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 1,207 records · Page 67Linked to original sources

One brain, one mind: A joint EPA-EAN leadership perspective on brain health.

Neurology and psychiatry have operated as separate disciplines for over a century, yet this division reflects historical and institutional developments rather than the underlying biology of the brain. Contemporary neuroscience shows that brain and mental health disorders share genetic susceptibilities, inflammatory and metabolic pathways, environmental and social risk factors, and clinical features that cross diagnostic boundaries. Cognitive, emotional, sensory, and motor symptoms regularly appear across both neurological and psychiatric populations, and conditions such as seizures, psychosis, mood disorders, cognitive disorders, and sleep disorders are common to both. A brain health framework addresses this reality by treating the brain as a single biological organ whose function emerges from the interplay between genome and exposome - including stress, trauma, social context, existential meaning, pollution, and physical health - and which underlies perception, behaviour, cognition, emotion, resilience, and vulnerability. Translating this perspective into practice requires coordinated action across domains. Clinically, collaborative models such as joint neurology-psychiatry consultations and shared outpatient pathways can be implemented within existing resources to improve diagnostic clarity and continuity of care. In training, a more harmonised curriculum with shared foundations in neurobiology, joint seminars, and cross-rotations would equip clinicians with a common language while preserving specialist depth, and support the emerging fields of preventive neurology and preventive psychiatry. In research, organising studies around shared mechanisms and symptom dimensions, and launching joint funding calls, would enhance translational relevance and reduce duplication. To realise this vision, sustained leadership from European professional bodies is essential to establish collaboration as a shared professional standard.

Humans↗

Dealing with our losses.

The repeated losses experienced by a clinical oncologist may constitute a significant source of personal stress. Studies documenting high stress levels on oncology services and the prevalence among physicians of alcoholism, cirrhosis, suicide, and marital discord lend urgency to the need to examine etiologic factors, clinical manifestations, and strategies for the management of job-related stress. Significant etiologic factors include death as an existential fact emphasizing our finite nature, the cumulative grief associated with repeated unresolved losses, the pressure of a health care system fueled by the medical information explosion, the inability to achieve the idealistic goals embraced by holistic medical care, stresses inherent in working as a "team," and an undermined context of meaning as an outcome of treatment failures. Clinical manifestations of stress are reviewed as an aid to early diagnosis. Strategies useful in the prevention and management of stress include the encouragement of increased awareness of stress in self and colleagues, the clarification of appropriate goals and priorities, encouragement of appropriate limit setting, the mobilization of collaborative input, the clarification of team roles and organizational patterns, the establishment of team support meetings and favorable working conditions, exercise, and the clarification and working through of previously unresolved personal psychodynamic issues. Differences between the work-related stress involved in clinical oncology as compared with hospice care are examined.

Attitude of Health Personnel↗

Practices and attitudes of Japanese oncologists and palliative care physicians concerning terminal sedation: a nationwide survey.

PURPOSE: To clarify the frequency of practice of sedation therapy for terminally ill cancer patients and to identify physicians' attitudes toward sedation. METHODS: Questionnaires were mailed to 1,436 Japanese oncologists and palliative care physicians with a request to report their practice of and attitudes toward palliative sedation therapy. RESULTS: A total of 697 physicians returned questionnaires (response rate, 49.6%). Use of mild, intermittent-deep, or continuous-deep sedation for physical and psychologic distress was reported by 89% and 64%, 70% and 46%, and 66% and 38%, respectively. In vignettes in which physicians were asked whether they would use sedation for a patient with refractory dyspnea or with existential distress, 14% and 15%, respectively, chose continuous-deep sedation as a strong possibility. Those physicians less confident with psychologic care and with higher levels of professional burnout were more likely to choose continuous-deep sedation. In vignettes in which they were asked whether they use sedation for a patient with depression or delirium, 39% and 31%, respectively, considered psychiatric treatment to be a strong possibility, and 42% and 50% regarded continuous-deep sedation as a potential treatment option. Physicians less involved in caring for the terminally ill and less specialized in palliative medicine were significantly less likely to choose psychiatric treatment. CONCLUSION: Sedation is frequently used for severe physical and psychologic distress of cancer patients. Physicians' clinical experiences with the terminally ill and their levels of professional burnout influence the decisions. Training and education for physicians in regard to end-of-life care and valid clinical guidelines for palliative sedation therapy are necessary.

Attitude of Health Personnel↗

The communication of palliative care for the elderly cancer patient.

