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It is widely acknowledged that co-occurring symptoms in patients with a psychosocial and spiritual aspects should also be considered. However, this multidimensional approach is difficult to integrate into daily practice, especially for generalist clinicians not specialized in palliative care. We aimed to identify the barriers and facilitators to multidimensional symptom management.
Focus group meetings were conducted with the following stakeholders: (1) patient representatives, (2) generalist community nurses, (3) generalist hospital nurses, (4) general practitioners, (5) generalist hospital physicians, and (6) palliative care specialists. Audiotapes were transcribed verbatim and thematically analyzed.
Fifty-one participants (6–12 per group) reported barriers and facilitators with 3 main themes: multidimensional symptom assessment, initiating management of nonphysical problems, and multidisciplinary collaboration. As barriers, generalist clinicians and palliative care specialists reported that generalist clinicians often lack the communication skills to address nonphysical problems and are unaware of available resources for multidimensional symptom management. Palliative care specialists felt that generalist clinicians may be unaware that assessing nonphysical problems is important and focus on pharmacological interventions. Generalist nurses and palliative care specialists indicated that hierarchical difficulties between them and generalist physicians are barriers to multidisciplinary collaboration. Reported facilitators included using symptom assessment scales and standardized questions on nonphysical problems.
Significance of results
Generalist clinicians can be supported by improving their communication skills, increasing their awareness of available resources for multidimensional symptom management, and by using a standardized approach to assess all 4 dimensions of palliative care.
Chapter 3 explores the role of water in everyday life in rural Nampula before the handpumps were constructed. Based on my ethnographic data, I describe how water was used in social, ritual, and everyday contexts, and the meanings water acquired through these activities. I argue that water has much to teach us about culture and society: its flows illuminate economic systems, social values, gender roles, power dynamics, exchange networks, and a person’s status in society. I also describe how gender roles influence men’s and women’s water practices and shape notions of what it means to be a ‘good wife and mother’. My analysis devotes special attention to the experience of water collection and the social interactions that take place between women at the water site. This theme complicates the development narrative that water collection is oppressive to women and that customary water sites should be replaced by more modern ones. The rich connections between water, gender, and society are not seen or addressed in the dominant water planning models, which treat water as an economic good that can be ‘improved’ through technology.
To investigate spiritual care perceptions, spiritual well-being, and empathy, examine the correlations among spiritual care perceptions, spiritual well-being, and empathy, and explore the mediating role of spiritual well-being between other two variables of Chinese nursing students.
A cross-sectional design was implemented, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist was used to ensure quality reporting of the study. A cluster sample of 2,718 nursing students was selected from 7 universities and colleges in China. The demographic characteristics questionnaire, the Chinese Version of the Spiritual Care-Giving Scale (C-SCGS), the Spiritual Health Scale Short Form (SHS-SF), and the Jefferson Scale of Physician Empathy-Nursing Student (JSPE-NS) were used. Descriptive statistics, correlation, and process plug-in mediation effect analyses were used to analyze the data.
The total score of spiritual care perceptions, spiritual well-being, and empathy were 173.83 ± 25.62, 98.74 ± 12.87, and 105.04 ± 21.34, respectively. Spiritual care perceptions were positively correlated with spiritual well-being (r = 0.617, p < 0.01) and empathy (r = 0.528, p < 0.01). And spiritual well-being played a partial mediating role between the other two variables (accounting for 28.1%).
Significance of results
Spiritual care perceptions, spiritual well-being, and empathy were quite moderate, which need in improving. It is suggested that nursing educators pay attention to the spiritual care education of nursing students, perfect the spiritual care education system, and take targeted measures according to nursing students’ individual personality traits and differences, improve their spiritual well-being and empathy in multiple ways, so as to improve their spiritual care perceptions and competence.
Theories of adult development and aging suggest that older adults turn towards religion and spirituality (R/S) to increase meaning and purpose in life, and to assist in coping with adverse experience. We sought to examine the relationship between R/S and positive mental health and mental illness (i.e., psychological distress) in adulthood, and to determine the potential moderating role of age. Data from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH), a national population health study, were used. A multivariable linear regression model revealed a significant R/S by age interaction for positive mental health (p = 0.001). Although R/S was associated with positive mental health among all participants, there was a stronger relationship between R/S and positive mental health for older adults. No statistically significant relationship between R/S and psychological distress was observed. Findings highlight the importance of R/S to positive mental health across the adult lifespan. The differential relationships among R/S, positive mental health, and mental illness underscore the utility of using the dual-continua of mental health and mental illness in order to understand their respective determinants.
