At-one-ment and twoness are not opposites

This paper explores how at-one-ment and twoness interact in the clinical setting. Namely, how the unconscious mode of knowing the other intuitively from the inside, by becoming at-one with them, interacts with the conscious-rational mode of knowing about the other from the outside; how experiencing the other's experience as one's own, rather than like one's own, informs (and is informed by) the common clinical stance of twoness, in which analyst and patient meet as separate persons. Through clinical illustrations, I argue that these are complementary (rather than contradictory) modes of knowing, communicating and being and that, paradoxically, twoness is essential for the emergence of at-one-ment, even though the latter is inadvertent.

Enforced Disappearances and Torture Today: A View from Analytical Psychology 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process: 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process1

In very rare cases, individuals survive the atrocities of abduction, imprisonment and torture that are part of the hallmark of enforced disappearances. Cases of people who survive torture and seek asylum in a third country help us understand some important aspects related to the crime of enforced disappearance. In the psychotherapy of torture survivors, at an early stage and for a long time, words often do not convey the core of the patient's experience. Survivors usually have tormented bodies in which individual and collective violence, hatred, anger, guilt and shame are painfully inscribed. Corporeal countertransference becomes the only possible way for a therapist to get in touch with a survivor's experience through a kind of body-to-body communication. The centrality of the body in these therapies suggests that the body is the involuntary recipient and container of mass political atrocities and, for this reason, the place where, in the case of horrific social violence, the possibility of social "knowing" is stored and can be retrieved. Thus, when it comes to forced disappearance, the determination of the relatives to get to the truth through the discovery of the remains of their disappeared demonstrates the importance of the body as the final witness of what happened, beyond any possible manipulation.

When 'Being There' Is Disallowed: Disruptions to Knowing and Caring During COVID-19 Visitor Restrictions

This qualitative study explored the accounts of five health professionals working in hospitals in Hamilton, Ontario, Canada who provided end-of-life care during the COVID-19 pandemic. The study goal was to understand how palliative care providers experienced and responded to the significant change in family presence when visitors were restricted to slow the spread of the virus. Identified was the loss and disruption of important forms of knowing including observational and embodied knowing. Family members' knowledge of how their person was faring was curtailed, as was providers' capacities to know families personally. Family members' less obvious needs did not come forward as readily in the absence of informal encounters with providers. Constraints on knowing and embodied actions often meant phone and video meetings failed to provide meaningful connection. Providers adapted their practice in a range of ways, including by offering verbal and visual images of the person in the setting, paying attention differently, and conveying to family members their knowledge of patients as individuals. The changes and challenges health providers remarked on and the ways they adapted and extended themselves reveal in a new way how the regular presence of family in the care setting shapes the quality of end-of-life care.

Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study

BACKGROUND

Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients.

AIM

To describe the caring ability of nurses and its potential predictors in China.

METHODS

From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted.

RESULTS

Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance.

CONCLUSIONS

Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.

Epistemic Curiosity and the Region of Proximal Learning

We propose a framework for understanding epistemic curiosity as a metacognitive feeling state that is related to the individual's Region of Proximal Learning (RPL), an adaptive mental space where we feel we are on the verge of knowing or understanding. First, we review several historical views, contrasting the RPL perspective with alternative views of curiosity. Second, we detail the processes, conditions, and outcomes within the RPL framework which are proposed to be related to curiosity. Finally, we review several lines of evidence relevant to the relation between RPL and curiosity. These include (1) differences in the conditions under which experts and novices mind wander, (2) experiments investigating people's choices of whether to study materials for which they have high versus low feelings of knowing, (3) results related to people's engagement with corrections to errors made with high confidence, and (4) curiosity, attention, and learning data related to the tip-of-the-tongue state.

Toward A Germinal Theory of Knowing- Revealing-Humanizing as Expressions of Caring in Cancer Palliative Care

OBJECTIVE

Survival chances of people with cancer in Nigeria are far worse than those in developed countries. While the chance of finding a lasting solution to cancer in Nigeria is remote, patients living with cancer still need treatment regardless of the terminal outcome, and hence cancer palliative care is necessitated. Caring patterns and expressions differ in diverse contexts. Therefore, this article aimed to present the meanings and expectations of caring and the resulting transformative theory of practice.

METHODS

A descriptive, qualitative inquiry was conducted with a purposive sample of 12 cancer palliative patients, 9 nurses, 3 physicians, and 5 relatives who were approached for an in-depth interview about their conceived meanings and expectations of caring for or being cared for in the cancer palliative unit.

RESULTS

Cancer palliative care in Nigeria is best exemplified through the processes/themes of "knowing," "revealing," and "humanizing." The meaning of care and the expectations of the patients and caregivers were grouped into these three overarching processes which then informed the conceptualization of a germinal theory of knowing-revealing-humanizing (TKRH) as expressions of caring in cancer palliative care.

