1
|
Wu C, Liu X, Liu J, Tao Y, Li Y. Strengthening the meaning in life among college students: the role of self-acceptance and social support - evidence from a network analysis. Front Psychol 2024; 15:1433609. [PMID: 39077206 PMCID: PMC11284095 DOI: 10.3389/fpsyg.2024.1433609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/04/2024] [Indexed: 07/31/2024] Open
Abstract
Meaning in life, which has two possible sources: self-acceptance and social support, is essential to the mental health and development of college students. The current study aims to further clarify the symptom-level relations between meaning in life, self-acceptance, and social support, finding possible ways to improve meaning in the life of college students. Thousand three hundred and forty-eight Chinese college students completed the online questionnaire, including Self-acceptance Questionnaire, Social Support Rating Scale, and Meaning in Life Questionnaire and the data from 1,263 participants was used. Cross-sectional network analysis was used to examine the relation between self-acceptance and social support. We also explored the relation between dimensions of self-acceptance and social support and meaning in life using the flow network. The results show symptom "SlA" (self-acceptance) is the bridge symptom linking self-acceptance and social support. In the flow diagrams, "SlA" is directly and positively associated with the presence of meaning. Objective Support shares the strongest positive association with the search for meaning. The symptom "SIA" may be an important targeting symptom when trying to improve the meaning in life of college students. Additionally, social support is essential for college students to develop meaning in life.
Collapse
Affiliation(s)
- Caiyun Wu
- Center for Psychological Education and Counseling, Southwest University of Science and Technology, Mianyang, China
| | - Xueting Liu
- Department of Student Affairs Management, Mudanjiang Normal University, Mudanjiang, China
| | - Jinxin Liu
- School of Computer Science and Technology, Southwest University of Science and Technology, Mianyang, China
| | - Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yuting Li
- Department of Chinese Medicine Nursing, School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| |
Collapse
|
2
|
Pynnönen K, Kokko K, Rantanen T. Social participation and mental well-being: Does purpose in life mediate the association among older adults? Aging Ment Health 2024:1-8. [PMID: 38907539 DOI: 10.1080/13607863.2024.2363356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/28/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVES We investigated the association of social participation with mental well-being among older people and whether purpose in life mediates the potential association. METHOD Cross-sectional (n = 1014) and longitudinal (n = 660, four-year follow-up) data comprised of three age cohorts (75, 80, and 85 years) of community-dwelling people. Life satisfaction was measured with the Satisfaction with Life Scale, depressive symptoms with the Centre for Epidemiologic Studies Depression Scale, and purpose in life with the Scales of Psychological Well-Being purpose in life subscale. Social participation was assessed with questions concerning the frequency of meeting close friends and acquaintances, and volunteering. The data were analyzed using structural equation modeling. RESULTS Higher social participation was associated with higher life satisfaction and fewer depressive symptoms both cross-sectionally and after a four-year follow-up. Higher purpose in life mediated the associations of more social participation with higher life satisfaction and fewer depressive symptoms cross-sectionally. In the longitudinal data, the mediation effect was not observed. CONCLUSION Older people with frequent social participation who had a sense of purpose in their lives will likely have higher mental well-being than those with less social participation. Enabling and supporting them to conduct purposeful actions in social contexts may help maintain their mental well-being.
Collapse
Affiliation(s)
- Katja Pynnönen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
3
|
Kumar SA, Borowski S, Vogt D. Meaning in life following service among post-9/11 military veterans: A latent growth mixture model analysis. Appl Psychol Health Well Being 2024; 16:723-744. [PMID: 38072466 PMCID: PMC11062845 DOI: 10.1111/aphw.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023]
Abstract
Meaning in life refers to the "sense made of, and significance felt regarding, the nature of one's being and existence." Meaningful living promotes well-being, resilience, and personal growth. Yet, much remains unknown about how meaning changes over time and determinants of meaning, particularly during major life transitions. We identified distinct trajectories of meaning using latent growth mixture models and examined prospective predictors of class membership in a military veteran cohort assessed at multiple time points throughout the first 3 years after leaving service. Three trajectories were identified: consistently high meaning (89.5%; n = 7025), diminishing meaning (6.1%; n = 479), and strengthening meaning (4.4%; n = 348). Veterans with greater posttraumatic stress symptoms, depression symptoms, and moral injury experienced increased odds of a less adaptive trajectory (i.e. diminishing and/or strengthening vs. consistently high meaning), whereas veterans who reported greater psychological resilience, community relationship satisfaction, and intimate relationship satisfaction experienced lower odds of a less adaptive trajectory. Several gender differences were also observed. Results provide insight into veteran subgroups that are more likely to experience lower meaning after leaving military service and thus may benefit from additional support to reduce their risk for poor longer-term health and well-being outcomes.
Collapse
Affiliation(s)
- Shaina A Kumar
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Shelby Borowski
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Dawne Vogt
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Wilski M, Wnuk M, Brola W, Szcześniak M, Żak M, Sobolewski P, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Bartosik-Psujek H, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stepien A, Jacek Z, Ratajczak A, Ratajczak M, Szałachowski R, Kroplewski Z, Lech B, Perenc A, Popiel M, Potemkowski A. Religious meaning system and life satisfaction: the mediating role of meaning in life among Polish people with multiple sclerosis. Front Psychiatry 2024; 14:1352021. [PMID: 38274416 PMCID: PMC10808159 DOI: 10.3389/fpsyt.2023.1352021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction The complexity of the associations between religiosity and indicators of well-being suggests the presence of a mediating mechanism. Previous studies indicate that religion may influence subjective well-being because it helps to find meaning and purpose. Therefore, the aim of our study was to examine the mediating role of the presence and search dimensions of meaning in life in the relationship between religious meaning system and life satisfaction in patients with multiple sclerosis (MS). Methods This cross-sectional study included 600 MS patients recruited from Poland who completed the Satisfaction with Life Scale (SWLS), the Religious Meaning System Questionnaire (RMS) and the Meaning in Life Questionnaire (MLQ). Model 6 of Hayes PROCESS was used to test the hypotheses. Results The results of our research indicate that there was a significant indirect effect of religious meaning system on life satisfaction through the presence of meaning in life. The specific indirect effect of religious meaning system on life satisfaction through searching for meaning in life was not significant. Discussion The results of our study are relevant because they show that religion as a meaning system is positively related to the presence of meaning in life, which in turn positively predicts life satisfaction. This is particularly important in the case of incurable illness, where finding meaning in life is one of the natural stages of adaptation. By incorporating these findings into mental health practice, professionals can enhance the holistic well-being of people coping with MS and contribute to a more comprehensive and effective approach to mental health care.
Collapse
Affiliation(s)
- Maciej Wilski
- Department of Adapted Physical Activity, Poznan University of Physical Education, Poznan, Poland
| | - Marcin Wnuk
- Department of Psychology, Adam Mickiewicz University, Poznań, Poland
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | - Marek Żak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | | | - Joanna Tarasiuk
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agata Czarnowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | | | | | | | - Natalia Morawiec
- Department of Neurology, Medical University of Silesia, Katowice, Poland
| | | | - Adam Stepien
- Military Institute of Medicine (Poland), Warsaw, Poland
| | - Zaborski Jacek
- Department of Neurology and Neurorehabilitation, Międzyleski Specialist Hospital, Warsaw, Poland
| | | | | | | | | | - Beata Lech
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
| | - Adam Perenc
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
| | - Małgorzata Popiel
- Clinical Provincial Hospital No. 2 im. St. Jadwiga Królowej in Rzeszów, Rzeszów, Poland
| | | |
Collapse
|
5
|
Reed DE, Stump TE, Monahan PO, Kroenke K. Comparable Minimally Important Differences and Responsiveness of Brief Pain Inventory and PEG Pain Scales across 6 Trials. THE JOURNAL OF PAIN 2024; 25:142-152. [PMID: 37544394 PMCID: PMC10859144 DOI: 10.1016/j.jpain.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
The 3-item pain intensity (P), interference with the enjoyment of life (E), and interference with general activity (G), or PEG, has become one of the most widely used measures of pain severity and interference. The minimally important differences (MID) and responsiveness of the PEG are essential metrics for solidifying its role in research and clinical care. The current study aims to establish the MID and responsiveness of the PEG by synthesizing data from 1,710 participants across 6 controlled trials. MIDs were estimated using absolute score changes among individuals reporting their pain was "a little better" on a retrospective global change anchor as well as distribution-based estimates using standard deviation thresholds and 1 and 2 standard errors of measurement. Responsiveness was assessed using standardized response means, area under the curve, and treatment effect sizes. MID estimates for the PEG ranged from 0.60 to 1.1 when using 0.35 SD, and 0.78 to 1.22 using 1 standard error of measurement. MID estimates using the global anchor had somewhat more variability but most estimates ranged from 1.0 to 1.75. Responsiveness effect sizes were generally large (>.80) for standardized response means and moderate (>.50) for treatment effect. Similarly, the most area under the curve values demonstrated an acceptable level of scale responsiveness (≥.70). Importantly, MID estimates and responsiveness of the PEG and BPI scales were largely comparable when aggregating data across trials. Our synthesis indicates that 1 point is a reasonable MID estimate on these 0- to 10-point pain scales, with 2 points being an upper bound. PERSPECTIVE: This article synthesizes data from 6 clinical trials to establish the minimally important difference (MID) and responsiveness of the 3-item PEG pain scale. The PEG demonstrated good responsiveness, and 1 to 2 points proved to be reasonable estimates for the lower and upper bounds of the MID.
Collapse
Affiliation(s)
- David E Reed
- Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care, Seattle, Washington; Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | - Timothy E Stump
- Department of Biostatistics and Health Data Science, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University Fairbanks School of Public Health and School of Medicine, Indianapolis, Indiana
| | - Kurt Kroenke
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Regenstrief Institute, Inc., Indianapolis, Indiana
| |
Collapse
|
6
|
Justice C, Sullivan MB, Van Demark CB, Davis CM, Erb M. Guiding Principles for the Practice of Integrative Physical Therapy. Phys Ther 2023; 103:pzad138. [PMID: 37815938 PMCID: PMC10757068 DOI: 10.1093/ptj/pzad138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 07/03/2023] [Accepted: 09/12/2023] [Indexed: 10/12/2023]
Abstract
Integrative health is an emerging specialty inside multiple disciplines within the medical community, yet the practice of integrative physical therapy remains undefined. This perspective paper suggests a set of guiding principles to support the role of physical therapy in integrative health. These guiding principles, including therapeutic partnership, whole person health, living systems, movement as an integrative experience, and salutogenesis, are described and explored in-depth as they relate to all aspects of patient care and clinician experience. These guiding principles are articulated within the context of social determinants of health and the interrelated roles that environment, trauma, stress, and lifestyle all play within an integrative physical therapy plan of care. Examples of current integrative physical therapy practices that embody these principles are described. The 5 guiding principles are designed to elicit interprofessional inquiry into how integrative health models can be applied to the art and science of physical therapy practice. The expansion of integrative health into the field of physical therapy has the potential to improve individual and population health, as integrative physical therapy can be used to address prevention, health promotion, primary care, and wellness while acknowledging the complex, dynamic, and interconnected nature of the human condition. IMPACT This perspective article presents 5 guiding principles to establish a framework to define and shape the growing application of an integrative health model to physical therapy practice. These integrative physical therapy guiding principles aim to improve the quality of whole-person, patient-centered care.
