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Religion's evolutionary landscape: counterintuition, commitment, compassion, communion.

Religion is not an evolutionary adaptation per se, but a recurring cultural by-product of the complex evolutionary landscape that sets cognitive, emotional, and material conditions for ordinary human interactions. Religion exploits only ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, and folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or "agency detector," whose proper (naturally selected) domain encompasses animate objects relevant to hominid survival--such as predators, protectors, and prey--but which actually extends to moving dots on computer screens, voices in wind, and faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order. However, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims.

Anxiety↗

Enhancing meaning in palliative care practice: a meaning-centered intervention to promote job satisfaction.

OBJECTIVES: This article introduces a new meaning-centered psycho-educational group intervention, called Enhancing meaning in palliative care nursing, designed to support nurses providing palliative care. This intervention aims at increasing job satisfaction and quality of life, as well as preventing burnout in this particular population. THEORETICAL FRAMEWORKS: Its format and content are founded on the meaning-centered psychotherapy approach developed for terminally ill cancer patients (Breitbart, 2001; Greenstein & Breitbart, 2000). Frankl's existential therapeutic approach, called logotherapy, serves as the underlying theoretical framework to this intervention. DEVELOPMENT: Following the presentation of the context and the development of the intervention, its content is described. CONCLUSION: A brief description of the ongoing randomized controlled trial testing the intervention is then provided. Finally, the way in which this intervention could contribute to nurses' quality of life and suggestions for future developments are briefly discussed.

Adaptation, Psychological↗

I am not an animal: mortality salience, disgust, and the denial of human creatureliness.

The present research investigated the need to distinguish humans from animals and tested the hypothesis derived from terror management theory that this need stems in part from existential mortality concerns. Specifically, the authors suggest that being an animal is threatening because it reminds people of their vulnerability to death; therefore, reminding people of their mortality was hypothesized to increase the need to distance from animals. In support, Study 1 revealed that reminders of death led to an increased emotional reaction of disgust to body products and animals. Study 2 showed that compared to a control condition, mortality salience led to greater preference for an essay describing people as distinct from animals; and within the mortality salient condition but not the control condition, the essay emphasizing differences from other animals was preferred to the essay emphasizing similarities. The implications of these results for understanding why humans are so invested in beautifying their bodies and denying creaturely aspects of themselves are discussed.

Adult↗

Making the history of psychology clinically and philosophically relevant.

The author discusses ways to make the history of psychology course relevant for a clinical psychology doctoral program within a multidenominational Protestant theological seminary. She uses a personalist orientation to emphasize the need to integrate psychology, philosophy, and theology. She differentiates among the intrapersonal, interpersonal, impersonal, and transpersonal dimensions of experience. She illustrates the rich multidisciplinary historical roots of contemporary psychology by tracing the the history of the term psychology and examining its meanings in the existential psychology of Søren Kierkegaard and in the 19th-century novel. She includes brief histories of the "new psychology" and of the unconscious. She describes how she uses the field of psychotheological integration to illustrate principles of historiography and summarizes resources used to supplement traditional textbooks.

Clinical Medicine↗

Making ethical choices: a comprehensive decision-making model for Canadian psychologists.

This paper proposes a theoretical augmentation of the seven-step decision-making model outlined in the Canadian Code of Ethics for Psychologists. We propose that teleological, deontological, and existential ethical perspectives should be taken into account in the decision-making process. We also consider the influence of individual, issue-specific, significant-other, situational, and external factors on ethical decision-making. This theoretical analysis demonstrates the richness and complexity of ethical decision-making.

Canada↗

Transcultural nursing: a perspective derived from Jean-Paul Sartre.

Transcultural nursing care is a well-established theoretical framework. This theory, developed by Madeleine Leininger, can have an impact on clinical practice, academic preparation and nursing research. The heightened interest in applying transcultural care and the increased need to espouse this framework have been triggered by constant population changes. This paper defines transcultural nursing care and expands its definition further by comparing and contrasting it with Jean-Paul Sartre's existentialist perspective. The two modes of existence as defined by Sartre are closely examined. Concrete examples are offered as cultural phenomena and the components of a cultural assessment are discussed and applied. The philosophical thesis is approached from a transcultural nursing perspective and existentialism is shown to serve as a foundation for transcultural nursing. The advantages and disadvantages of transcultural nursing practice and the preparation of transcultural nurses are finally addressed.

