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Li H, Xiong Y, Ye Z. Newman's theory of health as expanding consciousness: an evolutionary concept analysis. BMC Nurs 2024; 23:616. [PMID: 39227907 PMCID: PMC11373334 DOI: 10.1186/s12912-024-02262-8] [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: 05/01/2024] [Accepted: 08/14/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND The health as expanding consciousness (HEC) theory posits that health and disease are interconnected components of a comprehensive process aimed at expanding consciousness. AIM The objective of this study is to introduce the concept, research status and applications of HEC and offer a comprehensive understanding of its various key components. DATA SOURCES Databases including EMBASE, PubMed, ScienceDirect, ProQuest, Wiley, Web of Science, Sinomed, China National Knowledge Infrastructure, Wanfang, and CQVIP, covering the period from 1986 to 2023. METHOD Employing Rodgers' evolutionary concept analysis approach, this study included and analysed 70 studies. RESULTS The characteristics of HEC comprise aspects such as movement, time, space, energy, rhythm, and paradigm of health. The antecedents of HEC encompass disease, chaos, binding, centring, and choice point. Consequences associated with HEC include self-transcendence, unbinding, decentring, expanded consciousness, real freedom, pattern recognition, absolute consciousness, and death. CONCLUSION This study has identified substitute terms, related concepts, attributes, antecedents, consequences, and empirical references associated with HEC. The findings provide valuable information applicable across various domains of nursing, encompassing practice, education, research, and management.
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Affiliation(s)
- Hongman Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Ying Xiong
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 511436, China.
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2
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Iacovantuono M, Ferrigno S, Conigliaro P, Triggianese P, D'Antonio A, Spinelli FR, Bergamini A, Chimenti MS. Evaluation of diagnostic and therapeutic delay in patients with rheumatoid arthritis and psoriatic arthritis. Reumatismo 2024; 76. [PMID: 38523584 DOI: 10.4081/reumatismo.2024.1607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/04/2023] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE A monocentric cross-sectional study recruiting rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients residing in the Lazio region, Italy, to assess factors related to diagnostic delay and treatment accessibility. METHODS Clinical/serological data, including the time between symptom onset, diagnosis, and the beginning of treatment, were collected. Residence, referral to a rheumatologic center, physician who made the diagnosis, and previous misdiagnosis were also evaluated. RESULTS A higher diagnostic delay (p=0.003), and time between symptom onset and the start of I-line therapy (p=0.006) were observed in PsA compared to RA. A delayed start of II-line therapy was observed in RA compared to PsA (p=0.0007). Higher diagnostic delay (p=0.02), and time between symptom onset and the start of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (p=0.02) were observed among residents of small-medium cities for both groups. Patients who have been diagnosed by another physician rather than a rheumatologist had a longer diagnostic delay (p=0.034) and a delayed start of I-line therapy (p=0.019). Patients who received a different previous diagnosis experienced greater diagnostic delay (p=0.03 and p=0.003) and time of start of csDMARDs (p=0.05 and p=0.01) compared with those receiving RA or PsA as the first diagnosis. PsA had a delay in starting targeted synthetic disease-modifying anti-rheumatic drugs (p=0.0004) compared to RA. Seronegative RA had delayed diagnosis (p=0.02) and beginning of therapies (p=0.03; p=0.04) compared to seropositive ones. CONCLUSIONS According to our results, greater diagnostic delay was found in PsA compared to RA, in patients living in small-medium cities, in those who did not receive the diagnosis from a rheumatologist, in those who were previously misdiagnosed, and in seronegative RA.
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Affiliation(s)
- M Iacovantuono
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - S Ferrigno
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - P Conigliaro
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - P Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - A D'Antonio
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - F R Spinelli
- Rheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome.
| | - A Bergamini
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
| | - M S Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, Tor Vergata University, Rome.
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Shipley PZ, Falkenstern SK. Life Patterns of Family Caregivers of Patients With Amyotrophic Lateral Sclerosis. Nurs Sci Q 2023; 36:356-368. [PMID: 37800716 DOI: 10.1177/08943184231187903] [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] [Indexed: 10/07/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a terminal disease that greatly affects patients and the family caregivers who provide most of their care. Despite the psychological, physical, and financial strain placed on ALS caregivers, few research efforts have been directed to this caregiving phenomenon. The purpose of this research study, utilizing Newman's health as expanding consciousness as the theoretical framework and research method, was to advance understanding of the experience of ALS family caregivers for the advancement of nursing science. Nine patterns of the whole across all family caregivers emerged from the data, showing important implications for nursing research and practice.
