Humanized childbirth: the values of health professionals in daily obstetric care

ABSTRACT Objective: To understand health professionals' values in the process of thinking and feeling about obstetric care, based on their experienced needs in the care process. Methods: Phenomenological study based on the Schelerian framework, with 48 health professionals from four maternity hospitals within the Metropolitan Region II of the state of Rio de Janeiro. Data collection was done through a phenomenological interview; and the analysis, with the Ricoeurian methodological framework. Results: The vital value was signified in care centered on physiological processes, for an individualized and safe monitoring. The ethical value was signified in the attitudes that provide women with autonomy in their way of giving birth, and recognize dialogue as a process of sympathy, affection, and bonding. Conclusion: The resignification of obstetric practice, articulated with public policies in the field of delivery and birth, supported by a vital ethical value, positively contributes to the humanization of care for women.

Experiencia vivida del primer contacto con muerte en prácticas clínicas de estudiantes de enfermería

Introduction: Death is a complex phenomenon, nurses in training may face the process of dying and death of people, which can generate diverse situations that represent their lived experiences. Objective: To understand the lived experience of the first contact with death during clinical practicum of nursing students at a public university.Methodology: Qualitative study with phenomenological approach. It was conducted from October 2020 to February 2021. Selection of participants by intentional sampling with information saturation with seven participants. Data collection through phenomenological interview; participants gave informed consent. The analysis was carried out through the three phases of Max Van Manen's hermeneutic phenomenological method (description, interpretation, description plus interpretation). Results: The students refer to having been faced with the phenomenon in a state of helplessness, blockage, uncertainty, and fear; as well as facing death in a professional and reflective manner in order to provide quality care. Discussion: Death is a natural process; however, the first experiences are diverse and can produce in the students a set of emotions that condition their capacity to act, the way of adapting and observing the needs that arise during this experience. Conclusion: The experiences of nursing students show that they have difficulties in facing death, but it was not an impediment to provide the necessary care; it is considered that a deeper preparation on the process of dying can be favorable for their performance as professionals. Introducción: La muerte es un fenómeno complejo, las enfermeras en formación pueden enfrentarse al proceso de morir y muerte de personas, lo que puede generar diversas situaciones que representan sus experiencias vividas. Objetivo: Comprender la experiencia vivida ante el primer contacto con la muerte durante prácticas clínicas de estudiantes de enfermería de una universidad pública.Metodología: Estudio cualitativo con enfoque fenomenológico. Se llevó a cabo de octubre del 2020 a febrero del 2021. Selección de participantes por muestreo intencional con saturación de información con siete participantes. Recolección de datos a través de entrevista fenomenológica; los participantes emitieron su consentimiento informado. El análisis se llevó a cabo por las tres fases del método fenomenológico hermenéutico de Max Van Manen (descripción, interpretación, descripción más interpretación). Resultados: Los estudiantes refieren haber estado frente al fenómeno en un estado de impotencia, bloqueo, incertidumbre y miedo; así como afrontaron la muerte de manera profesional y reflexiva para brindar cuidado de calidad. Discusión: La muerte es un proceso natural, sin embargo, las primeras experiencias son diversas y pueden producir en los estudiantes un conjunto de emociones que condicionan su capacidad de actuar, el modo de adaptarse y observar las necesidades surgidas durante esta experiencia. Conclusión: Las experiencias de los estudiantes de enfermería demuestran que tienen dificultades para afrontar la muerte, pero no fue un impedimento para brindar los cuidados necesarios; se considera que una preparación más profunda sobre el proceso de morir puede ser favorable para su actuar como profesional.

Awareness in the void: a micro-phenomenological exploration of conscious dreamless sleep

This paper presents a pilot study that explores instances of objectless awareness during sleep: conscious experiences had during sleep that prima facie lack an object of awareness. This state of objectless awareness during sleep has been widely described by Indian contemplative traditions and has been characterised as a state of consciousness-as-such; while in it, there is nothing to be aware of, one is merely conscious (cf. Evans-Wentz, 1960; Fremantle, 2001; Ponlop, 2006). While this phenomenon has received different names in the literature, such as ‘witnessing-sleep’ and ‘clear light sleep’ among others, the specific phenomenological profile of this state has not yet been rigorously studied. This paper aims at presenting a preliminary investigation of objectless consciousness during sleep using a novel tool in qualitative research that can guide future research. Five participants experiencing objectless consciousness during sleep were interviewed following the Micro-phenomenological Interview technique (MPI; Petitmengin, 2005, 2006). All participants reported an experience they had during sleep in which there was no scenery and no dream. This period labelled as ‘No Scenery/Void’ was either preceded by the dissolution of a lucid dream or by other forms of conscious mentation. The analysis of the results advances four experiential dimensions during this state of void, namely (1) Perception of absence, (2) Self-perception, (3) Perception of emotions, and (4) Perception of awareness. While the results are primarily explorative, they refer to themes found in the literature to describe objectless sleep and point at potential avenues of research. The results from this study are taken as indications to guide future operationalisations of this phenomenon.

Can we trust the phenomenological interview? Metaphysical, epistemological, and methodological objections

The paper defends the position that phenomenological interviews can provide a rich source of knowledge and that they are in no principled way less reliable or less valid than quantitative or experimental methods in general. It responds to several skeptic objections such as those raised against introspection, those targeting the unreliability of episodic memory, and those claiming that interviews cannot address the psychological, cognitive and biological correlates of experience. It argues that the skeptic must either heed the methodological and epistemological justification of the phenomenological interview provided, or embrace a more fundamental skepticism, a “deep mistrust”, in which scientific discourse can have no recourse to conscious processes as explananda, with ensuing dire consequences for our conception of science.

