Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EXISTENTIALISM”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 829 records · Page 46Linked to original sources
PubMed1996

Depression in patients with pancreatic carcinoma. Diagnostic and treatment issues.

BACKGROUND: Cancer of the pancreas is a highly malignant illness with a very poor prognosis. Unfortunately, there has been little in the way of improvement in prognosis over the past 20 years. It is feared by patients because of its reputation as a deadly and often painful disease. Given these realities, it is not surprising that depression and cancer of the pancreas often occur co-morbidly. Depression and anxiety occur more frequently in patients with cancer of the pancreas than they do in patients with other forms of cancer. The etiology of depression in patients with cancer of the pancreas may be traced to more than the disease's poor prognosis, the pain it causes, or existential issues related to death and dying. METHODS: Clinical and research data on the connection between depression and cancer of the pancreas were reviewed. RESULTS: In many instances, symptoms of depression and anxiety may even precede knowledge of the diagnosis; one of several observations that have raised speculation that mood and anxiety syndromes are related to disruption in one of the physiologic functions of the pancreas (i.e., secretion of hormones, neurotransmitters, digestive enzymes, or bicarbonate). CONCLUSIONS: Whatever its etiology, the identification and treatment of depression associated with cancer of the pancreas is an important way in which oncologists and mental health professional can collaborate to enhance quality of life in this unfortunate population of patients. Diagnosis and treatment of depressive disorders as they applied to patients with cancer of the pancreas were reviewed, and psychologic and pharmacologic treatment strategies to deal with these issues were outlined.

Depression↗
PubMed1997

Death themes in anorexia nervosa: dimensions for a reply to Jackson et al.

OBJECTIVE: To provide a critical, theoretical response to some ideas argued initially by Jackson and Davidson (Int J Eat Dis, 5, 821-835, 1986). Those ideas developed an understanding of anorexia nervosa in terms of disturbed death ideation and the notion of the anorexia nervosa sufferer as a "survivor." This paper was intended to broaden the frame of reference for a consideration of the relationship between eating disorders and death ideation. METHOD: The approach is a reflection on three domains of thinking about death and destructiveness, two within psychology, the third a perspective provided by philosophy. Specifically, early post-Freudian work, personal construct psychology, and the philosophical tradition that makes death generally significant in human life, that is, Existentialism, are discussed in terms of their illumination of the ideas under review. RESULTS: The result is a series of speculative observations that constitute an argument that these three domains together provide a strong countercritical position to the idea of a universal, even a general significance of death, particularly etiologically, in anorexia nervosa. DISCUSSION: The discussion suggests that the particular significance of death ideation in a multidimensional condition like anorexia nervosa must be derived in each particular case where it will sometimes be more, sometimes less significant, and, importantly, will mean something different to each individual sufferer.

Anorexia Nervosa↗
PubMed1997

Phase II study of psychotherapeutic intervention in advanced cancer.

The effect of psychosocial counseling on tumor progression was studied in 96 cancer patients, who were no longer amenable to regular medical treatment. Patients were offered 12 session of individual experiential-existential counseling, each sessions lasting 1.5 to 2 hours. In addition patients participated fortnightly in group counseling meetings. In five out of 35 evaluable patients, tumor growth became stationary during or immediately following therapy. In four patients this stationary period last 3-9 months, and in one patient 2 years. Natural Killer cell activity, self-reported loneliness, depression, purpose in life and locus of control showed no change from pre- to post intervention.

Adult↗
PubMedDate not supplied

The role of religious and spiritual beliefs in coping with malignant melanoma.

This study investigated the role of spiritual and religious beliefs in ambulatory patients coping with malignant melanoma. One-hundred and seventeen patients with melanoma being seen in an outpatient clinic completed a battery of measurements including the newly validated Systems of Belief Inventory (SBI-54). No correlation was found between SBI-54 scores and levels of distress. However, there was a correlation between greater reliance on spiritual and religious beliefs and use of an active-cognitive coping style (r = 0.46, p < 0.0001). Data suggest that use of religious and spiritual beliefs is associated with an active rather than passive form of coping. We suggest that such beliefs provide a helpful active-cognitive framework for many individuals from which to face the existential crises of life-threatening illness.

Adaptation, Psychological↗
PubMedDate not supplied

Anxiety symptoms and panic attacks preceding pancreatic cancer diagnosis.