Collapse
Affiliation(s)
- Catherine Justice
- Integrative Health and Wellness Division of the Department of Medicine, Hennepin Healthcare Systems, Minneapolis, Minnesota, USA
| | - Marlysa B Sullivan
- Empower Veterans Program, Atlanta Veterans Administration Health Care System, Atlanta, Georgia, USA
| | - Cheryl B Van Demark
- Physical Rehabilitation Services, Dignity Health Yavapai Regional Medical Center, Prescott, Arizona, USA
| | - Carol M Davis
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Matt Erb
- The Center for Mind-Body Medicine, Washington District of Columbia, USA
| |
Collapse
|
7
|
Qi WG, Xia Y, Miao M, Gan Y. One Meaning for Two Persons: An Actor-Partner Interdependence Model Analysis of Meaning in Life, Anxiety, and Depression Among Rehabilitation Patients and Caregivers. J Am Med Dir Assoc 2023; 24:1054-1060. [PMID: 36870365 DOI: 10.1016/j.jamda.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE Patients and caregivers in the inpatient physical rehabilitation setting are presented with life-changing medical conditions, and their meaning in life can change dramatically. Meaning in life is associated with fewer depressive and anxiety symptoms, but little is known about how they are related interdependently among patients and caregivers. In the current study, we aim to explore their dyadic relationships. DESIGN Actor-partner interdependence model through structural equation modeling for dyadic analyses. SETTING AND PARTICIPANTS A total of 160 pairs of patients and caregivers recruited from 6 inpatient rehabilitation hospitals in China. METHODS Cross-sectional surveys were conducted among pairs of rehabilitation patients and caregivers. The presence of and search for meaning were measured with the Meaning in Life Questionnaire. RESULTS In 2 separate models, we found that patients' presence of meaning was negatively associated with their own depression (β = -0.61, P < .001) and anxiety (β = -0.55, P < .001), as well as their caregivers' depression (β = -0.32, P < .001) and anxiety (β = -0.31, P < .001). However, the caregivers' presence of meaning was only negatively associated with their own depression (β = -0.25, P < .05) and anxiety (β = -0.21, P < .05). A search for meaning was not significantly associated with depression or anxiety. CONCLUSIONS AND IMPLICATIONS The results indicate that the anxiety and depressive symptoms of rehabilitation inpatients and caregivers are associated with their own level of presence of meaning. Caregivers' depression and anxiety are interdependently associated with patients' presence of meaning. Clinicians should take dyadic interdependence into consideration when providing psychological services to rehabilitate patients and their caregivers. Meaning-centered interventions can be helpful for the dyads' meaning-making and mental health.
Collapse
Affiliation(s)
- Wei Gabriel Qi
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Yunhua Xia
- Beijing Huasheng Rehabilitation Hospital, Beijing, China
| | - Miao Miao
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China.
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
| |
Collapse
|
8
|
Jarego M, Ferreira-Valente A, Queiroz-Garcia I, Day MA, Pais-Ribeiro J, Costa RM, Pimenta F, Jensen MP. Are Prayer-Based Interventions Effective Pain Management Options? A Systematic Review and Meta-analysis of Randomized Controlled Trials. JOURNAL OF RELIGION AND HEALTH 2023; 62:1780-1809. [PMID: 36462092 DOI: 10.1007/s10943-022-01709-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
This review examined the effects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large effects emerged for 67% to 69% of between-group comparisons; participants in the prayer condition reported lower pain intensity (0.59 < d < 26.17; 4 studies) and higher pain tolerance (0.70 < d < 1.05; 1 study). Pre- to post-intervention comparisons yielded medium to large effects (0.76 < d < 1.67; 2 studies); pain intensity decreased. Although firm conclusions cannot be made because meta-analysis was based on only two studies, the analysis suggested prayer might reduce pain intensity (SMD = - 2.63, 95% CI [- 3.11, - 2.14], I = 0%). (PROSPERO: CRD42020221733).
Collapse
Affiliation(s)
- Margarida Jarego
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal
| | - Alexandra Ferreira-Valente
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal.
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Box 359612, Seattle, WA, 98104, USA.
- Faculty of Education and Psychology, Research Centre for Human Development, Universidade Católica Portuguesa, Rua de Diogo Botelho, 1327, 4169-005, Porto, Portugal.
| | - Inês Queiroz-Garcia
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal
| | - Melissa A Day
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Box 359612, Seattle, WA, 98104, USA
- Faculty of Health and Behavioral Sciences, School of Psychology, University of Queensland, St. Lucia Campus, Sta Lucia, QLD, 4072, Australia
| | - José Pais-Ribeiro
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal
| | - Rui M Costa
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal
| | - Filipa Pimenta
- William James Center for Research, Ispa - University Institute, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Box 359612, Seattle, WA, 98104, USA
| |
Collapse
|
9
|
Parsons RD, McParland JL, Halligan SL, Goubert L, Jordan A. Glass half full: A diary and interview qualitative investigation of flourishing among adolescents living with chronic pain. Eur J Pain 2023. [PMID: 37128852 DOI: 10.1002/ejp.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/17/2023] [Accepted: 04/20/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Counter to paediatric pain literature that typically highlights the deleterious impacts associated with adolescent chronic pain, evidence suggests that some adolescents flourish in their experience of pain. This study sought to explore how adolescents experience, understand and perceive flourishing while living with chronic pain. METHODS Twenty-four adolescents aged 11-24 years were recruited via clinical and online settings. All adolescents were asked to complete daily diary entries, with a subset of 10 participants asked to complete follow-up interviews. RESULTS Inductive reflexive thematic analysis generated two themes: 'Appreciating the moment' and 'Becoming a better version of myself'. Themes addressed how self and other comparisons facilitated a renewed appreciation for achievements and pleasures in life due to living with chronic pain. Adolescents further demonstrated a perception of continued personal and social growth in their experience of chronic pain, including increased emotional maturity, resilience, positivity, kindness and improved communication skills. CONCLUSIONS We conclude that adolescents can experience positive changes in functioning and flourish in some domains of life despite, or resulting from, chronic pain. Further research with an exclusive focus on flourishing is needed to build on this work and address this important gap in knowledge. SIGNIFICANCE We present evidence that adolescents can flourish when living with chronic pain. Such knowledge may inform the development of positive psychological treatment strategies that are focused on reinforcing adolescents' existing strengths, to expand on current treatment options for adolescents living with chronic pain.
Collapse
Affiliation(s)
- Ryan D Parsons
- Department of Psychology, University of Bath, Bath, UK
- Centre for Pain Research, University of Bath, Bath, UK
| | | | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK
- Centre for Pain Research, University of Bath, Bath, UK
| |
Collapse
|
10
|
Şimşek OM, Kaya AB, Çevık O, Koçak O. How is the problematic smartphone use affected by social support? A research model supported by the mediation of Ikigai. CURRENT PSYCHOLOGY 2023; 43:1-16. [PMID: 36845209 PMCID: PMC9938517 DOI: 10.1007/s12144-023-04362-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/21/2023]
Abstract
Social support and ikigai (making life worthwhile) have positive effects on problematic smartphone use and are seen to be related to each other. However, what mediates these relationships has not been adequately analyzed. This study aims to examine how the effect between social support and problematic smartphone use occurs by suggesting the mediator role of ikigai. The study was designed as quantitative and cross-sectional, and 1189 university participants aged 18 and over were reached online. The multidimensional scale of perceived social support, ikigai-9 scale, smartphone application-based addiction scale and sociodemographic information form were used as data collection tools in the study. The data obtained were carried out using SPSS 24 and Amos 25 statistical programs. Established hypotheses were tested with correlation, multiple regression and mediation analyzes. The results confirmed that social support was positively associated with ikigai, and ikigai was negatively associated with problematic smartphone use. In addition, interaction analyzes found that ikigai had a mediating effect. These findings show the importance of implementing specific applications based on the meaning and purpose of life (ikigai), especially for vulnerable groups, to minimize the problems that may arise with the excessive use of smartphones.
Collapse
Affiliation(s)
| | - Aysel Basmaci Kaya
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
| | - Orhan Çevık
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
| | - Orhan Koçak
- Department of Social Work, Faculty of Health Sciences, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey
| |
Collapse
|
11
|
Lakha SF, Assimakopoulos D, Mailis A. Comparison of Older and Younger Patients Referred to a Non-interventional Community Pain Clinic in the Greater Toronto Area (GTA). Pain Ther 2023; 12:213-224. [PMID: 36284073 PMCID: PMC9845447 DOI: 10.1007/s40122-022-00435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/09/2022] [Indexed: 01/21/2023] Open
Abstract
AIM To compare demographic and pain characteristics of older (≥ 65) vs younger (< 65) chronic non-cancer pain patients referred to a community pain clinic in the Greater Toronto Area (GTA), Ontario, Canada. METHODS This is a retrospective study of 644 consecutive new patients with pain seen during 2016-2017 (older group n = 126; younger group n = 518). Demographic characteristics, Brief Pain Inventory pain ratings, and diagnosis were obtained using retrospective chart review. Patients were classified into group I (pure biomedical pathology), group II (mixed biomedical causes and psychological factors) and group III (no detectable physical pathology but psychological factors were considered important). RESULTS Older patients comprised 19.6% of the overall population (higher than the average GTA older population). Regarding older vs younger group, male/female ratio was 1:1.3 vs 1:1.7 respectively, while 71% of the older patients were foreign born vs 37% of the younger group (p < 0.001). Low back was the most prevalent pain site for both groups; 70% of the older patients were classified as group I vs 35% of the younger patients (p < 0.0001), and only 6% as group III (vs 18% of the younger population, p < 0.05). CONCLUSION The study points to considerable differences between younger and older patients with pain with the latter presenting with significant biomedical pathology but lesser psychopathology. The results are comparable to those obtained from a university pain clinic as well as a rural Northern Ontario clinic. Implications of the study for planning of pain care are discussed.