Palliative care (PC) is often recommended by physicians for their elderly patients who are terminally ill. In contrast to hospice care, which precludes the use of any curative treatment at life's end stages, PC seeks primarily to comfort patients and to keep them pain free, yet it does not necessarily preclude medical treatment. It does seek to attend to patients' physical as well as psychological, emotional, spiritual, and existential needs in an attempt to enhance overall quality of life. A review of current literature in PC for oncology patients, elderly and otherwise, reveals a curious irony: Although PC plausibly entails a holistic, patient-centered approach to health care, much of the research on PC and, apparently, many of the practices in PC focus almost exclusively on the biomedical approach to patient care, particularly in regard to pain and symptom management. Furthermore, few methods in PC research incorporate patients' narratives and lived experiences in the final stages of their lives. We argue that a holistic, patient-centered approach must guide research in PC, including the treatment of elderly patients as "active interpreters, managers, and creators of the meaning of their health and illness" (Vanderford, Jenks, & Sharf, 1997, p.14) and of the meaning of their lives.

Aged↗

Mindfulness-based stress reduction lowers psychological distress in medical students.

BACKGROUND: Medical students confront significant academic, psychosocial, and existential stressors throughout their training. Mindfulness-based stress reduction (MBSR) is an educational intervention designed to improve coping skills and reduce emotional distress. PURPOSE: The purpose of this study was to examine the effectiveness of the MBSR intervention in a prospective, nonrandomized, cohort-controlled study. METHODS: Second-year students (n = 140) elected to participate in a 10-week MBSR seminar. Controls (n = 162) participated in a didactic seminar on complementary medicine. Profile of Mood States (POMS) was administered preintervention and postintervention. RESULTS: Baseline total mood disturbance (TMD) was greater in the MBSR group compared with controls (38.7 +/- 33.3 vs. 28.0 +/- 31.2; p < .01). Despite this initial difference, the MBSR group scored significantly lower in TMD at the completion of the intervention period (31.8 +/- 33.8 vs. 38.6 +/- 32.8; p < .05). Significant effects were also observed on Tension-Anxiety, Confusion-Bewilderment, Fatigue-Inertia, and Vigor-Activity subscales. CONCLUSION: MBSR may be an effective stress management intervention for medical students.

Adaptation, Psychological↗

Instruments for assessing quality of life in palliative care settings.

Quality of life is an outcome that is particularly important during palliative care. However, in order to measure this outcome, it is necessary to have a valid and reliable measure. The purpose of the article was to identify and describe quality of life measures that are appropriate for use in palliative care settings. Characteristics that are believed to be critical for quality of life instruments include the following. The instrument should: (1) be multidimensional; (2) provide self-report data; (3) be useful in the setting in which it is to be used; (4) be valid and reliable for use in palliative care settings. The five scales described measure a variety of dimensions including physical, psychological, social, spiritual, existential, support, symptoms and functional aspects of quality of life. All but one are self-report instruments. All have evidence of validity and reliability for use with palliative care populations.

Humans↗

Palliative care as a framework for older people's long-term care.

This article draws on the findings from several years of research on the health problems, quality of life and care of older people, especially during the later years of life, and argues that there is a need to develop and provide care according to the principles of palliative care. The findings indicate that palliative care, including a focus on symptom management, psychosocial and existential issues, may be appropriate for the long-term care of older or very old people - not just those at the very end of life. However, the way that palliative care is provided to older people at the very end of life needs to be adjusted. It should be adapted to the situation that accompanies advanced age and having lived a long life. It should recognize that symptom management ought to address clusters of health complaints rather than isolated symptoms, bodily changes and how they are perceived. Palliative care for older people should also take into consideration the importance of the social network as well as common fears of dying and the very essence of death, and fear of being separated from one's loved ones and the activities valued in life.

Activities of Daily Living↗

Gender differences in coping and control with memory aging.

This secondary analysis of data from a large study of memory perceptions among the elderly examined gender differences in control, coping, health, and metamemory and explored the influence of these factors on anxiety and depression in the elderly. Adults 55 years of age and older, 128 female and 41 males, were recruited from continuing education programs in two Southern states. Females were older than males and reported that their memories were better overall than males. There were no differences between the groups in depression, health, or memory control variables. Females had significantly greater state anxiety than males but no differences were seen in domain-specific memory anxiety or other metamemory domains. Females scored higher than males on help-seeking, existential growth, religiosity, and total coping strategies. In the two regression models the set of study variables predicted 79% of the variance in depression and 15% of the variance in memory anxiety. The addition of perceived health status to each model substantially changed each of their predictive values.

Adaptation, Psychological↗

The rise of homosexuality and the dawn of communism in Hong Kong film: 1993-1998.