Cancer of the pancreas is a highly malignant disease with a very poor prognosis. Depression and anxiety occur more frequently in cancer of the pancreas than they do in other forms of intra-abdominal malignancies and other cancers in general. Yet, the etiology of psychiatric symptoms in patients with cancer of the pancreas may not be traced solely to poor prognosis, pain, or existential issues related to death and dying. In as many as half of patients that go on to be diagnosed with the disease, symptoms of depression and anxiety precede knowledge of the diagnosis. This observation has raised speculation that mood and anxiety syndromes are related to disruption in one of the physiologic functions of the pancreas. In this paper, we present a patient who had no prior psychiatric history and developed panic attacks just prior to diagnosis of her cancer. To our knowledge, this is the first report in the literature where panic attacks, not simply anxiety, presented prior to a pancreatic cancer diagnosis. Her symptoms resolved following resection of the tumor. Implications of such phenomena for the diagnosis and treatment of anxiety and depression in pancreas cancer are discussed.

Adult↗
PubMedDate not supplied

Using beliefs and magical thinking to fight cancer distress-a case study.

This case relates to the way in which a young patient developed serious difficulties in coping with her life in the years following a successful bone-marrow transplant. By means of an illustrative metaphor, she revealed her existential position and the way in which she attempted to deal with her anxiety. Being diseased implied that life's order was replaced by disorder and a loss of basic trust. She tried to re-establish order by establishing beliefs that attributed specific regularities to life, and to influence the risk of recurrence by living according to these beliefs. Unfortunately, this meant that she had to tread a very thin line over a course mined with anxiety and eventually, she became a prisoner of her own creation. The author claims that we can learn from this case, as it clearly illustrates psychological dimensions commonly seen in cancer patients: the way anxiety is related to disorder and the way patients try to regain control of their lives through constructing belief-systems. The case also features a discussion of how we, as clinicians, may be able to help these patients.

Adaptation, Psychological↗
PubMed1991

Social support and the cancer patient. Implications for future research and clinical care.

This review assesses past progress, current practices, and future needs in research and clinical practice involving the social support needs of cancer patients. A review is given of the various conceptualizations of the social support/stress paradigm and of the state of the art of measuring social support. Then the current work in the field of social support and cancer is considered and an argument is made for the use of social support measures, which are relevant to the experiences of the cancer patient. Potential adaptations of an existing instrument (the Duke-UNC Functional Social Support Scale) are demonstrated, and a taxonomy of stages of cancer that would require additional types of social support measures and interventions is outlined. Interventions are discussed in terms of the traditional support groups as well as interventions by the oncologist and primary care physician. An argument is made for the inclusion of quality of life or functional measures as outcomes in clinical trials and the care of the cancer patient. Finally, the need to address the existential, philosophic, or religious issues surrounding cancer and its treatment is discussed.

Forecasting↗
PubMed1995

Stage IV malignant melanoma. Psychosocial issues.

The diagnosis of Stage IV malignant melanoma presents a difficult challenge for the patient with cancer, family, and health care providers. All must deal with a variety of psychosocial issues that range from the existential to the pragmatic. In the past decade an evolution in health care reimbursement methods has occurred, resulting in decreased length of stay in acute care facilities. It is at the point of hospitalization that patients' increasing needs most often become apparent. Physicians, nurses, and hospital social workers face the dilemma of providing care and support services in the reality of shrinking resources brought about by prospective payment, managed care, and cost containment policies. Health care delivery systems strive to meet the needs of patients with cancer through case management methods that link patients with a wide variety of medical and community resources. A case history is presented to demonstrate the need for collaboration among the members of the health care community in order to meet patient and family psychosocial needs.

Adult↗
PubMed2000

Living with cancer: "good" days and "bad" days--what produces them? Can the McGill quality of life questionnaire distinguish between them?

BACKGROUND: To determine the impact of care on quality of life (QOL), or to detect a change in QOL over time, measures of QOL must remain stable when QOL is stable (test-retest reliability) and change when QOL changes (responsiveness). This study addresses these issues for the McGill Quality of Life Questionnaire (MQOL). Unlike other studies that use disease status to indicate whether QOL has remained stable or changed, in this study the patient determines QOL stability or change. The authors also sought to clarify the determinants of "good" and "bad" days for oncology patients. METHODS: Patients attending an oncology outpatient clinic or who were being treated by a palliative care service were asked to complete MQOL 4 times: on days they judged to be "good," "average," and "bad" and 2 days after the first completion. They also were asked to directly rate the change in their QOL during the intervals between MQOL completion and to report the most important determinants of their good and bad days. RESULTS: The test-retest reliability of MQOL as measured by an intraclass correlation coefficient ranged from 0.69 to 0.78. All MQOL scores were significantly different on good, average, and bad days, except for the support subscale, in both clinical settings. Five domains were determinants of QOL: physical symptoms, physical functioning, psychologic well-being, existential well-being, and relationships. CONCLUSIONS: MQOL's reliability and responsiveness suggest it can be used to determine changes in the QOL of groups. The results allow interpretation of changes in MQOL scores with respect to meaning of the change to oncology patients. This in turn is helpful to determine the sample size required in future studies. Some of the domains important to the QOL of oncology patients are not included in widely used measures of QOL.

