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Results for “EXISTENTIALISM”

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PubMed1983

Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease.

This study describes the level of symptom distress, current concerns and mood disturbance in persons with a diagnosis of one of two life-threatening diseases at two occasions. The sample included 56 lung cancer patients and 65 heart attack patients who completed interviews at 1 and 2 months post diagnosis. Data were obtained using a modified version of the McCorkle and Young Symptom Distress Scale, the Weisman and Worden Inventory of Current Concerns and the Profile of Mood States. One conclusion that can be drawn from the study is that the plight of newly diagnosed lung cancer patients appears to be bleaker than that of heart attack patients. Cancer patients experienced more symptom distress of all kinds than heart attack patients. They also reported more health and existential concerns and they suffered more mood disturbances, on the average, than heart attack patients did. The most striking finding of the mean differences analysis was that, although symptom distress remained the same between occasions for both groups, both kinds of patients reported fewer concerns and better mood at the second interview. Although the plight of neither type of patient improved, patients reported being in better spirits and less worried at the second measurement occasion. This reduction in concerns and mood disturbance between interviews suggests that patients assimilate that their situation is not as immediately life-threatening as they had feared.

Adult↗
PubMed1984

Chronic pain from the perspective of health: a view based on systems theory.

Envisaging the phenomenon of pain within the concept of systems theory, different, mutually coherent system levels can be noted of interest, namely the existential person level, the psychological behavioural level and the organismal neurophysiological level. Viewed from this angle, and considering pain to be a signal indicating the whole system's integrity being threatened, the experience of pain can be seen as associated with an intrinsic system function: the pain function. This function is initiated in painful conditions with respect to the system as a whole, rather than being a symptomatic phenomenon lodged--in terms of cause and effect--in distinct system levels. The syndrome of chronic pain may therefore be regarded as a specific state resulting from a pathological derangement in the course of that function. In respect of the different ways in which the system, by way of this function, can cope with a painful event, various possible correlations may be pointed out with regard to the conditions of the system levels in concern. As to the specific course of the pain function--the system's 'answer' to the threatening condition--the pre-existing state of system's integrity can be proposed to be of major importance; the integrity being in clinical terms consonant with a given state of 'health'. Thus chronic pain may be considered as a pathological state resulting from the reaction to painful conditions of an already unhealthy individual. In view of this concept on (chronic) pain several implications can be pointed out with regard to the leading notions on chronic pain, as well as to the general therapeutic approach to be considered.

Chronic Disease↗
PubMed1988

Workplace wellness participation and the becoming of self.

This paper provides a sociological examination of workplace wellness participation as a process that occurs in two stages or levels. The existential model of self provides the theoretical orientation for this examination, and data are presented from an ethnographic study of a large workplace wellness program. The first stage or level of participation involves the establishment of a sense of competence. Competence refers to the perceived ability to 'fit in' with the program, to master the often subtle skills required for membership in the class. Once a minimal sense of competence is established, the employee may decide to join by viewing participation either as an extension of a commitment to wellness, or as a vehicle for experimenting with or establishing a new style of self, the identity of a 'well person' so highly valued in contemporary western culture. The dynamics of workplace wellness participation illustrate a more general cultural trend towards health-as-accomplishment.

Adult↗
PubMed1989

Generational equity in America: a cultural historian's perspective.

This paper examines the issue of generational equity in America through the lenses of cultural history and social criticism. It argues that generational equity reflects broader problems of contemporary aging policy, whose troubles in turn reflect the decline of American military and economic power, the legitimation crisis of the liberal welfare state, and population aging. The question of justice between the young and the old is also linked to the 'spiritual situation of the age'--in particular to American culture's inability to provide convincing answers to existential concerns like the quality of life in old age, the unity of the life cycle, and the meaning of aging. Both communitarian and liberal approaches to generational equity presuppose a life course or lifespan perspective, whose unifying ideological power took shape historically in a bourgeois culture that provided widely shared images of the integrity of the life course. The social power of this perspective emerged over the last century, when the U.S., along with other Western democracies, institutionalized the life course by creating age-homogeneous schools for youthful preparation, employment for middle-aged productivity, and publicly funded retirement benefits for the aged. The ideal of a society legitimately ordered by the natural divisions of human lifetime is now under siege in large part because its view of old age is neither socially nor spiritually adequate and because the social meanings of life's stages are in great flux. In our century, vastly improved medical and economic conditions of old age have been accompanied by a loss of cultural meaning and vital social roles for older people.

