Dignity experience among the participants was preserved when certain interactional qualities were present in their interactions with family, social network, and healthcare professionals. While supporting some of the findings of previous studies, this study adds new knowledge on the subject. Knowledge of relational interactions toward preserving dignity experience should be a fundamental part of future dementia care practice. Based on the results of this study, an empirical-theoretical model was developed for this purpose.

The aim of the study was to identify and describe spouses'/cohabitants' experiences of living with a partner with bipolar affective disorder over time. Qualitative research interviews were conducted with eight spouses/cohabitants. Transcribed interviews were analysed structurally based on Ricoeur's phenomenological hermeneutics as described by Lindseth and Norberg. The participants' shared lives ranged from 6 to 51 years, and the study found three major aspects that characterized their experience along this time-dimension; experience formed part of a cumulative process containing up to 14 experiences. Each experience created a preunderstanding that affected how subsequent experiences were perceived, and mastered. These three major aspects had a reciprocal influence on the following 14 experiences over time: Fear and the incomprehensible. Accusations. Self-doubt and doubt about own powers of judgement. Care and information vs. being overlooked or turned away by health personnel. Stigmatization and loss of social network. Uncertainty, powerlessness and hope. Loneliness. Anger and despair. The persistent threat. Own health problems. Grief over loss. Dawning acceptance. Reconciliation. New hope. A theoretical understanding using gestalt therapy theory suggests that burdensome experience can be seen as an inner imbalance in the spouse/cohabitant when she/he cannot find meaning in their experiences. When only parts of the whole are perceived, an incomplete gestalt is formed in the person's lived-experience that counteracts the equilibrium of the organism. Insight and meaning can protect them against burdensome experiences and nurses can empower them through care, health-promoting education and guidance. Nursing research should develop methods of education and guidance sensitive enough to help each spouse/cohabitant, regardless of where they are in their cumulative process.

BackgroundMeaning and purpose in life are fundamental to human beings. In changing times, with an aging population and increased life expectancy, the need for health care services and long-term care is likely to grow. More deeply understanding how older long-term care residents perceive meaning and purpose in life is critical for improving the quality of care and the residents’ quality of life. The purpose of this study was to explore crucial aspects promoting nursing home residents’ experience of meaning and purpose in everyday life.MethodAn exploratory hermeneutical design with qualitative interviews for collecting data.ResultsFour key experiences were found to promote meaning and purpose in life: 1) physical and mental well-being, 2) belonging and recognition, 3) personally treasured activities and 4) spiritual closeness and connectedness.ConclusionIn supporting meaning and purpose in life of nursing home residents, the residents’ everyday well-being should be a central focus of care and facilitate personally treasured activities. Focused attention should also be given to the meaning-making power of experiencing belonging, recognition and spiritual connectedness.

Research indicates the essentiality of dignity as a vital component for quality of life, reconfirming the emphasis on dignity preservation in the international code of nursing ethics. Applying Noblit and Hare's metaethnography, the aim of the study was to develop a theory model by synthesizing 10 qualitative articles from various cultural contexts, exploring nurse and allied healthcare professional perception/practice concerning dignity-preserving dementia care.

Background: The global health challenge of dementia is exceptional in size, cost and impact. It is the only top ten cause of death that cannot be prevented, cured or substantially slowed, leaving disease management, caregiver support and service innovation as the main targets for reduction of disease burden. Institutionalization of persons with dementia is common in western countries, despite patients preferring to live longer at home, supported by caregivers. Such complex health challenges warrant multicomponent interventions thoroughly implemented in daily clinical practice. This article describes the rationale, development, feasibility testing and implementation process of the LIVE@Home.Path trial. Methods: The LIVE@Home.Path trial is a 2-year, multicenter, mixed-method, stepped-wedge randomized controlled trial, aiming to include 315 dyads of home-dwelling people with dementia and their caregivers, recruited from 3 municipalities in Norway. The stepped-wedge randomization implies that all dyads receive the intervention, but the timing is determined by randomization. The control group constitutes the dyads waiting for the intervention. The multicomponent intervention was developed in collaboration with user-representatives, researchers and stakeholders to meet the requirements from the national Dementia Plan 2020. During the 6-month intervention period, the participants will be allocated to a municipal coordinator, the core feature of the intervention, responsible for regular contact with the dyads to facilitate L:

Dignity is seen as an essential need, fundamental right, and inherent quality of each human being. There is however, a need for increased knowledge on crucial dimensions constituting dignity experience in persons living with dementia. This study explored personal dimensions of life which persons with dementia perceived crucial for experiencing dignity in their daily lives. Based on the findings of eight empirical sub-dimensions, three main dimensions crucial for constituting dignity experience, were identified through hermeneutical interpretation: A historical dignity-dimension, acknowledging one's own life-projects and life-history; an intrapersonal dignity-dimension, recognizing one's own human worth, and living according to internal values; and an interpersonal dignity-dimension, experiencing being part of a caring and confirming communion. Knowledge of dignity preservation should be a crucial foundation for future dementia care.

In this study, we explored and identified crucial experiences that constitute dignity and loss of dignity among older women living with incurable cancer at home. In-depth interviews with 13 women, and participant observations of five of these women, were performed. Hermeneutical interpretations of interview texts and field notes were conducted. Crucial experiences that preserved the women's dignity included having a sense of control, making one's own decisions, experiencing hope and meaningfulness, feeling valued as a human being and having the opportunity to be in a treasured and nurturing environment. Dignity loss was related to losing the opportunity for self-determination, sensing hopelessness and worthlessness in a shroud of illness, experiencing violation of their personal life and being situated in surroundings that enhanced their sense of disconnection and alienation. Quality of care was experienced as more important than the physical place in which to spend their final stage of life. The findings suggest that dignity preservation should be a core dimension in care for older women living with incurable cancer at home. Future research should investigate how dignity-preserving care can be organized and practiced within municipal palliative care services.

The term user involvement is frequently applied in research. Frameworks for patient and informal caregiver participation as coresearchers in studies concerning patients with lifethreatening illness are however sparse. The PhD project Dying With Dignity-Dignity-Preserving Care for Older Women Living at Home With Incurable Cancer has implemented a thorough cooperation with patients and informal caregivers from the early stages of the research process. A framework for Patient and Informal Caregiver Participation In Research (PAICPAIR) is suggested-creating a stronger foundation for democracy, equality, and research quality by also promoting active participation among vulnerable people experiencing incurable, life-threatening illness, as coresearchers.