Singing Our Own Song

ABSTRACT

The demands of managed care and concurrent trends in our society challenge us to assert the crucial role of treating relationships and of pursuing the development of deepened self understanding in our patients and ourselves. In the name of speed, efficiency and cost containment too much that is healing can be undervalued and unreim-bursed. We must find ways to facilitate change in our patients through the treatment of their important relationships and through encouraging them to take the time for sensitive self confrontation and exploration.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

Understanding the Ageing Process: A Developmental Perspective of the Psychosocial and Spiritual Dimensions

SUMMARY

This chapter describes a perspective of psychosocial and spiritual development in the later years of life. It outlines a study of nurses conducted in six nursing homes using pre and post workshop tests to identify changes in nurses' assignment of a list of behaviours as psychosocial or spiritual. Use of SPSS found significant changes between the pre and post tests. Pre workshop tests only identified items as spiritual if they included the word God, or Bible. Results from this study highlight the potential role for nurses in aged care to provide spiritual care as part of holistic care. It also highlights the fact that many nurses feel ill prepared for this role.     

Continuity,Spiritual Growth,and Coping in Later Adulthood

SUMMARY

Continuity of values, lifestyles, and relationships combines with spiritual growth in later life to provide most people a sense of direction and adequate resources for coping with changes that occur with aging. Being able to recognize threads of continuity and to perceive benefit from one's inner life are significant predictors of being able to maintain life satisfaction in the face of negative aspects of aging. Data from a 20-year longitudinal study are used to provide details.     

Spiritual and Religious Implications of Aging with HIV: A Conceptual and Methodological Review

ABSTRACT

Spirituality and religious practices can buffer people from stressful life circumstances and promote positive biopsychosocial outcomes. The beneficial effects of spirituality and religious practices have been documented in aging and HIV. Unfortunately, little is known about spirituality and religious practices in older adults with HIV. As the number of older adults with HIV increases, with an estimated 91,000 adults over 50 being diagnosed with this disease in the United States, spirituality and religious practices may help HIV-positive people to age successfully. Crisis competence and spiritual trajectories are ways of conceptualizing spiritual development when confronting aging with a life-changing event such as a being diagnosed with HIV. Methodological issues in studying spirituality in adults aging with HIV are identified including defining spirituality and religiosity, heterogeneity of the population, timing of diagnosis, mode of transmission, sexual orientation, religious and cultural stigma, and hardiness. Implications for possible interventions are also posited.     

Spiritual Activities for Adults with Alzheimer's Disease: The Cognitive Components of Dementia and Religion

SUMMARY

Engaging adults with Alzheimer's disease in activities can prevent disease related agitation. Finding meaningful and enjoyable activities proves to be a difficult task due to severe damage to explicit memory and executive functioning. Fortunately, many spiritual and religious activities rely on more resilient cognitive features such as procedural memory and limbic system aspects of attachment and motivation. Such spiritual activities, if properly selected, can be used to engage adults with dementia. This approach, called Procedural and Emotional Religious Activity Therapy, can be used by various religious traditions and extended to multiple therapeutic venues.     

Gains without pains? Growth after positive events

While past research suggests that people experience positive psychological changes after adverse events, little is known about psychological changes that happen after positive events. Adult participants (N?=?605) went online to complete a new self-report instrument measuring positive psychological changes linked to positive events, changes that I provisionally call post-ecstatic growth. Factor analysis indicated that this growth happens in four domains: deeper spirituality, increased meaning and purpose in life, improved relationships, and greater self-esteem. Participants were particularly likely to report growth after events that evoked feelings of inspiration and meaning, and events that led them to see new opportunities.     

个人成长主动性的概念、测量及影响

个人成长主动性是个体有意识地提升和完善自己的倾向, 包括认知倾向和行为倾向两个方面, 由对改变的准备、计划性、利用资源和主动的行为四个维度构成。研究表明, 人格、家庭功能影响到个体的个人成长主动性。同时, 个人成长主动性对个体的心理健康和职业认同等具有显著的影响。然而, 纵观已有个人成长主动性的研究, 有关个人成长主动性的结构、研究样本、文化差异、影响因素等方面还有待深入探讨。     

创伤后成长的促进因素、模型及干预

创伤后成长(Post-traumatic Growth, PTG)是指人们在经历了严重的压力性生活事件或创伤性事件后, 由于对抗压力所引起心理的积极变化。本研究对国外创伤后成长进行归纳概括, 论述了促进创伤后成长的影响因素, 如人格特质、社会支持、益处寻求和意义建构。此外, 归纳了基于不同视角的PTG模型, 提出了促进PTG的干预策略, 针对PTG实证研究中某些相关变量的测量问题提出改进意见。未来应着重于开展具备多个评估点的纵向研究, 建构适用于不同人群的PTG理论模型。     

汶川地震三年半后中学生的感恩对创伤后成长的影响：社会支持的中介作用

采用感恩问卷、社会支持问卷和创伤后成长问卷对汶川地震三年半后的376名中学生进行调查,考察其感恩与社会支持对创伤后成长的影响,并检验社会支持在感恩与创伤后成长之间的中介作用。结果发现：（1）灾后中学生的创伤后成长水平较高,其中自我觉知的改变与人际体验的改变水平高于生命价值观的改变水平,女生人际体验的改变水平高于男生,初一学生的创伤后成长水平相对低于高年级学生;（2）感恩和社会支持可显著地正向预测创伤后成长;（3）社会支持在感恩与创伤后成长之间起着部分中介作用。这表明,汶川地震三年半后中学生的感恩可以直接正向预测创伤后成长,也可通过社会支持正向影响创伤后成长。