title: District nursing--sharing an understanding by being present. Experiences of encounters with people with serious chronic illness and their close relatives in their homes.
abstract: BACKGROUND
  In the homecare setting, district nurses assume a heavy responsibility and are involved in a variety of care activities. They view themselves as having a central role in care at home that centres on the development of a relationship with those who are ill and their families.
  
  
  OBJECTIVE
  The aim of this study was to elucidate the meaning of district nurses experiences of encounters with people with serious chronic illness and their close relatives in their homes. A purposive sample of 10 district nurses (female) was interviewed using a narrative approach.
  
  
  METHODS
  To achieve the aim, a phenomenological hermeneutic interpretation inspired by the philosophy of Ricoeur was used to interpret the interview text.
  
  
  RESULTS
  This study proposes that district nurses' experiences of encounters with people with serious chronic illness and their close relatives in their homes can be understood as district nurses being welcomed into the ill people's privacy, to share their intimacy and their understanding of being ill. This close relationship enables them to alleviate and to console the suffering and loneliness caused by illness. This is expressed in the three themes: being in a close relationship, sharing an understanding and weaving a web of protection.
  
  
  CONCLUSIONS
  It seems that by being entirely present, in a close relationship, district nurses share the experiences of illness and through interpretation of the whole persons' expressions; they share an understanding of this illness experience. In this close relationship, at the home of the ill people and their close relatives, district nurses are available to alleviate people's suffering and loneliness caused by illness.
  
  
  CONCLUSIONS
  This study reveals the need to be entirely present in encounters between the district nurses and people with serious chronic illness and their close relatives. This relation makes it possible to establish a shared understanding of the illness experience. Being aware of the importance of this shared understanding within a relationship, will increase the health care personnel's possibility to alleviate and console those suffering of illness. This proposed interpretation could be useful for reflection of care interventions, in education and supervision of district nurses.
authors.affiliation: Licentiate of Philosophy, Lecturer, Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden. marja.ohman@hv.luth.se
authors.forename: Marja
authors.initials: M
authors.lastname: Ohman
authors.forename: Siv
authors.initials: S
authors.lastname: Söderberg
mesh_terms: D002908:Chronic Disease / Q000451:nursing*; D003152:Community Health Nursing; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011320:Primary Health Care; D011368:Professional-Family Relations