A religious approach to the concept of the self.
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Nurses are increasingly being called on to engage in spiritual care with their patients. A diverse body of theoretical and empirical literature addresses spirituality as it relates to nursing practice, yet there is little consensus about what spiritual nursing care entails. The purpose of this article is to conceptualize spiritual care in relation to nursing practice. A brief historical review indicates that our current understandings of spiritual nursing care have been shaped by three eras characterized by particular approaches: the religious approach, the scientific approach, and the existential approach. We draw elements from each of these approaches to propose attributes of spiritual care in the context of nursing practice. We propose that spiritual nursing care is an intuitive, interpersonal, altruistic, and integrative expression that is contingent on the nurse's awareness of the transcendent dimension of life but that reflects the patient's reality.
Orthodox Jewish women with a prolonged menstrual flow or short follicular phase may be unable to attend the ritual bath early enough in their cycle for conception to take place. Oral estrogen supplementation may effectively delay ovulation beyond the time of the ritual bath, when intimate relations are allowed, thereby restoring the normal (23%) fecundity rate.
This booklet describes different ways used to tackle the problem of curriculum planning. By studying these approaches teachers can get an insight into the process in their own school. First they must decide whether there should be a particular focus for curriculum planning and if so what it should be. In the light of this they can modify their school's approach. To what extent do they wish to focus on: aims and objectives (engineering approach), teaching methods (mechanics approach), content (cookbook approach), timetable (railway approach), problems (detective approach), one idea or strategy (religious approach), the regulations (bureaucratic approach), or a curriculum designed to attract sponsorship (public relations approach)? The magician approach, in which it is not clear how a curriculum is developed, is not recommended. Second, what should be the pattern of staff involvement--a representative group or committee (United Nations approach), all the teachers (people's congress approach), one individual (the dictator approach), a collaboration with students, patients and other professional colleagues (consumer approach), or a collaboration with an external consultant (consultant approach)? Whichever approach is adopted, advantages should be maximized and deficiencies minimized.
Potential living organ donors who describe religious motivations as the basis for their donation, particularly in the absence of an emotional or genetic connection to the intended recipient, raise challenges for the transplant team who are more comfortable in assessing relational motivations than religious ones. This article provides a composite case scenario to illustrate some of the biases that may interfere with the assessment of the donor motivated by religious altruism and how religious altruism may be pathologized. The clinical challenges in assessing the religiously altruistic potential living donor are reviewed. Religious approaches to altruism and their implications for living organ donation are reviewed for a sample of the major world religions.
BACKGROUND: Although integrated care for existential suffering is an essential part of palliative care, little is known about its concept and efficacy as perceived by professionals. A questionnaire survey was carried out to 1) explore the underlying structure of psychosocial interventions recommended by specialists, 2) identify the professionally perceived effectiveness of each intervention for specific existential distress, and 3) examine the effects of specialty on their recommendations. METHODS: A questionnaire with three scenarios representing terminally ill cancer patients with uncertainty-related anxiety, guilt feelings, and dependency-related meaninglessness was mailed to 701 Japanese psychiatrists, 118 psychologists, and 372 palliative care nurses. RESULTS: A total of 456 responses were obtained (response rate = 38%). Recommended psychosocial interventions were classified into six subcategories: 'a supportive-expressive approach,' 'providing comfortable environments,' 'meaning-centered approach,' 'being,' 'education and coping skills training,' and 'a religious approach.' A 'supportive-expressive approach' was consistently recommended in all vignettes. On the other hand, 'providing comfortable environments' was most recommended for patients with uncertainty-related anxiety, and a 'meaning-centered approach' and 'being' were most recommended for patients feeling dependency-related meaninglessness. Psychiatrists estimated the effectiveness of psychopharmacological treatment significantly higher than psychologists and nurses, while nurses evaluated efficacy of all other interventions significantly higher than psychiatrists and psychologists. CONCLUSIONS: Experts evaluated a variety of clinical interventions as effective in palliating existential suffering, although the perceived levels of efficacy of each intervention differed according to the nature of suffering and their specialties. To effectively alleviate existential suffering in terminally ill cancer patients, an integrated care by an interdisciplinary team is necessary.