Collapse
Affiliation(s)
- Shehnaz Fatima Lakha
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Sciences, University of Toronto, Toronto, ON Canada
| | - Demetry Assimakopoulos
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.231844.80000 0004 0474 0428University Health Network, Comprehensive Integrated Pain Program Rehabilitation Pain Service, Toronto, ON Canada
| | - Angela Mailis
- Pain and Wellness Centre, 2301 Major Mackenzie Dr. West, Unit #101, Vaughan, ON Canada ,grid.17063.330000 0001 2157 2938Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON Canada
| |
Collapse
|
12
|
Yousefi Afrashteh M, Abbasi M, Abbasi M. The relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine patients: the mediating role of pain self-efficacy. BMC Psychol 2023; 11:17. [PMID: 36691101 PMCID: PMC9869619 DOI: 10.1186/s40359-023-01053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Migraine is a neurological disease that has several physical and psychological complications, which is characterized by disability and impaired quality of life. AIMS The aim of this study was to explore the mediating role of pain self-efficacy in the relationship between meaning of life, perceived social support, spiritual well-being and pain catastrophizing with quality of life in migraine sufferers. The relationship between these factors with quality of life (QOL) was not fully explored in migraine patients. METHOD This study was a correlational study of structural equations. Therefore, 300 patients with migraine who referred to one of the specialized neurological treatment centers in Zanjan in 2021 were recruited based on the inclusion criteria. Patients also completed the World Health Organization Quality of Life Scale (WHOQOL-BREF), Meaning in Life Questionnaire, Multidimensional Scale of Perceived Social Support, Spiritual Well-Being Scale, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire. Finally, the hypotheses were then analyzed with correlation coefficient and path analysis method by using SPSS-26 and LISREL-10.2 programs. RESULTS The results of the present study showed that pain self-efficacy has a mediating role in the relationship between meaning of life and quality of life (B = 0.015), perceived social support with quality of life (B = 0.022), spiritual well-being with quality of life (B = 0.021), as well as pain catastrophizing with quality of life (B = - 0.015). CONCLUSION According to the results of this study, by considering the role of self-efficacy of pain, it is possible to develop the programs to strengthen and improve the meaning of life, perceived social support, spiritual well-being and also reduce pain catastrophizing, in order to improve the quality of life of patients with migraine.
Collapse
Affiliation(s)
| | - Mahya Abbasi
- Department of Psychology, Family Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Mahsa Abbasi
- Department of Psychology, Faculty of Psychology and Educational Sciences, Shahid Beheshti University, Tehran, Iran
| |
Collapse
|
13
|
Dewitte L, Hill PL, Vandenbulcke M, Dezutter J. The longitudinal relationship between meaning in life, depressive symptoms, life satisfaction, and cognitive functioning for older adults with Alzheimer's disease. Eur J Ageing 2022; 19:1155-1166. [PMID: 36692743 PMCID: PMC9729662 DOI: 10.1007/s10433-022-00689-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 01/26/2023] Open
Abstract
Studies show the importance of the personal experience of meaning in life for older adults, but adults with dementia have been largely excluded from this research. The current study examined the longitudinal predictive effect of meaning in life for the psychological and cognitive functioning of older adults with Alzheimer's disease and whether cognitive decline predicted presence of meaning in life. On three yearly measurement occasions, presence of meaning in life, depressive symptoms, life satisfaction, and cognitive functioning were assessed in structured interviews with a convenience sample of 140 older adults with Alzheimer's disease from nine nursing homes in Belgium. Cross-lagged panel and latent growth curve models were used to analyze the longitudinal relationships between the variables. Over the three measurement waves, participants with higher presence of meaning reported lower depressive symptoms one year later. Presence of meaning and life satisfaction predicted each other over time, but only between the first and second wave. The analyses showed no strong evidence for a longitudinal association between meaning in life and cognitive functioning in either direction. The findings emphasize the importance of the experience of meaning in life for the psychological functioning of older adults with Alzheimer's disease. The lack of evidence for associations between meaning and cognitive functioning questions the prevailing view that intact cognitive abilities are a necessity for experiencing meaning. More attention to the potential of meaning interventions for persons with dementia is warranted.
Collapse
Affiliation(s)
- Laura Dewitte
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Patrick L Hill
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | | | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
14
|
Baños RM, Desdentado L, Vara MD, Escrivá-Martínez T, Herrero R, Miragall M, Tomás JM. How the COVID-19 Pandemic and its Consequences Affect the Presence of and Search for Meaning of Life: A Longitudinal Study. JOURNAL OF HAPPINESS STUDIES 2022; 24:17-33. [PMID: 36312909 PMCID: PMC9595083 DOI: 10.1007/s10902-022-00592-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity.
Collapse
Affiliation(s)
- Rosa Mª Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Comunidad Valenciana Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Lorena Desdentado
- Polibienestar Research Institute, University of Valencia, Valencia, Comunidad Valenciana Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Mª Dolores Vara
- Polibienestar Research Institute, University of Valencia, Valencia, Comunidad Valenciana Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Tamara Escrivá-Martínez
- Polibienestar Research Institute, University of Valencia, Valencia, Comunidad Valenciana Spain
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Rocío Herrero
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | - Marta Miragall
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| |
Collapse
|
15
|
Sherman AC, Williams ML, Amick BC, Hudson TJ, Messias EL, Simonton-Atchley S. Adjustment to the COVID-19 pandemic: associations with global and situational meaning. CURRENT PSYCHOLOGY 2022:1-16. [PMID: 35813567 PMCID: PMC9256532 DOI: 10.1007/s12144-022-03354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 has created pervasive upheaval and uncertainty in communities around the world. This investigation evaluated associations between discrete dimensions of personal meaning and psychological adjustment to the pandemic among community residents in a southern US state. In this cross-sectional study, 544 respondents were assessed during a period of reopening but accelerating infection rates. Validated measures were used to evaluate theoretically distinct dimensions of perceived global meaning (Meaning-in-Life Questionnaire) and pandemic-specific meaning (Meaning in Illness Scale). Adjustment outcomes included perceived stress, pandemic-related helplessness, and acceptance of the pandemic. In multivariate models that controlled for demographic and pandemic-related factors, stronger attained global meaning (i.e., perceptions that life is generally meaningful) and attained situational meaning (i.e., perceptions that the pandemic experience was comprehensible) were related to better adjustment on all three outcomes (all p's < .001). In contrast, seeking situational meaning (i.e., ongoing efforts to find coherence in the situation) was associated with poorer adjustment on all indices (all p's < .001). Results offer novel information regarding theoretically salient dimensions of meaning, which may have direct relevance for understanding how community residents adapt to the challenges of a major public health crisis.
Collapse
Affiliation(s)
- Allen C. Sherman
- Behavioral Medicine Division, University of Arkansas for Medical Sciences, #756, 4301 W. Markham Street, Little Rock, AR 72205 USA
| | - Mark L. Williams
- Department of Health Promotion and Disease Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Benjamin C. Amick
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Teresa J. Hudson
- Center for Health Services Research, Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Erick L. Messias
- Faculty Affairs and Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR USA
- Present Address: Department of Psychiatry and Behavioral Neurosciences, Saint Louis University, St. Louis, MO USA
| | - Stephanie Simonton-Atchley
- Behavioral Medicine Division, University of Arkansas for Medical Sciences, #756, 4301 W. Markham Street, Little Rock, AR 72205 USA
| |
Collapse
|
16
|
Chytas V, Costanza A, Mazzola V, Luthy C, Galani V, Bondolfi G, Cedraschi C. Possible Contribution of Meaning in Life in Patients With Chronic Pain and Suicidal Ideation: Observational Study. JMIR Form Res 2022; 6:e35194. [PMID: 35699974 PMCID: PMC9237781 DOI: 10.2196/35194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/06/2022] [Accepted: 04/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Chronic pain is associated with an elevated risk of suicidal ideation (SI). Objective We aimed to examine if the presence or the search for Meaning in Life (MiL) are associated with less SI and explore whether MiL profiles emerge in our cohort. These profiles can be described as high presence–high search, high presence–low search, low presence–low search, and low presence–high search. Methods In this observational study, we recruited 70 patients who were referred to the Multidisciplinary Pain Center of the Geneva University Hospitals and who answered positively to question 9 on the Beck Depression Inventory, 2nd Edition, investigating SI. Patients who agreed to participate in the study were further investigated; they participated in a structured diagnostic interview to screen for psychiatric diagnoses. During this interview, they completed the Meaning in Life Questionnaire and the semistructured Scale for Suicide Ideation (SSI) to assess the characteristics and severity of SI. Results There was a statistically significant correlation between the presence of MiL subscale and the SSI. These 2 scales had a negative and statistically highly significant correlation (R=–.667; P<.001). The results also showed a negative and statistically highly significant correlation between the score of the search for MiL and the SSI (R=–.456; P<.001). The results thus pointed to the presence of MiL as a potential protective factor against the severity of SI, while the search for MiL is also a possible resiliency factor, although to a lesser extent. The profile low presence–low search grouped the vast majority (47%) of the patients; in these patients, the mean SSI score was 14.36 (SD 5.86), much higher compared with that of the other subgroups. Conclusions This study’s results point to MiL as a concept of interest regarding devising psychotherapeutic interventions for chronic pain patients in order to reduce the suicidal risk and more accurately determine patients’ suffering.
Collapse
Affiliation(s)
- Vasileios Chytas
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland
- Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Vasiliki Galani
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland
- Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
17
|
Liu Y, Mao A. Exploring the Meaning in Life and the Influencing Factors among Patients Undergoing Hemodialysis in Macau. SAGE Open Nurs 2022; 8:23779608221092170. [PMID: 35434306 PMCID: PMC9008827 DOI: 10.1177/23779608221092170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/28/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction The meaning in life (ML) is a significant predictor of the physical and
mental health of patients with chronic diseases, and its construct is
culturally specific.As a group between normal people and the patients with
advanced cancer, patients with End-Stage Kidney Disease (ESKD) who are
undergoing hemodialysis (HD) are often outside of research focus on ML. Objectives This study was to investigate the status of ML of patients on HD in Macau of
China and to analyze the influence of social-demographic characteristics and
disease-related factors on their ML. The study findings would inform the
development of evidence-based interventions in nursing care for this patient
population. Methods This study employed a cross-sectional survey design. Eligible participants
were recruited by convenient sampling from the largest HD center in Macau in
January 2020. The participants’ social-demographic and disease-related
characteristics were collected, and their ML status was assessed by the
Meaning in Life Scale for Hemodialysis Patients (MLSHP). SPSS 22.0 software
was used to analyze the data. Results Questionnaires were distributed to 249 potential participants who were
patients on HD, and 238 patients replied to the questionnaires effectively.
