Self-Transcendence in Stem Cell Transplantation Recipients: A Phenomenologic Inquiry

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.

Self-Transcendence of Japanese Female Breast Cancer Patients with Hereditary Breast and Ovarian Cancer Syndrome

Objective

The present study examined self-transcendence of Japanese female breast cancer patients with hereditary breast and ovarian cancer (HBOC) syndrome.

Methods

Semi-structured interviews were conducted with 13 women with HBOC in their thirties to sixties, who consented to participate in the study. The obtained data were analyzed using a modified grounded theory approach.

Results

The analysis yielded seven categories of self-transcendence in women with HBOC: (1) the ability to face oneself while seeking optimal strategies to continue living; (2) the ability to come to terms with blood conditions inherited from previous generations; (3) the ability to use one's own experiences as a patient with HBOC to help others; (4) the ability to share mutual support with others; (5) the ability to accept the diverse views on HBOC; (6) the ability to break free from fixed ideas and live with HBOC; and (7) the ability to live with future perspectives.

Conclusions

The self-transcendence of Japanese female breast cancer patients with HBOC can be described as not giving up; confronting one's lineage, which is passed down from generation to generation, even as one is haunted and emotionally affected by the lifelong risk of developing cancer or facing death; and valuing not just oneself but also others through interactions with them. These abilities formed the foundation for the self-transcendence of the women in this study. In addition, because the women with this condition started valuing not just themselves but also others, they developed the ability to accept the diverse views surrounding HBOC and to coexist with their condition while being forward-looking.

Self-Transcendence: Moving from Spiritual Disequilibrium to Well-Being Across the Cancer Trajectory

OBJECTIVES

To synthesize research results on self-transcendence among people affected by cancer and their caregivers to inform oncology nursing practices that promote well-being across the cancer trajectory. Self-transcendence is an inherent capacity to expand self-boundaries beyond the person's usual form to create something meaningful, whether it is a new purpose, perspective, situation, or artifact that fosters well-being.

DATA SOURCES

Peer-reviewed, research-based publications, and peer-reviewed theoretical publications were used.

CONCLUSION

Research results are consistent with Reed's self-transcendence theory that proposes self-transcendence as a healing process for application in nursing practice. Self-transcendence facilitates well-being through the creative experiences afforded by expanding self-boundaries intrapersonally, interpersonally, and transpersonally. Nurses may use this knowledge in various practices that support well-being among people who have cancer and their families.

IMPLICATIONS FOR NURSING PRACTICE

Five comprehensive practice implications to support self-transcendence and foster well-being in individuals affected by cancer and their caregivers were synthesized from the research-based literature and aligned with Reed's self-transcendence theory.

Heideggerian structures of Being-with in the nurse-patient relationship: modelling phenomenological analysis through qualitative meta-synthesis

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse-patient relationship. We firstly considered and secured the most relevant Heideggerian elements to nurse-patient Being-with (Dasein-with, circumspection, solicitude, and discourse). Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode (task-orientated busyness, existential abandonment, rough handling and deficient modes of concern in potentially violent encounters), and the authentic self-mode (seeking connection [knowing], and openness [unknowing], which exposed their emotional vulnerability). Through circumspection (making room for, deseverance and directionality), technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement (solicitude) was expressed through either leaping-in care (also perceived as 'power over') or leaping-ahead care (moving the patient towards independence). There was a place for both inauthentic (idle talk) and authentic discourse (including non-verbal and spiritual discourse) that nurses wove through the ontic everydayness of nursing tasks.

Stress and coping strategies among allogeneic haematopoietic stem cell transplantation survivors: A qualitative study

OBJECTIVE

The aim of this qualitative study was to explore allogeneic haematopoietic stem cell transplantation (allo-HSCT) survivors' perspectives of stresses and their coping strategies, in order to attain a deeper understanding of their experience.

METHODS

We conducted semi-structured interviews with 20 Japanese allo-HSCT survivors about the stresses they experienced and how they coped. We then conducted a content-driven thematic analysis of the interview results. The interview questions probed stresses and coping strategies related to allo-HSCT.

