Movies and meaning : studying audience, fiction film and existential matters

In what ways and under what circumstances can a movie be a resource for individuals and their thoughts about existential matters? This central research question has been investigated using a both quantitative and qualitative approach. First, a questionnaire was distributed amongst 179 Swedish students to provide a preliminary overview of film habits. The questionnaire was also used as a tool for selecting respondents to individual interviews. Second, focus group and individual interviews were conducted, with viewers choosing their favourite movie of all time. In the study socio-cognitive theory and a schema-based theoretical tool is adopted to analyze how different viewers make use of movies as cultural products in an interplay between culture and cognition in three contexts; a socio-historic process, a socio-cultural interaction with the world and inner psychological processes. The viewers in the study seem to be inspired by movies as a mediated cultural resource, promoting the development of a personal moral framework with references to values deeply fostered by a humanistic tradition. It is argued that these findings support theories discussing individualised meaning making, developing ‘self-expression values’ and ‘altruistic individualism’ in contemporary western society.

Existential issues in surgical care : Nurses’ experiences and attitudes in caring for patients with cancer

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

Immigration, security and the public debate on US language policy : a critical discourse analysis of language attitudes in the United States of America

The narrative of the United States is of a "nation of immigrants" in which the language shift patterns of earlier ethnolinguistic groups have tended towards linguistic assimilation through English. In recent years, however, changes in the demographic landscape and language maintenance by non-English speaking immigrants, particularly Hispanics, have been perceived as threats and have led to calls for an official English language policy.This thesis aims to contribute to the study of language policy making from a societal security perspective as expressed in attitudes regarding language and identity originating in the daily interaction between language groups. The focus is on the role of language and American identity in relation to immigration. The study takes an interdisciplinary approach combining language policy studies, security theory, and critical discourse analysis. The material consists of articles collected from four newspapers, namely USA Today, The New York Times, Los Angeles Times, and San Francisco Chronicle between April 2006 and December 2007.Two discourse types are evident from the analysis namely Loyalty and Efficiency. The former is mainly marked by concerns of national identity and contains speech acts of security related to language shift, choice and English for unity. Immigrants are represented as dehumanised, and harmful. Immigration is given as sovereignty-related, racial, and as war. The discourse type of Efficiency is mainly instrumental and contains speech acts of security related to cost, provision of services, health and safety, and social mobility. Immigrants are further represented as a labour resource. These discourse types reflect how the construction of the linguistic 'we' is expected to be maintained. Loyalty is triggered by arguments that the collective identity is threatened and is itself used in reproducing the collective 'we' through hegemonic expressions of monolingualism in the public space and semi-public space. The denigration of immigrants is used as a tool for enhancing societal security through solidarity and as a possible justification for the denial of minority rights. Also, although language acquisition patterns still follow the historical trend of language shift, factors indicating cultural separateness such as the appearance of speech communities or the use of minority languages in the public space and semi-public space have led to manifestations of intolerance. Examples of discrimination and prejudice towards minority groups indicate that the perception of worth of a shared language differs from the actual worth of dominant language acquisition for integration purposes. The study further indicates that the efficient working of the free market by using minority languages to sell services or buy labour is perceived as conflicting with nation-building notions since it may create separately functioning sub-communities with a new cultural capital recognised as legitimate competence. The discourse types mainly represent securitising moves constructing existential threats. The perception of threat and ideas of national belonging are primarily based on a zero-sum notion favouring monolingualism. Further, the identity of the immigrant individual is seen as dynamic and adaptable to assimilationist measures whereas the identity of the state and its members are perceived as static. Also, the study shows that debates concerning language status are linked to extra-linguistic matters. To conclude, policy makers in the US need to consider the relationship between four factors, namely societal security based on collective identity, individual/human security, human rights, and a changing linguistic demography, for proposed language intervention measures to be successful.

Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

Film och mening : En receptionsstudie om spelfilm, filmpublik och existentiella frågor

In what ways and under what circumstances can a movie be a resource for individuals and their thoughts about existential matters? This central research question has been investigated using a both quantitative and qualitative approach. First, a questionnaire was distributed amongst 179 Swedish students to provide a preliminary overview of film habits. The questionnaire was also used as a tool for selecting respondents to individual interviews. Second, thirteen interviews were conducted, with viewers choosing their favourite movie of all time. In the study socio-cognitive theory and a schema-based theoretical tool is adopted to analyze how different viewers make use of movies as cultural products in an interplay between culture and cognition in three contexts; a socio-historic process, a socio-cultural interaction with the world and inner psychological processes. Summarizing the interviews some existential matters dominated. Matters of immanent orientation were in the foreground. Transcendental questions received much less attention. Summarizing the schema-based theoretical question, assessing which cognitive schema structures the narratives were processed through, the study found an emphasis on a combination of two main cognitive structures, person schema and self schema. Detailed person schematic cognitive processes about fictitious characters on the screen and their role model behaviour were combined by the respondents with dynamic cross-references to detailed self schematic introspections about their own characteristics, related to existential matters at some very specific moments in their lives. The viewers in the study seem to be inspired by movies as a mediated cultural resource, promoting the development of a personal moral framework with references to values deeply fostered by a humanistic tradition. It is argued that these findings support theories discussing individualised meaning making, developing ‘self-expression values’ and ‘altruistic individualism’ in contemporary western society.

Att inte spänna kärran framför hästen : precisering av Meads ”rollövertagande”

Not to put the cart before the horse: clarification of Mead’s ”role taking” George Herbert Mead’s “role taking” is subject to many interpretations. Some dominant definitions restrict role taking to reflective people trying to understand each other and taking on each others' roles. Other definitions restrict role taking to the stage of a developed language. Against these two types of definitions I assert that Meads concept is explanatory, not merely descriptive, functionally as well as existentially. It has a value also on elementary levels of human development, where man is socially similar to other primates. Swedish sociologists have contributed fruitfully to straighten the debate. My intention is to clarify it further, and to explicate my own interpretation. Basic role taking is a non-reflective activity going on in any place where living entities influence each other with gestures in similar ways. In human beings it gives rise to conscious discursive reflectivity, and it coincides phylogenetically and ontogenetically with development of language, rather than being created by it. Role taking emanates from breaking automatic responsivity. It introduces distance and reflectivity and results in conscious social behavior, rather than being produced by such. In this way, role taking is a major step in the development of intelligence on earth.

Manoeuvring between anxiety and control : Patients experience of learning to live with diabetes: a lifeworld phenomenological study

Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.

Personlighetsbedömning i samband med rekrytering : En studie om bemanningsbranschens personlighetsbedömning vid en rekrytering

Att medarbetare är av existentiell betydelse för en organisations överlevnad är sedan länge känt. Därmed är rekrytering en av de viktigaste funktionerna inom HR för att attrahera rätt kompetens till organisationen då en misslyckad rekrytering vanligen leder till bortkastad tid och dyra rekryteringsprocesser. Något som kommit att få allt större betydelse vid urvalet och bedömningen av nya medarbetare är kandidaters personlighet. Forskning visar att personlighetsdrag spelar en stor roll när det kommer till framtida arbetsprestationer och förmågan att göra rätt bedömningar av människor är därför central. Teorier om synen på personlighet, kompetens, kompetensbaserad rekrytering och urval samt bedömningsmetoder och personlighetsbedömning används för att analysera studiens resultat. Denna kvalitativa studies övergripande syfte var att öka förståelsen för hur rekryterare bedömer en kandidats personlighet vid en rekryteringsprocess inom bemanningsföretag. Bemanningsföretag är företag som ständigt arbetar med rekrytering och uthyrning av personal, varför ett proaktivt bemanningsarbete krävs för att skapa en konkurrensfördel på marknaden. Inför denna fallstudie kontaktades tre av den svenska bemanningsbranschens största aktörer varav två rekryterare på vardera företag deltog i semistrukturerade intervjuer. Personlighet ansågs generellt som något viktigt som samtliga rekryterare lade stor vikt vid under hela processens gång, från utformandet av kravprofilen till avslutande bedömning. Bedömningen skedde genom såväl test som intervju och referenstagning. Samtliga poängterade vikten av att alltid göra en helhetsbedömning av kandidaten och att det därmed var svårt att vikta exempelvis formella kompetenser mot personliga egenskaper. Resultatet visar att bemanningsbranschens arbete med personlighetsbedömning vid rekrytering utgår ifrån strukturerade bedömningsmetoder. Deras gedigna och proaktiva arbete med rekrytering lever upp till påståendet om att personalen är en organisations viktigaste resurs och vikten av att förstå innebörden av personlighetens betydelse i uttrycket ”rätt person på rätt plats”.