Researching Non-Conscious Dimensions of Architectural Experience

Editorial Summary Entitled »Researching Non-Conscious Dimensions of Architectural Experience«, Marcus Weisen’s contribution explores the investigation of pre-reflexive ways of knowing, sensory thought, and the embodied mind. He introduces the micro-phenomenological interview as a successful methodology to exploit immanent, non-conscious aspects of architectural experience. He emphasizes the relevance of investigating the individual, subjective perspective in architectural research, proposing the first-person description of experience as a starting point from which to derive insights into overarching, essential principles of lived experiences of, and encounters with, architectural spaces. Tracing the elusive, embodied dimensions of architectural experience, he aims for an »embodied rationalism« in architectural research. [Uta Graff]

A phenomenological investigation of patients’ experiences during direct observation in residency: busting the myth of the fly on the wall

Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. We do not know the patient perspectives on these interactions, nor, more broadly, what it is like to be a patient in a DO situation. Understanding the patient perspective may lead to a more complete understanding of the dynamics in DO situations, which may benefit patient wellbeing and improve the use of DO as an educational tool. We conducted a phenomenological interview study to investigate the experience of being a patient in a DO situation. Our analysis included multiple rounds of coding and identifying themes, and a final phase of phenomenological reduction to arrive at the essential elements of the experience. Constant reflexivity was at the heart of this process. Our results provide a new perspective on the role of the supervisor in DO situations. Patients were willing to address the resident, but sought moments of contact with, and some participation by, the supervisor. Consequently, conceptions of DO in which the supervisor thinks she is a fly on the wall rather than a part of the interaction, should be critically reviewed. To that end, we propose the concept of participative direct observation in workplace learning, which also acknowledges the observer’s role as participant. Embracing this concept may benefit both patients’ wellbeing and residents’ learning.

Continuity in intuition and insight: from real to naturalistic virtual environment

Intuition and insight can be deployed on the same continuum. Intuition is the unconscious ability to create links between information; insight is a process by which a sudden comprehension and resolution of a situation arises (i.e. euréka). In the present study, real and virtual environments were used to trigger intuition and insight. The study hypothesised that immersion in real primed environments would facilitate the emergence of intuition and insight in a virtual environment. Forty nine healthy participants were randomly assigned to two groups: “primed” and “non primed.” “Primed” participants were immersed in a real environment with olfactory and visual cues; “non primed” participants did not receive any cues. All participants were exposed to a 3D naturalistic virtual environment which represented a district in Paris via a Head Mounted Display (HMD). Locations presented in the virtual scene (i.e. café places) were related to both olfactory and visual primes (i.e. café) and were based on the continuity between real and virtual environments. Once immersed in the virtual environment, all participants were instructed to use their intuition to envision the selected locations during which Skin Conductance Responses (SCRs) and verbal declarations were recorded. When initiation (a) and immersion (b) phases in the virtual environment were considered, “primed” participants had higher SCRs during the immersion phase than the initiation phase in the virtual environment. They showed higher SRCs during the first part of the virtual immersion than “non primed” participants. During the phenomenological interview, “primed” participants reported a higher number of correct intuitive answers than “non primed” participants. Moreover, “primed” participants “with” insight had higher SCRs during real environment immersion than “primed” participants “without” insight. The findings are consistent with the idea that intuitive decisions in various tasks are based on the activation of pre-existing knowledge, which is unconsciously retrieved, but nevertheless can elicit an intuitive impression of coherence and can generate insight.

Therapeutic itinerary of families of children with chronic diseases

Objective: to understand the Therapeutic Itineraries of families of children with chronic diseases. Method: phenomenological study conducted at a university hospital, with ten families of children with chronic diseases who participated in a phenomenological interview with the guiding question - 'Tell me about the path you (and your family) traveled in search of health care for your child before arriving at this hospital'. Results: four thematic categories emerged: Walking in search of health care for their child - the beginning of the saga; Perceiving themselves as vulnerable in front of the Unified Health System; From the difficulty to get access to health care to unexpected help and Arriving at the reference service - from the relief of care to the perception of the existence of new problems. Discussion: some families were referred by bonds of friendship, transfer through zero vacancy and spontaneous demand in other health services. After the diagnosis and beginning of treatment, the family showed hope for a cure, reporting a sense of relief when they saw the child being cared for. Conclusion: it was evidenced that children with chronic diseases and their families experience a long process of seeking access to health care, mainly due to the need for referral to referral hospitals.

The formation of tolerance among various ethnic groups as a way to increase well-being

The paper focuses on the development of the ethnic intolerance preventative strategy and the development of ethnic tolerance.The objective of the paper is to study the problem of safe and emollient interaction of ethnic groups through the inoculation of tolerant and dialogoriented relation to each other and the development of the tolerance strategies. In the course of the research, the authors used the following methods: method of sociological survey, psycholinguistic experiment, observation method, and the method of the dialog-oriented competence formation. When solving this problem, the authors obtained the following results: revealed and described the hetero stereotypes about other ethnic groups, developed the strategies of positive perception of ‘others' as ‘our', studied effective ways of manifesting ethnic tolerance and ethnic integration of the peoples to each other. The results are reliable: the basic provisions of the paper were approbated and tested in the course of the free-associative experimentand phenomenological interview. The scientific results are fraught with novelty contributing to the theory of ethnic and communicative tolerance, assist in the development of new strategies and methods of inoculation of adaptive and tolerant behavior, and allow preparing the training programs on the coping behavior of ethnic groups.