multicultural class seems to be the attitudes and approaches to a different pupil; the teacher must be interculturally sensitive when facing children and young people from a foreign culture. Education and teaching affect every sector of the pupil’s well-being. Learning and learning results have a connection with teaching, education and well-being. Every sector is important for the going to school and integration of an immigrant pupil in need of special support. The basis of the study is the equality of opportunities and the humanistic idea of the human being in the Finnish education policy. The immigrant pupils selected for the study represented the following language groups: Arabian, Albanian, Somali, Russian and Vietnamese. In the four special education schools, the number of immigrant pupils belonging to these language groups (2004) totalled 104. A total of 89 pupils i.e. 86% answered the questionnaire, which is sufficient considering the generalisation of the study. Although this is basically a quantitative study, the interviewing method was used in part of the study, because the questionnaires were in Finnish and consequently, it was difficult for some immigrant pupils to understand them. Understanding the questions was also affected by the fact that the age distribution in the study was very wide (7–18). According to the results of the study, the immigrants felt that the biggest drawbacks in general education were their inability to speak Finnish and lack of concentration. The actual process of being transferred to a special education class remained unclear for immigrant pupils, and they could do very little about the transfer themselves. The results show that immigrant pupils coped well in special education school; they felt that their learning ability and concentration improved in the small groups of the special education school. They considered the individual support given in the special education schools to be useful. The lower-grade immigrant pupils had a more positive attitude towards special education school than the upper-grade immigrant pupils. In all the special education schools the immigrant pupils experienced that they were in a good position in the class; girls felt this even a little more strongly than boys. The teacher-pupil-relationship was felt to be good. School bullying being so common was a negative feature experienced by immigrant pupils, who were often targets or bullies themselves. Immigrant pupils believed in their success at school and in the opportunities offered by special education schools. Generally they were of the opinion that pupils are not labelled by special school; however, upper-grade immigrant pupils were more hesitant than lower-grade immigrant pupils. This study aimed at bringing out the immigrant pupils’ own opinions. Teaching immigrant pupils in special education schools has not been very much studied in Finland, which made the topic new and even more challenging.

Cardiovascular effects of short term exposure to electric and magnetic fields of electricity power transmission

In the electrical industry the 50 Hz electric and magnetic fields are often higher than in the average working environment. The electric and magnetic fields can be studied by measuring or by calculatingthe fields in the environment. For example, the electric field under a 400 kV power line is 1 to 10 kV/m, and the magnetic flux density is 1 to 15 µT. Electricand magnetic fields of a power line induce a weak electric field and electric currents in the exposed body. The average current density in a human being standing under a 400 kV line is 1 to 2 mA/m2. The aim of this study is to find out thepossible effects of short term exposure to electric and magnetic fields of electricity power transmission on workers' health, in particular the cardiovascular effects. The study consists of two parts; Experiment I: influence on extrasystoles, and Experiment II: influence on heart rate. In Experiment I two groups, 26 voluntary men (Group 1) and 27 transmission-line workers (Group 2), were measured. Their electrocardiogram (ECG) was recorded with an ambulatory recorder both in and outside the field. In Group 1 the fields were 1.7 to 4.9 kV/m and 1.1 to 7.1 pT; in Group 2 they were 0.1 to 10.2 kV/m and 1.0 to 15.4 pT. In the ECG analysis the only significant observation was a decrease in the heart rate after field exposure (Group 1). The drop cannot be explained with the first measuring method. Therefore Experiment II was carried out. In Experiment II two groups were used; Group 1 (26 male volunteers) were measured in real field exposure, Group 2 (15 male volunteers) in "sham" fields. The subjects of Group 1 spent 1 h outside the field, then 1 h in the field under a 400 kV transmission line, and then again 1 h outside the field. Under the 400 kV linethe field strength varied from 3.5 to 4.3 kV/m, and from 1.4 to 6.6 pT. Group 2spent the entire test period (3 h) in a 33 kV outdoor testing station in a "sham" field. ECG, blood pressure, and electroencephalogram (EEG) were measured by ambulatory methods. Before and after the field exposure, the subjects performed some cardiovascular autonomic function tests. The analysis of the results (Experiments I and II) showed that extrasystoles or arrythmias were as frequent in the field (below 4 kV/m and 4 pT) as outside it. In Experiment II there was no decrease detected in the heart rate, and the systolic and diastolic blood pressure stayed nearly the same. No health effects were found in this study.