Thick viewing : empirical examples of condensed moments of narrative impact in fiction film developing theoretical concepts for intensified engagements

Abstract  In a case study about viewing habits in a Swedish audience I sampled 309 questionnaires; interviews with five focus group were conducted together with ten in-depth individual interviews discussing altogether fifteen favorite films exploring specific scenes of idiosyncratic relevance.  The outcome supports claims about viewers as active and playful (cf. Höijer 1998, Frampton 2006, Hoover 2006, Plantinga 2009). In line with mediatization theory I also argue that spiritual meaning making takes place through mediated experiences and I support theories about fiction films as important sources for moral and spiritual reflection (Partridge 2004, Zillman 2005, Lynch 2007, Plantinga 2009). What Hjarvard calls the soft side of mediatization processes (2008) is illustrated showing adults experiencing enchantment through favorite films (Jerslev 2006, Partridge 2008, Klinger 2008, Oliver & Hartmann 2010).  Vernacular meaning making embedded in everyday life and spectators dealing with fiction narratives such as Gladiator, Amelie from Montmartre or Avatar highlights the need for a more nuanced understanding of elevated cinematic experiences. The reported impact of specific movies is analyzed through theories where cognition and affect are central aspects of spectators’ engagements with a film (Tan 1996, Caroll 1999, Grodal 2009). Crucially important are theories of meaning-making where viewers’ detailed interpretation of specific scenes are embedded in high-level meaning-making where world view issues and spectators’ moral frameworks are activated (Zillman 2005, Andersson & Andersson 2005, Frampton 2006, Lynch 2007, Avila 2007, Axelson 2008, Plantinga 2009).  Also results from a growing body of empirical oriented research in film studies are relevant with an interest in what happens with the flesh and blood spectator exposed to filmic narratives (Jerslev 2006, Klinger 2008, Barker 2009, Suckfüll 2010, Oliver & Hartmann 2010). Analyzing the qualitative results of my case study, I want to challenge the claim that the viewer has to suspend higher order reflective cognitive structures in order to experience suture (Butler & Palesh 2004). What I find in my empirical examples is responses related to spectators’ highest levels of mental activity, all anchored in the sensual-emotional apparatus (Grodal 2009). My outcome is in line with a growing number of empirical case studies which support conclusions that both thinking and behavior are affected by film watching (Marsh 2007, Sückfull 2010, Oliver & Hartmann 2010, Axelson forthcoming). The presentation contributes to a development of concepts which combines aesthetic, affective and cognitive components in an investigation of spectator’s moves from emotional evaluation of intra-text narration to extra-textual assessments, testing the narrative for larger significance in idiosyncratic ways (Bordwell & Thompson 1997, Marsh 2007, Johnston 2007, Bruun Vaage 2009, Axelson 2011). There are a several profitable concepts suggested to embrace the complex interplay between affects, cognition and emotions when individuals respond to fictional narratives. Robert K. Johnston label it “deepening gaze” (2007: 307) and “transformative viewing” (2007: 305). Philosopher Mitch Avila proposes “high cognition” (2007: 228) and Casper Thybjerg ”higher meaning” (2008: 60). Torben Grodal talks about “feelings of deep meaning” (Grodal 2009: 149). With a nod to Clifford Geertz, Craig Detweiler adopts “thick description” (2007: 47) as do Kutter Callaway altering it to ”thick interpretations” (Callaway 2013: 203).  Frampton states it in a paradox; ”affective intelligence” (Frampton 2006: 166). As a result of the empirical investigation, inspired by Geertz, Detweiler & Callaway, I advocate thick viewing for capturing the viewing process of these specific moments of film experience when profound and intensified emotional interpretations take place. The author As a sociologist of religion, Tomas Axelsons research deals with people’s use of mediated narratives to make sense of reality in a society characterized by individualization, mediatization and pluralized world views.  He explores uses of fiction film as a resource in every day life and he is currently finishing his three year project funded by the Swedish Research Council: Spectator engagement in film and utopian self-reflexivity. Moving Images and Moved Minds. http://www.du.se/sv/AVM/Personal/Tomas-Axelson Bibliography Axelson, T. (Forthcoming 2014). Den rörliga bildens förmåga att beröra.[1] Stockholm: Liber Axelson, T. (In peer review). Vernacular Meaning Making. Examples of narrative impact in fiction film questioning the ’banal’ notion in mediatization theory. Nordicom Review. Nordicom Göteborg. Axelson, T. (2011). Människans behov av fiktion. Den rörliga bildens förmåga att beröra människan på djupet.[2]Kulturella perspektiv. Volume 2. Article retrieved from www.kultmed.umu.se/digitalAssets/74/74304_axelson-22011.pdf Axelson, Tomas (2010) “Narration, Visualization and Mind. Movies in everyday life as a resource for utopian self-reflection.” Paper presentation at CMRC, 7th Conference of Media, Religion & Culture in Toronto, Canada 9 – 13th August 2010. Axelson, Tomas (2008) Movies and Meaning. Studying Audience, Favourite Films and Existential Matters. Particip@tions : Journal of Audience and Reception Studies. Volume 5, (1). Doctoral dissertation summary. ACTA UNIVERSITATIS UPSALIENSIS. Article retrieved from http://www.participations.org/Volume%205/Issue%201%20-%20special/5_01_axelson.htm  [1] English translation: Moving Images and Moved Minds. [2] English translation: Our need for fiction. Deeply Moved by Moving Images. Cultural Perspectives.

