title: Through the depths and heights of darkness; mothers as patients in psychiatric care.
abstract: BACKGROUND
  This study attempts to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients' existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering. Mothers struggle to cope with the demands of the illness and the responsibility for their children. They see themselves through their children and regard the child as an important part of themselves. Mothers experience guilt and shame related to motherhood, and when they have to relinquish their responsibility as a mother, they consider themselves a failure. Despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life.
  
  
  METHODS
  This study is rooted in philosophical hermeneutics inspired by Gadamer with an inductive-deductive-abductive approach. Interpretation of the data was made on different levels of abstraction described as rational, contextual, existential and ontological. The point of departure was the caring science theory about health and suffering and the hermeneutic philosophy of understanding.
  The interpretation revealed the mothers' experiences of health and suffering as a struggle between the darkness of suffering and their inner source of strength. In the light of the theory of caring, the conscience became visible as the bearer of the human being's inner ethos of love and compassion. Experiences of health and suffering were interpreted as a struggle between guilt and responsibility, where conscience emerged as the road from ontological guilt to responsibility that leads the human being to what is true, beautiful and good in life.
authors.affiliation: Department of Caring Science, Åbo Academy University, Vasa, Finland; Department of Nursing, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Nina Elisabeth
authors.initials: NE
authors.lastname: Blegen
authors.forename: Katie
authors.initials: K
authors.lastname: Eriksson
authors.forename: Terese
authors.initials: T
authors.lastname: Bondas
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*
keywords: caring science; experiences; health; hermeneutic; mothers; suffering