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PubMed1991

Relationships among defense style, existential anxiety, and religiosity.

63 participants whose mean age was 26.8 yr. answered a questionnaire which measured defense style, existential anxiety, and religiosity. Defense style was generalized to existential concerns; repressors, who tend to avoid threatening stimuli, were likely to have less existential anxiety than sensitizers, who tend to approach threatening stimuli. Religiosity was related to neither defense style nor existential anxiety. It was suggested that religiosity was more influenced by socialization than by individual anxieties or personality variables such as defense style.

Adult↗
PubMed1992

Existential anxiety as related to conceptualization of self and of death, denial of death, and religiosity.

82 students completed a questionnaire which measured their existential anxiety as described by Yalom, conceptualization of self and of death, denial of death, and religiosity. For these students, scores on existential anxiety correlated with identity confusion, feeling responsible toward others but fearing emotional closeness with them, seeing people as fundamentally different and not seeing oneself as living on in one's tasks or projects. Their existential anxiety scores were not related to a particular concept of death, but death was more likely to be seen as cold and denied. Their existential anxiety seemed symptomatic of adjustment problems for which religiosity was not helpful. Specific suggestions for further research are made.

Adolescent↗
PubMed2001

Living with newly diagnosed breast cancer--the meaning of existential issues. A qualitative study of 10 women with newly diagnosed breast cancer, based on grounded theory.

This study aimed to describe how 10 Norwegian women diagnosed with breast cancer experienced living with the disease. A qualitative method was used, including open-ended in-depth interviews based on principles in Grounded Theory. Data revealed that existential awareness was a central phenomenon in the women's experience. This central finding created the basis for the core category in data: the will to live. This core category includes existential aspects such as different levels of life expectations, the fight against death, life related to the future, religious beliefs and doubts, and increased awareness of values in life. Knowledge and an understanding of how women experience being diagnosed with cancer are prerequisites for supporting the women in a process of normalization. This study has shown that the existential aspects connected with the core category, the will to live, are a central issue in recovery and survival. The study suggests that health professionals, by increasing their awareness of existential aspects connected with the will to live, can assist women and their families in developing coping strategies.

Adaptation, Psychological↗
PubMed1998

[The "troubled" child from the existential analysis viewpoint].

Fundamental principles of the "Logotherapy and Existential Analysis", which was founded by FRANKL and further developed by LANGLE, are examined from the view of the Clinical Child and Adolescent Psychology with regard to theoretical aspects as well as to their practice-oriented relevance for the Child and Adolescent Psychiatry and Pediatry. Applying the "existential analytic diagnostic scheme" central subject-matters of finding the purpose in life as personal and existential basic motivations are considered in the differential-diagnostic proceedings and permits--as demonstrated by examples--a holistic consideration of specific problems. The indication of a functional, counseling-attendant or psychotherapeutic intervention depends on the impairment in the dimensions of personal and/or existential meaning-frustration. Finally the significance of personal attitude towards differential diagnosis as well as towards the motivation for therapy is emphasized, a criterion non considered in actual versions of international diagnostic schemes as ICD-10 or DSM-IV.

Adolescent↗
PubMed2002

Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues.

Neuropsychiatric problems, and how they interact to impact on quality of life (QOL) in brain tumor patients, are generally poorly understood. The objectives of this study were: (1) to document the prevalence of depression, fatigue, emotional distress, and existential issues in a sample of brain tumor patients (2) to examine the interconnectedness of these problems, and (3) to explore their relationship with disease-related variables and QOL. This is a cross-sectional, questionnaire-based survey of 73 patients with primary brain tumors who presented to a neurological clinic at a tertiary cancer centre for ongoing care. Data for 60 participants (29 women, 31 men) who completed validated questionnaires were retained for analysis. Results showed that there was a high burden of depressive symptoms as measured by the Beck Depression Inventory-II (mean score 11.1, SD 7.4), with 38% of the sample scoring in the clinically depressed range. Overall QOL scores for this sample were similar to a reference sample of brain tumor patients. The scores on the existential subscale of the McGill Quality of Life questionnaire were comparable to those of a reference sample of cancer patients receiving ongoing care (mean score 7.2; SD 1.7). Fifty per cent of the sample could be classified as struggling with existential issues. Although scores reflecting depression, fatigue, emotional distress, and existential problems were interrelated, the presence of depressive symptoms was the single most important independent predictor of QOL in this cohort of brain fumor patients. Implications for treatment are discussed.

Adult↗
PubMed2006

Existential loneliness in a palliative home care setting.