Det är enklare i teorin… Om skolutveckling i praktiken : En fallstudie av ett skolutvecklingsprojekt i en gymnasieskola

This dissertation is a case study dealing with a school development project that took place in an upper secondary school as a result of a merger of two schools with different cultures. The project used a method called “Frirumsmodellen” and was planned to be conducted in three steps. The first was to carry out a cultural analysis in order to map the preconditions to start a school development project. The second was to carry out concrete actions and finally study eventual effects from such activities by doing a second cultural analysis. My role was to be a supervisor in the school development work, but at the same time study how this work was conducted and its impact in the ordinary school day. The dissertation takes its departure in the fact that schools are political governed. The mission of schools is never neutral; it is always an expression of behind laying social forces, ideologies and ideals of the contemporary society. Of this reason, there is a close connection between the macro political level and the micro political level. Another point of departure is the transition from a modern to a post modern society that gives the character to the changes that take place in schools. Steering of schools has partly been treated as a technical implementation problem. Schools contain on going conflicts between different interest groups that, more or less regularly, end up in educational reforms. These reforms generate school development activities in the single school. Undoubtedly, this makes school development to a complex process. At a rather late stage of the study I decided not to fulfil my task to follow the original plan. I instead let the school development project as a model to be in focus. The over all purpose was formulated: How is it possible to understand what happened in the school development project in the Falkgymnasiet and why was it not possible to carry it out as it was said in the project plan? To interpret what took place during the project I did create an interpretation frame of implementation and complexity theory that also made it possible to critically scrutinise the “Frirumsmodellen”. Already in an early stage of the process it was obvious that the “Frirumsmodellen” did not supply any tools to use and it became disconnected from the project. The project in it selves was marginalised and made invisible. The headmaster used the situation to change things she thought were important to develop. As a result, things happened, but most of the involved people did not at first hand connect this to the project. It is, of course, difficult in detail to say what caused what. The complexity theory successively made the hidden patterns revealed, hidden unofficial potentates visible, as well as unpredictable conditions that generated reactions from the personnel in front of a development work. Together this was rather efficient obstacles for not changing this school. I also discuss school development and implementation problems on a general level, for example, the possibility to transform a top-down initiated project to be bottom-up driven and using project as a tool for school development work. It was obvious that headmasters and teachers must be prepared to handle the ideological dimensions of problems schools have to face. Consequently, development work is about making problems visible and to handle these in the intersection point between the intentions of educational policies, pedagogical researchers, school administrators, headmasters, teachers and pupils. The ideological dimension also contains an existential issue. Do I as a teacher share the intentions for the development work? If not, how must I act?

Om lärarskapets moraliska dimension : ett perspektiv och en studie av lärarstuderandes nätbaserade seminariesamtal

In this dissertation, an educational perspective called the moral dimension of teaching is developed. The work includes a theoretically informed discussion from a pragmatist point of view in which the concept of pedagogical rhythm is introduced. The concept captures the need for teachers to regularly shift their intentions and occasionally act in contradictory ways as a consequence of the moral which emerges from interaction in pedagogical situations. Using this perspective, criteria are developed for the characteristics of discussions of the work of teachers, which are desirable in order for students in pre-service teacher education to have opportunities to develop their teachership. Secondly, the educational perspective as it is conceptualised serves as a theoretical framework for a study of discussions taking place in net-based seminars among students in teacher education. The study consists of 14 recorded seminars in which discussions of the work of teachers are analysed in terms of content and direction for reflection. The result of the analysis is a construction of four different focal points for processes of making judgements: existential, performative, critical and professional. Mainly the performative, and to some extent the critical, focal points appear to be supported by the net-based environment, although potential for the professional focal point is found when available tools in net-based settings are used in deliberate ways. Finally, based on these four focal points, possible future predispositions among student teachers are deliberated. Student teachers’ future opportunities to develop a moral and epistemological authority are discussed, as well as teachers’ general opportunities to exercise professional responsibility. The conclusion emphasises that a perspective such as the one developed in the dissertation is important, as it creates an understanding for the need to educate student teachers to exercise a form of responsibility that goes beyond being accountable to society.