Ihminen organisaatiossa ja organisaatio ihmisenä - organisaatiotasojen kadottamisesta postmodernissa organisaatiotutkimuksessa

Abstract: Human being in organizations and organization as a human being - on loosing organizational levels in the postmodern research on organizatons

Ammatillisen osaamisen tukeminen muuttuvissa toimintaympäristöissä : tutkimus ikääntyvien työntekijöiden näkökulmasta

The purpose of the study was to describe the experiences of received support of aging employees and their work related self-image in changing working environments. Firstly, theaim was to discover how the support from organisations and leaders was verified. Secondly, the aim was to get answers how employees experienced themselves as workers and as learners in the current work context. Thirdly, the aim was to compare different knowledge information stages and company cultures and how they have influenced the experiences of professional competence development among aging employees. In addition the education- and career backgrounds were investigated to gain more understanding of their role in experiencing support and relation to the occupational self-image. The theoretical frame of reference of this researchis multidisciplinary. The theoretical part focuses on the meaning of work for human being from a sociological, late-modern perspective. On the other hand it examines the ageing process from a physiological and also from a perspective of age discrimination and life control. The occupational selfimage and the strength of motivation has an effect on learning in working life which is crucial and firmpart individual trajectories. According to the theoretical review company culture, leadership and especially the managers' role as a creator of a learning atmosphere are increasingly critical for aging adults' learning when the role of informal work-based learning is increasing. The empirical data was collected with aquestionnaire and interviews, which were carried out in May to October 2001. The data consists of 263 respondents of which further eight persons were interviewed. All respondents were over the age of 45 and represented all levels of their organisations in an IT-technology firm and a chemical industry plant. The central findings in this research show that the aging adults have experienced that theemployers do care about the development of their occupational skills. On the other hand there are fewer concrete activities to reveal this support. There is anobvious disproportion between the expressed aims and the realisation of the activities. Signs of age discrimination are few. The style of management has becomemore supporting for self directed activities which are seen to support adults learning. Higher education and individual activity to seek possibilities to learnwere encouraging the development of occupational skills. Age itself was not a crucial aspect when comparing the experiences among younger (45-54 years) and older (55-64 years) groups. Job satisfaction and professional self esteem seemed tobe considerably strong. The individual characteristics were more important elements in developing occupational skills than the age. The degree of anxiety at work was low. In addition among the older group the strong feeling of coherence and the occupational self image were significant for supporting the professional competence. The motivation to learn was also stable. Among the seniors there was some slight evidence of declining motivation. In the IT-firm the support was experienced stronger for aging employees than in the chemical industry plant. Thosewho had experienced support in the chemical industry plant had higher educational background than the others. In IT-firm they also experienced more support from the manager than in the chemical industry plant. The results show that it is more likely that the differences are caused mostly by the stage of information intensity and the character of company culture which is determined by the activities. IT-business demands constantly accommodation to changes and the chemical industry plant which is representing more traditional business field, where the atmosphere of learning is determined by the traditions of company culture, the changes are carried out slowly.

