”Lyhördhet” - Students´ conceptions of ”Lyhördhet”  in care and education

 (revised 16/2 2011)

Bodil Frisdal

Fil.dr, ass.Professor in Pedagogic


The word ”Lyhördhet” only exists in the Nordic languages. As it is impossible to translate the word “”Lyhördhet” exactly to English the Swedish word ”Lyhördhet” is used and marked in italics.

In English, German and French dictionaries ”Lyhördhet” is paraphrased in different ways without given the complete meaning as it has in the Nordic languages.

In English ”Lyhördhet” is translated as “to be keenly alive to” (aware of)”.


In German ”Lyhördhet” corresponds to among others “hellhörig” in the meaning of to hear clearly and “aufgeschlossen” in the meaning to be open for new ideas.

In French, Italian and Spanish dictionaries ”Lyhördhet” is translated into “être un esprit ouvert” (French), “essere aperto á“ (Italian) and “ester abierto á (Spanish)

corresponding to the meaning “to have an open mind, soul or spirit”.


Some nursing researchers (Parse, 1981, Liehr, 1989) consider nursing as a mutual exchange of energy and use the expressions “sensitive awareness” and true presence”, which partly, but not completely correspond to the Swedish word ”Lyhördhet”.


A linguistic analysis concerning the occurrence and application of the concept of ”Lyhördhet” in earlier times as well as currently in daily use, newspapers and media shows that ”Lyhördhet” reflects what is on in different times. A hundred years ago ”Lyhördhet” was often connected with poetry, mysticism and spirituality, While ”Lyhördhet” today often is used in association with leadership, market, economy and politics.


Since the concept of ”Lyhördhet” often is used in connection with the concepts of intuition and empathy a literature study, concerning these closely related concepts, was done.


Finally I have analysed the use of the concept  of ”Lyhördhet” in nursing literature, pedagogical literature and in literature concerning scientific methods.


The aim of the empirical study about ”Lyhördhet” was to describe how a group of  students thought about ”Lyhördhet” revealed through their descriptions of situations where nursing actions, according to the students understanding are characterized by ”Lyhördhet” or by the lack of ”Lyhördhet”, and through  their general statements about ”Lyhördhet”.


The aim was specified by the following questions:


·         What is the meaning of ”Lyhördhet” in nursing, in the collection of examples, described by the students, with focus on the direction of ”Lyhördhet”?


·         How do the students define ”Lyhördhet” after, compared with before the clinical education, how do they relate ”Lyhördhet” to a holistic view of care and how do the students value the importance of ”Lyhördhet” in connection with education and care?




The method is qualitative/hermeneutic,inspired by a phonographic orientation and

contextuell analysis as a qualitative methodology. The dissertation may be regarded as hermeneutik since it intends to attain understanding other human beings and our life situations by interpreting how human life and existence come to expression in the spoken and written language and in the actions of human.


The fundamental idea of phenomenography is to proceed from the world around and from everyday life. According to this the main material is from descriptions of ”Lyhördhets”-situations, observed and written by nursing students during their daily life with the patients in the clinical part of the education.


The descriptions of the ”Lyhördhets”-situations show how ”Lyhördhet” is expressed in actions relating to the patients. The data concerns situations where the actions directly or indirectly have implied a positive or negative change in the patients.


The informants in the empirical study were students in the nursing programme, during the clinical education part of their first year. They participated in a processoriented pedagogic based on the process:


Inventory - Planning - Realizing - Evaluating


As the teacher of this group I applied a pedagogic which I call ”Lyhördhets”-pedagogic. In my dissertation i have described the ideas, organization and context more extensive.

My intention was, beside the aim to collect data, to train the students and make them aware of the use of and the consequences of ”Lyhördhet” as an activity.


The data collection started with a brainstorming in which the students were asked to write down what associations, feelings and thought  they got when looking at the word                                                                                                                            


written on the blackboard.

To “open up” more I let them listen to music in the background.

The aim with this was to get the students spontaneous thoughts of ”Lyhördhet” before they had been influences by the teaching.


During the following clinical education the students were encourages to be observant to situations, which according to their understanding, had proceeded from ”Lyhördhet” or lack of ”Lyhördhet”. They were also encouraged to be open, aware and to use all their senses.


As a conclusion to the empirical clinical study the students were again asked to write down, define and describe their conceptions, concerning the implication of ”Lyhördhet”.

Further more they were asked to answer, in writing, if and when they thought that ”Lyhördhet”, according to their opinions, was important in caregiving and in education.

They were also asked to give their opinions about the pedagogical method to observe, write down and discuss ”Lyhördhets”-situations with other students and nurses.


Since the association to a holistic view of care often had been brought into the discussions, the students were finally asked to give their opinions on the relation between ”Lyhördhet” and a holistic view of care.

The students had, as I mentioned before, got instructions to observe and discuss situations, where the nursing, in their understanding, was build upon ”Lyhördhet” or lack of ”Lyhördhet”.

In this way the data came to consist of 104 ”Lyhördhets”-situations besides the introductory and final statements and the answers from the theoretical part of the educational process.

The situations represent a great variety of clinical specialities in hospital as well as in primary care.

Among the patients, women and men, through the whole lifecycle, from the fetus and the newborn baby to the aging and dying human, towards the end of life, where represented in the material.


Analysis. The names of the students were coded (stud A, B and so on).

The next step was to identify all that was significant for ”Lyhördhet”, with special focus on the aim and the direction of ”Lyhördheten”.