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Affiliation(s)
- Peggy Z Shipley
- Retired Assistant Professor of Nursing, Bloomsburg University, Bloomsburg, PA, USA
| | - Sharon K Falkenstern
- Retired Nursing Chair/Nursing Administrator, Department of Nursing, Clarion University, Oil City, PA, USA
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4
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Barton C, Hart R. The Experience of Self-Transcendence in Social Activists. Behav Sci (Basel) 2023; 13:66. [PMID: 36661638 PMCID: PMC9854886 DOI: 10.3390/bs13010066] [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: 12/05/2022] [Revised: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 01/14/2023] Open
Abstract
Every day the wellbeing of disadvantaged individuals and communities is being transformed through the activities of self-transcendent social activists. The positive contagion generated by their actions is felt globally through influence, replication, leadership training and education. These people are visionary, brave, and describe their lives as joyful, deeply fulfilled, and impactful. Seeking no personal recognition or accolade, born from a deep feeling of connectedness and a vision of how life could be better, participants describe the factors that influenced their decision to dedicate their lives to serving the greater good. Using Constructivist Grounded Theory, in-depth semi structured interviews were carried out with eight participants who self-identified as self-transcendent social activists, who have initiated non-mandated and not-for-profit community action. Data was analyzed to explore each participant's personal experiences of self-transcendence and how being self-transcendent has manifested their life choices. The findings present a definition of 'self-transcendent social activism' and a theoretical model that explains the development of participants' activism: trigger, activate, maintain and sustain, resulting in an impact experienced at three levels - individual, community and global. Theoretical and practical implications are discussed.
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Affiliation(s)
- Carol Barton
- Previously School of Psychology, University of East London, Water Lane, London E15 4LZ, UK
| | - Rona Hart
- School of Psychology, University of Sussex, Falmer, Brighton BN1 9RH, UK
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5
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Er S, Buzlu S. The relationships between self-transcendence and depressive symptoms, self-esteem, and locus of control in individuals diagnosed with substance addiction. Perspect Psychiatr Care 2022; 58:2137-2144. [PMID: 35124819 DOI: 10.1111/ppc.13040] [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: 10/18/2021] [Accepted: 01/23/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS This study examined the relationships between self-transcendence and depressive symptoms, self-esteem, and locus of control in persons with substance abuse disorder (SUDs). METHODS This descriptive-relational study examined 115 participants who had been diagnosed with SUD. RESULTS High self-transcendence scores were positively associated with lower levels of depressive symptoms, higher levels of self-esteem, and internal locus of control. PRACTICE IMPLICATIONS Mental health nurses are effective at finding and maintaining resources that promote self-transcendence and support the potential and well-being of individuals with SUD. This study addresses a research gap regarding self-transcendence in such individuals; it provides a basis for nurses to develop interventions to strengthen the mental health of patients and conduct future investigations on the topic.
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Affiliation(s)
- Seda Er
- Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Sevim Buzlu
- Department of Mental Health and Psychiatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Eppel-Meichlinger J, Kobleder A, Mayer H. Developing a theoretical definition of self-organization: A principle-based concept analysis in the context of uncertainty in chronic illness. Nurs Forum 2022; 57:954-962. [PMID: 35717596 PMCID: PMC9544185 DOI: 10.1111/nuf.12767] [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: 02/22/2022] [Revised: 05/16/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
Abstract
AIM To develop a theoretical definition of self-organization to increase the understanding of the Reconceptualized Uncertainty in Illness Theory (RUIT). BACKGROUND Mishel described the change of the uncertainty appraisal over time in people with a chronic illness by means of the RUIT. Therefore, she introduced the concept of self-organization. However, its meaning is difficult to comprehend because its descriptions remained highly abstract. DESIGN A principle-based concept analysis. DATA SOURCE Entries of lexicons and journal publications, explicitly or implicitly addressing self-organization in the context of any social phenomenon. REVIEW METHODS We conducted a conceptually driven literature search in lexicons and four databases and performed citation tracking. RESULTS Self-organization stands for a transition between psychological instability and psychological adjustment. It is conditioned by illness-related obstacles or uncertainties that are perceived as life-threatening. This adaptation process shows overlaps with cognitive reframing and is promoted by time, resilience, social support, and positive development of the disease. It leads to empowerment and a new perspective of life and uncertainty. CONCLUSIONS We enhanced the understanding of the RUIT by developing a theoretical definition of self-organization on a lower level of abstraction and by proposing a new approximation for the operationalization by means of cognitive reframing.
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Affiliation(s)
- Jasmin Eppel-Meichlinger
- Department of General Health Studies, Division Nursing Science with focus on Person-Centred Care Research, Karl Landsteiner University of Health Sciences, Krems, Austria.,Vienna Doctoral School of Social Sciences, University of Vienna, Vienna, Austria
| | - Andrea Kobleder
- Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Hanna Mayer
- Department of General Health Studies, Division Nursing Science with focus on Person-Centred Care Research, Karl Landsteiner University of Health Sciences, Krems, Austria
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Zagorac I, Stamenković Tadić B. Health within illness: The negativity of vulnerability revised. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2022; 25:207-217. [PMID: 35133570 DOI: 10.1007/s11019-022-10072-5] [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: 01/27/2022] [Indexed: 06/14/2023]
Abstract
This paper attempts to philosophically articulate empirical evidence on the positive effects of illness within the wider context of a discussion of the positive aspects of vulnerability. The conventional understanding holds that to be vulnerable is to be open to harms and wrongs; it is to be fragile, defenseless, and of compromised autonomy. In this paper, we challenge the assumption that vulnerability consists of nothing but powerlessness and dependence on others. This paper attempts to: (1) outline the theoretical conceptualisation of the positive aspects of coping with illness, while simultaneously showing how these findings provide empirical support for some classical philosophical ideas; (2) influence a change in the manners in which the ill are usually perceived (as weak, dependent, robbed of a good life) and (3) point to the importance of modernising the prevalent biomedical conception of illness with the subjective dimension of health. Biomedical understanding of illness focuses on the vulnerable experience of the sufferer, suggesting the importance of philosophical additions.