Lärande som text : en dramapedagogiskt förankrad läsning av det kroppsliga, rumsliga och retoriska i kunskapsbildande processer

My presupposition, that learning at some level deals with life praxis, is expressed in four metaphors: space, time, fable and figure. Relations between learning,knowledge building and meaning making are linked to the concept of personal knowledge. I present a two part study of learning as text in a drama pedagogical rooted reading where learning is framed as the ongoing event, and knowledge, as the product of previous processes, is framed as culturally formed utterances. A frame analysis model is constructed as a topological guide for relations between the two concepts learning and knowledge. It visualises an aesthetic understanding, rooted in drama pedagogical comprehension. Insight and perception are linked in an inner relationship that is neither external nor identical. This understanding expresses the movement "in between" connecting asymmetrical and nonlinear features of human endeavour and societal issues. The performability of bodily and oral participation in the learning event in a socio-cultural setting is analysed as a dialogised text. In an ethnographical case study I have gathered material with an interest for the particular. The empirical material is based on three problem based learning situations in a Polytechnic setting. The act of transformation in the polyphony of the event is considered as a turning point in the narrative employment. Negotiation and figuration in the situation form patterns of the space for improvisation (flow) and tensions at the boundaries (thresholds) which imply the logical structure of transformation. Learning as a dialogised text of "yes" and "no", of structure and play for the improvised, interrelate in that movement. It is related to both the syntagmic and the paradigmatic forms of thinking. In the philosophical study, forms of understanding are linked to the logical structure of transformation as a cultural issue. The classical rhetorical concepts of Logos, Pathos, Ethos and Mythos are connected to the multidimensional rationality of the human being. In the Aristotelian form of knowledge, phronesis,a logic structure of inquiry is recognised. The shifting of perspectives between approaches, the construction of knowledge as context and the human project of meaning making as a subtext, illuminates multiple layers of the learning text. In an argumentation that post-modern apprehension of knowledge, emphasising contextual and situational values, has an empowering impact on learning, I find pedagogical benefits. The dialogical perspective has opened lenses that manage to hold in aesthetic doubling the individual action of inquiry and the stage with its cultural tools in a three dimensional reading.

Rummet i vårdandets värld

This study is made in the context of basic research within the field ofcaring science. The aim is to make a theoretical and ontological investigation of what the space is in the world of caring. The basic proposition is that the space, as a fundamental dimension, has an impact on how the appreciation of one's mental health and suffering is shaped, and vice versa. The overall purpose is to develop a theoretical model of space from the caring science point of view andalso to offer an ideal concept of space to caring science. Guided by a theoretical horizon (Eriksson 1993, Eriksson 1995, Eriksson 2001) and methodological approach grounded in Gadamer's philosophic and existential hermeneutics a three-stage analysis and interpretation is conducted. The hermeneutic spiral of this investigation starts through a procedure in accordance with Eriksson's model (1997) of concept definition. The goal is to clarify the etymology of the concept as well as semantic differences between synonymous concepts, i.e. to identify the different extents of the concept of `space` (`rum`) in order to bring these closer for an exploration. The second phase is to analyse and interpret a sample of narratives in order to explicate the ontological nature and meaning of the space. The material used here is literary texts. The goal is to clarify the characteristics of the very inside of the space when it is shaped in relation to the human being in encountering suffering. In the third phase an interview study is taken place. The focus of the study is directed towards the phenomenon of space as it is known by a patient in a landscape of psychiatric care, i.e. what the space is in a contextual meaning. Then, a gradual hermeneutic understanding of the space is attempted by using theories from the field of caring science as well as additional theories from other disciplines. Metaphors are used as they are vivid and expressive tools for generating meaning. Different metaphoric space formations depict here a variety of purports that, although not quite the same, share extensive elements. Six metaphorically summarized entities of meaning emerged. The comprehensive form of space is pointed out as the Mobile-Immobile Room. Furthermore, the Standby, the Asylum, the Wall and the Place. In the further dialogue with the texts the understanding has deepened ontologically. The theoretical model ofthe space sums up the vertical, horizontal and the inward extent of deepness inthe movement of mental health. Three entities of ontological meaning have emerged as three significant rooms: the Common Land emerges as the ideal concept of mutual creation in the freedom of doing, being and becoming health. On the interpersonal level it means freedom, which includes sovereignty, choice and dignity of the human being. The Ice World signifies, ultimately, the space as a kind of frozenness of despair which "wallpapers" the person's entire being in the world in the drama of suffering. The Spiritual Home is shaped when the human being has acquired the very core of his/her inner and outer placeness as a kind of "at-homeness" and rootedness. Time is a central element and the inward extent of deepness of this trialectic space. Each of the metaphors is then the human being's unique, although even paradoxical, way of conceiving reality, and mastering spiritual suffering. They condense characteristic structures and patterns of dynamic scenery, which take place within the movement of health. The space encloses a contradictory spatiality constituted through the dynamic field of meaningfulness and meaninglessness. Anyway, it is not through a purging of these contradictions but through bringing them together in a drama of suffering that the space is shaped as ontologically good and meaningful in the world of caring.