CONCLUSIONS

The application of the KRH practice processes is illustrated as a transformative germinal theory of practice. This TKRH as expressions of caring is transformative and can restore positive meanings in the life-world of persons in the cancer palliative care setting.

Compassionate Knowing: Building a Concept Grounded in Watson's Theory of Caring Science

Compassionate knowing is the practice of intentional presence to relieve suffering. Inspired by Carper's patterns of knowing, it is an additional form of knowing grounded in caring science. Likewise, the concept of compassionate knowing is framed by tenets of Buddhist philosophy and George's emancipatory theory of compassion. Intentional presence is defined as a conscious and altruistic choice, born of moral virtue and selflessness, to act in a thoughtful, empathetic, and humanistic way that honors and gives meaning to the uniqueness of each patient and caring-healing nurse-client interaction. Relieving suffering is defined as the nurse responding to the needs of the patient with loving-kindness to alleviate a perceived or real threat to self-integrity.

From Knowing Nothing to Knowing What, How and Now: Parents' Experiences of Caring for their Children With Congenital Adrenal Hyperplasia

Objective

This study investigates various kinds of knowing that European parents use when caring for their children with congenital adrenal hyperplasia (CAH).

Methods

Semi-structured qualitative interviews with 20 parents of 22 children with CAH.

Results

Parents emphasized the importance of knowing what CAH is and what support their child needs, but also knowing how to cope and make sense of the new situation, how to attend to their child's medical needs as well as how to talk to their child. Parents also reported challenges related to connecting with their social network, experiences of emergency care, and how to help their children become independent. These challenges require knowing now : being able to respond appropriately to unique circumstances.

Conclusions

Parents experience diverse challenges that may moderate the effects of the diagnosis on children's well-being. Parenting children with CAH requires the development of knowing that goes beyond medical information.

Thinking together: What makes Communities of Practice work?

In this article, we develop the founding elements of the concept of Communities of Practice by elaborating on the learning processes happening at the heart of such communities. In particular, we provide a consistent perspective on the notions of knowledge, knowing and knowledge sharing that is compatible with the essence of this concept - that learning entails an investment of identity and a social formation of a person. We do so by drawing richly from the work of Michael Polanyi and his conception of personal knowledge, and thereby we clarify the scope of Communities of Practice and offer a number of new insights into how to make such social structures perform well in professional settings. The conceptual discussion is substantiated by findings of a qualitative empirical study in the UK National Health Service. As a result, the process of 'thinking together' is conceptualized as a key part of meaningful Communities of Practice where people mutually guide each other through their understandings of the same problems in their area of mutual interest, and this way indirectly share tacit knowledge. The collaborative learning process of 'thinking together', we argue, is what essentially brings Communities of Practice to life and not the other way round.

Intersections of the arts and nursing knowledge

The arts and nursing are profoundly connected. While the relationship between nursing and art has persisted over time, the majority of nursing scholarship on the arts has historically centered upon the art of nursing practice and the cultivation and application of aesthetic knowing. However, there is a burgeoning use of arts-based strategies is nursing education, research, and practice. Correspondingly, there is a need to understand how such approaches can uniquely contribute knowledge to the nursing discipline in order to support arts-integration for nursing scholars. We structure our inquiry into arts' contributions according to two dominant methods of engaging with arts-based strategies: knowing about (e.g., phenomena) vis-à-vis art-viewing, and knowing through (e.g., embodied knowing) vis-à-vis art-making. In doing so, we explore critical contributions of art to nursing research and educational practices, including arts' capacity to augment traditional research and communication approaches, democratize the research space, challenge issues of representation, and facilitate education, dissemination, and reflexivity.

Knowing, caring, and telehealth technology: "going the distance" in nursing practice

The use of technology in delivery of health care services is rapidly increasing, and more nurses are using telehealth to provide care by distance to persons with complex health challenges. The rapid uptake of telehealth modalities and dynamic evolution of technologies has outpaced the generation of empirical knowledge to support nursing practice in this emerging field, specifically in relation to how nurses come to know the person and engage in holistic care in a virtual environment. Knowing the person and nursing care have historically been associated with physical presence and close proximity in the nurse-client relationship, and the use of telehealth can limit the ways in which a nurse can observe the person, potentiate perceptions of distance, and lead to a reductionist perspective in care. The purpose of this article is to illuminate the dynamic and evolving nature of nursing practice in relation to the use of telehealth and to highlight gaps in nursing knowledge specific to knowing the person in a virtual environment. Such an understanding is necessary to inform future research and generate empirical evidence to support nurses in providing ethical, safe, effective, and holistic care by distance to persons through telehealth technology.