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At least 811 records · Page 45Linked to original sources
PubMed1994

Postmodernist theory and the physician-patient relationship.

The author discusses the postmodernist claim that the "grand theories" have lost credibility, even in the field of medical science and practice. Rather than representing a shared reality among physician and patient, illness represents two quite distinct realities - the meaning of one being significantly and distinctively different from the meaning of the other. However, existential clinical narratives can function as important bridges between the world of the patient and the world of the physician. Such narratives provide important information regarding the patient's biographical situation and, particularly, the personal and cultural meanings which are a function of the biographical situation. At the same time, these narratives provide physicians with useful information for the practice of medicine.

Biomedical Technology↗
PubMed2002

[Value of phenomenology for evidence-based nursing expertise and the development of nursing care knowledge. Part II].

This second article starts by an argumentation linked to the choice of hermeneutic approach in regards to little know, as the one of comfort. It goes on by a synthesis of several essential elements of the transcendental and Existential Phenomenology. The principal characteristics of the contemporary and interpretative Phenomenology are outlined such as the phenomenological approach of Benner. The activity of putting in parenthesis (bracketing) is presented, as criteria of participant's inclusion and exclusion, the context within the study was unfolded and the manner of lived interviews in other aspects, some kept data in the "carnet de bord" are put in perspective. The procedure of coding data is described as thematics categories which emerged from them direct observations are approached. Finally, criteria of rigour and ethical aspects of the research end this article.

Clinical Competence↗
PubMedDate not supplied

Challenging traditional teaching and learning paradigms: online learning and emancipatory teaching.

The thoughts and expectations of faculty leaving the traditional classroom for online teaching are explored. This article discusses teaching strategies and technological advances and how these are affected by changing philosophical viewpoints about nursing and education. Basic issues involving technology and education focus on a variety of issues including the ability of the learner to grow existentially.

Adaptation, Psychological↗
PubMed2006

Being a family in the midst of living and dying.

The aim of this study was to illuminate the way of being a family when one family member is in the midst of living and dying. A family systems frame and a life world perspective were used in interviews with five families. A qualitative analysis inspired by Giorgi revealed dialectic and dynamic processes in constant motion within and between the continua being in affinity-being in loneliness, being in power-being in helplessness, and being in continuity-being in disruption. When families were moving in the direction of being in affinity, power, and continuity, these seemed to be prerequisites for enduring their challenged life situation and for giving them a kind of repose. When the movements were in the opposite direction, existential and emotional suffering were manifested as individual embodied experiences such as depression and anxiety.

Adaptation, Psychological↗
PubMed2006

[From ontological compartimentalisation to ontological complexity].

Discussions about the foundations of psychiatry show repetitive traits. Although in the disputes that arise between the three mainframes of reference (i.e. physical/naturalistic, hermeneutic-phenomenological, and socio-critical) new ideas do emerge with regard to content, hardly any changes can be detected in the basic hypotheses. In this article this stalemate is analysed in terms of the fundamental ontological theories that lie at the root of the three perspectives. An attempt is made to drive the debate forwards by the introduction of the concept of ontological complexity. Eventually it is argued that existential and moral learning processes of the psychiatrist (and in the environment of their patients) are just as important for their profession as are empirical and analytical insights, measurement scales and methods and innumerable pharmacological aids.

Brain↗
PubMed1991

[Inner rupture].

The notion of crisis in psychopathology has several meanings, namely in the medical, psycho-analytic and systemic senses. Each meaning is relevant to its own field of application. However, major existential changes are events whose description defies any purely symptomatic approach, the reason being that what is at stake goes beyond the simple opposition of normal and pathological states. The restlessness that can be perceived when a client grows increasingly perturbed carries in it the seeds of creative behaviour that deserves consideration in all aspects of expression. To achieve this aim, phenomenological research provides interesting avenues: analysis of correspondences between language and emotion, between words, rhythms, colours, gestures and images.

Creativity↗
PubMed1991

Care or control. Questions and answers for psychiatric nursing practice.