BACKGROUND: The diagnosis of an incurable disease implies an existential crisis. This study focused on the emotions, perceptions, and experiences of existential isolation in palliative patients with cancer and their families. MATERIALS AND METHODS: A total of 40 respondents (20 patients and 20 family members) were interviewed in depth. All were Swedes who defined themselves as nonreligious. The patients were enrolled in an advanced hospital-based home care team. The interviews were taped, transcribed, and analyzed with a qualitative, hermeneutic method. RESULTS: The data revealed experiences of existential loneliness with the impending death as a primary source. Experiences of being alone in "a world of one's own" were common. The changes in everyday life and the increasingly restricted social interaction because of the illness meant that the patient partly lost the protection against isolation that the spirit of community normally provides. Other situations that had a triggered the existential isolation were, for example, when a patient in need of support was left alone, when he or she was treated disrespectfully or in a way that made him or her feel invisible, or when people avoided contact because of uneasiness or fear. Changes in one's own body and mood gave rise to feelings of loneliness and unfamiliarity toward oneself. When a staff member touched the patient's body in a nonempathic way, this could induce feelings of being treated like an animal.

Adult↗
PubMed2003

Professionally perceived effectiveness of psychosocial interventions for existential suffering of terminally ill cancer patients.

BACKGROUND: Although integrated care for existential suffering is an essential part of palliative care, little is known about its concept and efficacy as perceived by professionals. A questionnaire survey was carried out to 1) explore the underlying structure of psychosocial interventions recommended by specialists, 2) identify the professionally perceived effectiveness of each intervention for specific existential distress, and 3) examine the effects of specialty on their recommendations. METHODS: A questionnaire with three scenarios representing terminally ill cancer patients with uncertainty-related anxiety, guilt feelings, and dependency-related meaninglessness was mailed to 701 Japanese psychiatrists, 118 psychologists, and 372 palliative care nurses. RESULTS: A total of 456 responses were obtained (response rate = 38%). Recommended psychosocial interventions were classified into six subcategories: 'a supportive-expressive approach,' 'providing comfortable environments,' 'meaning-centered approach,' 'being,' 'education and coping skills training,' and 'a religious approach.' A 'supportive-expressive approach' was consistently recommended in all vignettes. On the other hand, 'providing comfortable environments' was most recommended for patients with uncertainty-related anxiety, and a 'meaning-centered approach' and 'being' were most recommended for patients feeling dependency-related meaninglessness. Psychiatrists estimated the effectiveness of psychopharmacological treatment significantly higher than psychologists and nurses, while nurses evaluated efficacy of all other interventions significantly higher than psychiatrists and psychologists. CONCLUSIONS: Experts evaluated a variety of clinical interventions as effective in palliating existential suffering, although the perceived levels of efficacy of each intervention differed according to the nature of suffering and their specialties. To effectively alleviate existential suffering in terminally ill cancer patients, an integrated care by an interdisciplinary team is necessary.

Analysis of Variance↗
PubMed2005

Existential needs of people with psychotic disorders in Pôrto Alegre, Brazil.

BACKGROUND: Needs for care in service users with schizophrenia are often defined by professionals and focus on basic needs for health and social care rather than broader existential issues. AIMS: To examine the perceptions of users and formal and informal carers of the needs of people with non-affective psychosis. METHOD: A qualitative study was conducted involving focus groups of service users and informal and formal carers in a major Brazilian city. RESULTS: Existential needs were the most important theme for people with psychotic disorders. Informal and formal carers mainly regarded such needs as secondary to needs for health, housing, leisure and work. Carers usually reduced the existential questioning of the ill person to symptoms or the result of a privation such as lack or failure of medication and its consequences. CONCLUSIONS: We require an approach to service users wherein respect and understanding are prized as the first needs from which all others will naturally follow. We also need to give greater priority to existential issues in validated schedules that measure needs in clinical work and research.

Attitude to Health↗
PubMedDate not supplied

An exploratory factor analysis of existential suffering in Japanese terminally ill cancer patients.

To determine an underlying factorial structure of existential distress in Japanese terminally ill cancer patients, a principal components analysis was performed on 162 Japanese hospice inpatients. Existential distress commonly identified was dependency (39%), meaninglessness in present life (37%), hopelessness (37%), burden on others (34%), loss of social role functioning (29%), and feeling emotionally irrelevant (28%). By a factor analysis, three primary components accounted for 66% of the variance. 'Dependency' and 'loss of social role functioning' loaded highly on the first factor, which was interpreted as 'loss of autonomy'. 'Burden on others' and 'feeling emotionally irrelevant' loaded highly on the second component interpreted as 'lowered self-esteem', while 'hopelessness' loaded highly on the third factor. On the other hand, 'meaninglessness in present life' loaded equally on all three components, and was significantly associated with other distress. In conclusion, existential suffering of Japanese terminally ill cancer patients has three principal components: loss of autonomy, lowered self-esteem, and hopelessness. It is also suggested that meaninglessness in present life would be an underlying theme in patients' spirituality.