Existentialism↗

The biomedical construction of ageing: implications for nursing care of older people.

This paper reports on an existential phenomenological study carried out in a care of elderly people setting in a 1000-bed hospital in the United Kingdom. Fourteen participants were interviewed, each on several occasions. Two themes derived from these narratives are discussed, revealing negative experiences which are related to feelings of powerlessness. These two themes, routine geriatric style and segregation, are shown to arise from the history and culture of the wards and are shown to result in care deprivation and depersonalization. Patients' individual needs are ignored as they become the objects of inflexible routines within health care practice. In order to understand the situation, the history of care of older people and the biomedical construction of ageing are examined. It is concluded that what is needed is a wider social and political movement which opposes ageism and challenges ageist stereotypes. In addition, in health care there is a need for a review of the routine geriatric style of care and of segregation based on age and a social gerontology programme for nurse education.

Activities of Daily Living↗

Understanding beliefs and meanings in the experience of cancer: a concept analysis.

Although the concepts of belief and meaning are commonly used in the cancer literature, there is often an overlap in the use of the terms. Some consider the two terms as synonyms while others link them as successive elements in adjustment. Using an adaptation of the methods of concept analysis, this article differentiates belief and meaning, and also suggests that meaning exists at two levels. The defining attributes and antecedents of these closely related concepts are identified and a model case illustrating each is presented. Clarity in the conceptual definitions of beliefs and meanings can help researchers select measures that accurately reflect the phenomenon of interest. Similarly, differentiation between the concepts can help practitioners in planning focused interventions that explore clients' existing beliefs and situational and existential meanings.

Attitude to Health↗

Spirituality and psychosocial factors in persons living with HIV.

AIM OF THE STUDY: This pilot study was designed to examine the relationships among spirituality and psychosocial factors in a sample of 52 adult males living with human immunodeficiency virus (HIV) disease and to determine the most reliable spirituality measure for a proposed longitudinal study. BACKGROUND: HIV disease is among the most devastating of illnesses, having multiple and profound effects upon all aspects of the biopsychosocial and spiritual being. Although research has suggested relationships among various psychosocial and spiritual factors, symptomatology and physical health, much more research is needed to document their potential influences on immune function, as well as health status, disease progression, and quality of life among persons with HIV disease. METHODS: This descriptive correlational study explored the relationships of spirituality and psychosocial measures. Spirituality was measured in terms of spiritual perspective, well-being and health using three tools: the Spiritual Perspective Scale, the Spiritual Well-Being Scale, and the Spiritual Health Inventory. Five psychosocial instruments were used to measure aspects of stress and coping: the Mishel Uncertainty in Illness Scale, Dealing with Illness Scale, Social Provisions Scale, Impact of Events Scale, and Functional Assessment of HIV Infection Scale. The sample was recruited as part of an ongoing funded study. The procedures from the larger study were well-defined and followed in this pilot study. Correlational analyses were done to determine the relationship between spirituality and the psychosocial measures. FINDINGS: The findings indicate that spirituality as measured by the existential well-being (EWB) subscale of the Spiritual Well-Being Scale was positively related to quality of life, social support, effective coping strategies and negatively related to perceived stress, uncertainty, psychological distress and emotional-focused coping. The other spirituality measures had less significant or non significant relationships with the psychological measures. CONCLUSIONS: The study findings support the inclusion of spirituality as a variable for consideration when examining the psychosocial factors and the quality of life of persons living with HIV disease. The spiritual measure that best captures these relationships is the EWB subscale of the Spiritual Well-Being Scale.

Activities of Daily Living↗

Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer.