RESULTS

We identified 74 stresses across 7 domains: symptoms after transplantation, limitations in daily life, appearance changes, relationship anxieties, work impairment and financial issues, uncertainty and disappointed expectations. In addition, 21 coping strategies were identified across 3 domains: direct efforts to manage problems, adaptive attitude, and seeking and using social support.

CONCLUSION

By identifying a broad range of stressors associated with allo-HSCT, insight was gained as to the impact of allo-HSCT on survivors' lives. These results provide a foundation for the future development of resources for survivors, their significant others and clinicians. Stressors and coping strategies among allo-HSCT survivors were comprehensively characterised, which will provide useful information for patients and enable healthcare practitioners to provide better care.

Heideggerian hermeneutic phenomenology as method: modelling analysis through a meta-synthesis of articles on Being-towards-death

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it's clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger's philosophy that there is either an inauthentic positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical 'hooks' for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials.

Factors influencing the perception of protective isolation in patients undergoing haematopoietic stem cell transplantation: A multicentre prospective study

OBJECTIVES

To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT).

METHODS

This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post-transplant. Statistical linear regression analysis was performed.

RESULTS

The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (β = .152), education level (β = -.245), double room (β = .186), satisfaction with visiting hours (β = -.174) and emotional support from nurses (β = -.169) were independently associated with isolation-related suffering. Significant predictors of the relationship with oneself included body temperature (β = -.179), fatigue (β = -.192) and emotional support from nurses (β = -.292). Factors independently associated with the relationship with others were education (β = -.230), chemotherapy cycles (β = -.218), pain (β = .150) and satisfaction with visiting hours (β = -.162).

CONCLUSION

Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support.

Spiritual Distress in Cancer Patients: A Synthesis of Qualitative Studies

Cancer affects individuals in all human dimensions. Cancer patients are more susceptible to spiritual distress. Several studies have addressed spiritual distress using quantitative designs; however, a qualitative approach to the experience of spiritual distress could provide a deeper understanding of the phenomenon. This study aims to synthesis the experience of spiritual distress as lived by cancer patients in qualitative primary studies. This is a literature review based on electronic databases search. A total of 4075 citations was identified and 23 studies were included. The most frequent qualitative research method was phenomenology (n = 15), and interviews were the main data collection method (n = 20). Two major themes have been identified related to the experience of spiritual distress: suffering and coping. Spiritual distress is an intimate, deep and suffering experience in life, which requires coping strategies and involves spiritual values and beliefs. Healthcare providers should be aware of this experience and recognize spiritual distress in cancer patients, as it is critical in providing holistic nursing care.

Being in a bubble - Childbirth as a potential path towards becoming in health - Lived experiences of mothers during childbirth

BACKGROUND

Childbirth is often seen as an existentially important life event. However, few studies focus on the experience from the woman's perspective.

THE AIM AND RESEARCH QUESTIONS

The aim of this study was to explore women's experiences of strength and health during childbirth through an ontological understanding. What enables women to experience strength and health during childbirth?

RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT

A hermeneutical approach was used. The material consists of texts from interviews with eight women who have recently (a few days to some weeks) given birth. The texts were interpreted through latent content analysis.

ETHICAL CONSIDERATIONS

Informed consent was sought from the participants regarding participation in the study and the storage and handling of data for research purposes.

FINDINGS

The overall theme was 'Childbirth as a movement towards becoming in health'. The three main themes were as follows: 'The self as a source of strength', 'The other as a source of strength in communion' and 'Alleviation of suffering as a source of strength'. Seven subthemes were also described.

CONCLUSION

Childbirth may be seen as a potential path towards becoming in health. The midwife has a central position in supporting women's experiences of health. Family-centred care may enhance women's experiences of becoming in health during childbirth. Further research in this field should focus on revealing midwives' perspectives on what gives women health in connection with childbirth.