An existential phenomenological approach is used to study the experiences of adults hospitalised with acute mental illness which they consider contribute to the stress of, or coping with, mental illness. The phenomenological research method used is described. The analysis of data reveals that consumers of acute mental health care view 'being controlled' as contributing to the stress of mental illness, and 'caring' as contributing to them coping with mental illness. The implications of these findings for nursing practice and further research are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Themes of grief.

A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

Adult↗
PubMedDate not supplied

[An exceptional human relationship (Michael P. Kierkegaard, Søren Kierkegaard)].

There were a father and a son, Michael and Sören Kierkegaard, both highly talented, imaginitive, witty, humorous, especially interested in shrewd dialectrical dialogues respectively debates, both profound melancholy ponderers. But according to very own individuality their congeniality wasn't absolute. The father, being under a questionable rigorous opinion of sin, suffered from undeserved divine grace since early childhood. And Michael Kierkegaard made Sören anxious with the religious experience of original sin. This anxiety moved (touched or affected) the sensitive son mighty. Nevertheless he should not despair hopelessly like his unlucky father. On the contrary: Sørens incomparable melancholy, mental agony and anxiety (fear or anguish) forced the faith, existing independently of them, in a radical refining. That is why Sören Kierkegaard succeeded in sublimation of all psychological and philosophic (al) attitudes (or opinions) in the sphere of religiousness. And the result? A novel philosophy of life: Christian existentialism.

Denmark↗
PubMed1984

[Unexplored themes in the psychopathology of Karl Jaspers].

This study discusses: (1) the impact of the methodological approach to psychopathology of K. Jaspers and its potential for further development; (2) the possibility of developing phenomenological sight to participating insight (into the inner experiences of patients) as a preliminary form of therapy; (3) Jaspers' discrimination between the "understandable" and the "non-understandable" as a problem of communication (strictly differentiating between common sense communication and psychotherapeutic understanding and communicating); (4) the considerable relationship between existential communication ("Existenzerhellung") or maieutic procedure and psychotherapy. The bibliography contains 151 references.

Communication↗
PubMed1978

[Open disponibility before self - on Medard Boss' Basis of Medicine and Psychology].

In this book, written in collaboration with Heidegger, Medard Boss endeavours for the first time to use Heidegger's late philosophical oeuvre as a basis for medicine and psychology. Boss attempts to uncover behind the understanding of man as existence, which prevail in "Sein und Zeit" and which has been so influential for Binswanger's existential analysis, a more original understanding of man as eksistence, as "open disponibility" (Offenständigkeit). The interest of this view resides in the resulting general principle of classification and interpretation of all forms of disease, giving rise to an "existenialistic pathology". The problematic aspect consists in the failure to integrate the "being-onself" in the understanding of human existence as open disponibility, which leads to a one-sided interpretation of disease processes.

Ego↗
PubMed1995

Clinical epistemology: a dialectic of nursing assessment.

Clinical assessment in nursing combines general knowledge from theory and research with particular knowledge about a client. A philosophical account of this synthesis is required to elucidate the paradox of knowledge that is both general and particular. The approach developed here is a dialectical model of clinical knowledge that culminates in existential safety rather than epistemic certainty. In the model, nursing assessment is the progression from subjective vulnerability through levels of objectivity (disengagement, reduction, holism) to an intersubjectivity in which nurse and client express their combined understanding in a relational narrative. The discussion concludes with reflection on the role of theory in a dialectically complete clinical narrative.

Clinical Competence↗
PubMed1994

Postmodernist theory and the physician-patient relationship.

The author discusses the postmodernist claim that the "grand theories" have lost credibility, even in the field of medical science and practice. Rather than representing a shared reality among physician and patient, illness represents two quite distinct realities--the meaning of one being significantly and distinctively different from the meaning of the other. However, existential clinical narratives can function as important bridges between the world of the patient and the world of the physician. Such narratives provide important information regarding the patient's biographical situation and, particularly, the personal and cultural meanings which are a function of the biographical situation. At the same time, these narratives provide physicians with useful information for the practice of medicine.

Existentialism↗
PubMedDate not supplied

[Funeral rites in memory of the elderly].