Sjuksköterskors upplevelser av att ge palliativ vård till patienter på somatiska vårdavdelningar En litteraturöversikt

Bakgrund: Många patienter har behov av palliativ vård innan de avlider. I Sverige finns idag flera olika alternativ för specialiserad palliativ vård. Dessa räcker dock inte till för att vårda alla palliativa patienter vilket leder till att sjuksköterskor som arbetar på somatiska vårdavdelningar på sjukhus ofta möter dessa patienter. Syfte: Att beskriva sjuksköterskors upplevelser av att ge palliativ vård till patienter som vårdas på somatiska vårdavdelningar. Metod: Studien genomfördes som en litteraturöversikt där 15 artiklar ingick i resultatet. Datainsamling har gjorts i databaserna Cinahl, PubMed och Web of Science. Resultat: Sjuksköterskor upplevde att kommunikationen vid vård av palliativa patienter var svår på flera sätt. Rädsla att bemöta existentiella frågor, tidsbrist och en dysfunktionell kommunikation mellan vårdpersonal upplevdes som svårigheter för sjuksköterskorna. Detta ledde till att sjuksköterskor upplevde ett stort behov av utbildning och kompetensutveckling. Slutsats: Ett stort utbildningsbehov finns hos sjuksköterskor då de upplever många svårigheter i att vårda palliativt. För att kunna utveckla denna vårdform på somatiska avdelningar behövs mer utbildning och forskning inom området.

Sjuksköterskors erfarenheter av andliga och existentiella frågor i palliativ vård : En litteraturöversikt

Bakgrund: Andliga och existentiella frågor hamnar i allt större utsträckning hos sjukvårdspersonal. Det palliativa förhållningssättet betonar vikten av att ge en god omvårdnad vad gäller andliga och existentiella frågor. Sjuksköterskans roll är att genom goda relationer skapa en anpassad och balanserad omvårdnad för att öka välbefinnandet för patienten den sista tiden i livet. Syfte: Syftet med litteraturöversikten var att sammanställa hur andliga och existentiella frågor beskrivs i forskning utifrån sjuksköterskors erfarenheter av palliativ vård. Metod: En litteraturöversikt som sammanställer aktuell forskning inom det valda omvårdnadsområdet. Resultat: I resultatet framträdde att tid är det vanligaste hindret och utbildning är det som främjar givandet av andlig och existentiell omvårdnad. Att skapa relationer och kommunicera är viktiga aspekter inom vårdandets konst. Egenskaper som sjuksköterskan bör inneha för att underlätta givandet av andlig och existentiell omvårdnad är; en god självkännedom, empati, intuition och observationsförmåga. Slutsats: För att kunna ge en bättre andlig och existentiell omvårdnad behöver de yttre förutsättningarna ge tid för mötet mellan sjuksköterska och patient, vårdmiljön organiseras så detta möjliggörs, teamarbete tillämpas och utbildning ges.

Facilitation of learning in specialist nursing training in the PICU : the supervisors´ concerns in the learning situation

With the aim to unfold nurses’ concerns of the supervision of the student in the clinical caring situation of the vulnerable child, clinical nurses situated supervision of postgraduate nursing students in the Pediatric Intensive Care Unit (PICU) are explored. A qualitative approach, interpretive phenomenology, with participant observations and narrative interviews, was used. Two qualitative variations of patterns of meaning for the nurses’ clinical facilitation were disclosed in this study. Learning by doing theme supports the students learning by doing through performing skills and embracing routines. The reflecting theme supports thinking and awareness of the situation. As the supervisor often serves as a role model for the student this might have an immediate impact on how the student applies nursing care in the beginning of his or her career. If the clinical supervisor narrows the perspective and hinders room for learning the student will bring less knowledge from the clinical education than expected, which might result in reduced nursing quality.