AIM: The aim of this qualitative study was to describe from the perspective of 10 women (aged 39-69 years), their experience of living with breast cancer. BACKGROUND: Although there is increasing research into a variety of aspects associated with breast cancer, there is a continuing need for research to increase nurses' understanding of how women experience living with newly diagnosed breast cancer. DESIGN/METHODS: Following ethical approval, open-ended interviews were analysed, using methods influenced by Grounded Theory. Verifiability and empirical grounding of the theory was established through use of the constant comparative method. FINDINGS: Existential issues arose as an important aspect of living with newly diagnosed breast cancer. The will to live emerged as the central theme. All energy was channelled into a tenacious fight for life. Furthermore, results revealed other aspects in the women's awareness of living with breast cancer, such as their experiences in relation to emotional reactions, bodily physical changes, their female identity, meaningful activities and their social network. CONCLUSIONS: An understanding of how women experience their new and changed life situation is important to the support nurses give in the process of healing. Nurses need this knowledge to be better able to assist women and their families in their development of coping strategies.

Activities of Daily Living↗

Shared humanity and the psychiatric nurse-patient encounter.

The paper is based on a phenomenological study of the nurse-patient encounter, the purpose of which was to uncover meaning and generate understandings of being a psychiatric nurse. The study was informed by the phenomenology of Martin Heidegger (1962) and the philosophical hermeneutics of Hans-Georg Gadamer (1975). Drawing upon this phenomenological study it is my intention to discuss three of the existential elements to emerge from an interpretative analysis of these encounters; 'Being-with' as understanding, 'Being-with' as possibility, and 'Being-with' as 'care-full' concern. The paper also discusses two modes of being-with patients; the modes of the 'they' nurse and the 'self' nurse. An underlying theme of shared humanity emerged from the study and had the effect of unifying the other concepts uncovered.

Adult↗

The human dimension of nosocomial wound infection: a study in liminality.

Nosocomial wound infection is a disease that has to date been primarily understood through the language of science and biomedicine. This paper reports on findings from a sociological, interpretive study that focused on the experiential dimension of this phenomenon. The illness experience of a nosocomial wound infection is examined within a cultural milieu that values the smooth, untroubled body and alternatively ascribes cultural meaning to a body that has a definable illness. Within this context the person with a chronic wound from nosocomial infection defies normative categorisation and is thus situated outside the patterning of society. The human dimension of nosocomial wound infection includes the private, existential and embodied aspects of living with a chronic, infected wound. This report indicates that the experiential dimension is characterised by an embodied state of liminality. People with this illness live an indeterminate existence that is in-between health and illness, cure and disease. As such they have no recognised place in the medical or social world.

Adaptation, Psychological↗

Meaning of dependency on care as narrated by nurses.

This article is part of an ongoing study aimed at illuminating the meaning of dependency on care. The aim of this particular study is to illuminate the meaning of the phenomenon 'dependency on care' as narrated by nurses. Interviews with 20 nurses were conducted, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic approach was used to interpret the data. The meaning of dependency on care is revealed as laborious for both patients and nurses. The nurses' text discloses that for patients, dependency on care is a miserable loss of self-determination and self-worth. Nurses appear to be moved by dependents' difficult life and want to do whatever they can for the dependent. Dependency on care is a burdensome responsibility for nurses. For nurses dependency on care is revealed as evoking feelings of guilt and insufficiency and of being constantly concerned and worried. It is to struggle to be patient and understanding, having the arduous task of putting oneself into the dependent patients' shoes in order to cope with the demanding task of balancing between helping and not helping too much. The interpretation discloses, however, that nurses distinguish between easy and trying dependency on care. The understanding indicates that when they meet 'good' patients, nurses reappraise the situation, transform it into something new and meaningful, that is dependency on care is disclosed as 'easy to take'. When coming across'difficult' patients dependency on care is disclosed as trying. It seems that within the unique nurse-patient relationship patients may participate in such a way as to facilitate or inhibit nurses in finding meaning in the immediate caregiving situation. Nurses' evaluations of what constitutes a 'good' or a 'difficult' patient, respectively, seem to play an important role in distinguishing between dependency on care that is easy and that which is trying. The result is viewed through an existential paradigm and there is also reflection about what nurses perceive as valuable qualities in patients which might influence the quality of care.