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Affiliation(s)
- Ivana Zagorac
- Department of Philosophy, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000, Zagreb, Croatia.
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Haugan G, Deliktaş Demirci A, Kabukcuoglu K, Aune I. Self-transcendence among adults 65 years and older: A meta-analysis. Scand J Caring Sci 2021; 36:3-15. [PMID: 33522632 DOI: 10.1111/scs.12959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/10/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Self-transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health-promoting resource among adults ≥65 years. Therefore, the objectives of this meta-analysis were to determine the mean score of self-transcendence based on place of residence and gender, and to evaluate the correlations of self-transcendence with meaning, sense of coherence, resilience and depression. METHODS Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self-transcendence and the correlation coefficients of the selected variables were estimated by random effects models. RESULTS The self-transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self-transcendence_depression (r = -0.40), self-transcendence_meaning-in-life (r = 0.53), self-transcendence_resilience (r = 0.50) and self-transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning-in-life, were homogeneous. CONCLUSION In a health-promoting perspective, the concept of self-transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self-transcendence can inspire health professionals in realising new health-promoting approaches to support older individuals in maintaining health, wellbeing and independency.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, NTNU Norwegian University of Technology and Science, Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | | | | | - Ingvild Aune
- NTNU Department of Clinical and Molecular Medicine, Trondheim, Norway
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9
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Haugan G, Kuven BM, Eide WM, Taasen SE, Rinnan E, Xi Wu V, Drageset J, André B. Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents? BMC Geriatr 2020; 20:168. [PMID: 32381032 PMCID: PMC7203905 DOI: 10.1186/s12877-020-01555-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL. Conclusion NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,NORD University, Faculty of Nursing and Health Science, Levanger, Norway.
| | - Britt Moene Kuven
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Eva Rinnan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Trondheim Municiaplity, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, The National University of Singapore, Singapore, Singapore
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Beate André
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Larkin PJ, De Casterlé BD, Schotsmans P. Transition towards End of Life in Palliative Care: An Exploration of its Meaning for Advanced Cancer Patients in Europe. J Palliat Care 2019. [DOI: 10.1177/082585970702300202] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Transition as a concept in healthcare has been explored, but there is limited empirical work which considers transition in the context of palliative care, specifically from the patient perspective. This article reports findings from a qualitative study designed to explore transition experiences of 100 advanced cancer patients in six European countries. Data were analyzed using the ATLAS.ti program. Findings suggest that transition is a confusing time of mixed messages, poor communication, and uncertainty, but the physical environment of the hospice offers a place of ontological security from which to address this. Transition concepts fail to capture the palliative care experience fully. Transience, as an alternative concept, is reported, although further research is needed to explore this. In clinical practice, the value given to hospice by patients suggests that clinicians must carefully balance the benefit of mainstream integration with sensitive assimilation of hospice philosophy.
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Malek Khahi A, Mohseny M, Soleimany F, Vejdani M, Keshvardoost A, Amiri P. Relationship between self-transcendence and physically-healthy patients under hemodialysis in participating in peer-support group; a randomized clinical trial. J Renal Inj Prev 2017. [DOI: 10.15171/jrip.2017.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Bala SV, Samuelson K, Hagell P, Fridlund B, Forslind K, Svensson B, Thomé B. Living with persistent rheumatoid arthritis: a BARFOT study. J Clin Nurs 2017; 26:2646-2656. [DOI: 10.1111/jocn.13691] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Sidona-Valentina Bala
- Department of Health Sciences; Lund University; Lund Sweden
- Section of Rheumatology; Department of Medicine; Helsingborg Hospital; Helsingborg Sweden
| | | | - Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Bengt Fridlund
- Department of Health Sciences; Lund University; Lund Sweden
- School of Health and Welfare; Jönköping University; Jönköping Sweden
| | - Kristina Forslind
- Section of Rheumatology; Department of Medicine; Helsingborg Hospital; Helsingborg Sweden
- Section of Rheumatology at the Institution of Clinical Science; Lund University; Helsingborg Sweden
| | - Björn Svensson
- Section of Rheumatology at the Institution of Clinical Science; Lund University; Lund Sweden
| | - Bibbi Thomé
- Department of Health Sciences; Lund University; Lund Sweden
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Abstract
The purpose of this research report is to describe women’s experiences living with rheumatoid arthritis (RA). Twenty women diagnosed with RA participated in semistructured interviews that were analyzed using qualitative content analysis. Findings indicated that how women with RA experience life in their physical bodies is fundamentally important. Corporeality, the name we chose for this phenomenon, is quite literally being one’s body. This experience of the reality of being in or being of a body or corpus was central, not only to participants’ perceptions of well-being but also to the impact rheumatoid arthritis was having on their lives and the actions they took to contend with the illness. The authors identified three themes that described what corporeality was for women with RA: relating to a noncompliant body, body out of synch, and private body made public. These results are discussed in light of other research about embodied experience in persons living with chronic illness.