I have designed this essay as a general overview of the self-evident trend towards queer subject matter in the past decade in Hong Kong film, a trend that not only coincides historically with the 1997 handover to the Mainland but also frequently comes equipped with parent-child relationships that can be read as allegories for the colony's future as the "child" to its mother country. Queerness in HK films has both alternated between and combined indigenous forms of queerness and the imported Western variety; by charting courses through internationalized concepts of homosexuality, HK films have posited their queerness not only as an existential allegory of (post)colonialism but also as a claim (or hope) for a utopian sexuality cum utopian international politics.

Art↗

Happy alone? Sad young men in East Asian gay cinema.

This essay chooses as its texts three films representing contemporary gay male subjects from each of the "three" China's: HK, Taiwan, and the Mainland. Relocating the homoerotic image of the "sad young man," a trope popular from Hollywood rebellion films of the 1950s and 1960s, to contemporary China, I discuss how this masculine icon has been transformed from one of heroic rebellion to one of existential isolation. Indeed, as the politics of both the outmoded Confucian family and fractured Chinese nationhood intersect, what the sad young (gay) man rebels against is a political fluctuation which is no longer fixed; as the young man's opposition is no longer fixed, so too does he become alienated even from his own rebellious cause.

Art↗

Land of forgetfulness: dementia care as spiritual formation.

The personal circumstances of dementia caregiving are sometimes experienced as so severely demanding as to be overwhelming. While sustenance within, and recovery from these experiences are increasingly addressed in helpful ways from psychological, emotional, and practical life planning frames of reference, we are still learning how to speak with one another about the spiritual dimensions of this peculiar journey. From a spiritual perspective, the caregiver initially, and frequently perpetually, finds her/himself in a state of spiritual exhaustion. Oddly enough, there are ample resources at hand to address this existential state with wisdom and grace, allowing for the possibility that the caregiver might move from spiritual weariness to enhanced spiritual formation.

Aged↗

Ideological pathways to policy and practice.

Social policy is a reflection of changing ideological stances; and ideological stances are influenced by social conditions and events. Policy-makers and social welfare administrators need to be acutely aware of the existing ideologies and the subtle or dramatic shifts as they occur and affect perceptions of clients, programmatic components, and the nature of social service delivery. The author offers a dichotomy of ideological positions as they are applied to the issues of social problems vs sub-populations, societal vs individual responsibility, residual vs institutional welfare, enforceable rights vs revocable privilege, existential vs preferential attention to social needs, government regulation vs deregulation, and governmental aid vs voluntary philanthropy.

Human Rights↗

[Not Available].

In a quasi-experimental design, four groups were compared, (a) patients who had terminated psychoanalysis of more than two years' duration; (b) patients who had terminated individual psychotherapy of more than two years' duration; (c) patients who had terminated various kinds of low-dose psychotherapies; (d) patients who had not been in any recent psychotherapy. Repeated follow-up questionnaires, roughly one and two years after termination, showed that psychoanalysis and long-term therapy patients had superior outcomes on measures of Symptom, social adjustment, and existential attitudes, in comparison with patients without any recent therapy or patients who had been in various kinds of low-dose therapies. During the second year of follow-up, the differentiation among the groups increased, with psychoanalysis developing in a more positive way than the other treatments.

Long-term follow-up↗

Body experience and mental representation of body image in patients with haematological malignancies and cancer as assessed with the Body Grid.

The domain of body image plays a central role in the quality of life of patients with haematological malignancies and metastasized cancer, since the disease itself as well as the enrolled therapies interfere with psychological and bodily well-being. We approached this highly subjective field by using the repertory grid technique and hypothesized that patients would display a restricted body image, focusing on functional aspects of the body. In all, 55 in-patients (27 men, 28 women, M age = 45.7 yrs, N = 46 with haematological malignancies, N = 9 with metastasized cancer), at the time of initial diagnosis, were included in the study and assessed with the Body Grid, an instrument specifically designed by us for the exploration of body image. The data were analysed by principal component analysis (PCA) and construct categorization. Further, 42 chronic tinnitus sufferers (20 male, 22 female, M age = 46.5 yrs) served as a comparison group. Based on the constructs elicited, six construct categories were formulated in the sense of a first attempt of a hierarchical model (emotion, control, activity, strength, function, appearance). The central constructs (373 construct pairs) were assigned to these categories by three inter-raters. The categories appeared in the following order of frequency: function (27.1%), emotion (20.4%), strength (20.1%), activity (15%), control (10.2%) and appearance (7.2%). PCA indicated that the patients mainly demonstrated a restricted view of their body. In the tinnitus group, the most frequent category proved to be activity (21.3%), closely followed by function (21.1%) and control (20.9%). The body image was also restricted (PCA). The restriction of body image, together with the specific construct choice, seen in the haematology and cancer patients reflects the existential threat of the disease and may serve as a coping strategy. The high percentage of emotional constructs may mirror the patients' need for further support. The distinct distribution of construct categories in the two different patient samples supports the applicability of the proposed preliminary model.

