This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson's model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity.

BackgroundRapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.MethodsHermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.ResultsTwo main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home.ConclusionsHome has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.

In 2008 two researchers completed a 2-year study in collaboration with nurse anesthetists and operating room nurses from three operating theaters in western Sweden. In this paper, with focus on methodology and the ethical approach to research, the aim was to describe a hermeneutical design with an element of application used in a perioperative clinical study. The element of application was chosen to involve clinical nurses to participate as coresearchers. This research was inspired by Lindholm's (2006) method for application research developed to bring new knowledge, to create change as well as to unite theory in dialogues with clinical nurses. Through the perioperative dialogue, the coreseacher not only became one who collected data but also the older patients' nurse, who cared for them. A hermeneutical text interpretation with five readings was used to gain new understanding. Perioperative care becomes evident and is dedicated to the patient in perioperative.

If perioperative nurses used the perioperative dialogue they could create continuity for patients and for themselves in the pre-, intra- and postoperative phases. The nurse is, in this context, the continuity and continuity gives the possibility of establishing a caring relationship and caring for the patient in a dignified way.

This literature review analyses eight research reports dealing with perioperative dialogues conducted between patients and nurses. The aim of this study was to summarise studies concerned with the perioperative dialogue as an organisation model for bringing safe operative practices and caring into perioperative nursing, by creating continuity for both patients and nurses in perioperative praxis and its research. How do patients and perioperative nurses experience the perioperative dialogue as a model? Perioperative nursing should be perceived as a caring profession emphasising that the focus is on perioperative caring. The perioperative dialogue has a humanistic and caring perspective and presents an ideal model on which to base perioperative nursing. There is general acceptance of the value of the perioperative dialogue for both patients and nurses as means of alleviating suffering and creating a safety nursing, with continuity in the process provided by nursing staff. This study suggests further research and that a means of measuring caring in the perioperative dialogue should be more developed.

The aim of this study was to obtain an understanding of what parents of children with severe autism experience in connection with their child's anaesthetics, in the presence and absence of the perioperative dialogue. Twelve parents who had experience of their child receiving anaesthetics on one or more occasions took part in this study, in which anaesthesia care was organized as a perioperative dialogue. Data were collected by means of conversational interviews, and the text was interpreted using a hermeneutic approach. The hermeneutic text interpretation led to a new understanding based on the knowledge that in the absence of the perioperative dialogue, previous anaesthetics had meant the suffering of care by the following: a hopeless struggle, unspeakable suffering and a disgraceful scenario. However, continuity in the perioperative dialogue provided to be a way out of the suffering by being received by warm hands, being received by a known face and a subtle interplay between the child and nurse. Although health and well-being may be unobtainable goals in this special context of care, the findings provided ample descriptions of the positive effects of the perioperative dialogue, which is all the more valuable when dealing with children who will need repeated anaesthetics in the future.

Hermeneutic text interpretation is discussed in this paper as a possible way of releasing nurses' knowledge, in order to develop a deeper understanding of professional caring. The text is a nurse's story, which has been gathered by means of the critical incident technique. The intention is to elicit the knowledge of professional caring in the stories and the language of caring science, which is concealed in a nurse's reality. Hermeneutic text interpretation through reading a text and having a dialogue with the nurse's reality will give a voice and a language to silent knowledge.

This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time).