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Plach SK, Napholz L, Kelber ST. Social, Health, and Age Differences Associated with Depressive Disorders in Women with Rheumatoid Arthritis. Int J Aging Hum Dev 2016; 61:179-94. [PMID: 16248289 DOI: 10.2190/2tr5-81fg-h7a6-l9dp] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Depression in women with rheumatoid arthritis (RA) may be related to social role experiences, physical health, and age. The purpose of this study was to examine the social and health factors contributing to depression in two age groups of women with RA. One-hundred and thirty-eight midlife and late-life women with a diagnosis of RA participated in this cross sectional survey study. Multiple regression analysis indicated that social role balance, functional status, number of co-existing health problems, and age were significant predictors of depression in midlife and late-life women with RA. Role balance was the strongest factor contributing to a woman's depression score. Compared to midlife women, late-life women reported significantly higher role balance and lower depression scores, despite poorer functional status and more concomitant health problems.
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Affiliation(s)
- Sandra K Plach
- College of Nursing, University of Wisconsin-Milwaukee, WI 53201, USA.
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Abstract
Over the past 20 years, many Newman scholars across the globe have investigated health as expanding consciousness with persons living with chronic illness. This integrative review examines the use of the concept, relationship, and its seven dimensions-health, caring, consciousness, mutual process, patterning, presence, and meaning with persons with chronic illness when engaged in health as expanding consciousness praxis. A regular and sustained pattern of publication of studies that included the seven dimensions was found. Relationships among the dimensions of a Newman praxis relationship, chronic illness, and health as expanding consciousness are discussed.
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Abstract
Clinical reasoning has been identified as a necessary skill to practice nursing. Multiple studies suggested that a gap exists between the education of nurses and their ability to transition into practice. Newman’s theory of health as expanding consciousness and research as paxis methodology was used to collect and analyze data of seven senior baccalaureate nursing students. Patterns of individual and across participants revealed the emergence of patterns of relating, knowing, and clinical decision-making as contributing to the evolving pattern of clinical reasoning. The findings of this study were consistent with Newman’s theory and support the theoretical framework and methodology.
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JadidMilani M, Ashktorab T, AbedSaeedi Z, AlaviMajd H. The impact of self-transcendence on physical health status promotion in multiple sclerosis patients attending peer support groups. Int J Nurs Pract 2015; 21:725-32. [DOI: 10.1111/ijn.12186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Tahereh Ashktorab
- Faculty of Nursing and Midwifery; Shahid Beheshti University/Medical Sciences; Tehran Iran
| | - Zhila AbedSaeedi
- Faculty of Nursing and Midwifery; Shahid Beheshti University/Medical Sciences; Tehran Iran
| | - Hamid AlaviMajd
- Faculty of Paramedical Sciences; Shahid Beheshti University/Medical Sciences; Tehran Iran
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McCarthy VL, Ling J, Bowland S, Hall LA, Connelly J. Promoting self-transcendence and well-being in community-dwelling older adults: A pilot study of a psychoeducational intervention. Geriatr Nurs 2015; 36:431-7. [PMID: 26166003 DOI: 10.1016/j.gerinurse.2015.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 06/09/2015] [Accepted: 06/15/2015] [Indexed: 11/30/2022]
Abstract
Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being in older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility study supports further investigation to assess the effectiveness of the intervention in a larger sample.
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Stack RJ, Sahni M, Mallen CD, Raza K. Symptom complexes at the earliest phases of rheumatoid arthritis: a synthesis of the qualitative literature. Arthritis Care Res (Hoboken) 2013; 65:1916-26. [PMID: 23926091 PMCID: PMC4030621 DOI: 10.1002/acr.22097] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 07/30/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Understanding the features and patterns of symptoms that characterize the earliest stages of rheumatoid arthritis (RA) is of considerable importance if patients are to be identified and started on treatment early. However, little is known about the characteristics of symptoms at the onset of a disease that eventually progresses to RA. METHODS A systematic review of qualitative peer-reviewed publications was conducted to identify the earliest symptoms associated with the onset of RA. A total of 1,736 abstracts were searched to identify relevant publications. Twenty-six publications were identified, assessed for quality, and subjected to analysis informed by thematic and grounded theory frameworks. RESULTS Several interacting themes describing the early symptoms of RA were identified, including swelling, pain and tenderness, stiffness, fatigue and weakness, and the emotional impact of symptoms. For each symptom, different and evolving intensities were described; in some cases, patterns of symptom onset and symptom complexes at the onset of RA were highlighted. Importantly, this review has emphasized major deficiencies in the literature. None of the studies reviewed originally aimed to explore symptoms at RA onset (often discussions about symptom onset were secondary to the study's primary aim). Also, many of the articles identified sampled people diagnosed with RA many years previously, making their recollection of symptoms at onset less reliable. CONCLUSION In order for clinicians to fully understand the earliest phases of disease, the nature of symptoms at onset needs to be understood. The current work represents a useful starting point, but this area needs further qualitative investigation, followed by quantitative explorations of symptom clusters and their associated features.