This a phenomenologial study rites in the memory of elderly people, originated from the discomfort lived by the authors in their professional life dealing with death and dying. Verbal information from elderly people was collected with the objective of recovery and decoding mortuary rites. Nine themes originated from these informations: feelings and meanings in relation to death, the time of death, the annunciation death, the body's preparations, the watcher, the funeral procession, the grave, the return to home, the remembered death. The results gave the authors opportunity to understand better the attitudes of health professionals in caring for patients and their families in this existential experience of to-be-for-death. The death rationalized by scientific knowledge and nonpersonal technological care hides new rites, transmuted by new representations which the society built.

Adaptation, Psychological↗
PubMed2000

Health-related quality of life in neurology.

CONTEXT: In a climate of growing concern about costs of health care, professional accountability, and the effectiveness and efficiency of treatment, neurologists should understand measures of health-related quality of life (HRQoL) and appreciate both their values and their limits. OBJECTIVE: To provide a critical review of current concepts in the measurement of HRQoL, with particular emphasis on those pertaining to neurologic conditions. DESIGN: A selective overview of measurement strategies and specific instruments. SETTING: Clinical and research settings. PARTICIPANTS: Special attention to people with such conditions as multiple sclerosis and Parkinson disease. MAIN OUTCOME MEASURES: The utility and relevance to neurologists of available measures of HRQoL. RESULTS: There are both generic and condition- or disease-specific measures of HRQoL. Though many measures do not elicit response or are even offensive to people with such conditions as multiple sclerosis and Parkinson disease, other measures pertain directly to their circumstances and needs. CONCLUSIONS: Measures of HRQoL are both meaningful and relevant to neurologists. However, they must be refined-enabled-and used in combinations to address the clinical and existential realities of many neurologic conditions. Arch Neurol. 2000;57:1224-1227

Health Status Indicators↗
PubMed1979

Which short-term therapy? Matching patient and method.

In recent years, numerous forms of short-term psychotherapy have been developed, without clear guidelines for choosing among them. There are three major approaches in terms of both their techniques and their criteria for patient selection. The "interpretive" method stresses the use of insight produced by a therapist's interpretations, the "existential," the maturational effect of a brief empathic encounter with the therapist, and the "corrective," the behavioral changes resulting from patient management by the therapist. The question facing a short-term therapist is how to choose a particular method for a particular patient. A framework is proposed based on developmental phases of adult life to help therapists match patient and method.

Adult↗
PubMed1981

Therapeutic factors in group psychotherapy. A review.

This is a review of theoretical, empirical, and clinical research on therapeutic factors (TFs) in group psychotherapy covering the period 1955 to 1979. Therapeutic factors are processes that contribute to improvement in the patient's condition; they are different from conditions for change and from techniques. The following TFs are examined: self-disclosure, interaction, acceptance (cohesiveness), insight, catharsis, guidance, altruism, vicarious learning, instillation of hope, and an existential factor. Criteria for adequate experimental design in group research are proposed. About 40% of the works reviewed contain empirical studies; the quality of these studies is variable both conceptually and methodologically. It is difficult to assess the extent to which clinical practice has actually been influenced by this work on TFs.

Catharsis↗
PubMed2001

Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial.

BACKGROUND: Metastatic breast cancer carries with it considerable psychosocial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and traumatic stress symptoms. Supportive-expressive group psychotherapy was developed to help patients with cancer face and adjust to their existential concerns, express and manage disease-related emotions, increase social support, enhance relationships with family and physicians, and improve symptom control. METHODS: Of 125 women with metastatic breast cancer recruited into the study, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive group therapy and educational materials. Control women received educational materials only. Participants were assessed at baseline and every 4 months during the first year. Data at baseline and from at least 1 assessment were collected from 102 participants during this 12-month period, and these participants compose the study population. RESULTS: Primary analyses based on all available data indicated that participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition, but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect size, 0.25) and traumatic stress symptoms (effect size, 0.33) for the treatment condition compared with the control condition. CONCLUSION: Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.

Adaptation, Psychological↗