The effective response rate was 95.58% (238/249). The average score of ML
for the patients was 93.75 ± 10.00, which was 72% of the total score of 130
on the ML scale. Gender, religious belief, duration of dialysis treatment,
and symptom-related distress had impacts on ML levels
(p < .05), with religious belief being a particularly
strong predictor (p < .001). Conclusion The level of ML for patients on HD in Macau is relatively high. Different
demographic or disease-related factors impact participants’ ML, supporting
or contradicting previous studies. While the study findings are meaningful
under the local cultural contexts, they have implications for nurses in
other places to develop evidence-based interventions for patients on HD.
Collapse
Affiliation(s)
- Yuanyi Liu
- Kiang Wu Nursing College of Macau, Macau, China
- Kiang Wu Hospital, Macau, China
| | - Aimei Mao
- Kiang Wu Nursing College of Macau, Macau, China
| |
Collapse
|
18
|
Aydin Yildirim T, Kes D. Relation between Coping with Pain & Spiritual Wellbeing in Chronic Pain Living Individuals. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:158-167. [PMID: 34666629 DOI: 10.1080/19371918.2021.1991543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of this study was to investigate the relationship between coping with pain in individuals with chronic pain and their levels of spiritual wellbeing. The research was conducted as a cross-sectional study. It was conducted with 148 participants who were experiencing chronic pain. Data were collected using Sociodemographic Questionnaire, Pain Coping Questionnaire (PCQ) and Spiritual Well-Being Scale (SWBS). Data were analyzed using Kolmogorov-Smirnov/Shapiro-Wilk's test, skewness, kurtosis, Cronbach's α, mean, standard deviation, mean rank and binary logistic regression analysis. According to the data obtained, it was concluded that participants' levels of spiritual wellbeing were high, and spiritual wellbeing could be used as an effective mechanism for coping with pain. It is therefore recommended that training sessions and information meetings be organized to create awareness in health care and social work professionals and in those living with chronic pain and their families.
Collapse
Affiliation(s)
- Tuğba Aydin Yildirim
- Nursing Department, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Duygu Kes
- Nursing Department, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| |
Collapse
|
19
|
Reed DE, Bokhour BG, Gaj L, Barker AM, Douglas JH, DeFaccio R, Williams RM, Engel CC, Zeliadt SB. Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites. Glob Adv Health Med 2022; 11:21649561211065374. [PMID: 35174004 PMCID: PMC8841911 DOI: 10.1177/21649561211065374] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/19/2021] [Indexed: 12/16/2022] Open
Abstract
Objective Veterans Healthcare Administration (VHA) conducted a large demonstration project of a holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns of service use among Veterans with chronic pain, comparing those with and without PTSD. Methods We assessed the use of Whole Health services in a cohort of Veterans with co-occurring chronic pain and PTSD (n = 1698; 28.9%), comparing them to Veterans with chronic musculoskeletal pain only (n = 4170; 71.1%). Data was gathered from VA electronic medical records and survey self-report. Whole Health services were divided into Core Whole Health services (e.g., Whole Health coaching) and CIH services (e.g., yoga). Logistic regression was used to determine whether Veterans with co-occurring chronic pain and PTSD utilized more Whole Health services compared to Veterans with chronic pain but without PTSD. Results A total of 40.1% of Veterans with chronic pain and PTSD utilized Core Whole Health services and 53.2% utilized CIH therapies, compared to 28.3% and 40.0%, respectively, for Veterans with only chronic pain. Adjusting for demographics and additional comorbidities, Veterans with comorbid chronic pain and PTSD were 1.24 ( 95% CI: 1.12, 1.35, P ≤ .001) times more likely than Veterans with chronic pain only to use Core Whole Health services, and 1.23 ( 95% CI: 1.14, 1.31, P ≤ .001) times more likely to use CIH therapies. Survey results also showed high interest levels in Core Whole Health services and CIH therapies among Veterans who were not already using these services. Conclusion Early implementation efforts in VHA led to high rates of use of Core Whole Health and CIH therapy use among Veterans with co-occurring chronic pain and PTSD. Future assessments should examine how well these additional services are meeting the needs of Veterans in both groups.
Collapse
Affiliation(s)
- David E. Reed
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States
| | - Barbara G. Bokhour
- Center for Healthcare Organization and Implementation Research, Bedford, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Boston, MA, United States
| | - Lauren Gaj
- Center for Healthcare Organization and Implementation Research, Bedford, MA, United States
| | - Anna M. Barker
- Center for Healthcare Organization and Implementation Research, Bedford, MA, United States
| | - Jamie H. Douglas
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
| | - Rian DeFaccio
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
| | - Rhonda M. Williams
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Charles C. Engel
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Steven B. Zeliadt
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, United States
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States
| |
Collapse
|
20
|
Boring BL, Maffly-Kipp J, Mathur VA, Hicks JA. Meaning in Life and Pain: The Differential Effects of Coherence, Purpose, and Mattering on Pain Severity, Frequency, and the Development of Chronic Pain. J Pain Res 2022; 15:299-314. [PMID: 35140515 PMCID: PMC8820455 DOI: 10.2147/jpr.s338691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Meaning in life is consistently associated with better health outcomes across a range of mental and physical domains. However, meaning in life is a complex construct involving three distinct facets: coherence, purpose, and mattering. While these facets have been studied individually in relation to pain, they have not been assessed concurrently to parse out their potential distinct contributions to pain outcomes. We sought to identify the unique relationships of these individual facets of meaning with pain experiences and specify the components associated with pain-related resilience. Methods The associations of coherence, purpose, and mattering with pain outcomes were examined across three studies. Study 1 used data from the Midlife in the United States National Survey to determine associations between facets and the frequency of various recently experienced pains, and the development of chronic pain nine years later. Study 2 cross-sectionally observed the association between facets and recent pain severity in young adults. Using a diary-type approach, Study 3 captured fluctuations of pain severity in relation to the facets across the span of four weeks. Results Coherence was uniquely associated with less headache, backache, joint, and extremities pain frequency in Study 1, over and above purpose and mattering, controlling for other health variables. Coherence was also associated with lower odds of developing chronic pain. In Study 2, coherence was associated with less pain severity and fully mediated the relationship between global meaning in life and pain. Study 3 found that coherence predicted the most unique variance in weekly pain fluctuations. Conclusion Across three studies and timescales, coherence was uniquely associated with fewer and less severe pain experiences over and above purpose and mattering. These findings provide support for the value of coherence as a resilience factor in the context of pain and suggest a potential benefit for coherence-specific interventions in clinical settings.
Collapse
Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
- Correspondence: Brandon L Boring, Department of Psychological and Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX, 77843, USA, Email
| | - Joseph Maffly-Kipp
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
- Institute for Neuroscience, Texas A&M University, College Station, TX, 77843, USA
| | - Joshua A Hicks
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77843, USA
| |
Collapse
|
21
|
Relationships between Sense of Community, Authenticity, and Meaning in Life in Four Social Communities in France. SUSTAINABILITY 2022. [DOI: 10.3390/su14021018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This research explored the effects of sense of community and authenticity on meaning in life in social communities in France. The sample included one hundred participants from four social communities (i.e., political, religious, virtual learning, and mutual aid). The Meaning in Life Questionnaire, the Sense of Community Scale, and the Authenticity Scale were administered to the respondents. The correlational analyses indicated that sense of community and authenticity were more related to the presence of meaning (r = 0.29 and r = 0.54, respectively) than to the search for meaning (r = −0.39 and r = 0.03, respectively). In addition, no interaction effects were found between sense of community and the three dimensions of authenticity, suggesting that the level of authenticity did not influence the relationships between sense of community and presence of or search for meaning. The practical and research implications of the study for social communities in the field of existential psychology were discussed.
Collapse
|
22
|
Böhmer MC, la Cour P, Schnell T. A Randomized controlled trial of the Sources of Meaning Card Method: A new meaning-oriented approach predicts depression, anxiety, pain acceptance, and crisis of meaning in chronic pain patients. PAIN MEDICINE 2021; 23:314-325. [PMID: 34730813 DOI: 10.1093/pm/pnab321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 07/25/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Although considered the first-line psychological treatment of chronic pain, cognitive behavioural therapy has recently been criticized as being too limited, insufficient, and sometimes ineffective in the treatment of chronic pain patients. Moreover, important existential perspectives are sparsely or not at all integrated into CBT. We therefore propose to complement chronic pain treatment with a meaning-based intervention, the Sources of Meaning Card Method (SoMeCaM). This study tested its efficacy. DESIGN A randomized controlled trial was conducted with 42 chronic pain patients, comparing an intervention group (standard care and participation in the SoMeCaM, a meaning-oriented approach) with a control group (standard care). We evaluated both groups at baseline, 1 (t1) and 2 months (t2) after the intervention. The primary outcome assessed was pain acceptance, while depression, anxiety, pain intensity, pain medication, satisfaction with life, meaningfulness, and crisis of meaning were examined as secondary outcomes. RESULTS Comparisons within and between groups showed significant treatment effects at t1. Higher increases in pain acceptance and decreases in anxiety, depression and crisis of meaning were observed in the intervention group. Improvements in pain acceptance and anxiety persisted until t2, when pain intensity was also lower. Effect sizes at t2 were medium to large. CONCLUSION Our preliminary work demonstrates the importance of the existential perspective in chronic pain therapy.
