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PubMed1990

Change: a central concern of nursing.

The purpose of this paper is to explore the concept of change. More precisely, considering insights from Buddhism, existential philosophy, and modern developmental thought, this paper will discuss two aspects of change: (a) change as a fundamental, inevitable aspect of life, and (b) change as a process of risking to choose. The discussion includes an analysis of the correspondence of the concept with four nursing frameworks, and some implications for nursing theory, research, and practice.

Buddhism↗
PubMed1999

Caring needs of patients with rheumatoid arthritis.

The goal of this study was to identify, through the application of Watson's 10 carative factors, the caring needs specific to the human experience of having rheumatoid arthritis and undergoing acupuncture treatment. The study was conducted at a large university hospital in Stockholm, Sweden. Interviews were conducted during manual acupuncture treatment employing a conversation guide derived from Watson's theory of caring. Six women had 20 sessions each over an 11-week period. A thematic analysis of the resulting 120 audiotaped sessions revealed four predominant themes: seeking help, searching for meaning, uncertainty, and fear of being disappointed. These four phenomena captured the complexities of the physical, emotional, social, and existential experiences of the patients.

Acupuncture Therapy↗
PubMed1997

Perimenopausal women's alienation.

A feminist perspective was used to interpret data gathered from perimenopausal women using hormonal replacement therapy. Silence was the most pervasive and disquieting theme. These women parroted biomedical cognizance and iterated little authentic expression of experience. This silence reflected the women's existential position of the double other, marginalized first by being a woman and second by reason of medical norms for women being based on reproductive function. This position of alienation is explored within the context of Western culture and the patriarchal values of rationality and science. Implications are drawn for holistic nurses to facilitate women's physical awareness and articulation of their personal experiences.

Adult↗
PubMed2000

Dualistic notions about children with motor disabilities: hands to lean on or to reach out?

This article is an attempt to break through the dualistic thinking in theories on the treatment of children with a motor impairment. There is the Cartesian thinking that views the body and mind as separate entities; alternatively, some existential phenomenologists have constructed a dichotomy between the (positively valued) unnoticed body and the (negatively valued) noticed body. Dualistic notions of this kind can lead therapists to treat parts of the child (arms, legs, or speech) rather than the whole child. How can the disadvantageous effects of these dichotomies be overcome in the treatment of children? First, a concrete sketch of the development of corporality in (disabled) children will be provided. Next, the dualistic notions will be discussed. Finally, there is a discussion about how children and their care providers might benefit from this phenomenological explication.

Attitude of Health Personnel↗
PubMed2006

An Eastern perspective on change.

In Eastern, particularly Buddhist, thinking the process of change and impermanence is an integral part of existence. All suffering in life is the result of ignorance of this basic reality. A deeper awareness and appreciation of this fact leads to enlightenment and real happiness. It is the rapidity of change that is responsible for the illusory processes that create the sense of solidity, continuity, permanence, entity, agency, self or ego. Thus, the mind is able to mix the real with the unreal. In reality, there are merely processes. However, mere intellectual understanding of this is not enough. It requires experiential understanding through the expansion of consciousness and attention to these processes. It also requires experiential training, appropriate attitudes (such as kindness, compassion, joy and equanimity) and development which is often gradual. Thus, learning to appreciate and delight in the existential process of change is at the heart of the Buddhist approach. It is beneficial not only in the long run (i.e., leading to enlightenment and freedom from the cycle of birth and rebirth, the ultimate purpose of life) but also in the short term (i.e., by making living and dying enjoyable).

Attention↗
PubMed2006

Intention to register as organ donors: a survey of adolescents.

BACKGROUND: Little is known about factors that influence the intention of adolescents to register as organ donors. The identification of such factors has important implications for the development and implementation of educational programs and subsequent donor registration rates. OBJECTIVE: To determine whether adolescents with an expressed commitment to becoming organ donor registrants differ significantly from nondonors on sociodemographic characteristics and factors influencing their decision. PARTICIPANTS: Four hundred forty-five adolescents visiting a Department of Motor Vehicles office for a permit or license (n=153) or attending a driver's education course (n=292) completed a semistructured interview and questionnaire. RESULTS: Female (52.6%) and white (55.8%) adolescents were more likely to have favorable donation intentions relative to male (45.6%) and nonwhite (39.0%) adolescents (chi2 = 7.5, P = .02, and chi2 = 19.7, P = .003, respectively). Those with favorable donation intentions also endorsed significantly more positive factors (benevolence, need awareness, existentialism) as being more important in their decision. Adolescents who did not want to donate (58.7%) and those who were undecided (23.1%) were less likely to have discussed their decision with parents than were those who wanted to donate (67.7%, chi2 = 63.6, P = .0001). Finally, providing adolescents with a free driver's license in exchange for organ donor registration would have the greatest impact on registering undecided adolescents (29.8%, chi2 = 33.2, P = .0001). CONCLUSIONS: There is a pressing need for more systematic and culturally sensitive organ donation education directed toward adolescents, and the Department of Motor Vehicles and driver's education courses may be appropriate venues. An educational program from the U.S. Department of Health and Human Services, Decision: Donation, could be used in this context.

