Spirituality,health care,and bioethics

This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their sense of ultimate meaning and related values. The holistic model of health care also affirms that one should not simply treat a body in pain, but respond to the suffering of the whole person within his or her full life. A narrative emphasis in ethics also maintains that ethical decisions occur within the framework of interacting life-stories, each of which embodies a certain core vision and set of values. In each instance it is the life stories of people, their lived narratives, that provide a common thread. The telling of these stories and the discernment of the lived spirituality they contain may assist persons in the process of achieving understanding, making decisions, and finding purpose in the experience of illness, injury, or disability.Maureen Muldoon, Ph.D., is Associate Professor in the Department of Religious Studies, University of Windsor, Windsor, Ontario, and Norman King, Ph.D., is Professor in the same department.     

An introduction to some of the ideas of Humberto Maturana

In recent years the work of Humberto Maturana, a research biologist and neurophysiologist from the University of Santiago, Chile, has come to the forefront of dialogue between several well-known family therapists. This paper introduces the reader to some of his original ideas and shows its connection with family therapy through linkages between it and some of the theoretical underpinnings of the Milan School     

The epidemiology of developmental disabilities in low-income countries

Although most of the world's children live in developing countries and may be at high risk for disability, very little is known about the prevalence and causes of developmental disabilities in these countries. This paper discusses methodological difficulties contributing to this lack of knowledge, and provides an overview of what is known about the epidemiology of developmental disabilities in low-income countries. At least some forms of developmental disability appear to be more common in low-income countries than in wealthier countries, despite the probability of higher mortality among children with disabilities in low-income countries. For example, most studies of severe mental retardation in low-income countries report prevalences greater than 5 per 1,000 children, while prevalence estimates from industrialized countries are consistently below this. Major risk factors for developmental disabilities in some low-income countries include specific genetic diseases, a higher frequency of births to older mothers, consanguinity, and specific micronutrient deficiencies and infections. Trauma and toxic exposures are also important risk factors, but their contributions to the etiology of developmental disabilities in low-income countries are not well documented. Though many of the causes of developmental disabilities are understood and preventable, proven methods of prevention are not being fully implemented in developing countries. Epidemiologic studies are needed to raise awareness of the public health impacts of developmental disabilities in low-income countries and to provide a basis for setting priorities and designing efficient interventions.     

Organization structure as a moderator of the relationship between procedural justice,interactional justice,perceived organizational support,and supervisory trust

Organizational justice researchers recognize the important role organization context plays in justice perceptions, yet few studies systematically examine contextual variables. This article examines how 1 aspect of context--organizational structure--affects the relationship between justice perceptions and 2 types of social exchange relationships, organizational and supervisory. The authors suggest that under different structural conditions, procedural and interactional justice will play differentially important roles in determining the quality of organizational social exchange (as evidenced by perceived organizational support [POS]) and supervisory social exchange (as evidenced by supervisory trust). In particular, the authors hypothesized that the relationship between procedural justice and POS would be stronger in mechanistic organizations and that the relationship between interactional justice and supervisory trust would be stronger in organic organizations. The authors' results support these hypotheses.     

Psychosocial safety climate as a precursor to conducive work environments,psychological health problems,and employee engagement

We constructed a model of workplace psychosocial safety climate (PSC) to explain the origins of job demands and resources, worker psychological health, and employee engagement. PSC refers to policies, practices, and procedures for the protection of worker psychological health and safety. Using the job demands–resources framework, we hypothesized that PSC as an upstream organizational resource influenced largely by senior management, would precede the work context (i.e., job demands and resources) and would in turn predict psychological health and work engagement via mediation and moderation pathways. We operationalized PSC at the school level and tested meso‐mediational models using two‐level (longitudinal) hierarchical linear modelling in a sample of Australian education workers (N = 209–288). Data were repeated measures separated by 12 months, nested within 18 schools. PSC predicted change in individual psychological health problems (psychological distress, emotional exhaustion) through its relationship with individual job demands (work pressure and emotional demands). PSC moderated the relationship between emotional demands and emotional exhaustion. PSC predicted change in employee engagement, through its relationship with skill discretion. The results show that the PSC construct is a key upstream component of work stress theory and a logical intervention site for work stress intervention.