Anxiety↗
PubMed1976

Relationship between sex drive and sexual frustration and purpose in life.

Forty-eight college students (18 males, M age = 24.3, 30 females, M age = 23.5) participated in a study that investigated the relationship between one's sense of purpose in life and sexual attitudes and behavior. The test instruments included the Purpose in Life Test (PIL), a Sex Drive and Interest Scale, and a Sexual Frustration and Maladjustment Scale. Correlations were computed between the students' PIL scores and scores on each of the sex scales. The results indicated no relationship between PIL scores and the scores on the sex drive scale, whereas significant negative correlations were found between PIL scores and the sexual frustration scores for males and for the combined group of males and females. The scores on the PIL and the sexual frustration scale were not related to the students' sex. These results support Frankl's theory that sexual frustration may be a manifestation of a more general existential frustration.

Adult↗
PubMed1976

The relationship of self-disclosure to personality, adjustment and self-actualization.

This study tested the hypothesis that a high level of self-disclosure is indicative of psychological adjustment and self-actualization. The self-disclosure scale, Social Avoidance and Distress, Fear of Negative Evaluation, Alienation and Repression-Sensitization scales were administered to 60 Ss. The results for all scales indicated that a high level of disclosure was associated with adjustment as measured by these scales. A second group of 94 Ss completed the self-disclosure scale and the Personal Orientation Inventory, a measure of self-actualization. The results indicated that high disclosers compared to low disclosers had achieved a higher level of self-actualization. That is, there were significant correlations between self-disclosure and measures of self-actualization such as Time Competence, Internal Support, Existentiality, Self-Acceptance and Capacity for Intimate Contact.

Female↗
PubMed1989

Clinical meaning of the Keane PTSD Scale.

A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.

Adult↗
PubMed2003

Interaction of angiotensin II with the C-terminal 300-320 fragment of the rat angiotensin II receptor AT1a monitored by NMR.

Interaction between angiotensin II (Ang II) and the fragment peptide 300-320 (fCT300-320) of the rat angiotensin II receptor AT1a was demonstrated by relaxation measurements, NOE effects, chemical shift variations, and CD measurements. The correlation times modulating dipolar interactions for the bound and free forms of Ang II were estimated by the ratio of the nonselective and single-selective longitudinal relaxation rates. The intermolecular NOEs observed in NOESY spectra between HN protons of 9Lys(fCT) and 6His(ang), 10Phe(fCT) and 8Phe(ang), HN proton of 3Tyr(fCT) and Halpha of 4Tyr(ang), 5Phe(fCT)Hdelta and Halpha of 4Tyr(ang) indicated that Ang II aromatic residues are directly involved in the interaction, as also verified by relaxation data. Some fCT300-320 backbone features were inferred by the CSI method and CD experiments revealing that the presence of Ang II enhances the existential probability of helical conformations in the fCT fragment. Restrained molecular dynamics using the simulated annealing protocol was performed with intermolecular NOEs as constraints, imposing an alpha-helix backbone structure to fCT300-320 fragment. In the built model, one strongly preferred interaction was found that allows intermolecular stacking between aromatic rings and forces the peptide to wrap around the 6Leu side chain of the receptor fragment.

Angiotensin II↗
PubMed2003

Attitudes of medical oncologists toward palliative care for patients with advanced and incurable cancer: report on a survery by the European Society of Medical Oncology Taskforce on Palliative and Supportive Care.

BACKGROUND AND METHODS: In part of a quality improvement program, the European Society of Medical Oncology (ESMO) surveyed its membership regarding their involvement in and attitudes toward the palliative care (PC) of patients with advanced cancer. RESULTS: Of 895 members who responded, 82.5% were European and 12.1% were American. Sixty-nine percent of respondents reported that patients with advanced cancer constituted a major proportion of their practice; for 22% of respondents, patients with advanced cancer constituted most of their practice. Only a minority of respondents collaborated often with a PC care specialist (35%), a palliative home care service (38%), an in-patient hospice (26%), or a psychologist (33%). In response to questions regarding specific involvement in PC clinical tasks, respondents were involved more commonly in treating physical symptoms, such as pain (93%), fatigue (84%), and nausea/emesis (84%), than in managing psychological symptoms and end-of-life care issues, such as depression/anxiety (65%), existential distress (29%), or delirium (12%). Forty-three percent of respondents reported that they directly administered end-of-life care often, and 74% reported that they derived satisfaction from their involvement in end-of-life care. Overall, 88.4% of respondents endorsed the belief that medical oncologists should coordinate the end-of-life care for their patients, but a substantial minority (42%) felt that they were trained inadequately for this task. Positive attitudes toward PC were correlated highly with the degree of direct involvement in PC practice. Practitioners in private practice or teaching hospitals had substantially more positive attitudes regarding PC compared with physicians based in comprehensive cancer centers (P < 0.05). Although most of the responding medical oncologists expressed positive views regarding their involvement in the PC of patients with advanced cancer and dying patients, 15% of respondents had pervasively negative views. CONCLUSIONS: Most ESMO oncologists recognize the importance of PC and supportive care for patients with advanced cancer. Despite this, many are prepared inadequately for these tasks, and actual participation levels commonly are suboptimal.