Adult↗
PubMed1994

Existentialism and postmodernism. Continuities, breaks, and some consequences for medical theory.

Since existentialism lost its influence in philosophy in the 1960s, postmodern theory has taken over criticizing basic concepts of western thought. From a postmodern point of view, the main shortcomings of existentialism is that it criticizes traditional unitarian concepts, while re-inventing new unitarian models. Against these unitarian approaches postmodernism holds that the world can only be described in terms of difference. In this article the postmodern program and its differences from existentialism are explained in reference to three concepts of western philosophy: subject, truth, and ethics. Applying these concepts, the relevance of postmodernism for medical theory is illustrated.

Ethics↗
PubMed2004

Being a Parkinson's patient: immobile and unpredictably whimsical literature and existential analysis.

What is characteristic of being a Parkinson's patient? This article intends to answer this question by means of an analysis of novels about people with Parkinson's disease, personal accounts, and scientific publications. The texts were analyzed from an existential-phenomenological perspective, using an adapted version of the existential analysis. Being a Parkinson's patient is apparently characterized by an existential paradox: life appears simultaneously immobile and unpredictably whimsical. This may manifest itself in the person's corporeality, in his being-in-time and in-space, in his relating to things and events, his life-world, and in his being-together-with-others as an individual. Finally, some specific characteristics of being a Parkinson's patient are described that may be relevant for purposes of adequate care, as is to be specified by further research.

Adaptation, Psychological↗
PubMed2006

Nurses in cancer care--stress when encountering existential issues.

Previous research related to stress among health care staff has highlighted several complex issues; however, a deeper analysis of the existential components has been lacking. The purpose of this paper is to study the stress of registered nurses who work with terminally ill and dying cancer patients, according to an earlier model developed by Ekedahl [2001. How can you bear the Challenge of Working at the Edges of Life and Death? Coping Processes with Hospital Chaplains Encountering Existential Confrontation: a Study in Psychology of Religion., Uppsala University, Thesis Uppsala]. The present study is qualitative and hypothesis-generating. The material analyzed are based on a life story approach and interviews carried out with 15 Swedish nurses working in hospices, oncology wards, and outpatient services for patients with advanced cancer. The nurses' stress levels ranged from low to severe, including multifaceted stress with existential dimensions. Different types of stress appear to be related with the individual, group, institutional, and cultural level.

Adaptation, Psychological↗
PubMed2006

The caregiver's perspective on existential and spiritual distress in palliative care.

There is a paucity of research relating to how palliative caregivers conceptualize, identify, and provide for spiritual and existential domains of care. Focus groups comprising experienced palliative care providers participated in three semistructured 2-2.5 hour interviews, which were transcribed and subjected to thematic analysis. Eight themes were revealed: conceptualization of spirituality; creating openings; issues of transference and countertransference; cumulative grief; healing connections; the wounded healer; sustaining a healing environment for the caregiver; and challenges and strengths for the spiritual and existential domains of palliative care. While the spiritual and existential domains were variously conceived by experienced care providers, their significance for both patient and caregiver was affirmed. Transference and countertransference issues and the "wounded healer" concept were considered fundamental to effective care. Strategies for promoting therapeutic depth discussion were suggested and the importance of self-awareness and staff support emphasized.

Adult↗
PubMed2003

A holistic-existential approach to health promotion.

Health promotion seems to be implicit in many nursing theories, but the theoretical and philosophical basis of health promotion in nursing is not always explicitly stated. The interpretation of health promotion is closely related to the interpretation of man, health, illness and nursing. There is a need to clarify, refine and redefine health promotion in nursing because the concept is partly nonspecific and has not been used to identify a distinctive nursing focus. The aim of this study was to formulate a stipulative definition of health promotive nursing with a holistic-existential approach. A philosophical frame of reference in combination with conceptual analysis and theoretical synthesis were used as the methodological approach. The philosophical framework served as a basis in selecting the nursing theories and influenced the analysis. Two nursing theories and one nursing model were selected due to their influence on Norwegian nursing and because of their philosophical basis. Through analysis and synthesis of the selected nursing theories, the concepts man, health, illness/disease and nursing were analysed. The paper proposes a stipulative definition of health promotion in nursing based on a holistic-existential approach, supported by five necessary conditions. The definition and conditions needs to be further investigated by both empirical studies and by comparing with other relevant nursing theories, in order to formulate theoretical statements. The proposed definition may be the first step in a process of developing a theoretical framework of health promotive nursing with a holistic-existential approach.