Activities of Daily Living↗

The journey of recovery after a rape experience.

In this existential-phenomenological investigation seven women were interviewed about their experiences of recovering from rape trauma. The purpose of the study was to discover the meaning of recovery from the perception of the victim, how recovery is experienced, and what contributed to the growth and recovery of the woman who has been raped. Transcribed interviews were analyzed using a hermeneutic process. The thematic structure of a woman's recovery from rape comprises three main themes: reaching out, reframing the rape, and redefining the self. These findings are important to professionals working with women who have been raped because it is the raped woman, rather than the clinician, who is able to define what constitutes recovery.

Adaptation, Psychological↗

A systematic review of recent research on adolescent religiosity/spirituality and mental health.

There is accumulating evidence that religiosity/spirituality (R/S) are important correlates of mental health in adult populations. However, the associations between R/S and mental heath in adolescent populations have not been systematically studied. The purpose of this article is to report on a systematic review of recent research on the relationships between adolescent R/S and mental health. Twenty articles between 1998 and 2004 were reviewed. Most studies (90%) showed that higher levels of R/S were associated with better mental health in adolescents. Institutional and existential dimensions of R/S had the most robust relationships with mental health. The relationships between R/S and mental health were generally stronger or more unique for males and older adolescents than for females and younger adolescents. Recommendations for future research and implications for mental health nursing are discussed.

Adolescent↗

"Crying alone with my child:" parenting a school age child diagnosed with bipolar disorder.

Recent years have seen a rise in the number of children diagnosed at an early age with bipolar disorder and evidence is increasing that parents are performing most of the caregiving and illness management. This existential phenomenological study describes the personal experience of the parents whose children, age 6-11 years, are diagnosed with Bipolar Disorder. The thematic structure that emerged revealed that the parents in this study, strong advocates for their children, were experiencing unrelenting fear, frustration, loneliness, and hurt. The considerable health implications, affecting both the parent and the child, of lack of respite, loss of self, asynchrony, and chronic fear are discussed. Based on the findings of this study, the psychiatric nurse is in an ideal position to increase interventions that are supportive of parents.

Adaptation, Psychological↗

Spiritual well-being and anxiety in adults diagnosed with cancer.

Exploring the theory that anxiety is lower in highly spiritual persons confronting life-threatening illness, this correlational study was conducted with 114 adults who had been diagnosed with cancer. Relationships were measured between spiritual well-being and state-trait anxiety, using the Spiritual Well-Being Scale, which distinguishes between the religious and existential dimensions of spirituality, and the State-Trait Anxiety Inventory, which differentiates between transitory and characteristic anxiety. Efforts were made to identify demographic features of the sample which could influence spirituality and anxiety and their interactions. A consistent inverse relationship (p less than .001) was found between spiritual well-being and state-trait anxiety, regardless of influences of gender, age, marital status, diagnosis, group participation, and length of time since diagnosis. This supports the theory that persons with high levels of spiritual well-being have lower levels of anxiety. Controlled studies now are indicated, with attention to diversity and specificity of ethnic, socioeconomic, and religious backgrounds, as well as cancer type, stage, symptoms, and prognosis. The hospice community is challenged to undertake studies of the spiritual dimension and its healing potential.

Adult↗

Meanings of death seen through the lens of grieving.

Through the lens of grief we can discern many meanings of death, human existence, suffering, the life of the deceased, the life of the mourner, and love. This essay summarizes what the author, in part inspired by Herman Feifel, has learned about such meanings in nearly three decades of thinking, teaching, and writing about grieving as an active response to what happens in bereavement and the suffering that loss entails. It recasts his rethinking of grief within the broad categories of philosophical reflection, including meta-theory and philosophy of science, conceptual analysis, existential-phenomenological analysis, philosophy of mind, epistemology, metaphysics, and ethics.

Death↗