Theoretical and empirical background Dependency in an ontological and cultural perspective According to Henriksen and Vetlesen (2000), dependency determines what it means to be a human being. Dependency is linked to a resulting vulnerability meaning that the human being is referred to the care of others, as the human being is not a self-sufficient self, but

always in relationships with other human beings. In this referral there is an inherent risk of not being seen and the caring needs of the individual are not met. Dependency thus contributes to making life frail. Dependency on others Ceritinib is constituted by our lives, but it is often in connection with severe illness that we become conscious of this dependency on others. It is when serious illness marks you, you become aware of things that have functioned previously. Dependency on others is often associated with negative feelings and powerlessness and that is a value-laden LY2157299 ic50 concept. This can be understood from a cultural–historical perspective as autonomy in the western culture is considered an overall value. Autonomy means to be self-governing and self-determining. This interpretation of the concept of autonomy comes from the moral philosopher Kant (1724–1804) and is still leading today. To be self-sufficient financially and in relation to

work as a cultural ideal can create a basis for the thought that as human beings we are independent. To be independent becomes an ideal demonstrating freedom that can be won by the human being. Dependency is considered something you can grow out of or detach yourself from. Thus, there is a tension between dependency as a basic human condition and the cultural ideal of individual freedom and independency (Henriksen & Vetlesen, 2000). Dependency on care in the ICU The literature review showed that the majority of studies investigate dependency from an organizational perspective. They focus on how dependency can be estimated to assess the optimal nurse–patient ratio, the effect of different classification systems for this assessment, or an estimation of the workload of nurses (Adomat & Hewison, 2004; Adomat

& Hicks, 2003; Donoghue, Decker, Mitten-Lewis, & Blay, 2001; Large, Nattrass, & Simpson, 1991; Thymidine kinase Wardle, 1997). Three articles discuss different aspects of dependency on care from a patient perspective. Griffin (1982) discussed how the self of critically ill patients is threatened when they are forced to be dependent on others. Forced dependency and loss of control are described as significant stressors in the intensive care patient; some patients described the feeling of lack of control and helplessness as more threatening than the threat of death. The article is rather old, and it is uncertain whether it is based on actual research as it has not been possible to procure the sources on which the article is based.