To get different aspects, as a base for categorization, to appear, each ”Lyhördhets”-situation was illustrated as a “drawing“ with the persons involved as “actors on a scene”.

During the analysis of the data a kind of “overview maps” was drawn to get the comprehensive view and to integrate the material.

The analysis of the answers, before and after the clinical education, was performed in a similar way, except for the drawings.

The material was repeatedly read through by me and “overview maps” were   used with the purpose to find and describe the structure of the material.


Results. Through the described analysis of the 104 situations of ”Lyhördhet” a pattern of

two main categories and a number of subcategories emerged.


The first main category (main category I) concerns:

·         ´”Lyhördhet” for the patient´s resources, needs and problem´


The second  main category (main category II) concerns

·         ´”Lyhördhet” for the patient´s vulnerability in the care situation´.


The subcategories, under the main category I, concern:

”Lyhördhet” for the patients´ need of support, to be paid attention to, to be confirmed as well as to their need of security and relief and for respect of the need of autonomy and integrity.

”Lyhördhet” could also imply ´to see´ and ´be aware of´ the unspoken, of social evils and signs on child- or women abuse and of ”Lyhördhet” in wider sense, for example for the relatives and their influence on the patient.

One   subcategory concerns ´listening to oneself´ and to “the signals from one´s own body´.


The main category II is including examples of  ´lack of ”Lyhördhet”´ for the patients vulnerable situation in the caring situation.

The examples included in this category concern different types of  violence towards the patients. This violations can be of different degrees of difficulty and more or less conscious.

Three subcategories of the main category II include to ´make physical or psychical harm´, ´lack of respect for needs and wishes´ and ´to make a person “invisible”.


The definitions and the answers after the clinical education were less extensive compared with the main  material of the situations of ”Lyhördhet”.


They consisted of definitions and short descriptions concerning the students´view on the relation between ”Lyhördhet” and holistic view of care and of the importance of ”Lyhördhet” in care and education.


The results showed differences in how the students expressed their thinking about ”Lyhördhet” after compared with before the descriptions of the ”Lyhördhets”-situations. The total picture of ”Lyhördhet” may seem equivalent, but the different conceptions were afterwards shared by more students.

Another difference is that the students seem to have become more aware, more open-minded and have entered more deeply as well as broader into their thinking about ”Lyhördhet”.

Furthermore they emphasize context and don´t focus only ”Lyhördhet” towards the patients but also to themselves as well as to relatives and workmates.

They are afterwards not only concentrated upon symptoms and illness, but more upon resources and health.

The majority of the students emphasize that they have become more aware of the importance of ”Lyhördhet” and keep it in their mind every day.

The importance of ”Lyhördhet” as well as their own ability to be “lyhörda” has increased and become more important to them.

The importance of a holistic view is now more emphasized. As to the students´ opinions about relation between holism and ”Lyhördhet”, the result show that the majority of the students consider that ”Lyhördhet” and holism belong together and that ”Lyhördhet” ís prerequisite for a holistic view in this context.


Concerning the students´ opinions of the importance of ”Lyhördhet” in care and education they emphasize that ”Lyhördhet” is fundamental for work with human beings.

The motivation for this is the exposed position of the patient, being vulnerable in the situation, where she/he often, due to her/his position, is weakened and has difficulties in expressing her/his needs.

Some students emphazise that the need for ”Lyhördhet” is so obvious that it is easily forgotten. Because of that they think that it is important to train and make them aware of ”Lyhördhet”.


”Lyhördhet” in pedagogy and nursing have some similarities, but also some differences.

The similarities lay in the ability to “see” that which is underlying and the resources and needs of the students/patients. The main difference lies in that ”Lyhördhet” in nursing serves healing purposes, while ”Lyhördhet” in pedagogy serves the improvement of learning.



Conclusions of the study about ”Lyhördhet”


·         ”Lyhördhet” is relevant in domains concerning  meetings and  interhuman relations


·         ”Lyhördhet” implies a positive view of humans and belief that they have ability to be active, creative and to take responsibility as well as that they have many unused and unconscious resourses


·         ”Lyhördhet” implies openness, awareness, true presence and focusing in time and space


·         ”Lyhördhet” implies to act according to the ethical principle “ to do good and no harm


·         ”Lyhördhet” is built on humanity and respect for human integrity and autonomy


·         ”Lyhördhet” provides for and is built on empathy and intuition


·         ”Lyhördhet” is characterized by cooperation instead of rivality and own prestige


·         ”Lyhördhet” presume holism and implies that everything is connected  and exists in a context


·         ”Lyhördhet” in pedagogy and nursing aspire to increase motivation and self confidence in the students/patients


·         ”Lyhördhet” aspire to give the human/student/patient help to find her/his own strength and ability



Final definition of “Lyhördhet”


Lyhördhet is human experience and knowledge

integrated with empathy and human kindness

which through intuition and sensitiveness

for what is necessary in a special moment

in a particular situation leads to an action

which gives positive consequences.



Frisdal, B (2001) ”Lyhördhet” - Students conceptions of  ”Lyhördhet” in care and education.                      Doctoral Dissertation. Lund: Lund University.

If you want to read the whole dissertation which is written in Swedish, you can borrow or buy it from me. If you are interested in discussing the phenomena “Lyhördhet” and how we can integrate this in education and in our society you are very welcome to:


Lund 2011-02-16