Hjärtats vanor, tankens välvilja och handens gärning : dygd som vårdetiskt grundbegrepp

The main aim of the study is to elucidate the meaning and dimensions of the concept of „virtue‟, and to find the place of virtue in a caritative caring ethics, i.e. a caring ethics based on human love and mercy. The intention is to create a theory model which utilizes the possibilities of virtue in developing the caritative caring ethics as a whole. The caritative caring ethics has a universal potential – it is primarily not a professional ethics, but it may form a frame of reference and basis for formulating ethical codes, and for ethical discussions within different caring contexts. The hermeneutic approach of the study is inspired by Gadamer‟s philosophical hermeneutics combined with the view of hermeneutics as a hypothetical-deductive process. The study is guided by Eriksson‟s model of definition of concepts. The concept of „virtue‟ is studied focusing on its ethical dimensions. These ethical dimensions of virtue are seen as anchored to an inner ethos, whereas ethos stands for the ontological goodness, a basic notion of the Good that permeates the entity of the human being, and forms the base of the culture where he lives and acts. The overarching research questions are: 1. What is virtue? 2. What is „virtue‟ as a basic concept in caring science? 3. What place does virtue have in caritative caring ethics? The answer of the first question is mainly searched for by an ontological determination comprising partly an etymologic and semantic analysis of „virtue‟, and partly a determination of the essence of virtue. The answer to the second and third questions are mainly searched for using a contextual determination, where the purposive context and pragmatic features of virtue are studied in relation to caring ethics. The ontological and contextual determinations are brought together through hermeneutical interpretation, forming a new whole, which constitutes the results of the study. The results of the study are depicted in a theory model, in which the movement of virtue from ethos to deed is moulded as caritative caring ethics. The material of the study consists of dictionaries, texts written by Aristotle and St. Thomas Aquinas, articles, dissertations, and books, as well as parts of a pilot survey answered by 33 nurses. The results of the study show that the essence of virtue is primarily functional, not ethical. The ethical emerges when virtue is contextualized in a human communion. Virtue makes something fulfil its function well; makes the human being good, and gives him morals and morality. The human being needs prudence, love, and humility to acquire and develop the moral virtues. Virtue is a power, related to a value, which considering a caritative caring ethics consists of the caritas motif. Human love is shown through deeds, making the human being do what he is expected to do. Virtue, as an active power of becoming, affirms and clarifies the human being‟s ability to develop in the direction of the Good. Virtue becomes essential and unifying when morality appears in the human mind as auctoritas, an inner, prompting power based on divinity or a transcendental ethos. Together ethos and virtue create opportunities for an inner ethics based on voluntariness and joy in being and doing the true, the good, and the beautiful.

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.

Hemmet som ethos : en idéhistorisk studie av hur hemmet som ethos blev evident i hälsosysterns vårdande under 1900-talets första hälft