Collapse
Affiliation(s)
- Miriam C Böhmer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Peter la Cour
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tatjana Schnell
- Institute of Psychology, Leopold-Franzens University, Innsbruck, Austria.,MF Norwegian School of Theology, Religion and Society, Oslo, Norway
| |
Collapse
|
23
|
Segerstrom SC, Monroe AD, Crofford LJ. Pain, Goal Engagement, and Eudaemonic Well-Being: Moderation by Autonomous Motivation. J Gerontol B Psychol Sci Soc Sci 2021; 77:493-498. [PMID: 34129029 DOI: 10.1093/geronb/gbab105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pain may decrease well-being in older adults by limiting social and leisure activities. However, some activities can exacerbate pain. We hypothesized that autonomously motivated goal engagement could ameliorate negative effects of pain on goal engagement and amplify positive effects of goal engagement on eudaemonic well-being (EWB). METHOD Midlife and older women (N=200) were oversampled for chronic pain. Daily diaries (n=10,697) including goal lists and ratings, pain, and EWB were completed for 7 days every 3 months for 2 years. RESULTS Pain was not a correlate of goal engagement. More engagement was associated with higher EWB when motivation was autonomous. However, more goal engagement correlated with lower EWB the next day and, when not autonomously motivated, higher pain. DISCUSSION Goal engagement can benefit people with or without physical pain, but the motivation behind goal engagement is equally if not more important. Goals motivated by autonomous sources increase EWB and may protect against maladaptive patterns of activity associated with pain.
Collapse
Affiliation(s)
| | | | - Leslie J Crofford
- Department of Internal Medicine, Vanderbilt University School of Medicine
| |
Collapse
|
24
|
Lovell M, Corbett M, Dong S, Siddall P. Spiritual Well-Being in People Living with Persistent Non-Cancer and Cancer-Related Pain. PAIN MEDICINE 2021; 22:1345-1352. [PMID: 33296472 DOI: 10.1093/pm/pnaa414] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Existential and spiritual factors are known to play an important role in how people cope with disability and life-threatening illnesses such as cancer. However, comparatively little is known about the impact of pain on factors such as meaning and purpose in one's life and their potential roles in coping with pain. OBJECTIVES The aim of this study was to determine spiritual well-being scores in people with persistent pain and to compare these with people with cancer and healthy controls. METHODS We assessed 132 people with chronic pain, 74 people with cancer (49 with pain and 25 without pain) and 68 control participants using standardised measures of pain-related variables including pain intensity, physical function, mood and cognitions. Spiritual well-being was also assessed using a validated and widely used questionnaire, the Functional Assessment of Chronic Illness Therapy - Spirituality Scale (FACIT-Sp). RESULTS Spiritual well-being scores were significantly lower in people with persistent pain when compared with controls and were no different when compared with people with cancer, including those who had cancer and pain. In addition, low levels of meaning and purpose were significant predictors of depression, anxiety, and stress across all groups. CONCLUSION The findings demonstrate that persistent pain is associated with spiritual distress that is equal to those observed in people who have cancer. Furthermore, those who have higher levels of meaning and purpose are less likely to develop mood dysfunction when experiencing pain, indicating they may have a protective role.
Collapse
Affiliation(s)
- Melanie Lovell
- Department of Palliative & Supportive Care, Greenwich Hospital, HammondCare, Sydney, Australia.,Sydney Medical School - Northern, University of Sydney, Sydney, NSW, Australia
| | - Mandy Corbett
- Department of Pain Management, Greenwich Hospital, HammondCare, Sydney, Australia
| | - Skye Dong
- Department of Pain Management, Greenwich Hospital, HammondCare, Sydney, Australia
| | - Philip Siddall
- Sydney Medical School - Northern, University of Sydney, Sydney, NSW, Australia.,Department of Pain Management, Greenwich Hospital, HammondCare, Sydney, Australia.,Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| |
Collapse
|
25
|
Costanza A, Chytas V, Piguet V, Luthy C, Mazzola V, Bondolfi G, Cedraschi C. Meaning in Life Among Patients With Chronic Pain and Suicidal Ideation: Mixed Methods Study. JMIR Form Res 2021; 5:e29365. [PMID: 34003136 PMCID: PMC8214181 DOI: 10.2196/29365] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/06/2021] [Accepted: 05/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with chronic pain have elevated risk of suicidal ideation and behavior, including suicide attempts and completed suicides. In most studies, associations between chronic pain and suicidal ideation/suicidal behavior are robust even after adjusting for the effect of sociodemographics and psychiatric comorbidity. However, to refine the risk profile of these patients, further exploration of other possible risk and protective factors is necessary. OBJECTIVE There is a common clinical observation that experiencing chronic pain often requires a revision of life goals and expectations, and hence, it impacts the existential domain including one's perception of the meaning in life (MiL). This study aimed to characterize the main domains that constitute the personal MiL, including the "presence of" and "search for" constructs, in a group of patients with chronic pain and suicidal ideation. METHODS Seventy participants were enlisted by ongoing recruitment through a larger project anchored in daily clinical practice at the Multidisciplinary Pain Center of the Geneva University Hospitals. It was an observational mixed method study. Data were recorded through both validated quantitative questionnaires and qualitative open-ended questions. RESULTS The total sample consisted of 70 patients. Responses to questionnaires showed a depressive episode in 68 (97%) patients and anxious disorders in 25 (36%) patients. With a score threshold for positive MiL of 24, the mean score for the "presence of" construct was 20.13 (SD 8.23), and 63% (44/70) of respondents had a score <24. The mean score for the "search for" construct was lower at 18.14 (SD 8.64), and 70% (49/70) of respondents had a score <24. The "presence of" and "search for" constructs were significantly positively correlated (R=0.402; P=.001). An open question addressed the "presence of" construct by inviting the respondents to cite domains they consider as providing meaning in their life at the present time. All patients responded to this question, citing one or more domains. The three main dimensions that emerged from content analysis of this qualitative section were as follows: the domain of relationships, the domain of personal activities, and pain and its consequences on MiL. CONCLUSIONS The study results provide insights into patients with chronic pain and suicidal ideation, including the domains that provide them with meaning in their lives and the impact of pain on these domains with regard to suicidal ideation. The main clinical implications concern both prevention and supportive/psychotherapeutic interventions. They are based on a narrative approach aiming to explore with the patients the content of their suffering and the MiL domains that they could identify to mitigate it, in order to restructure/reinforce these domains and thus possibly reduce suicidal ideation. Specifically, a focus on maintaining the domains of interpersonal relationships and personal activities can allow patients to ultimately escape the biopsychosocial vicious cycle of chronic pain-induced deep moral suffering.
Collapse
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Vasileios Chytas
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Valérie Piguet
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
26
|
Lin L, Shek DTL. Meaning-in-Life Profiles among Chinese Late Adolescents: Associations with Readiness for Political Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115765. [PMID: 34072032 PMCID: PMC8198389 DOI: 10.3390/ijerph18115765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/20/2022]
Abstract
This study explored the association between meaning in life and readiness for political participation based on meaning-in-life profiles among Chinese late adolescents. A total of 1030 college students (mean age = 19.69 ± 1.47 years) in Hong Kong participated in this study. First, we used a cluster analysis to investigate meaning-in-life profiles based on two dimensions: “presence of meaning” and “search for meaning”. Furthermore, we investigated the association between meaning profiles and readiness for political participation. Results revealed three distinguishable profiles, which emerged in both male and female adolescents. Students with “high-presence” and “high-search” attributes and students with “low-presence” and “high-search” characteristics showed greater readiness to engage in normative and non-normative political actions than did those with a “high-presence” and “low-search” profile. Our research fills the research gap on meaning profiles in Asian adolescents and provides the empirical basis for an alternative account of youth political participation.
Collapse
|
27
|
Quiroga-Garza A, Cepeda-Lopez AC, Villarreal Zambrano S, Villalobos-Daniel VE, Carreno DF, Eisenbeck N. How Having a Clear Why Can Help Us Cope With Almost Anything: Meaningful Well-Being and the COVID-19 Pandemic in México. Front Psychol 2021; 12:648069. [PMID: 34093332 PMCID: PMC8175781 DOI: 10.3389/fpsyg.2021.648069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/26/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has resulted in an increase in known risk factors for mental health problems. Mexico adopted lockdown and physical distancing as a containment strategy with potential consequences on day to day life, such as social isolation, loss of income and loneliness that can have important consequences in terms of mental health. Objective: We aimed to examine the effect of the initial phases of the COVID-19 pandemic on psychological distress, well-being and perceived physical health among Mexican-base respondents and to examine whether coping strategies would play a potential intermediating role in relation to these variables. Under the Existential Positive Psychology perspective, an emphasis was made on meaning-centered coping. Methods: A cross-sectional study was conducted between April 30 and June 16th 2020 among 604 Mexicans-base respondents of which 471 were women and 132 men. Data was collected by using online questionnaires. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The Brief COPE Inventory was used to assess problem-focused and emotion-focused coping strategies. We also used the Meaning-Centered Coping Scale (MCCS). PERMA-Profiler was used to assess well-being, perceived physical health, and loneliness. Profiler and Descriptive analyses and bivariate linear regression were performed to examine the association of variables. Results: 45.9% of the participants reported moderate to extremely severe psychological distress. Our results demonstrate that problem-focused and emotion-focused coping were positively related to psychological distress, whereas meaning-centered coping was negatively associated with distress. Furthermore, psychological distress played a potential negative role in the perceived physical health, while meaning-centered coping and well-being buffered the negative influence of psychological distress on perceived physical health (completely standardized indirect effect = -0.01, SE: 0.012, 95% CI [-0.065; -0.017]. Conclusion: Meaning-centered coping was found to suppress the negative influence of psychological distress on sensation of decreased physical health corroborating the critical role of meaning in life in promoting well-being. Future studies can further examine the value of the critical role of meaning in life in promoting well-being as a protective factor against severe distress during traumatic events. Findings of this study can be used to orient policies and interventions aimed to alleviate suffering in the midst of the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Ana C. Cepeda-Lopez
- Department of Basic Sciences, School of Medicine, Universidad de Monterrey, Monterrey, Mexico
| | | | | | - David F. Carreno
- Department of Psychology, Universidad de Almería, Almería, Spain
| | | |
Collapse
|
28
|
Psychosocial intervention and the reward system in pain and opioid misuse: new opportunities and directions. Pain 2021; 161:2659-2666. [PMID: 33197164 DOI: 10.1097/j.pain.0000000000001988] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
29
|
Alhaj-Mahmoud FM, Ahmad SA. Psychological well-being program efficacy on meaning-in-life in a sample of University of Jeddah students. JOURNAL OF PSYCHOLOGY IN AFRICA 2021. [DOI: 10.1080/14330237.2021.1927337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Somia A. Ahmad
- Department of Psychology, University of Jeddah, Jeddah, Saudi Arabia
- Department of Educational Psychology, Minya University, Minya, Egypt
| |
Collapse
|
30
|
Meaning Matters: Self-Perceived Meaning in Life, Its Predictors and Psychological Stressors Associated with the COVID-19 Pandemic. Behav Sci (Basel) 2021; 11:bs11040050. [PMID: 33924422 PMCID: PMC8070341 DOI: 10.3390/bs11040050] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 11/20/2022] Open
Abstract
Past research has found that a perceived meaning in life can act as a protective factor against adverse mental health symptomology, while also providing coping resources to buffer against the impact of negative life events. The current research investigated how the impact of self-perceived meaning in life as well as its predictors interact with stressors and worry related to the COVID-19 pandemic. We collected survey based data (n = 260) from Australian participants during the pandemic, measuring their meaning in life, orientation to differing life goals and COVID-19 related stressors via the impact of events scale. We found that meaning in life predicted less stress and worry associated with COVID-19. We also found that intrinsic based aspirations related positively to meaning in life within this context whereas extrinsic based goals related negatively to it, although these aspirations were not significant in reducing the stressors associated with COVID-19. These results reinforce past findings that meaning in life can effectively buffer against the impact of negative life events such as the COVID-19 pandemic. They also suggest that intrinsic based aspirations centred on relationships and self-acceptance may be an important mechanism in how people choose to pursue life meaning during uncertain life events.