Age Factors↗
PubMed1989

Ayurveda: a multilectic interpretation.

Ayurveda, in practice, comprises far more than a medical tradition in Sri Lanka. It provides, in addition to a manuscript for health care, a popular knowledge paradigm by which the population addresses social, epistemological and ontological issues in their lives. The concept of health expands to include the many existential levels that are basic to a definition of the self and the many arenas of life in which it is made evident. The concept of 'multilectic' process is introduced in this paper to explain this dynamic that characterizes popular Ayurveda, a dynamic that Sri Lankans specify as consisting of a fundamental complex interplay of mutually interrelated factors that are capable of referencing multiple meanings and life contingencies neither contradictory, dichotomous, nor unidirectional in nature. Because of the extent to which Ayurveda is embedded in the everyday lives and fundamental conceptual frameworks of the Sri Lankans, it is likely to remain an integrating knowledge system and a powerful explanatory paradigm in their general lives as well as for their health care dilemmas.

Attitude to Health↗
PubMed1990

Health and social inequities in Spain.

This article examines the relationship between health and social differences in Spain. The dominant explanatory models (medical, health system oriented and economical) have focused on health care as the main source of health. They have disregarded the role of socioeconomic variables in the genesis, development and cure of illness. In relation to the distribution of health, the variables analysed here are those of poverty, social class, sex, age, living conditions, lifestyles and some existential indicators using both official aggregated data and survey data. We conclude that Spain is a country with major economic, social and regional differences and manifests important variations in the health of its population. The evidence taken from the data presented here seems to indicate that poverty, living conditions and income play a relevant explanatory role.

Cross-Cultural Comparison↗
PubMed1991

Loneliness and social support of mothers of chronically ill children.

To address the problem of loneliness and social support in mothers of chronically ill children, we interviewed 90 mothers, among them 33 whose children suffered from a chronic life-threatening disease and 57 whose children had a chronic illness. In addition, we conducted home interviews with a control group of 92 mothers of healthy children. In responding to questions on the revised UCLA Loneliness Scale and the Norbeck Social Support Questionnaire, the mothers of children with either chronic life-threatening or chronic illness revealed higher loneliness than the mothers of healthy children. Larger social networks and perceived greater support was reported by mothers whose children had a chronic life-threatening disease. In this group, no significant relationship was found between the variables of loneliness and social support; whereas, in the group with chronically ill children, and in the controls, a significant inverse relationship between the two variables was noted. Mothers of children with chronic life-threatening diseases may become subject to higher existential loneliness.

Adaptation, Psychological↗
PubMed1991

Women's perspectives on chronic illness: ethnicity, ideology and restructuring of life.

This inquiry into the lives of women living with a chronic illness brings to attention the complex processes that frame the existential meanings of illness. Data from immigrant Chinese and Anglo-Canadian women with diabetes are used to show that illness is constructed in a complex social, political and economic nexus. When the circumstances of women's lives are examined, styles of managing illness that could be attributed to ethnicity, become recognizable as pragmatic ways of dealing with the harsh realities of material existence. It is argued that the trends toward individualizing social problems, and shifting the responsibility for caretaking from the state to the individual, obfuscate the social context of illness, and exclude the socially disadvantaged from adequate health care.

Adaptation, Psychological↗
PubMed1996

Adaptive demands along the HIV disease continuum.

