Buddhism-as-a-meaning-system for coping with late-life stress: a conceptual framework

The Effect of Work Stress on the Well-Being of Primary and Secondary School Teachers in China

Primary and secondary school teachers face increasing work stress, and more attention needs to be paid to their well-being. The present study was conducted to analyze the influence of work stress on the well-being of such teachers in China, and to explore the effects of family-work conflict and a self-transcendent meaning of life. A total of 562 primary and secondary school teachers completed questionnaires assessing work stress, family-work conflict, and a self-transcendent meaning of life (including grasping the meaning of failure and detachment from success or failure) as potential predictors of well-being. Work stress negatively predicted teachers' well-being; family-work conflict mediated this relationship and a self-transcendent meaning of life moderated it. The results of this study can be used as a reference for education departments seeking to intervene to prevent teachers from developing well-being problems from the perspective of a self-transcendent meaning of life.

Death anxiety as mediator of relationship between renunciation of desire and mental health as predicted by Nonself Theory

In the present paper, we report two studies examining the relationships among renunciation of desires, death anxiety, and mental health. In the first study, we constructed the Desire Questionnaire (DQ), which measures success in renouncing certain desire. The DQ has satisfactory psychometric properties. In the second study, 501 adults from a Chinese society ranging in age from 17 to 84 years (M = 35.58, SD = 14.76) completed the DQ, the Death Anxiety Scale (DAS), and the Chinese Health Questionnaire (CHQ), which measures mental health and the presence of psychiatric symptoms. As predicted, DQ had significant negative correlations with both DAS (p < 0.05) and CHQ (p < 0.01). DAS had a significant positive correlation with CHQ (p < 0.01). In the linear mediation model, DAS was found to partially mediate the relationship between DQ and CHQ (β = - 0.18, p < 0.001). These results suggest that the negative effect of poor control of desires on mental health can be partially accounted for by death anxiety. These findings imply that training in eliminating desires can be a successful strategy to improve mental health. These results also support the Nonself Theory as a theory of death anxiety and show its relevance to the relationship between nonself and mental health.

Confronting and Coping with Multidrug-Resistant Tuberculosis: Life Experiences in Thailand

In this article, we aimed to understand the life experiences of Thai persons diagnosed with multi-drug-resistant tuberculosis (MDR-TB). A qualitative study using a face-to-face in-depth interview was conducted at a hospital in Thailand which has the highest prevalence of MDR-TB in the country between January and February 2019. Twenty persons living with MDR-TB in Thailand were purposively selected to represent a variety of experiences based on different gender, ages, and treatment phases. Qualitative data were transcribed and thematic analysis was applied to identify common themes and sub-themes. The results indicated that all participants faced emotional difficulties, such as fear of death, fear of stigmatization, confusion, and sadness when first knowing of their diagnosis. Family and social support were the main ways that the patients coped with difficult situations. Suicidal ideas were more prevalent among patients with poor family support. Screening for mental health problems should be routinely performed in MDR-TB patients. Proper health education should be provided to patients and families to reduce emotional difficulties and stigmatization.

Meaning Making in a Retirement Migrant Community: Religion, Spirituality, and Social Practices of Daily Lives

Meaning in life has also been seen as crucial to well-being, and especially, in later life. This study focused on the social complexity of meaning making processes and the role of religion and spirituality in them, by finding out the following: (1) How are meaning-making practices connected with religion and spirituality for Finnish retirement migrants of the boomer generation? (2) What does the role of religion and spirituality in meaning-making practices teach us about the relationship between individual and social aspects of meaning making? This was done by examining a particular group of older persons: Finnish retirement migrants aged 60 or over in Costa del Sol, Spain. The material for this study consists of 58 texts (written correspondence, dataset 1, year 2009), 10 semi-structured interviews (dataset 2, year 2011), and 30 completed online surveys with open-ended questions (dataset 3, year 2019). Key findings include that religion and spirituality are present in the lives of our informants in a variety of ways, playing a significant role in their meaning making, and that they appear as intertwined and not so easy to separate. A variety of religious and non-religious forms of spirituality exist in this population, and all of these forms can be relevant factors in meaning making. Also, the engagement in meaning making, contrary to what has been suggested in some of the literature about meaning in later life, not only occurs in response to confrontations with health issues, death, or other major life events. Instead, we found that meaning making occurs as a process that is often inherent to daily activities which may seem "trivial," but in fact turn out to be important sources of purpose, values, and connectedness. Contrary to the dominant modern ideal of the authentic, self-sufficient human agent, which is based on a problematically atomistic and individualistic anthropology, for our respondents, their authentic subject position is embedded in the social practices of their daily lives, which nourish their individual spirituality and are vital to making meaning.

Culturally sensitive conceptualization of resilience: A multidimensional model of Chinese resilience

Cultural sensitivity is missing in the widely researched construct of resilience. The assumption that resilience takes the same form in all cultures fails to acknowledge that culture shapes the interpretation and instantiation of resilience. Examining how suffering and adversity are perceived and dealt with in Chinese contexts, can identify cultural concepts related to resilience. In this paper, we examine the ways in which Confucianism, Buddhism, and Taoism, the three main belief systems that have influenced Chinese people's perception of the nature of life, can serve as sources of strength to individuals facing adversity. We summarise three culturally inflected elements of dealing with adversities and compare them with existing, widely researched notions of resilience. Taking a socio-ecological perspective to explore resilience, this paper proposes a multidimensional model that can improve understanding of culturally embedded resilience.