Adult↗

Dimensions of grandparent-adult grandchild relationships: From family ties to intergenerational friendships.

This paper examines the growing demographic phenomenon of grandparent-adult grandchild relationships from the perspectives of both generations. Drawing on qualitative life-history interviews (n = 37), this research explores the subjective meanings of the relationship, as well as the experiences of being grandparents and adult grandchildren. Despite tremendous diversity in grandparent-adult grandchild relationships, including differences among and between generations, both groups in this study view one another positively and conceptualize their ties as personally and existentially meaningful. They classify their relationships as a distinct family tie centred on unconditional love, mutual support, respect, and obligation. A number of individuals also discuss their grandparent-adult grandchild relationships as friendships, involving mutual trust, shared confidences, and personal choice. Overall, this research suggests that grandparent-grandchild relationships often grow more profound and meaningful as grandparents and grandchildren age, move through the life course, and experience life events.

Adult↗

Why psychiatric conditions are special: an evolutionary and cross-cultural perspective.

In non-Western and premodern societies, approaches to sickness involved moral considerations laden with existential and spiritual implications. Healers and physicians had access to this aspect of their patient's lives, were expected to use it constructively, and often did so. The contemporary biomedical theory of disease no longer assigns to illness such metaphysical connotations. While general physicians are permitted - perhaps even advised - to avoid involvement in morally laden dialogues tied to illness and the self, such dilemmas are more prominent and qualitatively different in psychiatry, as psychiatric conditions often entail changes in self-conception, psychological disaffection, unacceptable behavior, and untoward personal reactions to social circumstances. Manifestations of psychiatric conditions can overwhelm an individual's control in areas of cognition, emotion, autonomy, social responsibility, behavior, and body functions - exactly those matters that "modern" individualistic minds are supposed to master. Consequently, psychiatric conditions challenge basic presuppositions of the modern, secular credo about personhood, disease, and behavior. They comprise a species of human problems ontologically distinct from the conditions handled by other medical disciplines.

Cross-Cultural Comparison↗

Violent behavior in Chinese adolescents with an economic disadvantage. Psychological, family and interpersonal correlates.

Two studies investigating the psychological, family and interpersonal correlates of adolescent violent behavior are reported in this paper. In Study 1, secondary school students (N = 1,519) responded to established scales assessing their psychological attributes, family functioning, parenting qualities and psychosocial support and conflict. Results of Study 1 showed that: a) adolescents who showed higher levels of perceived stress and psychological symptoms displayed more signs of adolescent violence; b) adolescents who had a higher sense of mastery and existential mental health displayed less signs of violence; c) adolescents' attitudes towards poverty and traditional Chinese beliefs about adversity were significantly related to adolescent violence; d) higher levels of family functioning, positive parenting styles as well as interpersonal support and lower levels of interpersonal conflicts were associated with a lower level of adolescent violence. Results further showed that some of the above factors were more strongly related to adolescent violence in adolescents experiencing economic disadvantage than in adolescents who did not experience economic disadvantage. Some of the findings of Study 1 were replicated in Study 2, where adolescents from 229 families (either families on welfare or low income families) were recruited. These studies suggested that several psychological, family and interpersonal factors are related to adolescent violent behavior, particularly in adolescents with economic disadvantage.

Adolescent↗

Anaesthesia or psychotherapy: eradicating thoughts or working them through.

The author presents two sessions from the analysis of a depressive narcissistic doctor, which are characterised by a mixture of co-operation and pseudo-co-operation. The dialogue is in parts intellectualised, complicated, lifeless and schizoid. Points at which the patient shows surprising insights are then partly denigrated by him, on the basis that change is not to be expected. Semi-lifeless contact assists the defensive claustrophobia that he experiences in meaningful contact. It becomes very clear that he is then afraid of entering into an openly aggressive conflict that entails the existential threat of object loss. However, this has so far been avoided. The secret pleasure in an anal-narcissistic, sadomasochistic addiction to doubt persists in the partial denigration. The patient's artificially maintained self-doubt and doubt of the object reinforce a genuine confusion that consists in never knowing exactly what lies behind the helpful and needed object.

Adult↗