Collapse
|
31
|
Kent M, Mardian AS, Regalado-Hustead ML, Gress-Smith JL, Ciciolla L, Kim JL, Scott BA. Adaptive Homeostatic Strategies of Resilient Intrinsic Self-Regulation in Extremes (RISE): A Randomized Controlled Trial of a Novel Behavioral Treatment for Chronic Pain. Front Psychol 2021; 12:613341. [PMID: 33912102 PMCID: PMC8074861 DOI: 10.3389/fpsyg.2021.613341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/12/2021] [Indexed: 11/29/2022] Open
Abstract
Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention (n = 38) or control (n = 37). Fifty-eight Veterans completed pre- and post-testing (intervention n = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well validated measures were used to assess three domains of functioning: health and well-being, symptoms, and cognitive functions. Two-way Analysis of Variance was used to detect group and time differences. Broadly, results indicated significant intervention and time effects across multiple domains: (1) Pain decreased in present severity [F(1, 56) = 5.02, p < 0.05, η2p = 0.08], total pain over six domains [F(1, 56) = 14.52, p < 0.01, η2p = 0.21], and pain interference [F(1, 56) = 6.82, p < 0.05, η2p = 0.11]; (2) Affect improved in pain-related negative affect [F(1, 56) = 7.44, p < 0.01, η2p = 0.12], fear [F(1, 56) = 7.70, p < 0.01, η2p = 0.12], and distress [F(1, 56) = 10.87, p < 0.01, η2p = 0.16]; (3) Well-being increased in pain mobility [F(1, 56) = 5.45, p < 0.05, η2p = 0.09], vitality [F(1, 56) = 4.54, p < 0.05, η2p = 0.07], and emotional well-being [F(1, 56) = 5.53, p < 0.05, η2p = 0.09] Mental health symptoms and the cognitive functioning domain did not reveal significant effects. This resilience intervention based on homeostatic self-regulation and survival strategies of survivors of extreme external environments may provide additional sociopsychobiological tools for treating individuals with chronic pain that may extend beyond treating pain symptoms to improving emotional well-being and self-growth. Clinical Trial Registration: Registered with ClinicalTrials.gov (NCT04693728).
Collapse
Affiliation(s)
- Martha Kent
- Research Department, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.,Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Aram S Mardian
- Department of Family, Community, and Preventive Medicine, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, United States.,Chronic Pain Wellness Center, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States
| | - Morgan Lee Regalado-Hustead
- Chronic Pain Wellness Center, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.,Department of Educational Psychology, Northern Arizona University, Flagstaff, AZ, United States
| | - Jenna L Gress-Smith
- Department of Psychology, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States
| | - Lucia Ciciolla
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Jinah L Kim
- Department of Psychology, University of California, San Diego, San Diego, CA, United States
| | - Brandon A Scott
- Department of Psychology, Midwestern University, Glendale, AZ, United States
| |
Collapse
|
32
|
Enhancing meaning in the face of advanced cancer and pain: Qualitative evaluation of a meaning-centered psychosocial pain management intervention. Palliat Support Care 2021; 18:263-270. [PMID: 32115006 DOI: 10.1017/s1478951520000115] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objectives of this study were to obtain patient evaluations of the content, structure, and delivery modality of Meaning-Centered Pain Coping Skills Training (MCPC), a novel psychosocial intervention for patients with advanced cancer and pain. MCPC aims to help patients connect with valued sources of meaning in their lives (e.g., family relationships), while providing training in evidence-based cognitive and behavioral skills (e.g., guided imagery) to reduce pain. METHODS Semi-structured interviews were conducted with 12 patients with stage IV solid tumor cancers and persistent pain. Transcripts were analyzed using methods from applied thematic analysis. RESULTS When evaluating MCPC's educational information and skills training descriptions, participants described ways in which this content resonated with their experience. Many coped with their pain and poor prognosis by relying on frameworks that provided them with a sense of meaning, often involving their personally held religious or spiritual beliefs. They also expressed a need for learning ways to cope with pain in addition to taking medication. A few participants offered helpful suggestions for refining MCPC's content, such as addressing common co-occurring symptoms of sleep disturbance and fatigue. Concerning MCPC's structure and delivery modality, most participants preferred that sessions include their family caregiver and described remote delivery (i.e., telephone or videoconference) as being more feasible than attending in-person sessions. SIGNIFICANCE OF RESULTS Participants were interested in an intervention that concurrently focuses on learning pain coping skills and enhancing a sense of meaning. Using remote delivery modalities may reduce access barriers (e.g., travel) that would otherwise prevent many patients from utilizing psychosocial services.
Collapse
|
33
|
Kang KA, Kim SJ, Kim DB, Park MH, Yoon SJ, Choi SE, Choi YS, Koh SJ. A meaning-centered spiritual care training program for hospice palliative care teams in South Korea: development and preliminary evaluation. BMC Palliat Care 2021; 20:30. [PMID: 33563253 PMCID: PMC7871309 DOI: 10.1186/s12904-021-00718-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Spirituality is a fundamental, intrinsic aspect of human beings and should be a core component of quality palliative care. There is an urgent need to train hospice palliative care teams (HPCTs) to enhance their ability to provide spiritual care. This study aimed to develop and evaluate a meaning-centered, spiritual care training program (McSCTP) for HPCTs (McSCTP-HPCTs). METHODS The modules' content was informed by Viktor Frankl's meaning-centered logotherapy with its emphasis on spiritual resources, as well as the spiritual care model of the Interprofessional Spiritual Care Education Curriculum (ISPEC). Following development, we conducted a pilot test with four nurses. We used the results to inform the final program, which we tested in an intervention involving 13 members of HPCTs. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test, we analyzed the participants' demographic and career-related characteristics, as well as the degree of variance between three outcome variables: compassion fatigue (CF), spiritual care competencies (SCCs), and spiritual care therapeutics (SCT). RESULTS We divided the McSCTP-HPCTs into five modules. Module I: The HPCTs' SCC evaluation, understanding the major concepts of spiritual care and logotherapy; Modules II-IV: Meaning-centered interventions (MCIs) related to spiritual needs (existential, relational, and transcendental/religious); Module V: The process of meaning-centered spiritual care. The preliminary evaluation revealed significant differences in all three outcome variables at the posttest point (CF, p = 0.037; SCCs, p = 0.005; SCT, p = 0.002). At the four-week follow-up test point, we only found statistical significance with the SCCs (p = 0.006). CONCLUSIONS The McSCTP-HPCTs is suitable for use in clinical settings and provides evidence for assessing the SCCs of HPCTs.
Collapse
Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Republic of Korea
| | - Shin-Jeong Kim
- School of Nursing, Hallym University, 39 Hallymdaehak-gil, Chuncheon, Gangwon-do 24252 Republic of Korea
| | - Do-Bong Kim
- Holistic Healing Institute of Sam Medical Center, Gunpo, Republic of Korea
| | - Myung-Hee Park
- Hospice & Palliative Center, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Soo-Jin Yoon
- Dongbaek St. Luke Hospice, Gyeonggi-do, Republic of Korea
| | - Sung-Eun Choi
- Hospice Care Center of the Regional Cancer Center, Chungnam University Hospital, Daejeon, Republic of Korea
| | - Young-Sim Choi
- Department of Nursing, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| |
Collapse
|
34
|
Fischer IC, Shanahan ML, Hirsh AT, Stewart JC, Rand KL. The relationship between meaning in life and post-traumatic stress symptoms in US military personnel: A meta-analysis. J Affect Disord 2020; 277:658-670. [PMID: 32911216 DOI: 10.1016/j.jad.2020.08.063] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/18/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Subjective meaning in life has been theorized to play a critical role in the adjustment to traumatic events. However, its association with post-traumatic stress symptoms has not been quantitatively reviewed. METHODS Informed by Park's integrated meaning-making model and evidenced-based psychological treatments for post-traumatic stress disorder, the goals of this meta-analysis were to: (1) to determine the direction and magnitude of the association between meaning in life and post-traumatic stress symptoms; and (2) to examine potential moderators of this association (i.e., age, sex, race, marital status, type of trauma, and meaning in life conceptualization). CINAHL, Embase, PILOT, PsycINFO, PubMed, and Web of Science core collection databases were searched. RESULTS A random-effects meta-analysis was conducted on 26 associations (N = 9,751). A significant, moderate, negative relationship was found between meaning in life and post-traumatic stress symptoms (r = -0.41; 95% CI: -0.47 to -0.35, k = 25). No significant moderators were detected. CONCLUSIONS Findings suggest that meaning in life plays a crucial role in adjustment to traumatic events. Development and testing of randomized controlled trials to determine whether increases in meaning in life result in reductions of post-traumatic stress in US military personnel may facilitate ongoing efforts aimed at recovery from trauma.
