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PubMedDate not supplied

Love and caring. Ethics of face and hand--an invitation to return to the heart and soul of nursing and our deep humanity.

This manuscript offers a new view of old and timeless values: the essential ethic of love, informed by contemporary European philosophies, and caring theory, as well as ancient poetry and wisdom traditions. It integrates some of the philosophical views of Levinas and Logstrup with Watson's Transpersonal Caring Theory. The metaphysics, metaphors, and meanings associated with "ethics of face," the "infinity of the human soul," and "holding another's life in our hands" are tied to a deeply ethical foundation for the timeless practice of love and caring, as a means to sustain, not only our shared humanity, but the profession of nursing itself.

Empathy↗
PubMed2003

Association between renal insufficiency and inducible ischemia in patients with coronary artery disease: the heart and soul study.

Chronic renal insufficiency (CRI) is a predictor of stroke, cardiovascular, and all-cause mortality, but the mechanisms responsible for these associations are unclear. Whether CRI was associated with severity of coronary artery disease (CAD) as measured by exercise stress echocardiography among outpatients with stable CAD was evaluated. This study is a cross-sectional analysis of the Heart and Soul study, a prospective cohort of patients with known CAD. Renal function was assessed by 24-h urine collection, and CRI was defined as measured creatinine clearance < or =60 ml/min. Exercise stress echocardiography was used to identify inducible ischemia, defined as any wall motion abnormality seen at stress but not at rest. Logistic regression was used to evaluate the association of CRI with exercise-induced ischemia after adjustment for cardiovascular risk factors. Participants with CRI composed 97 (23%) of the 431 participants and were characterized by older age, worse CAD, lower ejection fraction, greater left ventricular mass and higher C-reactive protein values. The prevalence of exercise-induced ischemia was also substantially greater in the participants with CRI (42% versus 23%; odds ratio [OR], 2.3; 95% confidence interval [CI], 1.4 to 3.8; P < 0.001). This association was minimally changed by adjustment for traditional cardiovascular risk factors and coronary disease history (OR, 2.0; 95% CI, 1.3 to 3.3; P < 0.01) and remained strong even after adjustment for C-reactive protein (OR, 2.3; 95% CI, 1.0 to 5.1; P = 0.04). CRI is strongly associated with exercise-induced ischemia in patients with CAD. The greater severity of atherosclerotic disease observed in patients with CRI may in part explain the association of CRI with increased cardiovascular risk among individuals with CAD.

Aged↗
PubMed2004

Association of chronic kidney disease and anemia with physical capacity: the heart and soul study.

Chronic kidney disease (CKD) and anemia are common conditions in the outpatient setting, but their independent and additive effects on physical capacity have not been well characterized. The association of CKD and anemia with self-reported physical function was evaluated and exercise capacity was measured in patients with coronary disease. A cross-sectional study of 954 outpatients enrolled in the Heart and Soul study was performed. CKD was defined as a measured creatinine clearance <60 ml/min, and anemia was defined as a hemoglobin level of <12g/dl. Physical function was self-assessed using the physical limitation subscale of the Seattle Angina Questionnaire (0 to 100), and exercise capacity was defined as metabolic equivalent tasks achieved at peak exercise. In unadjusted analyses, CKD was associated with lower self-reported physical function (67.6 versus 74.9; P < 0.001) and lower exercise capacity (5.5 versus 7.9; P < 0.001). Similarly, anemia was associated with lower self-reported physical function (62.6 versus 74.3; P < 0.001) and exercise capacity (5.7 versus 7.5; P < 0.001). After multivariate adjustment, CKD (69.4 versus 74.2; P = 0.003) and anemia (67.5 versus 73.6; P = 0.009) each remained associated with lower mean self-reported physical function. In addition, patients with CKD (6.3 versus 7.7; P < 0.001) or anemia (6.5 versus 7.4; P = 0.004) had lower adjusted mean exercise capacities. Participants with both CKD and anemia had lower self-reported physical function and exercise capacity than those with either alone. CKD and anemia are independently associated with physical limitation and reduced exercise capacity in outpatients with coronary disease, and these effects are additive. The broad impact of these disease conditions merits further study.

Aged↗
PubMed2006

In search of the true self: a clinical journey through the vale of soul-making.