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Affiliation(s)
- Rebecca J Stack
- Sandwell and West Birmingham Hospitals NHS Trust and Centre for Translational Inflammation Research, University of BirminghamBirmingham, UK
| | - Melanie Sahni
- Sandwell and West Birmingham Hospitals NHS TrustBirmingham, UK
| | - Christian D Mallen
- Arthritis Research UK Primary Care Centre, University of KeeleStoke-on-Trent, UK
| | - Karim Raza
- Sandwell and West Birmingham Hospitals NHS Trust and Centre for Translational Inflammation Research, University of BirminghamBirmingham, UK
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Daker-White G, Donovan J, Campbell R. Redefined by illness: meta-ethnography of qualitative studies on the experience of rheumatoid arthritis. Disabil Rehabil 2013; 36:1061-71. [PMID: 24001261 DOI: 10.3109/09638288.2013.829531] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To synthesize published qualitative studies concerning the lived experience of rheumatoid arthritis (RA). To compare the conceptual features of qualitative studies covering two different time periods. METHODS In 2002, 24 items published 1975-2001 were identified in comprehensive literature searches and assessed by multiple reviewers. In 2010, the first author found 28 articles published 2002-2009 in a simple search of the Medline database and synthesized them alone. Articles were synthesized using meta-ethnography. RESULTS Both syntheses found that the main symptoms of RA are variable and unpredictable. However, in the first synthesis a sociological model dominated where RA was seen as an assault on self-identity with devastating social consequences. The main concepts were biographical disruption, role incompetence and the dread of dependency on others. In the second synthesis, the findings produced a model for health care practitioners tied to perceptions of control and incorporating a career-adaptation model of the experience of RA. CONCLUSIONS We recommend that future synthesizers and primary qualitative health researchers focus more on non-hospital based populations and non-English language articles or study participants. The implications for rehabilitation follow from reflecting the findings of the synthesis against existing psychological models of coping and adaptation in RA. Implications for Rehabilitation Coping and adaptation are biographical processes, although the relative importance of active "disease mastery" versus more passive "getting used to it" is unclear. The uncertainty and fluctuating nature of symptoms and disease course presents existential challenges for people with RA in relation to maintaining physical functioning and social roles. Within a social model of disability, these findings point to potential intervention sites in society and relationships that would benefit people living with RA.
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Affiliation(s)
- Gavin Daker-White
- Centre for Primary Care, Institute of Population Health, University of Manchester , Manchester , UK and
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Stack RJ, Simons G, Kumar K, Mallen CD, Raza K. Patient delays in seeking help at the onset of rheumatoid arthritis: the problem, its causes and potential solutions. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/ahe.13.42] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease for which early treatment is vital to limit long-term joint damage. However, individuals often delay seeking medical help at the onset of RA symptoms. The early interpretation of symptoms and the process of making sense of symptoms impacts on both help-seeking decision-making and self-management. Furthermore, the general public’s perceptions and knowledge of RA may also affect the way that symptoms are interpreted. Examining the psychology behind early-symptom interpretation, the barriers to help-seeking behavior and investigating the public’s understanding of RA, can help us understand how decisions are made and guide us in developing interventions that encourage individuals to seek help promptly at the onset of RA.
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Affiliation(s)
- Rebecca J Stack
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
- Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.
| | - Gwenda Simons
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Kanta Kumar
- Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Christian D Mallen
- Arthritis Research UK Primary Care Centre, University of Keele, Keele, UK
| | - Karim Raza
- Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
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Abstract
Newman's theory of health as expanding consciousness was used to explore the patterns and their meaning for people living with chronic hepatitis C. A hermeneutic dialectic method was used to engage nine participants who had been diagnosed with hepatitis C. Patterns and themes were identified and included struggling to overcome, transcending the illness, and wanting to give back. Despite their struggles, all participants moved on to a higher level of consciousness through transformative changes in their lives.
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Haugan G, Rannestad T, Hammervold R, Garåsen H, Espnes GA. Self-transcendence in cognitively intact nursing-home patients: a resource for well-being. J Adv Nurs 2012; 69:1147-60. [DOI: 10.1111/j.1365-2648.2012.06106.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, ; Norway
| | - Toril Rannestad
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Sør-Trøndelag University College, ; Norway
| | - Randi Hammervold
- Trondheim Business School; Sør-Trøndelag University College, ; Norway
| | - Helge Garåsen
- Faculty of Medicine and City Executive for Health and Welfare Services; Norwegian University of Science and Technology; Trondheim, ; Norway
| | - Geir Arild Espnes
- Faculty of Nursing; Research Centre for Health Promotion and Resources; Norwegian University of Science and Technology and Sør-Trøndelag University College,; Norway
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Smith MC. Integrative Review of Research Related to Margaret Newman’s Theory of Health as Expanding Consciousness. Nurs Sci Q 2011; 24:256-72. [DOI: 10.1177/0894318411409421] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Since 1978 when Margaret Newman first introduced her theory of health as expanding consciousness, the theory has been widely expanded upon by Newman and nursing scholars around the world. This manuscript provides an integrative review of research related to the theory of health as expanding consciousness and analyzes strengths, limitations, and directions for the future. A consistent method of praxis within a unitary, participatory worldview was found. Health as expanding consciousness praxis provides a lens for guiding and interpreting meaning and has cross-cultural appeal and utility.
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Affiliation(s)
- Marlaine C. Smith
- Associate Dean and Helen K. Persson Eminent Scholar, Florida Atlantic University
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25
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Flanagan J. The life patterns of individuals who had been recently hospitalised for an exacerbation of chronic obstructive pulmonary disease. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-9824.2010.01064.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
The ability of human beings to find meaning by being directed toward something, or someone, other than themselves is termed "self-transcendence." Previous research indicated that the ability of nurses to self-transcend and thus derive positive meaning from patient-caring experiences increased work commitment and fostered work engagement. However, the relationship between self-transcendence and work engagement had not been investigated. The purpose of this study was to explore the levels and relationships of self-transcendence and work engagement in acute care staff registered nurses (ACSRNs). This was a descriptive correlational study using Reed's theory of self-transcendence. The Self-transcendence Scale, the Utrecht Work Engagement Scale, and a demographic questionnaire were completed by a convenience sample of 84 ACSRNs who attended an annual acute care nursing conference in northern Illinois. ACSRNs level of self-transcendence was high, similar to that of other nurses, but higher than that of nonnurses. ACSRNs level of work engagement was at the high end of the "average" range. There was a significant positive correlation between self-transcendence and work engagement. Nurses with higher levels of self-transcendence had more energy toward and were more dedicated and absorbed in their work.