Collapse
Affiliation(s)
- Ian C Fischer
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA.
| | - Mackenzie L Shanahan
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| |
Collapse
|
35
|
Costanza A, Chytas V, Mazzola V, Piguet V, Desmeules J, Bondolfi G, Cedraschi C. The Role of Demoralization and Meaning in Life (DEMIL) in Influencing Suicidal Ideation Among Patients Affected by Chronic Pain: Protocol of a Single-Center, Observational, Case-Control Study. JMIR Res Protoc 2020; 9:e24882. [PMID: 33144275 PMCID: PMC7728536 DOI: 10.2196/24882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chronic pain is a significant risk factor for suicidal ideation (SI) and suicidal behavior (SB), including a 20%-40% prevalence rate of SI, a prevalence between 5% and 14% of suicide attempts, and a doubled risk of death by suicide in patients with chronic pain compared to controls. In most studies, associations between chronic pain and suicidality are robust, even after adjusting for the effect of sociodemographics and psychiatric comorbidity, and particularly for depressive conditions. A number of specific conditions that can modulate suicidality risk in patients with chronic pain have been investigated, but there is a need for their more specific characterization. Numerous recent studies have shown that demoralization and meaning in life (MiL) constructs affect suicidality as risk and protective factors, respectively. These constructs have been mainly investigated in patients with somatic illness and in community-dwelling individuals who may present with SI or SB independently of a psychiatric diagnosis of depression. However, a paucity of studies investigated them in suicidal patients affected by chronic pain. OBJECTIVE The primary objective of this project is to investigate the relationship between demoralization and MiL on SI risk in patients with chronic pain. The secondary objectives are (1) to test whether demoralization can occur independently of depression in patients with chronic pain and SI, (2) to examine whether the expected association between demoralization and SI may be explained by a sole dimension of demoralization: hopelessness, (3) to examine whether the presence of MiL, but not the search for MiL, is associated with less SI, and (4) to explore whether previously described MiL profiles (ie, high presence-high search, high presence-low search, moderate presence-moderate search, low presence-low search, and low presence-high search) emerge in our cohort. METHODS This project is a single-center, observational, case-control study-the Demoralization and Meaning in Life (DEMiL) study-conducted by the Division of Clinical Pharmacology and Toxicology, the Multidisciplinary Pain Centre, and the Service of Liaison Psychiatry and Crisis Intervention at the Geneva University Hospitals. Self- and hetero-administered questionnaires were conducted among patients and controls, matched by age and gender. The Ethics Committee of the Canton of Geneva approved the scientific utilization of collected data (project No. 2017-02138; decision dated January 25, 2018). Data have been analyzed with SPSS, version 23.0, software (IBM Corp). RESULTS From March 1, 2018, to November 30, 2019, 70 patients and 70 controls were enrolled. Statistical analyses are still in progress and are expected to be finalized in November 2020. To date, we did not observe any unfavorable event for which a causal relationship with the collection of health-related personal data could be ruled out. Results of this study are expected to form the basis for possible prevention and psychotherapeutic interventions oriented toward demoralization and MiL constructs for suicidal patients with chronic pain. CONCLUSIONS The interest in exploring demoralization and MiL in chronic pain patients with SI arises from the common clinical observation that experiencing chronic pain often requires a revision of one's life goals and expectations. Hence, the impact of chronic pain is not limited to patients' biopsychosocial functioning, but it affects the existential domain as well. The major clinical implications in suicidal patients with chronic pain consist in trying to (1) delineate a more precise and individualized suicide risk profile, (2) improve detection and prevention strategies by investigating SI also in individuals who do not present with a clinically diagnosed depression, and (3) enhance the panel of interventions by broadening supportive or psychotherapeutic actions, taking into consideration the existential condition of a person who suffers and strives to deal with his or her suffering. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24882.
Collapse
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Vasileios Chytas
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Valérie Piguet
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Jules Desmeules
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Cedraschi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
36
|
The Psychometric Properties of the Meaning in Life Questionnaire (MLQ) in Patients with Life-Threatening Illnesses. ScientificWorldJournal 2020; 2020:8361602. [PMID: 32963500 PMCID: PMC7486629 DOI: 10.1155/2020/8361602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/12/2019] [Accepted: 01/08/2020] [Indexed: 11/18/2022] Open
Abstract
Background Meaning in life is one of the psychological domains that is most severely affected in patients with life-threatening illnesses. The importance of meaning-making mandates the development of reliable tools to assess this construct. Steger's Meaning in Life Questionnaire (MLQ) is one of the most valid and reliable instruments that determines the search for and presence of meaning in life. The present study was conducted to provide psychometric data on the MLQ in a sample of patients with life-threatening illnesses. Methods The MLQ was completed by 301 patients (aged 20–80 years) diagnosed with life-threatening illnesses (cancer and multiple sclerosis) and referred to hospitals. Confirmatory factor analysis and Pearson's correlation test were used to determine the construct validity of the questionnaire. Results The confirmatory factor analysis supported the original two-factor model of the MLQ, comprised of the presence of meaning (five items) and search for meaning (five items). The responses to the MLQ did not differ by sociodemographic factors. Most importantly, contrary to previous findings, the correlation between the two subscales, i.e., search for meaning and presence of meaning, was significant and positive. Conclusion The results showed that the MLQ is a valid and reliable measure for assessing meaning in life that can be applied in research on meaning in life among other patient populations.
Collapse
|
37
|
Golovchanova N, Dezutter J, Vanhooren S. Meaning profiles and the perception of the working alliance at the start of outpatient person-centered, experiential, and existential psychotherapies. J Clin Psychol 2020; 77:770-781. [PMID: 32926757 DOI: 10.1002/jclp.23057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/27/2020] [Accepted: 09/05/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE(S) Quantitative research on meaning in life in the context of psychotherapy is relatively limited. The current study aims to investigate the profiles of the meaning of clients and their perception of the working alliance and initial symptomatology at the start of therapy. DESIGN In a sample of 145 clients (62.1% female; mean age, 34.77) who started person-centered psychotherapy, the relationship between meaning, search for meaning, symptomatology, and the working alliance was analyzed. The assessment took place after the second session. RESULTS Cluster analysis revealed four profiles: Low Presence High Search, High Presence Low Search, High Presence High Search, and Low Presence Low Search. These meaning profiles are distinguished in terms of symptomatology but not in terms of the working alliance perception. However, the experience of meaning is significantly associated with the working alliance. CONCLUSIONS Results show the relevance of meaning-related questions for certain groups of clients at the start of therapy.
Collapse
Affiliation(s)
| | - Jessie Dezutter
- Faculty of Psychology and Educational Sciences, Research Unit of School Psychology and Development in Context, KU Leuven, Leuven, Belgium
| | - Siebrecht Vanhooren
- Faculty of Psychology and Educational Sciences, Research Group Clinical Psychology, KU Leuven, Leuven, Belgium
| |
Collapse
|
38
|
Nguyen NP, Kim SY, Daheim J, Neduvelil A. Social Contribution and Psychological Well-Being among Midlife Adults with Chronic Pain: A Longitudinal Approach. J Aging Health 2020; 32:1591-1601. [PMID: 32762575 DOI: 10.1177/0898264320947293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Contributing to the welfare of others has been shown to have positive effects on people's social and psychological well-being (PWB). The current study examined whether social contribution (SC) could alleviate the negative effects of chronic pain on PWB through perceived social support (PSS) among midlife and older adults. Methods: The study consisted of 520 participants with chronic pain from the two waves of the Midlife in the United States dataset (MIDUS II and III). Results: Results from the longitudinal moderated mediation analysis indicated that SC at Time 2 (T2) significantly buffered the negative effect of pain interference (PI) at Time 1 (T1) on PSS at T2, which indirectly alleviated the negative effect of PI at T1 on PWB at T2. Discussion: The study suggested the protective role of SC and prosocial behaviors in mitigating the detrimental effects of chronic pain on social support and PWB.
Collapse
|
39
|
Conceptual Barriers to Palliative Care and Enlightenment From Chuang-tze’s Thoughts. Camb Q Healthc Ethics 2020; 29:386-394. [DOI: 10.1017/s0963180120000110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThis paper claims that palliative care (PC) is a suitable approach for offering comprehensive support to patients with life-threatening illness and unavoidable asthenia, to enhance their quality of life in aging and chronic illness. There are however some conceptual barriers to accessing that care on the Chinese Mainland: (1) Death-denying culture and society; (2) Misguidance and malpractice derived from the biomedical model; (3) Prejudice against PC and certain deviant understandings of filial piety culture. To counter these obstacles, the study introduces the philosophy of Chinese Taoist Chuang-tze to enlighten the public from ignorance and remove some illusions about death and dying; inspire people to face and accept illness and death calmly, and keep harmony and inner peace of mind to alleviate suffering, with the aim of providing wisdom and a shift of attitude toward life and death. Chuang-tze’s thoughts are consistent with the provision of palliative care, and to a certain degree, can promote its acceptability and delivery, and the conception of good death in practice.
Collapse
|
40
|
Exploring the Experience of Exercise in Older Adults With Chronic Back Pain. J Aging Phys Act 2020; 28:294-305. [PMID: 31722296 DOI: 10.1123/japa.2019-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/22/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022]
Abstract
Physical inactivity and chronic back pain are prevalent among older adults; however, there are individuals who persist in exercising despite daily pain. This research explored the meaning of exercise in the lives of older adults with chronic back pain. Hermeneutic phenomenology, valuing everyday experiences and highlighting meaning, was employed. Individual in-depth interviews with 10 adults aged 65 years and older gathered rich descriptions of their experiences. Data collection and analyses were iterative processes. The experience of exercise was inextricably connected with older adults' chronic back pain. The essence of embodied relief from pain offered by exercise was considered through themes reflecting the restoration of existential coherence-enjoying exercise experiences, social engagement, gratitude, learned latitudes, maintaining mobility, and aging. Understanding that older adults can live in their bodies pain-free for some time with regular physical activity may endorse adherence to exercise participation for maintained or improved well-being.
Collapse
|
41
|
Evaluation of meaning of life and self-care agency in nursing care given to chronic obstructive pulmonary patients according to health promotion model. Appl Nurs Res 2020; 51:151208. [DOI: 10.1016/j.apnr.2019.151208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/20/2019] [Indexed: 12/22/2022]
|
42
|
Abstract
Engaging in altruistic behaviors is costly, but it contributes to the health and well-being of the performer of such behaviors. The present research offers a take on how this paradox can be understood. Across 2 pilot studies and 3 experiments, we showed a pain-relieving effect of performing altruistic behaviors. Acting altruistically relieved not only acutely induced physical pain among healthy adults but also chronic pain among cancer patients. Using functional MRI, we found that after individuals performed altruistic actions brain activity in the dorsal anterior cingulate cortex and bilateral insula in response to a painful shock was significantly reduced. This reduced pain-induced activation in the right insula was mediated by the neural activity in the ventral medial prefrontal cortex (VMPFC), while the activation of the VMPFC was positively correlated with the performer's experienced meaningfulness from his or her altruistic behavior. Our findings suggest that incurring personal costs to help others may buffer the performers from unpleasant conditions.