Adolescent↗
PubMed2003

Conflicts of interest: experiences of close relatives of patients suffering from amyotrophic lateral sclerosis.

It is well known that close relatives of terminally ill patients endure great emotional stress. Many factors, such as existential concerns, contribute to the distress of these relatives. In this study, interviews were conducted to explore experiences concerning life restrictions, emotional distress, and limited support, in a group of close relatives of patients with amyotrophic lateral sclerosis (ALS). The purpose was to identify, illuminate and clarify ethical problems related to these experiences. The results indicate that close relatives of patients with ALS need someone to talk to, as well as more information about the disease and its process. Furthermore, the study illustrates how ethical problems are related to choices and conflicts, and that a process including shared decision making is often an ideal when trying to find a solution to ethical problems.

Adaptation, Psychological↗
PubMed1986

Group treatment of patients with irritable bowel syndrome.

Irritable bowel syndrome, a chronic illness affecting a large segment of the population, has no known anatomic etiology. Symptoms are precipitated or aggravated by stress or emotional factors as well as diet, drugs and hormones. This article describes the illness and a group treatment approach which takes into account developmental antecedents, communication deficits and existential issues.

Adult↗
PubMedDate not supplied

[Experience of women in labor. Nurses' observations].

This study emerged from my own experience in Obstetric Nursing and my living in Obstetrics. I searched for comprehending the real meaning of delivery labor experiences as a situated phenomenon. It is a qualitative research with phenomenological approach. The lying-in women were the witnesses through the question: 'What was your daily experience in the pre-delivery room like?' Through analysis and hermeneutics of speeches, I have used the knowledge of Matin Heidegger's philosophical-theoretical referential. Thus, I managed to clarify that the parturient is fearful when left by herself in her experience, showing surprise for the labor of delivery is singular, noting down the pain as a possibility of the existential limit, being open to help and noticing the impersonality of care provided. With this watchful sense, I approached the comprehension of a lying-in woman as a being-in-a-world-with-health-professionals. This discovery indicated the possibility of new ways of caring in Obstetrics.

Adaptation, Psychological↗
PubMed1997

[Phenomenology and nursing: reflections].

The project is about phenomenology and its elements. It points out the essential ideas of existential phenomenology interpreted by Maurice Merleau-Ponty's ideas and tries to connect this philosophy to nursing world.

Existentialism↗
PubMedDate not supplied

Assessing the cultural appropriateness of the Finding Meaning Through Caregiving Scale for Korean caregivers.

Before psychometric instruments can be used for populations other than those for whom they were originally developed, validation of cultural appropriateness is essential. This article describes the assessment of the cultural appropriateness of the Finding Meaning Through Caregiving Scale (FMTCS) with Korean female family caregivers. The FMTCS measures finding meaning among caregivers from an existential perspective and has three subscales: Loss/Powerlessness, Provisional Meaning, and Ultimate Meaning. The instrument's cultural appropriateness was examined through semistructured interviews with ten Korean-born female family caregivers, five caregivers living in Korea, and five living in the United States. The interview data are reported according to the three dimensions described by Flaherty and colleagues (1988): content, semantic, and conceptual equivalence. Although the majority of items of the FMTCS appeared applicable to Korean caregivers, items on the Loss/Powerlessness and Provisional Meaning subscales asking caregivers about feelings related to missing their past relationships or communications appeared inappropriate for many Korean daughters-in-law. Of equal importance, a unique source of meaning among Korean caregivers that is not assessed in the FMTCS is an interpersonal context, including the importance caregivers place on teaching children and feeling proud of one's caregiving accomplishments in the eyes of other relatives. The addition of new items that address the interpersonal context is warranted to improve the instrument's cultural appropriateness for Korean caregivers.

Adult↗
PubMed2006

Neuropathography: origins and methodology.

Neuropathography is a genre of case study which balances the clinical neuroscientific perspective with the descriptive acuity and existential interests of phenomenological psychopathology. Its subjects are persons of exceptional talent whose contributions are widely recognized, and also those whose seemingly ordinary lives include personally profound experiences of discernible cultural significance. In all instances, the chief focus is on the shaping influence of brain dysfunction in the subject's life and work. Six methodological guidelines are outlined, their topics ranging from the subjects, source material, aesthetic standards, and multidisciplinary character of neuropathography to normative standards and concepts of neuropsychological causation.

Aptitude↗
PubMed2000

Happiness and self-actualization under conditions of strain: a sample of homeless men.

Maslow's contention that happiness includes striving and is more than a hedonistic construct was tested in a sample of 146 homeless men. Since all participants were homeless, environmental experiences can be considered as largely held constant, allowing an examination of personality and happiness under conditions of strain. Principal axis factor analysis with promax and oblique rotations placed scores from the measures Unhappy-Happy and the Brief Index of Self-actualization on the same factor which supported Maslow's idea. Humanistic-existential psychology has interest in the happiness construct particularly regarding the development of human potential.

