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.
Hermeneutics and narration: a way to deal with qualitative data This article focuses a hermeneutic approach on the interpretation of narratives. It is based on the French philosopher Paul Ricoeur's theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur's theory of interpretation, before going on to describe the interpretation process as modified by the authors. The interpretation process, which consists of several stages, is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur's theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur's thinking, is not the goal of the process but rather a means to deal with the researcher's pre-understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text 'as text' and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretation process. The researchers further argue that distanciation must be followed by reflection, where the interpretations are linked back to the empirical context.
In this article, abduction is discussed as a possible way of developing an epistemology for an autonomous caring science based on an ontology that requires deeper understanding of the world of caring. The intention is to elicit a more distinct caring-scientific pattern of knowledge based on the innermost core and historical conditions of caring. Abduction makes it possible to perceive connections on a deeper level and to penetrate in a way that reveals a richness of meaning, reflecting the true being in the dynamic process which is expressed in clinical reality. In the tradition of knowledge developed by Peirce, a synthesis of Hume's and Kant's tradition of knowledge, abduction is a fundamental idea. Peirce sees abduction as an operation of thought in which the recognition of underlying patterns makes a complex reality comprehensible. We regard the triad of abduction, induction and deduction as the basis for developing a caring-scientific epistemology where abduction makes a synthesizing abstraction possible and may implement understanding of deeper patterns.
If psychiatric patients are allowed to narrate freely they develop different plot structures, which can either hide or reveal suffering. Patients who could establish an answer to the why-question of suffering could also interpret their suffering in a way that enabled growth and reconciliation. In order to do so, they had to abandon the shelter of the façade and confront suffering and shame. This turning point opened them up to life-sustaining relationships with themselves as well as with abstract and concrete others.
There seems to be a great need in clinical practice to give priority to, and increase, the consciousness and competence of nurses to see and respond to the spiritual/existential concerns of patients with a serious cancer disease.
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