The home as ethos, an ethical dimension of human beings, is this study’s focus of interest. Can the home as ethos comprise motive and driving force for a human being? This dissertation has a mainly hermeneutic approach with a Caring Science interpretive horizon. Firstly, the purpose of this study is to develop the concept “home” through etymological and semantic analysis. The concept’s Caring Science content is also investigated. Secondly, the purpose of this study is to investigate, through the use of a history of ideas method, how the home as ethos is made visible and evident in public health nurses’ caring during the first half of the 20th century. Which motives compromise the driving force behind public health nurses’ caring? Which idea patterns are stressed? Material for the study’s concept determination consists of tymological dictionaries as well as Swedish language dictionaries published from 1850 – 2001. The results of the concept determination provide a preliminary idea-model, where dimensions such as ethos as a human being’s innermost room, human beings’ manner of being, and the metaphor “my home is my castle” are stressed. These results comprise the background of the history of ideas portion of the study. The study’s history of ideas investigation occurs through the evaluation and interpretation of historical sources focusing on the caring provided by public health nurses. Public health nurses comprise both the context and prevalent traditions during the time-period studied. The historical sources consist of three different types of sources, namely textbooks, archived material, and the professional nursing journals Epione and Sairaanhoitajatarlehti. The purpose is to rediscover fundamental idea-patterns through the thematic structuring of the patterns appearing in the historical sources. Three main idea-patterns and underlying themes are rediscovered: love- a fire which burns inside human beings; reverence for human beings and home; and the honor of responsibility. The emerging patterns are tightly interwoven and form a pattern. A new interpretation occurs, widening the study’s horizon and leading to the emergence of the theory-model’s contours. The study’s theory-model is formed from three different levels. Ethos as a human being’s innermost room- the spirit, encompasses a human being’s value base and the spirit that he/she is permeated with. Fundamental values are converted into an internal ethic, becoming visible in human beings’ manner of being- the manner of conduct. The metaphor “my home is my castle”- the tone, symbolizes the room where a human being’s abstract or concrete being lives. The spirit, the ethos, is expressed in a home’s culture and atmosphere, that is to say the tone of a home or how one lives in a room. Communion is a significant component in the creation of a culture and atmosphere. This study’s theory-model gives rise to a new perspective that can generate new patterns of action. The study’s theory-model results in a new historically-based view that create new patterns of action in care and Caring Science today.

Convergence and divergence in global economy and social development : global perspectives on the contents of economic and soical development policy and its effects on rich and poor countries

The study of convergence and divergence in global economy and social development utilises comparative indicators to investigate the contents of economic and social development policy and their effects on the global samples that represent the rich industrial, semi-industrial and the poor developing nations. The study searchesfor answers to questions such as "what are the objectives of economic growth policies in globalisation under the imperatives of convergence and divergence, and how do these affect human well-being in consideration to the objectives of social policy in various nations?" The empirical verification of data utilises the concepts of the `logic of industrialism´ for comparative analysis that focuses mainly on identifying the levels of well-being in world nations after the Second World War. The perspectives of convergence and divergence in global economy and social development critically examine the stages of early development processes in global economy, distinguish the differences between economy and social development, illustrate the contents of economic and social development policies, their effects on rich and poor countries, and the nature of convergence and divergence in propelling economic growth and unequal social development in world nations. The measurement of convergence and divergence in global economy and social development utilised both economic and social data that were combined into an index that measures the precise levels of the effects of economic and social development policies on human well-being in the rich and poor nations. The task of finding policy solutions to resolve the controversies are reviewed through empirical investigations and the analyses of trends indicated within economic and social indicators and data. These revealed how the adoption of social policy measures in translating the gains from economic growth, towards promoting education, public health, and equity, generate social progress and longer life expectancy, higher economic growth, and sustain more stable macro economy for the nations. Social policy is concerned with the translation of benefits from objectives of global economic growth policies, to objectives of social development policy in nation states. Social policy, therefore, represents an open door whereby benefits of economic growth policies are linked with the broader objectives of social development policy, thereby enhancing the possibility of extending benefits from economic growth to all human being in every nation.

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.