Adaptation, Psychological↗
PubMed1981

Alcoholics Anonymous and the recovering alcoholic: an exploratory study.

Alcoholics Anonymous as a treatment modality for alcoholism has been widely accepted by both the public and mental health professionals. Evidence cited in this exploratory study of Alcoholics Anonymous membership among alcoholics in treatment demonstrated critical differences between Alcoholics Anonymous members and nonmembers on important dimensions related to the treatment of alcoholism. Alcoholics Anonymous members demonstrated a greater degree of internal locus of control, greater expectations of the successful outcome of treatment and less existential anxiety as compared to nonmembers. since these attributes are commonly encouraged in both the psychotherapeutic treatment of alcoholism and the 12 steps of Alcoholics Anonymous, the utilization of Alcoholics Anonymous as a adjunct to traditional therapy for alcoholism may reinforce important therapeutic goals.

Alcoholics Anonymous↗
PubMedDate not supplied

Essential structure and meaning of recovery from clinical depression for middle-adult women: a phenomenological study.

The author interviewed 22 women who had been clinically depressed and were in the recovery stage, as evidenced by their self-evaluations and scores on the Beck Depression Inventory. The focus of the interviews was on the phenomenological question concerning the meaning of the women's experiences of recovering from depression. Five phases in the recovery process were identified from analysis of the data: existential alienation/pain, crises of adulthood, first turning point, second turning point, and becoming a gardener. Nurses can use perceptions of clients in this study about what was helpful and not helpful and the tools they used to help themselves in recovering from depression to enhance the recovery process for other depressed women.

Adaptation, Psychological↗
PubMed2002

The voice of art and the art of medicine. The 2002 presidential address.

Vincent van Gogh's life, letters, and art are the framework for this existential speech about the nature of alienation, as well as its threat to humanity and to the artful practice of medicine. The honest, human voice expressed in van Gogh's art stands in opposition to alienation, which occurs when we divide the world into two parts: the "perfect" world of science versus the "flawed" world of human experience. Bridging this divide allows for an "authentic" life, one which honestly defines itself and faces difficult human truths. The most difficult truth relates to our own mortality, but it must be faced if we are to understand the value of existence. Film clips from Woody Allen's Hannah and Her Sisters illustrate how an artist's portrayal of these issues can be both profound and humorous, and how art brings us closer to our own humanity and to the essence of medicine. Neurosurgeons are warned about the lure of science and technology as a substitute for purpose and meaning, both as physicians and as human beings. The role of the American Association of Neurological Surgeons is explored and found to offer neurosurgeons a bridge away from alienation and toward a neurosurgical community. Neurosurgeons are urged to find meaning through service to their profession and to find the voice and art of medicine. [Note: Actual film clips were used when this address was delivered. Unofficial transcripts of the clips have been included in this article so that the integrity of the speech would not be compromised.]

Art↗
PubMed2004

Cervical cancer screening in Korean American women: findings from focus group interviews.

PURPOSE: Korean American women have twice the rate of cervical cancer than white women and demonstrate low rates in participation in cervical cancer screening. This study was to describe the perceptions about cervical cancer and factors related to cervical cancer screening among Korean American women. METHOD: Focus group methods. RESULT: Five themes emerged. First, knowledge about cervical cancer; misconceptions about cervical cancer, its causes, reproductive anatomy and the treatment. Second, perceived meanings of having cervical cancer; most of the women felt that cervical cancer represented a loss of femininity and existential value of womanhood. Third, knowledge about cervical cancer screening ; regular medical check-ups were necessary for early detection and prevention of cervical cancer. Fourth, experiences and perceived meanings of cervical cancer screening; the participants expressed their feelings; embarrassment, fear, shame and shyness. Fifth, practices of cervical cancer screening; various intervals in participating in cervical cancer screening. But they mentioned several deterrents, language, insurance, time constraint, embarrassment, fear of the screening results, misbelief about susceptibility, lack of health prevention behavior, and lack of information written in Korean. CONCLUSION: Results emphasize the critical need for culturally appropriate health education to encourage participation of Korean American women in cervical cancer screening.

Adult↗
PubMed1976

[Vital contact with reality].

From the standpoint of existential phenomenology, the contact with reality lies in the very phocus of theory, being closely related to another basic conception: that of being-in-the-world. In order to ratify those conceptions, the author reviews some concepts imported from Kurt Lewin's Field Theory, among which: a) vital psychological space, embedding the subject and in close interchange with him; b) intrapsychic regions, having, to a certain extent, autonomous functions, but being related to each other and integrated into the higher unity of the subject. As both systems are interdependent, any modification of the equilibrium of one of them reverberates into the other's, and changes the general conditions of both of them. Reviewing, at the same time, Minkowski's views on schizophrenia, the author sets forth the production of an inner world that becomes autonomous and possesses a degree of reality that overwhelms the true outer world. There is not only the splitting from reality, but the creation of a whole fantastic field, in which the individual participates with all his vital availability. Both views lead to a similar contention: that in some pathological states, the primal link man-real world, is replaced by a new inner correspondence, focused on the imaginary and having effects similar to those of the real world.

Existentialism↗