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Heideggerian structures of Being-with in the nurse–patient relationship: modelling phenomenological analysis through qualitative meta-synthesis

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Abstract

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse–patient relationship. We firstly considered and secured the most relevant Heideggerian elements to nurse–patient Being-with (Dasein-with, circumspection, solicitude, and discourse). Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode (task-orientated busyness, existential abandonment, rough handling and deficient modes of concern in potentially violent encounters), and the authentic self-mode (seeking connection [knowing], and openness [unknowing], which exposed their emotional vulnerability). Through circumspection (making room for, deseverance and directionality), technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement (solicitude) was expressed through either leaping-in care (also perceived as ‘power over’) or leaping-ahead care (moving the patient towards independence). There was a place for both inauthentic (idle talk) and authentic discourse (including non-verbal and spiritual discourse) that nurses wove through the ontic everydayness of nursing tasks.

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Acknowledgements

We acknowledge the support of the 2018 Summer Scholar Program, Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health, University of Sydney

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Authors and Affiliations

  1. University of Sydney (Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health), Sydney, NSW, Australia

    Janice Gullick, John Wu, Cindy Reid, Agness Chisanga Tembo, Sara Shishehgar & Lisa Conlon

  2. University of Sydney (Sydney Conservatorium of Music and University Library), Sydney, NSW, Australia

    John Wu

  3. Maitland Hospital (Intensive Care Unit), Maitland, NSW, Australia

    Agness Chisanga Tembo

  4. Faculty of Health, University of Technology, Sydney, NSW, Australia

    Sara Shishehgar

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  1. Janice Gullick
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Gullick, J., Wu, J., Reid, C. et al. Heideggerian structures of Being-with in the nurse–patient relationship: modelling phenomenological analysis through qualitative meta-synthesis. Med Health Care and Philos 23, 645–664 (2020). https://doi.org/10.1007/s11019-020-09975-y

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