Spiritual coping in rehabilitation - a comparative study: part 1

Inner posture as aspect of global meaning in healthcare: a conceptual analysis

Based on our empirical research on global meaning in people with spinal cord injury and people with stroke, we formulated 'inner posture' as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer's notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.

Characterizing mobility from the prosthetic limb user's perspective: Use of focus groups to guide development of the Prosthetic Limb Users Survey of Mobility

BACKGROUND

Input from target respondents in the development of patient-reported outcome measures is necessary to ensure that the instrument is meaningful.

OBJECTIVES

To solicit perspectives of prosthetic limb users about their mobility experiences and to inform development of the Prosthetic Limb Users Survey of Mobility.

STUDY DESIGN

Qualitative study.

METHODS

Four focus groups of lower limb prosthesis users were held in different regions of the United States. Focus group transcripts were coded, and themes were identified. Feedback from participants was used to develop a framework for measuring mobility with a lower limb prosthesis.

RESULTS

Focus group participants (N = 37) described mobility as a confluence of factors that included characteristics of the individual, activity, and environment. Identified themes were defined as individual characteristics, forms of movement, and environmental situations. Prosthetic mobility was conceptualized as movement activities performed in an environmental or situational context.

CONCLUSION

Respondent feedback used to guide development of Prosthetic Limb Users Survey of Mobility established a foundation for a new person-centered measure of mobility with a prosthetic limb.

CLINICAL RELEVANCE

Perspectives of target respondents are needed to guide development of instruments intended to measure health outcomes. Focus groups of prosthetic limb users were conducted to solicit experiences related to mobility with a lower limb prosthesis. Results were used to inform development of a clinically meaningful, person-centered instrument.

Use of instruments to measure quality of life among healthy and ill adults in community settings

International interest in quality of life (QoL) has been affected by patients' prolonged survival, the increasingly aging population, the increase in chronic conditions and the increasing costs of health care. This has also led to the development of QoL instruments that meet the psychometric criteria necessary for reliable and valid outcome measures in research, health policy decision-making and, increasingly, in clinical practice. Despite the proliferation of QoL instruments available to inform best practice, clinicians seldom routinely apply them. One of the barriers to using QoL instruments is the unfamiliarity nurses have with existing instruments. In order to increase community health nurses' familiarity with existing QoL assessments, the aim of this paper is to describe five instruments and modules that have been developed by the World Health Organization's Quality of Life Assessment Group for the assessment of QoL among healthy and ill adults and to describe how their applicability could enhance evidence-based practice in community nursing.

Aplikacija adaptacijskega modela Calliste Roy pri pacientu z rakom in s kronično bolečino

Uvod: Prilagajanje je ključni dejavnik za uspešno soočenje posameznika s spremembami v svojem notranjem in zunanjem okolju. Z aktivnostmi zdravstvene nege medicinske sestre pomagajo zagotoviti potrebne vire za uspešnejši proces prilagajanja. Avtorji v prispevku razpravljajo, ali bi teoretični model prilagoditve Calliste Roy ustrezal pri obravnavi in zdravstveni negi v enoti za zdravljenje bolečine.Metode: Uporabljena je triangulacija metod pregleda literature in kvalitativne metode z raziskovalno tehniko kritičnega dogodka. Pregled literature je bil narejen v vzajemni bibliografsko-kataložni bazi COBIB.SI in Cumulative Index to Nursing and Allied Health Literature (CINAHL). Pridobljenih je bilo 165 zadetkov in uporabljenih 34 znanstvenih člankov ter 7 monografij. Kriteriji izbora so bili primarni viri Calliste Roy, dostopnost, relevantnost, kritična ponazoritev teoretičnega modela. Tehnika kritičnega dogodka v treh fazah opiše incident, ga analizira ter poda možne izide. Rezultati: Adaptacijski model Calliste Roy je aplikativen, uporaben in v sedanji situaciji se dobro dopolnjuje s štirinajstimi temeljnimi življenjskimi aktivnostmi po Virginie Henderson. Model daje možnost ocene tako fizičnega kot psihosocialnega stanja. Najpomembnejše prepoznane intervencije medicinske sestre, ki pripomorejo k prilagoditvenemu procesu pacienta, so psihosocialna podpora, učenje in svetovanje. Diskusija in zaključek: Prednost obravnave pacienta z rakom in bolečino po izbranem modelu zdravstvene nege je v možnosti ocene stanja po vseh štirih ravneh prilagajanja in v prikazu načrta zdravstvene nege. Pokazalo se je kot pozitivno, da medicinska sestra lahko s psihosocialno podporo in informiranjem vpliva na kakovost življenja pacienta. Pacient in družina se soočata s kronično boleznijo, načinom življenja in pomenom poznavanja ter nadzorovanja bolečine. 

Spiritual coping in rehabilitation- a comparative study: part 2

Spiritual coping, which may or may not contain religiosity, may enhance adaptation of clients with chronic illness. Part 1 of this article (Baldacchino et al, 2013) presented the research methodology of this cross-sectional comparative study, which explored the spiritual coping of clients with chronic illness receiving rehabilitation services in Malta (n=44) (lower limb amputation: n=10, chronic heart disease: n=9, osteoarthritis in an institution: n=10 and in the community: n=15) and Norway (n=16) (post-hip/shoulder surgery: n=5; chronic heart disease: n=5; chronic pain: n=6). Data were collected from seven purposive samples by focus groups. Roy's adaptation model (1984) and Neuman's Systems Model (2010) guided the study. Part2 discusses the findings, which consist of one main spiritual coping theme and three sub-themes: 'adopting religious coping strategies, relationship with God, and time for reflection and counting one's blessings'. Commonalities were found in the findings except in one dimension, which was found only in the Malta group, that is, being supported by others with a similar condition. This difference may be a result of the environment in the rehabilitation centres, cultural, and geographical differences between the two countries. While considering the limitations of this study, recommendations are proposed to the rehabilitation and education sectors and further trans-cultural comparative longitudinal research with mixed method approach on various clients with acute, chronic and life-threatening illness.