Once a person accepts any form of mainstream mental health care, she is faced with the paradox of disabling caring. Every time an emotionally distressed individual is professionally rescued, she forfeits a golden opportunity to discover and utilize her own healing potential. Yet within a mental health service that is heavily medicalized and investing more and more in time-limited therapies, can it ever be otherwise? Drawing on the developmental theory of Donald Winnicott, together with the poet John Keats' concept of 'Soul-making', this case study provides an account of therapy delivered from outside the parameters of a health-illness model of caring. It acknowledges human suffering as a natural and inevitable part of life and, whilst acknowledging the value of therapeutic companionship, proclaims the mentally distressed person as best placed to navigate her own recovery.

Adaptation, Psychological↗
PubMed2003

Beauty: soul or surface?

It is proposed that beauty can be external or internal or both. External or physical beauty is immediately visible. Internal or inner beauty is not always immediately visible. Ideally both types of beauty are connected and spring from one another. The opposite situation, in which only one exists while the other is suppressed, is exemplified in this paper, using a tale from 19th century Croatian literature as a model. The main character is Tena. Initially physically beautiful, she is later disfigured by smallpox. Consequently her psyche metamorphoses through illness, distress and destitution, and she discovers an inner self that allows her full personality to develop. The story of Tena illustrates how love based only on outer appearance may end in unhappiness. Perhaps true love depends more on soul than surface. Endless quests for external beauty are part of medical practice today more then ever before. Skin is the paradigm of this. The dermatologist needs many clinical skills, including an understanding of psychology, when addressing skin-related problems--appearance-related problems in particular. Sometimes the humanities (e.g. literature, poetry, etc.), may help broaden our perspective of such a complex phenomenon as beauty.

Journal Article↗
PubMed1975

Soul foods for some older Americans.

The elderly person brings with him a lifetime of food preferences. For him, nutritional adequacy is dependent upon continuation of similar underlying influences and the varying conditions which determine the food intake of any group. The significance of individuality cannot be minimized in assessing nutritional well-being and in developing a plan of action. Among the factors affecting food acceptance and health status are foods which are foods which are considered "soul" by some persons. Recognition of, and respect for, individual food preferences can be invaluable to members of the health professions in providing services to aging Americans.

Aged↗
PubMed1993

The heart: location of the human soul--site of surgical intervention.

Over millennia, the heart has played an important role in philosophy, medicine, literature, art, and theology. Most cultures consider the heart to be the location of the soul or mind, the "center" of the human body. Modern natural sciences, however, downgrade it to a mere organic blood pump and, simply, a site of surgical interventions. Dealing with this central organ of the body, cardiac surgery is a royal discipline among the medical professions and is highly respected by the public.

Cardiac Surgical Procedures↗
PubMed1998

Belief in transmigration of the soul and psychopathology in Israeli Druze. A culture-sensitive psychotherapeutic approach.

One of the central tenets of the Druze religion is the transmigration of the soul. In rare cases this belief may be related to psychopathology or cause a temporary inability to function normally. We report on 5 Druze patients whose preoccupation with transmigration was the basis of their pathological behavior. These cases illustrate the interaction between cultural and religious beliefs, and psychopathology, and emphasize the importance of employing a culture-specific psychiatric approach in the management of this type of patients.

Adult↗
PubMed2005

Depression, stress, and quality of life in persons with chronic kidney disease: the Heart and Soul Study.

BACKGROUND: The effect of mild chronic kidney disease (CKD) on depression, stress, quality of life (QOL), and health status is not well understood. We compared these outcomes in subjects with and without CKD. METHODS: We performed a cross-sectional study of 967 outpatients enrolled in the Heart and Soul Study. CKD was defined as a measured creatinine clearance < 60 ml/min. Outcome measures included depressive symptoms measured using the Patient Health Questionnaire (PHQ), stress measured using the Perceived Stress Scale (PSS), and QOL and overall health rated as excellent, very good, good, fair, or poor. RESULTS: The prevalence of depressive symptoms (17 vs. 19%, p = 0.4) or perceived stress (11 vs. 16%, p = 0.09) did not vary significantly by CKD. The prevalence of fair or poor QOL was not significantly different in subjects with CKD, compared with those without CKD (24 vs. 23%, p = 0.65). Age-adjusted analyses revealed a significant association of CKD with QOL (p = 0.003), however, this association no longer reached statistical significance after adjustment for confounders (p = 0.06). Subjects with CKD were more likely to report poor or fair overall health than subjects without CKD (42 vs. 34%, p = 0.03). After multivariate adjustment, CKD remained significantly associated with worse overall health (OR = 1.65, 95% CI 1.21-2.24, p = 0.001), and modestly associated with QOL (OR = 1.31, 95% CI 0.99-1.75, p = 0.06), but had no association with depression (p = 0.48) or stress (p = 0.24). CONCLUSION: In this study of persons with coronary artery disease, subjects with CKD had reduced overall health and modestly reduced QOL; however, mental health was similar in those with and without CKD. These findings suggest that self- assessed overall health may decline at earlier stages of renal dysfunction than mental health outcomes or QOL.