Adult↗
PubMedDate not supplied

Continuity and discontinuity: the quality of life following stroke.

The purpose of this existential-phenomenological study was to investigate the experience of life after stroke rehabilitation, to provide a holistic view for nurses and others in providing care. Analysis involved a part-to-whole dialectic; selected transcripts, including the bracketing interview, were analyzed in an interpretive research group. There were 14 participants, with a 2-year median length of time since stroke; participants exhibited various disabilities. The world of the stroke survivor is grounded in a life of loss and effort from which emerged interrelated themes: independence/dependence, in control/out of control, and connection/disconnection with others. A fundamental aspect of these themes is a sense of continuity that coexists with discontinuity in the experience of self. The findings have implications for how nurses interact with stroke survivors, for goal-setting, and for specific strategies that focus on meanings for clients.

Activities of Daily Living↗
PubMed2002

Forgiveness and romantic relationships in college: can it heal the wounded heart?

This study evaluated the effects of two versions of a six-week group forgiveness intervention for college women who had been wronged in a romantic relationship. Participants (N = 58) were randomly assigned to a secular, religiously integrated, or no-intervention comparison condition. Participants completed a variety of forgiveness and mental health measures at one-week pretest, one-week posttest, and six-week follow-up. Participants in both intervention conditions improved significantly more than did those in the comparison condition on two measures of forgiveness and a measure of existential well-being. Program effects were maintained at six-week follow-up. Contrary to hypotheses, there were no differential treatment effects when comparing participants in the secular and the religiously integrated conditions. Participants generally rated the programs favorably. Forgiveness strategies utilized by participants also were examined.

Adaptation, Psychological↗
PubMed2005

Paternal and maternal influences on the psychological well-being, substance abuse, and delinquency of Chinese adolescents experiencing economic disadvantage.

On two occasions separated by one year, Chinese adolescents with economic disadvantage in Hong Kong (N = 199) responded to instruments measuring perceived parental parenthood qualities (indexed by perceived parenting styles, support and help from parents, and conflict and relationship with the parents) and psychosocial adjustment (psychological well-being, substance abuse, and delinquency). Results showed that parental parenthood variables were concurrently associated with different measures of adolescent psychological well-being and problem behavior at Time 1 and Time 2. While paternal parenthood qualities at Time 1 predicted changes in existential well-being and delinquency in adolescent boys, but not in adolescent girls, at Time 2, maternal parenthood qualities at Time 1 predicted changes in the mental health and problem behavior in adolescent girls, but not in adolescent boys, at Time 2. There is no strong support for the thesis that adolescent adjustment influences perceived parental parenthood qualities over time. The present study suggests that the influences of fathers and mothers on the adjustment of Chinese adolescents experiencing economic disadvantage vary with the gender of adolescent children.

Adaptation, Psychological↗
PubMed2007

Sense of coherence as a protective factor for demoralisation in women with a recent diagnosis of gynaecological cancer.

BACKGROUND: Demoralisation is a dysphoric mood state commonly seen in the medically ill. Its core features comprise hopelessness, helplessness, loss of purpose and meaning, despair, and existential distress. Sense of Coherence (SOC) is a quantifiable dispositional orientation that captures the character traits likely to protect against demoralisation. In this study, we hypothesised on theoretical grounds that a strong SOC would be associated with lower levels of demoralisation in the context of gynaecological cancer (GC). METHOD: One hundred and twenty women with a recent (<12 months) diagnosis of GC were recruited from outpatient clinics. Participants were interviewed and completed questionnaire measures of demoralisation and SOC. A multiple regression analysis was performed using the five subscales of the Demoralisation Scale as predictor variables and SOC as the dependent variable. RESULTS: Together, the five subscales of the Demoralisation Scale accounted for 60% of the variance in SOC. CONCLUSIONS: The results supported the hypothesis, suggesting that SOC may be protective against demoralisation in the context of serious illness. Larger, multivariate studies that examine additional variables (such as coping) would be required to further clarify the relationship between SOC and demoralisation. In the meantime, clinicians may want to consider efforts to enhance SOC in patients.

Adaptation, Psychological↗