Kierkegaard is well-known as a philosopher who stresses the meaning of individual human existence. However, in The Sickness unto Death he argues that the human self exists as “spirit,” and spiritual life is essentially relational life. The significance of this is sometimes missed because readers assume that the “other” to which humans must relate is God, and a God-relation does not seem genuinely social. This view is doubly mistaken, and this can be seen if the relationship between the two parts of the book are understood. First, it is not true that Kierkegaard thinks that God is the only “other” by which the self can be defined. Human beings continually seek to ground their identity in many “others” and human persons and groups are the major way this happens. Kierkegaard believes this is the source of numerous pathological forms of selfhood; far from being impossible, grounding the self in something other than God is ubiquitous. Second, the relation to God is for Kierkegaard a genuinely social relation, since God is viewed as one who has the authority to give human lives meaning by assigning meaningful vocations to humans and holding them accountable for fulfilling those vocations.
Mindfulness-based therapies (MBTs) have shown promising results in non-psychotic disorders. Unlike most other psychotherapy models, which are claimed to be Western in origin, MBTs are firmly based in Indian philosophy and traditions. This paper summarises the concepts of the observer self (sakshi) and attention (dhyana) that underlie the principles and practice of MBT, correcting some erroneous assumptions in the process. It is argued that better understanding of these concepts is beneficial not just for specialist psychotherapists, but for all clinicians interested in the craft of healing.
The Hermetic literature should be seen not in terms of philosophical speculation but as a path of experiential practice that aimed at radical spiritual liberation. To understand it properly, we must pay attention to the problematics of translation and be aware of philhellenist frames.
While some aspects of the material world occur naturally, many are affected by various processes of production. Making, craft, industry, and work are all categories important for understanding the formation and alteration of much of the human-made and shaped world. The author focuses on animating objects in the Caribbean, Central, and South America, and undertakes comparisons with the Western tradition.
The study of materiality and religion incorporates spaces, equipment, dress, and other material expressions of belief. The study of material religion and spirituality has taken a truly interdisciplinary turn in scholarship and this chapter explores currents in scholarship that embrace a material approach to understanding lived religion, organized practices, as well as religious opposition and conflict.
In the context of globalization, post-modernity and transnationalism, identity, for most people, is no longer securely located in specific material environments. Yet the desire to 'ground' identity in place by acting in and on the material world remains, even as people shift between multiple locations. This chapter focuses considerson the materiality of identity, and on the relationship between agency, identity and place. It focuses particularly on place-based communities, for whom this relationship is fundamental, and who therefore exemplify the centrality of place in composing identity.
El ritual chamánico de la ayahuasca ha sido adoptado, adaptado y reinventado en contextos urbanos y cosmopolitas de diferentes países del mundo, un proceso que ha estado fuertemente permeado por prácticas y creencias de tipo new age. Una de las versiones locales de este fenómeno se conoce en Colombia como “tomas de yajé”, donde participan citadinos no indígenas de clase media y alta en busca de alteridad tradicional e inspiración espiritual. La investigación que dio origen a este artículo se basa principalmente en observaciones etnográficas y entrevistas, gracias a las cuales se analizaron las maneras en que se interpreta esta forma de chamanismo, indagando particularmente sobre los usos y sentidos del concepto de espiritualidad en las narrativas de los adeptos a las tomas. Los resultados son discutidos a la luz de teorías sobre las subjetividades y las religiosidades en la modernidad, lo cual permite comprender mejor los fundamentos socioculturales y las implicaciones de esta espiritualización del chamanismo. Se concluye que el giro subjetivo de la modernidad tardía es un factor clave para entender la reciente valoración del ritual, el cual se ha convertido, paradójicamente, en un vehículo para la difusión de valores individualistas.
Prior research suggests that religiosity may be associated with healthier levels of mental health in certain domains (eg, higher self-esteem and lower rates of substance use problems). However, very little is known about religiosity and impulsive plus compulsive tendencies. This study examined associations between religiosity and impulsive and compulsive behaviors and traits among university students.
Nine thousand, four hundred and forty-nine students received a 156-item anonymous online survey which assessed religiosity, alcohol and drug use, mental health issues, and impulsive and compulsive traits. Two groups of interest were defined: those with high religiosity, and those with low religiosity, based on z-scores. The two groups were compared on the measures of interest.
Three thousand, five hundred and seventy-two university students (57.1% female) responded to the survey. Those with high levels of organizational religious activity, as well as those with high levels of intrinsic or subjective religiosity, differed from their fellow students in having better self-esteem, being less likely to have alcohol or drug problems, and generally being less impulsive in terms of attention and planning. Compulsivity did not differ between groups. Associations were of small effect size except for the link between religiosity and lower impulsivity, which was of medium effect size.
This study shows a link between higher religiosity and lower impulsivity, as well as higher levels of mental health across several domains. Whether these associations are causal—and if so, the direction of such causality—requires rigorous longitudinal research.
A growing volume of research suggests that religion protects against late-life suicide, but it remains unclear whether effects are relevant to clinical samples, which facets of religion are most relevant, and variations over the course of mood disorders (e.g. during periods of euthymia, depression, and/or heightened suicidality).
Eighty adults aged 55–85 years with mood disorders completed assessments of religion (affiliation, service attendance, importance of religion, belief and faith in God), depression, and suicidality over time (M = 7.31 measurements over M = 727 days). We computed metrics to identify mean and maximum levels of depression and suicidality, and the number of episodes of significant depression and suicidality experienced by each participant.