Den vårdande och helande bilden: möten med bildkonst i vårdandets värld

Denna vårdvetenskapliga avhandling syftar till att avtäcka och belysa en vårdande och helande dimension vid existentiellt lidande patienters möten med bildkonst inom vårdkontext. Kunskapssökandet sker i två studier. Den första (studie I) är en ikonografi sk tolkning av konstnären Matthias Grünewalds (ca 1460–1528) senmedeltida altarskåpsmålningar. I studien uttolkas lidandets uttryck och narrativa budskap samt symboliska gestaltningar av vårdande och helande i valda delar av detta s.k. Isenheimaltares bildprogram. Tolkningen utgår från rekonstruktionen av altarskåpets ursprungskontext, det medeltida Isenheimklostret, där svårt sjuka och döende patienter vårdades. I studie två (II) fortsätter sökandet i den moderna hospicevårdens kontext med hjälp av en kvalitativ intervjustudie som utforskar patienters meningsskapande vid möten med självvald bildkonst (oljemålningar och akvareller av fi nländska konstnärer som donerats till det sjukhus där intervjustudien gjordes). Forskningsansatsen är inspirerad av Hans-Georg Gadamers (1901–2002) hermeneutik. Vidare används några nyare tolkningsteoretiska ansatser inom bildkonstens område. Forskningens tolkningsresultat visar att bildkonsten har potentialer såväl på ett miljöestetiskt plan som på en djupare individuell symbolnivå. Som designkomponent i vårdmiljöns rumsliga gestaltning bygger bildkonsten in estetiska, etiska och andliga kvaliteter utifrån tidsmässiga och kulturella koder. I den medeltida klostervårdens kontext sammanföll bildkonstens dekorativa betydelse med andliga och helande syften. När det gäller självvalda konstverk i den moderna vårdkontexten bidrar de till det enskilda patientrummets atmosfär på ett unikt sätt utifrån patientens personlighet och behov. På en fördjupad mötesnivå, i samspel med bildens symboliska funktion, sker en inlevelsemässig förfl yttning in i bildens värld. Betraktarens inlevelse aktiveras till en transcenderande rörelse som går bortom det faktiska rummets och den reella tidens gränser. Vid resor i konstens bildvärld spelas minnesvärda händelser upp från det förgångna, men även framtiden kommer betraktaren till mötes. I en existentiell livssituation söker människan i konstverkets bildinnehåll efter symbolisk mening som kan ge svar på lidandets frågor. Bilderna iscensätter då helande motbilder som utgör korrektiv i symboliska former när olika existentiella förluster hotar. När livet förbleknats av sjukdom besvarar bildvärlden den lidandes blick med lysande violer som blommar upp, ger livskraft och bekräftar personens värdighet mitt i det förvissnande människolivet. När ångest och otrygghet nalkas inbjuds betraktaren till besök i landskap som utvidgar sjukhusrummets väggar mot hemgårdens trygghet. Där livet hotas av förgänglighet tar bildvärlden människan med sig till naturens eviga återfödelse. Upplevelsen av att vara delaktig i ett större och heligt sammanhang öppnar vägen ut ur lidandets avskurenhet. I medeltidens vårdkontext erbjöd den sakrala bilden en kollektiv och helande Symbolon som genom sin representationskraft synliggjorde det osynliga. Vid bildmöten i den moderna hospicevårdens kontext var det naturteman som gläntade på dörren till ”det hemliga rummet i djupet av hjärtat”. Forskningen antyder att även om meningsskapandet i ett bildmöte är avhängigt tidsepok, betraktarens förförståelse och kulturella kontext samt typen av bilder kan bildsymboliken, generellt förstådd som den saknade formen eller det saknade livssammanhanget, framvisa en helande och hoppingivande ordning i lidandets kaos.

