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PubMedDate not supplied

The recovery mosaic: older women's lived experiences after a myocardial infarction.

OBJECTIVE: The purpose of this study was to examine the experience of recovery in women 65 years of age and older during initial recovery from acute myocardial infarction. DESIGN: The study was designed with Heideggerian phenomenology, purposive sampling, and unstructured interactive interviews. Data were analyzed with interpretive processes of hermeneutics. SETTING: The study was set in a Canadian metropolitan teaching hospital and in patient homes. PARTICIPANTS: Seven women who had had a first time myocardial infarction were recruited. Age ranged from 67 to 86 years (mean, 74 years). RESULTS: Analysis revealed that recovery for these women was highly contextual and consisted of life experience resembling a mosaic, in which the women described how they "created a new picture for themselves." The data were clustered into 4 substantive themes that included: life is scattered; trying to make sense of it; learning to live with it; and getting settled. CONCLUSION: The older women in this study underestimated their susceptibility to acute myocardial infarction, were avid planners and coordinators of their recovery, equated the loss of the homemaker role to job loss, used their ability to socialize as an indicator of the recovery progress, and lacked support to perform household duties, such as laundry, and those women with fewer symptoms "cheated" in relation to activity and diet. These findings may serve as a basis for the development of healthcare strategies reflective of older women's recovery.

Adaptation, Psychological↗
PubMed1975

Masochism: a clinical and theoretical overview.

This paper will review some of the theoretical and clinical features of masochism from an eclectic point of view. The topic of masochism has been taken up by authors of many perspectives because it addresses one of the anomalous, absurd, difficult-to-explain aspects of behavior for which no psychological system has an easy answer. Therefore, a wide-ranging literature on the topic of masochism is available. However, few previous reviewers have attempted to draw from a variety of disciplines and theoretical frameworks. In this review the historical development of the term and some of the psychoanalytic conceptualizations will be presented first. Since previous reviews of masochism from a strictly psychoanalytic perspective are adequate (Brenner, 1959; Eisenbud, 1967; Fenichel, 1945; Loewenstein, 1957; Panken, 1967), our discussions of masochism will be developed employing more extensively the interpersonal, social, learning theory, and biological perspectives.

Conflict, Psychological↗
PubMed1979

Mental health viewed as an ideal.

The concepts of health and disease have always challenged the human mind. They continue to be frequently discussed with reference to both the body and the mind, but conclusions seem elusive or at best heuristic. With respect to the mind, especially, the challenge seems awesome: When the investigator and what is being investigated are one and the same, impartiality, objectivity, and the other virtues of scientific inquiry appear difficult to assess, much less attain. And yet, not surprisingly, the subject continues to attract investigators (e.g., Kaplan, 1967; Sabshin, 1967; Shakow, 1967; Offer, 1973; Sedgwick, 1973; Bruhn, 1974; Margolis, 1976). Philosophers and physicians alike respond to the subject's appeal--its theoretical interest, the conceptual problem it presents, and its implications for our understanding of ourselves. And those of us who are clincians cannot deny the practical importance of our concepts of mental health and illness: We each daily base decisions on our understanding of these concepts, and even if we cannot provide solid basis for such an understanding, we perhaps owe it to our patients to make explicit what this understanding, our philosophy, is.

Attitude to Health↗
PubMed2004

An intergenerational group benefits both emotionally disturbed youth and older adults.

This qualitative descriptive study examined the perceived benefits of an intergenerational program for low-income older adults residing in subsidized housing and youth who were part of a support group for emotionally disturbed youth. The intergenerational group met bimonthly for 11 months at the independent living facility for the elderly. Activities consisted of group discussions, games, talent expressions, trips, picnics, and crafts. Frequently a teen was paired with an older adult to complete a craft project. Bonding between each pair occurred over time, as the older adults became role models for the youth. The perceived benefits of including emotionally disturbed youth and vulnerable but well older adults in an intergenerational program were determined by a structured interview and then through categorization of the participants' responses to a series of emotional, attitudinal, and behavioral questions using Yalom's (1985)Therapeutic Factors. The results indicated that both of the age groups' attitudes toward each other and relationships with each other changed positively. Behavioral changes among the youth included improved social skills observed by the co-facilitators of the group.

Adolescent↗
PubMedDate not supplied

Spiritual well-being, sleep disturbance, and mental and physical health status in HIV-infected individuals.