Collapse
Affiliation(s)
- Yilu Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 100871 Beijing, China
| | - Jianqiao Ge
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China
| | - Hanqi Zhang
- School of Economics and Management, Key Laboratory for Behavioral Economic Science & Technology, South China Normal University, 510006 Guangzhou, China
| | - Haixia Wang
- Management School, Jinan University, 510632 Guangzhou, China
| | - Xiaofei Xie
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 100871 Beijing, China;
| |
Collapse
|
43
|
Costanza A, Baertschi M, Richard-Lepouriel H, Weber K, Pompili M, Canuto A. The Presence and the Search Constructs of Meaning in Life in Suicidal Patients Attending a Psychiatric Emergency Department. Front Psychiatry 2020; 11:327. [PMID: 32425828 PMCID: PMC7212391 DOI: 10.3389/fpsyt.2020.00327] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022] Open
Abstract
Meaning in Life (MiL) is considered protective against suicidal behavior (SB). However, few studies specifically addressed the role of the constructs, "presence of MiL" and "search for MiL," and their dynamic interplay. In this cross-sectional study of patients with SB (N = 199) visiting a psychiatric Emergency Department for either suicidal ideation (SI) or suicide attempt (SA), we pursued the following objectives: 1) to explore the relationship between the two constructs; 2) to verify the protective value of presence of MiL on SB; and 3) to assess the influence of search for MiL on the relationship between presence of MiL and SI. The two constructs were found to be independent of one another. Higher presence of MiL was globally associated with lower SB levels, particularly SI. Search for MiL was not related to SB and did not moderate the relationship between presence of MiL and SI. In conclusion, formal support for the role of presence of MiL against SB in a psychiatric sample was demonstrated. These findings, with a view toward refinement of SB risk assessment and new psychotherapeutic approaches, may lead to an enrichment of the dialogue with suicidal patients to help alleviate their unbearable suffering. Our conclusions must be replicated in psychiatric clinical populations in settings other than a psychiatric ED and by using a longitudinal prospective and case-control study design.
Collapse
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Marc Baertschi
- Service of General Psychiatry and Psychotherapy, Nant Foundation, Montreux, Switzerland
| | - Hélène Richard-Lepouriel
- Service of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandra Canuto
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| |
Collapse
|
44
|
Lifestyle Medicine – New Concept, Innovative Discipline. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
A large percentage 63% of premature deaths and chronic diseases could be prevented by adhering to healthy dietary patterns, being physically active and avoid smoking. The concept of lifestyle medicine introduced 20 years ago by Rippe is defined as the integration of modern lifestyle practices into evidence-based medicine, in order to lower risk factors or to be support for chronic therapies. A new taxonomy is proposed in lifestyle medicine, with determinants, as drivers for chronic diseases, anthropogens and metaflammation, the metabolic inflammatory state. Other possible determinants are proposed for lack os scope in life, estrangement and lost identity. Despite all health messages, healthy behaviors are exceptions, not the rule. It will be important in the future to change how practitioners will support individuals in their efforts to live healthier. More psychological and social factors should be analyzed. Many doctors are not self-confident with prescribing healthy lifestyle or nutritional recommendations. Creating a new discipline should foster development of preventive recommendations. General practitioners will need specific academic trainings to learn how to promote recommendations for lifestyle changes for health, for prevention and for diseases management, starting by adopting themselves healthy lifestyles.
Collapse
|
45
|
Maguire R, Hanly P, Maguire P. Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. J Health Psychol 2019; 26:1494-1507. [PMID: 31647344 DOI: 10.1177/1359105319883923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Positive social and psychological appraisals may help maintain well-being in illness, but few studies have systematically investigated this in a European context. After controlling for sociodemographic, health and objective social factors, we employed multilevel regression modelling to establish if appraisals predict well-being in three illness groups (n = 10,577). In addition to health and financial status, positive appraisals were consistent predictors of well-being. Social appraisals had stronger associations with well-being than extent of social contact. Optimism and resilience appeared more important in those limited by health than those who were not. Findings may inform interventions aimed at supporting people coping with illness.
Collapse
Affiliation(s)
| | - Paul Hanly
- School of Business, National College of Ireland, Ireland
| | - Phil Maguire
- Department of Computer Science, Maynooth University, Ireland
| |
Collapse
|
46
|
Polenick CA, Kales HC, Birditt KS. Perceptions of Purpose in Life Within Spousal Care Dyads: Associations With Emotional and Physical Caregiving Difficulties. Ann Behav Med 2019. [PMID: 29538622 DOI: 10.1093/abm/kax005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Greater feelings of purpose in life are associated with better health and may reduce the negative impact of chronic stress. Yet little is known about how purpose in life may buffer the negative effects of caregiving, a common chronic stressor in middle and later life. Methods This cross-sectional study utilized a U.S. sample of 315 spousal caregivers and their partners with functional disability drawn from the 2011 National Health and Aging Trends Study and National Study of Caregiving to examine how both parties' perceptions of purpose in life are associated with caregivers' emotional and physical caregiving difficulties. We also evaluated whether care recipients' purpose in life moderates the association between caregivers' purpose in life and care-related difficulties. Finally, we considered whether these links differed by caregiver gender. Models controlled for caregivers' sociodemographics, care tasks, support resources, valued activity participation, and each care partner's health conditions. Results Caregivers' greater purpose in life was significantly linked to fewer physical caregiving difficulties. Caregivers' greater purpose in life was significantly associated with fewer emotional care-related difficulties among caregiving wives and when care recipients' purpose in life was low. Conclusions Although the associations between purpose in life and care-related difficulties are likely bidirectional, purpose in life may represent an important resource for combating the adverse consequences of caregiving. This study highlights the value of considering personal resources and their implications for caregivers' well-being within a dyadic context.
Collapse
Affiliation(s)
- Courtney A Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Program for Positive Aging, University of Michigan, Ann Arbor, MI
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI.,Program for Positive Aging, University of Michigan, Ann Arbor, MI.,Department of Veterans Affairs, HSR&D Center for Clinical Management Research (CCMR), Ann Arbor, MI.,Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Kira S Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| |
Collapse
|
47
|
Almeida VM, Carvalho C, Pereira MG. The contribution of purpose in life to psychological morbidity and quality of life in chronic pain patients. PSYCHOL HEALTH MED 2019; 25:160-170. [PMID: 31522538 DOI: 10.1080/13548506.2019.1665189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Chronic pain is a cause of morbidity, interference with daily functioning, decreased health and quality of life. Purpose in life acts as a protective factor and mitigates these consequences. This cross-sectional study aimed to determine whether purpose in life contributed to psychological morbidity and quality of life in patients with chronic pain by controlling psychological variables related to health (pain severity and interference, pain perceptions, pain catastrophizing and coping). The sample included 103 patients diagnosed with chronic pain. Results showed that purpose in life independently contributed to psychological morbidity and to mental quality of life, but not to physical quality of life, after controlling for pain-related variables. Results showed the relevance of purpose in life to identify patients at risk of developing psychological morbidity and decreased quality of life, suggestting the need to intervene in chronic pain, specifically on purpose in life, to prevent psychological morbidity and promote quality of life, in this population.
Collapse
Affiliation(s)
| | - Cátia Carvalho
- School of Psychology, University of Minho, Braga, Portugal
| | | |
Collapse
|
48
|
Intra- and interindividual differences in the within-person coupling between daily pain and affect of older adults. J Behav Med 2019; 43:707-722. [PMID: 31489518 DOI: 10.1007/s10865-019-00099-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 08/30/2019] [Indexed: 01/23/2023]
Abstract
The bidirectional interplay between chronic pain and negative affect is well-established in patient samples. However, less is known about the day-to-day relationship between pain and affect of older adults without severe illnesses and to what extent this association differs within and between individuals. A total of 224 participants (Mage = 77.6, SDage = 6.2) reported their daily experience of pain, impairment by their pain and affect during 21 consecutive days. Multilevel modeling results showed that on days with increased pain individuals also reported less positive affect and more negative affect. Time-lagged results indicated a temporal carry-over from yesterday's pain to today's negative affect but not to today's positive affect. Moreover, on days when individuals reported stronger impairment by their pain, they showed a stronger within-person coupling between daily pain and affect in contrast to days with a weaker experience of daily impairment. Yesterday's pain and today's negative affect were more strongly associated within individuals who reported higher levels of impairment. Interindividual differences in the within-person coupling between daily pain and affect were found with regard to general physical health conditions and general satisfaction with health. This study demonstrated the importance of focusing on within-person couplings between daily pain and affect beyond patient samples in order to better understand the maintenance of emotional stability despite daily hassles in older adults' everyday lives.
Collapse
|
49
|
The Meaning in Life in Suicidal Patients: The Presence and the Search for Constructs. A Systematic Review. ACTA ACUST UNITED AC 2019; 55:medicina55080465. [PMID: 31405240 PMCID: PMC6723920 DOI: 10.3390/medicina55080465] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/03/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Abstract
Background and Objectives: Research on suicidal behavior (SB) has frequently focused more on risk factors than protective factors. Since the historic works of Viktor E. Frankl, who inquired how some Nazi concentration camps prisoners maintained their will to live though confronted with pervasive absurdity, Meaning in Life (MiL) has been interpreted as a potent resiliency factor. MiL then declined along a multitude of theoretical perspectives and was associated with various functioning domains of the individual. Surprising, few studies investigated the role of MiL on SB. We aimed to review and synthetize current literature on possible associations between MiL and SB, which included suicidal ideation (SI), suicidal attempts (SA), and completed suicide, focusing on two MiL constructs (the presence of MiL and search for MiL) from the Michael F. Steger’s recent conceptualization. Material andMethods: A systematic strategy following PRISMA guidelines was used to search for relevant articles in Pubmed/MEDLINE, Scopus, PsycINFO, and ScienceDirect (January 1980–February 2019) and yielded 172 articles, 37 of which met our inclusion criteria. Results: MiL emerged as a protective factor against SI, SA, and completed suicides, directly or through mediation/moderation models with other SB-related variables. When distinguishing the presence of MiL and the search for MiL, a consensual protective impact was described for the former. Data for the latter were less consistent but rather oriented towards a non-protective impact Conclusions: These findings could have clinical repercussions for SB prevention, in both suicide risk assessment refinement and psychotherapeutic interventions. Further research is needed to examine the dynamic interplay of the two constructs.
Collapse
|
50
|
Kim SY, Shigemoto Y, Neduvelil A. Survive or Thrive? Longitudinal Relation Between Chronic Pain and Well-Being. Int J Behav Med 2019; 26:486-498. [DOI: 10.1007/s12529-019-09805-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|