The illness experience for people with amyotrophic lateral sclerosis: A qualitative study

Aims and objectives

This study aims to gain a comprehensive understanding of the illness experience of amyotrophic lateral sclerosis (ALS) patients in China and the meaning they attach to those experiences.

Background

ALS is a progressive and fatal neurodegenerative disorder that significantly impacts individuals and families. There is a large number of patients with ALS in China. However, little is known about how they live with ALS.

Design

Phenomenological qualitative research was performed among twenty people with ALS from the neurology department of a tertiary hospital in China. Colaizzi's method was used to analyse the participants’ data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used as a guideline to secure accurate and complete reporting of the study.

Results

We proposed three themes and eight subthemes on the illness experience of participants: (1) life countdown: ‘my body was frozen’ (body out of control and inward suffering); (2) family self‐help: ‘we kept an eye on each other’ (family warmth and hardship, and supporting the supporter); and (3) reconstruction of life: ‘what was the meaning of my life’ (learning to accept, rebuilding self‐worth, resetting the priority list and living in the moment).

Conclusions

In the family self‐help model, patients are prompted to turn from negative mentalities to search for meaning in life actively. Healthcare providers need to attach importance to the family self‐help model to alleviate the pressure on medical resources.

Relevance to clinical practice

Healthcare providers should encourage patients to play a supportive role in the family and provide more care support and professional care knowledge guidance to caregivers, to promote the formation of the family self‐help model which might help to improve the experience of patients and families.

The lived experience of Buddhist-oriented religious coping in late life: Buddhism as a cognitive schema

This article explores how older Buddhists in Singapore use Buddhist beliefs and practices to cope with stress. Semi-structured interviews with six older Buddhists were conducted. Interview transcripts were analyzed using interpretative phenomenological analysis. Data analysis identified three ways of Buddhist-oriented religious coping: meaning-making coping, meditative coping, and ego-transcendence coping. In meaning-making coping, participants employed the notions of karma and duḥkha to make sense of stress. Participants’ meditative coping methods included visualization and mantra meditation. During ego-transcendence coping, participants drew on the notion of non-attachment to the ego. The three ways of Buddhist-oriented religious coping can be examined in a Buddhism-as-cognitive-schema perspective.

Factors associated with emergency room visits and hospitalisation amongst low-income public rental flat dwellers in Singapore

BACKGROUND

In Singapore, a densely urbanised Asian society, more than 80% of the population stays in public housing estates and the majority (90%) own their own homes. For the needy who cannot afford home ownership, public rental flats are available. Staying in a public rental flat is associated with higher hospital readmission rates and poorer access to health services. We sought to examine sociodemographic factors associated with hospital admissions and emergency room visits amongst public rental flat residents.

METHODS

We surveyed all residents aged ≥60 years in a public rental housing precinct in central Singapore in 2016. Residents self-reported their number of emergency room visits, as well as hospitalisations, in the past 6 months. We obtained information on residents' sociodemographic characteristics, medical, functional and social status via standardised questionnaires. We used chi-square to identify associations between emergency room visits/hospitalisations and sociodemographic characteristics, on univariate analysis; and logistic regression for multivariate analysis.

RESULTS

Of 1324 contactable residents, 928 participated in the survey, with a response rate of 70.1%. A total of 928 residents participated in our study, of which 59.5% were male (553/928) and 51.2% (476/928) were ≥ 70 years old. Around 9% (83/928) of residents had visited the emergency room in the last 6 months; while 10.5% (100/928) had been admitted to hospital in the past 6 months. On multivariable analysis, being religious (aOR = 0.43, 95%CI = 0.24-0.76) and having seen a primary care practitioner in the last 6 months (aOR = 0.46, 95%CI = 0.27-0.80) were independently associated with lower odds of emergency room visits, whereas loneliness (aOR = 1.96, 95%CI = 1.13-3.43), poorer coping (aOR = 1.72, 95%CI = 1.01-3.03) and better adherence (aOR = 2.23, 95%CI = 1.29-3.83) were independently associated with higher odds of emergency room visits. For hospitalisations, similarly poorer coping (aOR = 1.85, 95%CI = 1.12-3.07), better adherence (aOR = 1.69, 95%CI = 1.04-2.75) and poorer functional status (aOR = 1.85, 95%CI = 1.15-2.98) were all independently associated with higher odds of hospitalisations, whereas those who were religious (aOR = 0.62, 95%CI = 0.37-0.99) and those who were currently employed (aOR = 0.46, 95%CI = 0.37-0.99) had lower odds of being hospitalised.

CONCLUSION

In this public rental flat population, functional status, coping and adherence, and having a religion were independently associated with emergency room visits and hospitalisation. Residents who had seen a primary care practitioner in the last 6 months had lower odds of visiting the emergency room.