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27
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Farren AT. Power, uncertainty, self-transcendence, and quality of life in breast cancer survivors. Nurs Sci Q 2010; 23:63-71. [PMID: 20026731 DOI: 10.1177/0894318409353793] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of the study was to examine the relations among power, uncertainty, self-transcendence, and quality of life in breast cancer survivors from the perspective of Rogers' science of unitary human beings. A correlational, cross-sectional study with purposive sampling (n = 104) was conducted. The results included statistically significant correlations, explained variance, and mediating relations among the pattern manifestations. The researcher concluded that there are complex and synergistic relations among the cluster of field pattern manifestations that contribute to quality of life in breast cancer survivors. Implications for theory, research, and practice are discussed.
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28
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Endo E, Takaki M, Nitta N, Abe K, Terashima K. Identifying Patterns in Partnership With Students Who Want to Quit Smoking. J Holist Nurs 2009; 27:256-65. [DOI: 10.1177/0898010109342889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Students who wanted to quit smoking were invited to partner with teachers/support persons to identify the meaningful patterns of their lives. The theoretical framework guiding the study was Newman’s theory of health as expanding consciousness from the perspective of the unitary-transformative paradigm in nursing science. Student participants shared the meaningful relationships and events of their lives with their supportive partners, and together they reflected on the patterns of the students’ lives. Two similarities among the individual patterns were found: a difficult experience in interpersonal relationships at some point in their lives and the initiation of smoking in their search for connectedness with friends. In the dialectic process, students experienced insight regarding their evolving patterns and made transformative changes in their lives, reflecting varying levels of tobacco control.
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Affiliation(s)
- Emiko Endo
- Musashino University, Faculty of Nursing, Tokyo,
| | - Mari Takaki
- Musashino University, Faculty of Nursing, Tokyo
| | | | - Keiko Abe
- Miyazaki Prefectural Nursing University
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29
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Musker KM. Life patterns of women transitioning through menopause: a Newman research study. Nurs Sci Q 2009; 21:330-42. [PMID: 18953012 DOI: 10.1177/0894318408323489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was recognition of a unitary pattern emergent within the lives of women transitioning through menopause. This research as praxis method study included 10 women transitioning through menopause. The findings showed that participants recognized unitary pattern within their unique life patterns. Unitary pattern also emerged through three themes which were coming to terms with losses and unexpected gains, increasing awareness of time passing, and concentrating on health and vitality. The findings were connected to the theory of health as expanding consciousness, thereby contributing to nursing knowledge, expanding the theory, and enhancing understanding of unitary pattern.
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Reed PG. Demystifying self-transcendence for mental health nursing practice and research. Arch Psychiatr Nurs 2009; 23:397-400. [PMID: 19766931 DOI: 10.1016/j.apnu.2009.06.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 06/19/2009] [Indexed: 11/19/2022]
Abstract
Because human development is an integral aspect of life, pathways to mental health necessarily involve developmentally based issues or resources. This column provides an overview of self-transcendence as one developmentally based resource for mental health. The Self-Transcendence Scale is presented to encourage its use in mental health nursing practice and research.
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Affiliation(s)
- Pamela G Reed
- College of Nursing, The University of Arizona, Tucson, AZ 85721-0203, USA.
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The power of wholeness, consciousness, and caring a dialogue on nursing science, art, and healing. ANS Adv Nurs Sci 2008; 31:E41-51. [PMID: 20531260 DOI: 10.1097/01.ans.0000311535.11683.d1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Wholeness, consciousness, and caring are 3 critical concepts singled out and positioned in the disciplinary discourse of nursing to distinguish it from other disciplines. This article is an outgrowth of a dialogue among 4 scholars, 3 who have participated extensively in work aimed at synthesizing converging points in nursing theory development. It proposes a unified vision of nursing knowledge that builds on their work as a reference point for extending reflection and dialogue about the discipline of nursing. We seek for an awakening of a higher/deeper place of wholeness, consciousness, and caring that will synthesize new ethical and intellectual forms and norms of "ontological caring literacy" to arrive at a unitary caring science praxis. We encourage the evolution of a mature caring-healing-health discipline and profession, helping affirm and sustain humanity, caring, and wholeness in our daily work and in the world.