Religious affiliation and importance of religion, but not service attendance, belief, or faith in God, were associated with lower mean and maximum depression. Conversely, all facets of religion predicted significantly lower mean and maximum levels of suicidality (rs ranging from −0.24 to −0.39), and substantially less likelihood of experiencing significant suicidality during the study (ORs ranging from 0.19 to 0.33). Service attendance, belief, and faith in God predicted less suicidality even among individuals who did not affiliate with a religious group.
Religious factors, particularly faith in God, are associated with substantially less suicidality over time among older adults with mood disorders, irrespective of religious affiliation.
To investigate the spiritual care needs and associated influencing factors among elderly inpatients with stroke, and to examine the correlations among spiritual care needs, spiritual well-being, self-perceived burden, self-transcendence, and social support.
A cross-sectional quantitative design was implemented, and the STROBE Checklist was used as the foundation of the study. A convenience sample of 458 elderly inpatients with stroke was selected from three hospitals in China. The sociodemographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale, the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being, the Self-Perceived Burden Scale, the Chinese Self-Transcendence Scale, and the Perceived Social Support Scale were used. Descriptive statistics, correlation, Student's t-test, ANOVA, non-parametric, and multiple linear regression analyses were used to analyze the data.
The total score of spiritual care needs was 29.82 ± 7.65. Spiritual care needs were positively correlated with spiritual well-being (r = 0.709, p < 0.01), self-transcendence (r = 0.710, p < 0.01), and social support (r = 0.691, p < 0.01), whereas being negatively correlated with self-perceived burden (r = −0.587, p < 0.01). Religious beliefs, educational level, residence place, disease course, spiritual well-being, self-perceived burden, self-transcendence, and social support were found to be the main influencing factors.
Significance of results
The spiritual care needs were prevalent and moderate. It is suggested that nurses should enhance spiritual care knowledge and competence, take targeted spiritual care measures according to inpatients’ individual personality traits or characteristics and differences of patients, reduce their self-perceived burden and improve their spiritual well-being, self-transcendence and social support in multiple ways and levels, so as to meet their spiritual care needs to the greatest extent and enhance their spiritual comfort.
This essay looks at the Christian context in which Britten lived and its impact on his work. When in 1940 he wrote that he was a member of a Christian nation, he could not have meant that Britain was a churchgoing nation, for most people were not active churchgoers. In fact, it would be necessary to go back to the seventeenth century to find a time when nearly everyone went to church. Britain was a Christian nation in the sense that its political, legal, ethical, and cultural life had been shaped by Protestant Christianity. By the 1920s this was a specifically English, rather than British, identity, for the disestablishment of the Welsh (1920) and Scottish (1921) churches, and the secession of the Irish Free State (1922) meant all three were intent on establishing their own distinctive identities and cultures. In mid-twentieth-century England, the Established Anglican Church, historically regarded as a ruling-class institution, remained closely associated with the monarchy and the state; thus, Anglican ritual governed public occasions and it was still regarded as part of an elitist and conservative Establishment.
This classic book, now in a second, expanded edition, is an invitation to think along with major theologians and spiritual authors, men and women from the time of St Augustine to the end of the fourteenth century, who profoundly challenge our (post-)modern assumptions. Medieval theology was radically theocentric, Trinitarian, Scriptural, and sacramental, yet it also operated with a rich notion of human understanding. In a post-modern setting, when modern views on 'autonomous reason' are increasingly questioned, it is fruitful to re-engage with pre-modern thinkers who did not share our modern and post-modern presuppositions. Their different perspective does not antiquate their thought; on the contrary, it makes them profoundly challenging and enriching for theology today. This survey introduces readers to key theologians of the period and explores themes of the relationship between faith and reason; the mystery of the Trinity; soteriology; Christian love; and the transcendent thrust of medieval thought.
This chapter studies the Trinitarian theology of Jan van Ruusbroec and his ideal of the common life. It finishes with a short examination of the remarkable movement known as the Devotio Moderna (Modern Devotion), founded by Geert Grote.
In this chapter the profound theology and spirituality of St. Bonaventure is discussed. After a short introduction of his life, his views on emanation, exemplarity and illumination receive due attention. Bonaventure’s spirituality in light of his profound Trinitarian theology is also discussed in detail.
Violence and the Sikhs interrogates conventional typologies of violence and non-violence in Sikhism by rethinking the dominant narrative of Sikhism as a deviation from the ostensibly original pacifist-religious intentions and practices of its founders. This Element highlights competing logics of violence drawn from primary sources of Sikh literature, thereby complicating our understanding of the relationship between spirituality and violence, connecting it to issues of sovereignty and the relationship between Sikhism and the State during the five centuries of its history. By cultivating a non-oppositional understanding of violence and spirituality, this Element provides an innovative method for interpreting events of 'religious violence'. In doing so it provides a novel perspective on familiar themes such as martyrdom, Martial Race theory, warfare and (post)colonial conflicts in the Sikh context.