Aged↗
PubMed2003

C-reactive protein and ischemia in users and nonusers of beta-blockers and statins: data from the Heart and Soul Study.

BACKGROUND: Elevated levels of C-reactive protein (CRP) are associated with an increased risk of coronary events, but whether inflammation is associated with inducible ischemia in patients with stable coronary disease is unknown. METHODS AND RESULTS: We recruited patients with known coronary disease from 2 VA Medical Centers and 1 University-based medical center for the Heart and Soul Study. We measured CRP levels in 118 participants who had exercise-induced ischemia and in 111 who did not have inducible ischemia, as determined by stress echocardiography. We used logistic regression to examine the risk of exercise-induced ischemia associated with elevated CRP. We found that 75% (39/52) of participants in the highest CRP category (>0.38 mg/dL) had inducible ischemia, compared with 45% (79/177) in the lower 4 categories combined (adjusted odds ratio 4.2; 95% confidence interval 1.6 to 11; P=0.004). However, this association differed in users and nonusers of beta-blockers and statins. Among 89 participants who did not use beta-blockers, 93% in the highest CRP category had exercise-induced ischemia, compared with 42% in the lower 4 categories (P=0.03). Among 67 participants who did not use statins, 94% in the highest CRP category had exercise-induced ischemia, compared with 44% in the lower 4 categories (P=0.009). We did not observe a significant association between CRP and ischemia among participants who were treated with either of these medications. CONCLUSION: Elevated CRP levels are associated with inducible ischemia in patients with stable coronary disease, particularly among those not treated with beta-blockers or statins.

Adrenergic beta-Antagonists↗
PubMed1977

Witchcraft and soul loss: implications for community psychiatry.

The author uses the case study of a Chicana patient who believes in witchcraft and soul loss to illustrate the importance of understanding alternate theories of disease causation. He describes the patient's unsuccessful attempts to find treatment appropriate for her culturally determined beliefs and feels her efforts were hampered because she was a member of a culture in transition. She was finally treated through home visits and medication. The author discusses factors related to the underuse of mental health services by Chicanos and the role of the indigenous therapist. He also suggests how mental health centers can be made more relavant to Chicanos by providing such services as home visits and family therapy.

Adult↗
PubMed1994

The soul and the pneuma in the function of the nervous system after Galen.

Galen's teaching on anatomy and physiology was generally accepted in the Middle Ages and this applies to the part he thought was played by the pneuma in the functions of the body. In this essay I have outlined the advances made after Galen in the study of the nervous system leading eventually to a time when the soul and the pneuma were no longer thought necessary for the proper functioning of the brain and nerves.

Electrophysiology↗
PubMedDate not supplied

What language shall I borrow? The poetry of Rainer Maria Rilke and the care of souls.

This article suggests that the reality of the world is socially constructed through the words and narratives chosen and used. These social constructions may be from science and technology, business and economics, or poetry and metaphors, and as such each shapes a different world. The work of the poet Rainer Maria Rilke is used to illustrate how the power of words and images shape and form the world. The implications of the use of language for the care of souls are discussed.

History, 19th Century↗
PubMed2003

Whatever happened to the soul? Theological perspectives on neuroscience and the self.

Traditional religious teachings about the nature of the person, especially body-soul dualism, influence majority views of the self. Following a historical overview, it is argued that a purely physicalist account of human nature is equally compatible with contemporary science and with Christian thought. However, an account that reduces higher human capacities to neurobiology is unacceptable from a theological perspective.

Ego↗
PubMed1989

A search for soul. Strategic planning will chart the way.