Our knowledge of the problems or adaptive demands associated with HIV infection has largely been derived from clinical history taking and qualitative research of persons with AIDS. This study uses a behaviour-analytic approach to systematically describe and quantify the specific adaptive demands encountered by persons with HIV across the disease continuum. Ninety six HIV-infected gay men and 33 seronegative comparison group participants were interviewed in depth. Participants were divided into three groups representing the disease continuum: seronegative, HIV asymptomatic and HIV symptomatic groups. Responses to a Problem Checklist were statistically and content analysed. Distressing emotions, relationship difficulties and HIV-related symptoms were the three most frequently endorsed problems and were also the three most frequently reported problems of most concern. Overall there was a trend for instrumental difficulties to increase with disease progression, whereas emotional and existential problems did not vary as a function of HIV stage. The behaviour-analytic approach to the specification of problems related to HIV infection has implications for both clinical and research endeavours. The specification of problems provided a means for accurately identifying common problems to target and could, therefore, provide the basis for developing suitably matched interventions for use with HIV-infected persons.

Adaptation, Psychological↗
PubMed1996

The 'limits' of medicalization?: modern medicine and the lay populace in 'late' modernity.

Taking as its point of departure the medicalization thesis and its limitations, this paper provides a critical discussion of certain more recent theoretical perspectives on life in contemporary society, and their relevance for understanding the relationship between modern medicine and the lay populace. In particular, attention is paid to the contours and existential parameters of life in 'late' modernity in terms of the following four key themes: (i) modernity as a 'reflexive' social order, (ii) 'risk' and the dialectic of scientific and social rationality; (iii) the "mediation' of contemporary experience; and (iv) lay 're-skilling' and the 'life political' agenda. On the basis of this, it is argued that far from being simply passive and dependent, a 'critical distance' is beginning to emerge between modern medicine and the lay populace; a situation which resonates with broader social trends and currents within society at large.

Aged↗
PubMed1983

[Primary prevention in the area of drug addiction: perspectives, errors and fallacies].

Primary prevention in drug abuse has been, most of the time, reduced to its informational aspect. This paper points out some of the errors made in this field, both by contributing to the 'inflation' of the drug problem and by using scare tactics as preventive arguments. It invites consideration of drug addiction not as an isolated problem, but as one of the multiple results of an existential crisis, the author tries to show that in this field the emphasis of primary prevention should be on education.

Fear↗
PubMed1994

Psychosocial counseling to improve quality of life in HIV infection.

Psychosocial interventions such as cognitive behavioral stress management (CBSM), may enhance coping and social support which contribute to an improvement of quality of life factors such as emotional functioning, social functioning, and sense of well-being, for HIV-infected men during several phases of HIV spectrum disease. These phases include the acutely stressful period immediately following notification of HIV+ status, the adjustment period following this news, and the process of dealing with chronic symptomatic HIV infection. Normalization of some aspects of immunological status were found to accompany some of these psychosocial changes in the short-run. Longer-term follow-up indicated relationships between psychosocial factors and improved immunological status and physical functioning up to 2 years later. Factors such as an increased use of active coping strategies, including relaxation exercises, use of more functional appraisals and elicitation of social support, and decreased use of denial/avoidance coping strategies, may be key predictors of longer-term emotional well-being, social functioning, and physical functioning in HIV-infected populations. Special issues need to be addressed in emerging models of quality of life assessment in HIV populations. For example, the way resurgence of stigmatization and self-doubt affects sense of identity and well-being need to be addressed in quality of life research as well as in psychosocial interventions. Loss of employment and its financial and existential consequences are also factors which impact sense of self and well-being, and need to be addressed both in research as well as in interventions. The effect of repeated HIV-related bereavements upon an individual's social network and the emotional, social, and physical sequelae of bereavement have implications for HIV quality of life research as well. Quality of survival time has become a paramount issue in the context of HIV spectrum disease. Examining the relationships among coping strategies, social support, emotional well-being, realistic appraisals of one's functioning in comparison to their aspirations, and the influence of psychosocial functioning on disease course are central missions of our research program.