Attitude of Health Personnel↗
PubMed1999

'A leg to stand on': an existential-phenomenological analysis.

The analysis of a paradigm-case (a person with an injured leg, an autobiographical history related by Dr Sacks) presented here is an illustration of how existential-phenomenological analysis can be done. The aim of existential-phenomenological research is to analyse and to describe some dimensions of being. The person with an injured leg appears 'to bescotomized'. Well then, 'being-scotomized' can be analysed and described as a particular mode of 'being', even as a particular mode of 'being-ill'. 'Being' has been studied (in the philosophical tradition of Husserl, Heidegger, Merleau-Ponty and Sartre) as that existential movement that brings an individual, the 'self', towards the world, meanwhile 'affecting' the personal body, personal time and space, the objects in a person's life-world, the individual's life-world and, finally, coexistence. The study of 'being-ill' is the study of the particular way the self, the body, time and space, the objects, the life-world, and coexistence are affected when being-ill. 'Being-scotomized' may appear as affecting: (i) the self, isolating the subject and leading to a personal disintegration; (ii) the body to which he maintains an ambiguous relationship: being a body and having a body, and not having a part of the body any more; (iii) time and space being vanished with the vanished leg. The subject is 'at' a nowhereness and 'at' a motionless time; there is no meaningful future; (iv) the things in the person's life-world, to which it appears impossible to give the 'right' sense; (v) the life-world, revealing itself as a noland, characterized by silence and motionlessness; (vi) the others in this life-world that appears no-man's-land, uninhabitable nearly by definition. Coexistence reveals not to be possible.

Body Image↗
PubMed1989

Existential and psychopathological evaluation of group psychotherapy of neurotic and psychotic patients.

General problems in researching group psychotherapy are reviewed, especially for those with similar theoretical and methodological approaches. The sample consisted of 100 subjects, 26 of whom were neurotic and 24 of whom were psychotic. They were treated in small groups, headed by the author (the experimental group). An equal number and the same categories of patient attended control psychiatric sessions (the control group). All subjects were tested twice. With three instruments: the semantic differential (with twelve existential categories, five general therapy, and three ego psychology categories), the Kotchen test, and MMPI (midiform). A discriminative analysis of tests and the repeated test data, statistically significant, revealed experiential changes in existential categories, such as "Freedom," "Sex," and "Love" amongst psychotics; and in the case of both psychotic and neurotic patients, treated in groups and compared with the controls, such categories as "Understanding among people." With the help of MMPI, a statistically significant reduction of hysteria in neurotic subjects was established, as well as the preventive effects of group psychotherapy regarding the emergence of psychopathy in psychotic patients. Correlation calculations indicated a greater discrimination in the perception of changes using existential categories in the experiencing of psychotic and depressive patients. Finally, the results obtained are discussed from the viewpoints of clinical experience, results obtained in similar research studies, and unanswered questions resulting from such research.

Adaptation, Psychological↗
PubMed2004

Dying young, dying poor: a sociological examination of existential suffering among low-socioeconomic status patients.

Palliating the whole person requires that medicine attend more fully to the phenomenon of existential suffering. The role of social factors, in particular, is often overlooked in attempts to understand why end-of-life suffering does not always respond to physiologic, psychological, and spiritual interventions. Using qualitative data from in-depth interviews with 33 low socioeconomic status (SES) terminally ill patients with cancer, I examine how a sociological framework can provide insights on existential suffering at the end of life. Specifically, I discuss how dying "off time" in the life course, being exposed to the illness trajectories of others, and experiencing social isolation and social death contribute to existential suffering among the terminally ill.

Adaptation, Psychological↗
PubMed2002

Personality traits and existential concerns as predictors of the functions of reminiscence in older adults.

This study examines to what extent personality and existential constructs predict the frequency of reminiscence, in general, and its various functions, in particular. Eighty-nine older adults completed the NEO-Five Factor Inventory, the Life Attitude Profile--Revised, and the Reminiscence Functions Scale. Neuroticism predicted total reminiscence frequency, as well as reminiscence for self-understanding and ruminating about a negative past. Extraversion predicted total reminiscence frequency, as well as reminiscence for generating stimulation, conversation, and maintaining memories of departed loved ones. Openness to experience predicted total reminiscence frequency and reminiscence for addressing life meaning and death. Existential concerns, and in particular low desire to seek new challenges, added significant additional predictive power for total reminiscence frequency and for such uses as generating stimulation, preparing for death, and ruminating about the past. The discussion draws the implications of the finding that the combination of personality traits and existential concerns predicted the overall reminiscence frequency together with the intrapersonal functions of reminiscence.

Adaptation, Psychological↗