As the 1980s has been the decade of competition and financial challenge for Catholic healthcare facilities, the 1990s will challenge organizational identity. The struggle for existence is leaving many facilities spiritually depleted. The Catholic healthcare facility of the 1990s will need to do some soul searching. A key tool will be strategic planning; the key planner will be the trustee. In its simplest form strategic planning is a tool for defining and establishing organizational identity. In Catholic healthcare it answers the questions, How can I awaken to a deeper understanding of the Catholic healthcare ministry in changing times? and, How should the organization be transformed to keep mission and values alive? Good strategic planning takes practice and discipline. As a judge of quality and effectiveness, as well as a participant in strategic planning, the trustee needs some benchmarks for assessing how well he or she is doing and how well the organization is doing. To understand how strategic planning will contribute to better governance and how the trustee should be involved, it is necessary to resolve three basic questions: (1) What is a good plan? (2) What are a good structure and process for planning? and (3) How is success measured?

Catholicism↗
PubMed2000

[The dishonest, the ignorant and the insane artists--psychopathography and other paths to soul of the artist].

Psychopathography is a specific kind of biography focusing on psychological and psychopathological aspects of the personality and their significance for creative activity, especially in famous persons. Psychopathography evolved as a discipline from the 1830's onwards, as a product of psychiatry emerging as a science, reflecting its reductionist and nosological approach. An illustration of this method is the analysis of the author E.T.A. Hoffmann, a prototypical representative of the German romanticism at the beginning of the century. Hoffmann himself expresses, in allegorical terms, the menacing, irrational and unconscious domains of the human soul. Romanticism may be seen as a forerunner of the psychoanalytic movement. Confronted with modernism in art, pathographic considerations were to a large extent based upon the object of art itself, often with arrogant and repudiating conclusions concerning the artist. Classical psychoanalysis has had a marked tendency to deduce a great deal about the personality of the artist or the writer solely from analysis of a picture or written text. The pathographic approach of the first century of scientific psychiatry has had a renaissance over the last 15-20 years: The ever increasing interest in affective syndromes has entailed a tendency to trace and identify affective pathology in artists and writers, deceased or alive, often emphasizing the affective dynamics of the creative process, aspects also noted by the classical pathographers. More recent studies of the creative personality may also present improved instruments for the study of the creative process.

Creativity↗
PubMed2002

Steps to soulful living (steps): a weight loss program for African-American women.

BACKGROUND: The disproportionate disease burden experienced by African-American women can be explained partially by the higher rates of obesity in this population. African-American women who can benefit from weight loss may be less likely to attempt it and may have relatively less success in using traditional weight loss programs compared to White women. Steps to Soulful Living (Steps) was a pilot study to test the effects of a culturally adapted weight loss program on weight loss in African-American women. METHODS: Sixty-six African-American women participated in a 6-month weight loss program that included weekly group meetings and supervised exercise sessions. Mean baseline body mass index was 39 kg/m2, and mean baseline weight was 107 kg. Cultural adaptations, defined as program adjustments, made in response to women's preferences as expressed in focus group interviews included changes in intervention format, the content of the group meetings, and the location and format of the exercise sessions. RESULTS: Seventy-six percent of the participants attended at least 50% of the 26 weekly sessions, and 56% attended at least 75% of the sessions. Average hours of exercise per week approximately doubled during the program in comparison to baseline levels. Mean weight loss at 26 weeks was 3.7 kg, categorizing those who were lost to follow-up as having zero weight loss. Participants who attended at least 75% of the group meetings lost a mean of 6.2 kg at six months. Those who attended fewer meetings lost a mean of 0.9 kg. CONCLUSIONS: This 6-month program was associated with relatively larger weight losses, particularly among participants with high attendance, than have usually been observed in culturally adapted programs for African-American women.

Adult↗
PubMed1975

[Heart as mirror of the soul (findings and status)].

It took a period of five thousand years to proceed from the assumption of the heart being the origin of life, and "seat" of soul to today's point of view, that heart function is a mere indicator of psychophysic activation. Both advanced electronic technologies and mathematical procedures had to be developed to be able to separate the informational constituents of the cardiac signals. Even today the problems of specificity concerning the different variances and patterns are not solved at all. Many failures in research derive from overestimation of single values in correlational statistics. There are indications that, on the basis of consequent application of pattern recognition techniques, it would be possible to obtain major progress in the field of psychophysiological covariance research.

Culture↗