The fundamental revelations to the founders of the three monotheistic religions, among many other revelation experiences, had occurred on a mountain. These three revelation experiences share many phenomenological components like feeling and hearing a presence, seeing a figure, seeing lights, and feeling of fear. In addition, similar experiences have been reported by non-mystic contemporary mountaineers. The similarities between these revelations on mountains and their appearance in contemporary mountaineers suggest that exposure to altitude might affect functional and neural mechanisms, thus facilitating the experience of a revelation. Different functions relying on brain areas such as the temporo-parietal junction and the prefrontal cortex have been suggested to be altered in altitude. Moreover, acute and chronic hypoxia significantly affect the temporo-parietal junction and the prefrontal cortex and both areas have also been linked to altered own body perceptions and mystical experiences. Prolonged stay at high altitudes, especially in social deprivation, may also lead to prefrontal lobe dysfunctions such as low resistance to stress and loss of inhibition. Based on these phenomenological, functional, and neural findings we suggest that exposure to altitudes might contribute to the induction of revelation experiences and might further our understanding of the mountain metaphor in religion. Mystical and religious experiences are important not only to the mystic himself, but also to many followers, as it was indeed with respect to the leaders of the three monotheistic religions. Yet, concerning its subjective character, mystical experiences are almost never accessible to the scholars interested in examining them. The tools of cognitive neuroscience make it possible to approach religious and mystical experiences not only by the semantical analysis of texts, but also by approaching similar experiences in healthy subjects during prolonged stays at high altitude and/or in cognitive paradigms. Cognitive neurosciences, in turn, might profit from the research of mysticism in their endeavor to further our understanding of mechanisms of corporeal awareness and self consciousness.
AIM: This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. BACKGROUND: Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed breast cancer increasing each year, there is no information on how Iranian women cope with breast cancer when compared with women of other cultures. METHOD: In this qualitative study, 19 women with newly diagnosed breast cancer were interviewed during the period May-September 2004 about coping with their disease. Interviews were analysed using a content analysis method. FINDINGS: The main themes emerging from this qualitative study included coping using a religious approach (acceptance of disease as God's will; spiritual fighting), thinking about the disease (positive thinking: positive suggestion, hope, intentional forgetfulness; negative thinking: hopelessness, fear, impaired body image), accepting the fact of the disease (active acceptance; passive acceptance), social and cultural factors and finally finding support from significant others. CONCLUSION: Understanding how Iranian women cope with diagnosis of breast cancer is important to nurses involved in the process of healing. The majority of strategies used by Iranian women were positive, and religious faith played a major role in this. The findings of the study can be used to design a nursing approach to improve successful coping in Iranian women suffering from breast cancer, and can provide nurses and other healthcare professionals with deeper understanding of these women as they face this diagnosis.
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This essay explores the historical process in which homosexuality became an object for pastoral, medical, and mental health care in the Dutch Catholic community during the twentieth century. The confrontation between a moral-religious approach and the professional (medical and psychological) treatment of homosexuality is the central issue. In a continuing dialogue and a process of changing power relations between clergymen, physicians, psychiatrist, psychologists, and pedagogues as well as Catholic homosexuals themselves, homosexuality was transformed from sin and pathology into a psychological and social problem that could be treated in pastoral and mental health care. The changing attitudes of Catholics towards homosexuality can be explained in the context of the changing relations between religion on the one hand and health care on the other hand. Current viewpoints resulting from sociohistorical studies on the development of the medical and welfare professions have concluded that religion lost importance in modern society because physicians, psychiatrists, psycho-therapists, and social workers not only created new areas of intervention in people's private lives, but also took over the traditional tasks of the church in the field of charity and pastoral care. Medical anamnesis, psychoanalysis, and psychotherapy took the place of confession and pastoral care, thus the argument runs, and remission of sins and redemption were replaced by health and welfare. However, especially in the case of the development of the Dutch welfare state, there was a more complicated interplay between changing religious values and professional strategies. In the Netherlands professional health care and welfare institutions often were organized in a religious context and it is difficult to make a clear differentiation between religious and moral discourses on the one hand and medical and psychological ones on the other hand. Moreover, professional interventions did not take the place of pastoral care; it appears that pastoral care for homosexuals gained ground and was intensified after medical and psychological definitions of homosexuality had found acceptance in the Catholic community. Professional strategies did not supersede religion, but rather contributed to a moral re-orientation and a new pattern of Christian values and appreciations in the field of sexuality.
A group of 106 Yoruba traditional healers who practice midwifery were interviewed, by means of a semistructured questionnaire, regarding their knowledge of various aspects of perinatal care. The study confirmed earlier reports that these herbalists are indispensable to delivery services in Nigeria. Their procedures for assisting at births were described and the healers were found to be ignorant in such important areas as normal duration of labor, causes of various obstetric complications and functions of the placenta. It was concluded that the lacunae in their knowledge could be responsible for the high morbidity and mortality associated with their practice, and might also explain their unscientific and sometimes magico-religious approach to management of perinatal health problems. The need to provide them with appropriate training is emphasized.
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