Adult↗
PubMed1991

Borderline personality disorder and group therapy.

This study examined the process and outcome of group therapy for community health center clients with borderline personality disorder. The results indicated that group members rated Yalom's curative factors to be increasingly helpful over time, and that universality and existential factors were consistently ranked as very helpful group process variables. The group sessions also were associated with positive outcomes, as evidenced by significant improvement in Goal Attainment Scale scores and the depression and hostility scales of the Brief Symptom Inventory. The results of this study suggest that group therapy is a valued and effective treatment option for people with borderline personality disorder.

Adult↗
PubMed1991

Psychological correlates of loneliness in the older adult.

Loneliness is the emotional response to the discrepancy between desired and available relationships. As people grow old, the likelihood of experiencing age-related losses increases. Such losses may impede the maintenance or acquisition of desired relationships, resulting in a higher incidence of loneliness. This pilot study examines how loneliness relates to age-related losses, hopelessness, self-transcendence, and spiritual well-being in a convenience sample of 107 adults aged 65 years or older. The collective utility of the independent variables in predicting loneliness was investigated by means of a regression decision tree with an automatic random subset crossvalidation procedure. This procedure explained 46% of the variance. Higher scores for age-related losses and hopelessness were associated with higher loneliness scores. Higher scores for self-transcendence and existential spiritual well-being were associated with lower loneliness scores.

Aged↗
PubMed1992

Have we looked beyond the physical and psychosocial?

Palliative care can easily focus on physical and psychosocial problems but, for various reasons, ignore the spiritual needs of patients. There is confusion between the words 'religious' and 'spiritual,' the latter being the search for existential meaning, something done by all men and women--particularly as they approach death. This paper looks at excuses for not looking at spiritual issues but suggests the attending professional cannot avoid this aspect of care.

Humans↗
PubMedDate not supplied

Spiritual well-being: a predictor of hardiness in patients with acquired immunodeficiency syndrome.

This study examined the relationship between spiritual well-being and hardiness in a group of 100 subjects who either tested positive for the human immunodeficiency virus (HIV+) or who had diagnoses of acquired immunodeficiency syndrome (AIDS)-related complex (ARC) or AIDS. Each subject completed the Spiritual Well-Being Scale, the Personal Views Survey (to measure hardiness), and a Demographic Data Survey. Analysis of data included Pearson Product-Moment Correlation Coefficients and multiple regression techniques. The results demonstrated that there was a significant relationship between spiritual well-being and hardiness (multiple R = .4165; P less than .001) as well as between the existential component of spiritual well-being and hardiness (multiple R = .5047; P less than .001). The conclusions of the study are that in this sample those individuals who were spiritually well and who were able to find meaning and purpose in their lives were also hardier. This finding has significance for the care that is provided to persons who are HIV+ or who have diagnoses of ARC or AIDS.

AIDS-Related Complex↗
PubMed2006

Making up one's mind:--patients' experiences of calling an ambulance.

The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals' and caregivers' perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients' existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients' experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals' point of view but also take account of the patients' reactions when they experience a threat to their life and health.

Adaptation, Psychological↗
PubMed2006

Relational learning in pediatric palliative care: transformative education and the culture of medicine.

The discrepancy between what is taught in formal educational settings and what is learned by practitioners in the informal flow of everyday practice has been called the hidden curriculum. In this article, the authors apply a well-documented range of concerns about the hidden curriculum and the erosion of professionalism to the arena of pediatric palliative care education. The authors propose that educational initiatives must always be grounded in the charged existential space of relationships among children, families,and practitioners, because the learning that matters most occurs within these relationships. The authors present an educational approach, which they call relational learning, and offer some preliminary strategies educators may wish to foster this kind of learning in their own health care organizations.

Clinical Competence↗