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Hagen B, Grant-Kalischuk R, Sanders J. Disappearing Floors and Second Chances: Men's Journeys of Prostate Cancer. ACTA ACUST UNITED AC 2007. [DOI: 10.3149/jmh.0603.201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Larkin PJ, Dierckx de Casterlé B, Schotsmans P. Towards a conceptual evaluation of transience in relation to palliative care. J Adv Nurs 2007; 59:86-96. [PMID: 17543009 DOI: 10.1111/j.1365-2648.2007.04311.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a concept evaluation of transience and its relevance to palliative care. BACKGROUND A qualitative study into palliative care patients' experiences of transition revealed a gap between current definitions of transition and their expression of the palliative care experience. Transience appears to offer a better definition but remains conceptually weak, with limited definition in a healthcare context. METHODS A qualitative conceptual evaluation of transience was undertaken using two case examples, interview data and the literature. Multiple sources were used to identify the literature (1966-2006), including a search on Cumulative Index to Nursing and Allied Health Literature Medline, and Ovid and Arts and Humanities Index using the keywords 'transience' and 'palliative care'. Thirty-one papers related to transience were retrieved. Analysis and synthesis formulated a theoretical definition of transience relative to palliative care. FINDINGS Transience is a nascent concept. Preconditions and outcomes of transience appear contextually dependent, which may inhibit its conceptual development. Transience depicts a fragile emotional state related to sudden change and uncertainty at end-of-life, exhibited as a feeling of stasis. Defining attributes would seem to include fragility, suddenness, powerlessness, impermanence, time, space, uncertainty, separation and homelessness. CONCLUSIONS Transience is potentially more meaningful for palliative care in understanding the impact of end-of-life experiences for patients than current conceptualizations of transition as a process towards resolution. As a nascent concept, it remains strongly encapsulated within a framework of transition and further conceptual development is needed to enhance its maturity and refinement.
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Affiliation(s)
- Philip J Larkin
- Aras Moyola, Department of Nursing and Midwifery Studies, The National University of Ireland, Galway, Ireland.
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35
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Affiliation(s)
- Dorothy A Jones
- William F. Connell School of Nursing, Boston College, Massachusetts General Hospital, Boston, Massachusetts, USA
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Stinson CK, Kirk E. Structured reminiscence: an intervention to decrease depression and increase self-transcendence in older women. J Clin Nurs 2006; 15:208-18. [PMID: 16422738 DOI: 10.1111/j.1365-2702.2006.01292.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS/OBJECTIVES The purpose of this study was to assess the effect of group reminiscing on depression and self-transcendence of older women residing in an assisted living facility in southeast Texas. There were two major objectives for this study. One objective was to determine if depression decreased in older women after structured reminiscence group sessions held twice weekly for a six-week period. A second objective was to determine if self-transcendence increased after structured reminiscence group sessions held twice weekly for a six-week period. BACKGROUND Reminiscence has been studied to determine its impact on a variety of conditions including but not limited to depression, self-esteem, fatigue, isolation, socialization, well-being, language acquisition and cognitive functioning. This review of research specifically focused on reminiscence, depression, self-transcendence and older people. DESIGN/METHODS Two groups were assessed at baseline, three and six weeks to answer the research questions. A sample of 24 women between the ages of 72 and 96 years were randomly assigned to either a reminiscence (experimental) group or the activity (control) group of the facility. Pearson's r was used to determine the magnitude of the relationship between subjects' responses on the Geriatric Depression Scale and the Self-Transcendence Scale. A mixed design analysis of variance (anova) was used to determine if there was a difference between the experimental and control groups on scores of the Geriatric Depression Scale and the Self-Transcendence Scale at baseline, three and six weeks. CONCLUSIONS Data revealed a non-significant decrease in depression and increase in self-transcendence in the reminiscence group at the completion of six weeks, indicating a trend toward a positive result with reminiscence group sessions. The study also revealed an inverse relationship between depression and self-transcendence. These findings underscore the importance of screening older people for depression. RELEVANCE TO CLINICAL PRACTICE One of the primary modalities used for the treatment of depression in elderly women is medication. Antidepressant medications lead to harmful side effects without alleviating the underlying depression. For these reasons, there is a need to research alternative therapies for treatment of depression in the older female. Reminiscence offers a possible intervention for treatment of depression in older women.
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Neill J. Exploring Underlying Life Patterns of Women With Multiple Sclerosis or Rheumatoid Arthritis: Comparison With NANDA Dimensions. Nurs Sci Q 2005; 18:344-52. [PMID: 16210750 DOI: 10.1177/0894318405280368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In Newman’s theory, disease is one of many manifestations of underlying pattern and its existence provides meaningful information about person-environment interactions. Underlying patterns manifest differently over time, so clues to their understanding can be found within life stories. Further interpretation subsequent to illustrating expanding consciousness for seven women living with multiple sclerosis or rheumatoid arthritis suggested six underlying patterns expressed in theoretical terms as energy~fatigue, giving~receiving, rejecting~accepting, vulnerability~resilience, control~release, and being silent~speaking out. Discussion and comparison with the North American Nursing Diagnosis Association’s dimensions for assessment of human response patterns illustrates how nurses caring for women could identify and use underlying patterns in practice.
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Affiliation(s)
- Jane Neill
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
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Neill J. Health as Expanding Consciousness: Seven Women Living With Multiple Sclerosis or Rheumatoid Arthritis. Nurs Sci Q 2005; 18:334-43. [PMID: 16210749 DOI: 10.1177/0894318405280366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The meaning of health as expanding consciousness is explored through stories of seven women who developed multiple sclerosis or rheumatoid arthritis during their lives. Using Newman’s hermeneutic-dialectic approach, unstructured interviews were conducted over a 2-year period. Analysis and interpretation of narratives concerning person-environment interactions revealed turning points and separate choice points before four new ways of living including finding simple pleasures, being positive, gaining self-control, and self-differentiation, were found. Support for Newman’s stages of expanding consciousness and more comprehensive descriptions of self-transcendence in space and time are presented. Implications for theory development and theory-guided practice are offered.