Lengsel - en kraft til helse

The aim of this study is to explore longing and its implication for health. The overall purpose is to develop a theory model of longing. The research question is: What is the substance of longing in a caring science perspective? The model is developed based on theoretical and empirical studies, which contains three different research materials; hermeneutic reading of texts by Augustine and Kierkegaard, and interpretation of research interviews with nine women in a cancer context. The design of the study is explorative and the ontological hermeneutics of Gadamer is chosen as a guidance for understanding. The main standpoint of the study is performed within the systematic caring science, which through basic research, generates knowledge about the human desire as crucial for the deeper health processes. Through the contextual study there is a link to the clinical caring science. In the ontology of the systematic caring science, the character of longing is in touch with two different aspects. Longing is rooted in the inner source of love of the ethos of the human where the inscrutable depth exists and contains the reality beyond the visible. Further, longing is essential for human being becoming in health and suffering, through holiness as a unit of body, soul and spirit. The results of the study are presented in a theory model. The model has by abduction provided new and deeper understanding of dimensions of longing related to health. On a general level the forces in longing unfolds in two perspectives; suffering and the basis of love. There appears to be a relationship between human and the source of love in all three materials. When human opens up his life in a larger perspective, resting in love, he can manage to stand in the thrill, and acknowledge loss and emptiness. In the transparency of an inner dialogue unfolding dispair, deeper longing can be opened up so that lives are released from the source of love. The holiness of the human desire has such appeal because the holiness of the source of love is always more than the suffering and the particular. The holiness in longing seems to satisfy the hearts deepest searching. The directon of longing is performed in relation to human and the source of love. The study reveals how longing is associated with the source of love, where the holiness of longing seems to drag the human and by that gives the answer to the seeking of the heart. Dynamics forces have direction from the human suffering in the foundation and a release of the power is given back to transform, deepen and reconcile life and suffering. The movements of the power released by longing are keys to understand the suffering of human in relation to the source of love, becoming in health. By this study, results contribute to deepen the ontological core of caring science. Firstly, human in his longing is connected to the inner ethos and by that the most sacred and absolute in itself so that parts of the potential of love can be released to health. Secondly, longing is the road of reconciliation and can further expand to authentic reconciliation, where human is becoming towards unity and holiness. Thirdly, the spirituality is unfolding through longing and the transcendental is received. In longing, human is in touch with the mystery, the longing exceeds the present and moving towards eternity and infinity, and is in what is yet to come. Such deep experience of longing moments leave an impression and show the longing fulfilled.

Bry sig om : ett vårdvetenskapligt praxisbegrepp

’Bry sig om’ förekommer flitigt i sammanhang där människor vårdar och tar hand om varandra såväl i det vardagliga naturliga vårdandet som i det professionella vårdandet. ’Bry sig om’ är ett språkligt uttryck i människors vardagsspråk som hör samman med ’små vardagliga saker’ som är av betydelse. ’Bry sig om’ har även tydlig förbindelse med vårda och ansa i Erikssons caritativa vårdteori men har inte tidigare varit föremål för klinisk vårdvetenskaplig forskning vilket är bakgrunden till denna studie. Inom Erikssons caritativa vårdteori utgörs grundordningen av kärnbegreppen caritas, enheten människa, hälsa, lidande och vårdande. I den här avhandlingen är syftet att vidga förståelsen för kärnbegreppet vårdandet genom att utforska innebörden i praxisbegreppet ’bry sig om’. Studien har en hermeneutisk ansats och är en sammanläggningsavhandling med fyra delstudier i form av begreppsanalys och tre empiriska studier. Materialet i begreppsutredningen är etymologisk ordbok och svenska ordböcker. I de empiriska delstudierna består materialet av självbiografisk text skrivet av en patient och händelser som patienter och vårdare varit med om vilket förstås som betydelsefullt material för klinisk vårdvetenskaplig forskning. Den nya förståelsen gestaltas i ett tankemönster där ’bry sig om’ framträder som en inre etisk hållning där människan som är på plats kan finnas till och därmed betyda något för en annan människa. Att betyda något för en annan människa är uttryck för det naturliga omsorgsfulla vårdandet där patienten förnimmer en kärleksfull hållning i vårdarens varsamma kärleksfulla händer och varma röst. ’Bry sig om’, har sin grundval i det naturliga omsorgsfulla vårdandet som konstituerar människan som människa. Det som framkommit i avhandlingen är möjligheten att undersöka praxisbegrepp inom vårdvetenskapen där ’bry sig om’ bidragit till att synliggöra vårdandet och därmed innebörden och meningen i ansandet, lekandet och lärandet på ett nytt och annorlunda sätt ur ett kliniskt vårdvetenskapligt perspektiv.