A growing body of evidence demonstrates a significant relationship between spirituality and health. HIV-infected individuals often find new meaning and purpose for their lives while establishing new connections and strengthening old ones. This descriptive, correlational study examined the relationships among spiritual well-being, sleep quality, and health status in 107 HIV-infected men and women. Spiritual well-being was found to be a significant factor related to both sleep quality and mental and physical health status. Every study participant reported sleep disturbance. The findings suggest that spiritual well-being and sleep quality need to be assessed so appropriate interventions can be implemented to improve health outcomes in this population.

Adaptation, Psychological↗
PubMed1981

Looking back: an analysis of reminiscence function and triggers.

The purpose of this study was two-fold: to determine if hypothesized functions and triggers of reminiscence are empirically supported by a Reminiscence Uses Scale and Reminiscence Triggers Scale, and to determine if functions can be predicted from triggers subject variables.Ninety-one elderly residents of retirement communities completed the paper and pencil survey instrument. A factor analysis of the Reminiscence Uses Scale yielded three factor subscales: Self-Regard/Image Enhancement, Present Problem Solving, and Existential/Self-Understanding. In contrast, five factor subscales were extracted from the Reminiscence Triggers Scale: Death Awareness/Resignation, Death Awareness-Other, Realization of Goals/Accomplishments, Changes/Threats to body, and Change in Career/Life's Direction. A multiple regression analysis indicated that Self-Regard/Image Enhancement was predicted by Realization of Goals/Accomplishments and Reminiscence Frequency; Present Problem Solving was predicted by Death Awareness/Resignation; and Existential/Self-Understanding by Changes/Threats to body and Life Review. These findings support a basic distinction between inter-and intrapersonal reminiscence, suggest a relationship between contemporaneous experiences and memories, and lend empirical support to the construct validity of earlier theoretical views on reminiscence in old age.

Aged↗
PubMedDate not supplied

Care--beyond virtue and command.

The academic turn in the field of health care has placed the study of health within the confines of a logocentric or scientistic framework. This development has led to the devaluation of many issues important to professional practice. One of these is the issue of care. In this article, different ways to enhance caring qualities are discussed. It is shown that the key to care lies not within abstract theories and principles, but rather in reflecting over our own life-world experience.

Caregivers↗
PubMedDate not supplied

Women's anger and its meanings: a phenomenological perspective.

This study focused on the interactions of somatizations, thoughts, and social processes evolving from unrecognized, unexpressed, or repressed anger in women. Material from patients' clinical narratives was phenomenologically described and interpreted. The most critical finding was the transformation of anger as lived by women into socially acceptable pathology. Anger was left in silence, and the possibilities for its expression were found in physiological disorders, substance abuse, self-deprecation, and affiliation problems, among other conditions.

Adaptation, Psychological↗
PubMed2000

Searching for the meaning of meaning: grief therapy and the process of reconstruction.

A comprehensive quantitative review of published randomized controlled outcome studies of grief counseling and therapy suggests that such interventions are typically ineffective, and perhaps even deleterious, at least for persons experiencing a normal bereavement. On the other hand, there is some evidence that grief therapy is more beneficial and safer for those who have been traumatically bereaved. Beginning with this sobering appraisal, this article considers the findings of C.G. Davis, C.B. Wortman, D.R. Lehman, and R.C. Silver (this issue) and their implications for a meaning reconstruction approach to grief therapy, arguing that an expanded conception of meaning is necessary to provide a stronger basis for clinical intervention.

Adaptation, Psychological↗
PubMedDate not supplied

Parental bereavement: the crisis of meaning.

This descriptive study used qualitative methods to look at two aspects of the search for meaning in parental bereavement--the search for cognitive mastery and the search for renewed purpose. One hundred and seventy-six bereaved parents answered open-ended questions about the experience of their child's death and the meaning of their life since the death. For most parents, the child's death precipitated a severe crisis of meaning and initiated a search for meaning that involved both cognitive mastery and renewed purpose. Those parents who were able to find meaning in the death cited connections with people, the memory of the child, and positive gains resulting from the trauma. The great majority of parents believed that their lives since the death of the child had meaning. Meaning came from connections with people, activities, beliefs and values, personal growth, and connections with the lost child. Implications for grief counseling are discussed.

Bereavement↗