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Affiliation(s)
- Jane Neill
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
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Abstract
The purpose of this article is to examine the concept of self-organization in chronic pain using Rodgers' (2000) evolutionary approach. This article describes the antecedents, attributes, and consequences of self-organization in chronic pain. Self-organization in chronic pain may be achieved through the attributes of being believed, accessing credible resources, and taking action and responsibility. Self-organization occurs when the patient with pain develops a transformed identity, new insights, and is an active, in-control participant in care. Chronic pain is a common and costly problem, and recognition of the key attributes of self-organization in this condition is an important step in promoting positive health outcomes. Rehabilitation nurses play a key role in providing credible resources and working with the patient to take action and responsibility.
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Abstract
Approximately 1% of the population is diagnosed with schizophrenia, and despite longstanding critiques of the (bio)medical model, understanding of the disorder still arises primarily through (bio)medical explanations. In turn, causation, symptoms and treatments are increasingly sophisticated and well known while understanding of other aspects of the disorder, especially the intersubjective experience of people living with schizophrenia, remains fragmented. For this reason, the present study sought to understand how people experience schizophrenia. To do this, the stories of 19 people diagnosed with the disorder were hermeneutically interpreted. These stories appeared in The Schizophrenia Bulletin--a journal which publishes 'first person accounts', sometimes anonymously, of people's experience of mental illness. Within the study context, the findings indicate that facing the adversity of schizophrenia means living: (i) wisely--understanding the nature of self-with-schizophrenia and of life-with-schizophrenia; (ii) mindfully--keeping understandings in conscious thought; and (iii) purposefully--acting deliberately. Doing this results in a stable and meaningful life and in a different, more resilient self.
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Affiliation(s)
- Rene Geanellos
- School of Nursing, Family and Community Health, University of Western Sydney, New South Wales, Australia.
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Jonsdottir H, Litchfield M, Pharris MD. The relational core of nursing practice as partnership. J Adv Nurs 2004; 47:241-8; discussion 249-50. [PMID: 15238117 DOI: 10.1111/j.1365-2648.2004.03088_1.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Consideration of the relational core of nursing has gained significance in today's health systems, where the work of nurses is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. This has led to disregard for individual experiences of living life with diverse health conditions. AIM The aim of this paper is to articulate the relational core of nursing practice as partnership. DISCUSSION The relational core of nursing practice is explicated as a process of professional partnership, focusing on the evolving dialogue between nurse and patient. In partnership, the dialogue is open, caring, mutually responsive and non-directive. The nurse attends to that which is of concern to patients in relation to their health predicaments and the meaning in the health experience unfolds. Nurse and patient reach insight that represents more useful ways of comprehending and acting on their health predicaments. CONCLUSIONS Partnership represents theoretically-driven practice that invites nurses to meet patients where they are in understanding their health predicaments and what can be done about them. As such, partnership strengthens the resolve of nurses to resist the pressures of contemporary health service delivery to provide a technical form of practice and it protects the relational core of a fully professional practice.
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Abstract
Nursing praxis was explored from the perspective of one Newman scholar. She shared her evolving perspectives on research as a doctoral candidate and as a member of a hospital-based praxis team she went on to develop with colleagues focusing on women with cancer. Using Newman's research method, the team interviewed families regarding meaningful persons and events in their lives. They then conducted another study in the form of action research. The praxis team found that Newman's theory resonated throughout nursing practice. Newman nursing praxis integrates theory, practice, and research.
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Affiliation(s)
- Emiko Endo
- Miyazaki Prefectural Nursing University, Miyazaki, Japan
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43
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Abstract
Ken Wilber's philosophy of no boundaries provides a backdrop for letting go of boundaries between art and science, research and practice, and nursing theories. Major nursing concepts are cited from a variety of theoretical persuasions to illustrate a statement of a unified perspective of the discipline. The author calls for exploration of a world of no boundaries in the expansion of nursing knowledge and practice.
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Plach SK, Heidrich SM, Waite RM. Relationship of social role quality to psychological well-being in women with rheumatoid arthritis. Res Nurs Health 2003; 26:190-202. [PMID: 12754727 DOI: 10.1002/nur.10087] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to examine the mediating and moderating effects of women's social role quality on the psychological well-being of women with rheumatoid arthritis (RA). One hundred and fifty-six women with a diagnosis of RA (M age = 59, SD = 11) completed self-report measures of arthritis history, physical health, psychological well-being, and role quality. Hierarchical multiple regression analyses indicated that role quality mediated the effects of physical health on depression and purpose in life, moderated the effects of health on depression, and moderated the effects of pain on purpose in life. Women in poor health with high role quality were significantly less depressed than women in poor health with poor role quality. Women with high levels of pain and high role quality had more purpose in life than women with high levels of pain and low role quality. Despite difficulties with their physical health, women who had high role quality had higher levels of psychological well-being. Findings from this study may aid in the development of meaningful interventions to help women with RA manage their daily lives to optimize well-being.
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Affiliation(s)
- Sandra K Plach
- School of Nursing, University of Wisconsin-Milwaukee and Froedtert Hospital, Milwaukee, WI 53226, USA
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