Daily Meditation Practice for Managing Glaucoma Patients' Attitudes and Acceptance.

PRCIS: Overall, 63% of glaucoma patients agreed to 45-60 minutes of daily meditation. Predictors of accepting meditation included previous meditation practice, a diagnosis of glaucoma <1 year, and having a marital status of "single". PURPOSE: To explore patients' acceptance and barriers towards 45-60 minutes daily meditation for glaucoma management and to identify glaucoma patients with higher perceived stress levels who may benefit more from meditation practice. METHODS: Glaucoma patients attending the Royal Victorian Eye and Ear Hospital, Melbourne, Australia outpatient department were invited to complete a patient survey. This survey explored if patients would agree to 45-60 minutes of daily meditation and included the Determinants of Meditation Practice Inventory and Perceived Stress Scale questionnaires. Questionnaire scores were compared across participants' clinical and demographic characteristics using Student t test, ANOVA, and multiple-linear-regression analysis. RESULTS: Of the 123 eligible patients screened, 100 completed the survey (81.3%). Sixty-three (63%) patients would agree to 45-60 minutes of daily meditation if advised by their doctor. Univariate analysis showed increased acceptance of meditation (lower Determinants of Meditation Practice Inventory scores) to be associated with agreeing to meditate 45-60 minutes daily ( P =0.002), currently or previously practicing meditation ( P =0.006 and P =0.0004 respectively), and having a marital status as "single" ( P =0.02). Multivariate regression analysis showed previous meditation practice and a glaucoma diagnosis of <1 year to be predictive of accepting meditation ( P =0.01 and P =0.03 respectively). There were no predictive factors of Perceived Stress Scale scores. CONCLUSION: Given the high acceptance rate of 45-60 minutes daily meditation (63% of glaucoma patients sampled), this may be recommended for the benefit of patients. Patients who have previously meditated, have a relatively new diagnosis of glaucoma, and are single (marital status) were more accepting of meditation practice.

Philosophic reflections on the meaning of touch in nurse-patient interactions.

In this paper I examine the meaning of physical touch as it occurs in the nurse-patient interaction. There are two aspects of the nurse-patient relationship that are found in most nurse-patient interactions which together have profound implications for nurses as practitioners and as individual human persons. The first is the clinical intimacy of the nurse-patient relationship where nurses touch, rub, smooth, clean, dress and otherwise physically interact with patients. The other is the existential crisis, the possibility of loss, suffering and death that lurks at the horizon of most, if not all, healthcare encounters. Edmund Husserl, Merleau-Ponty and more recently Robert Sokolowski argue that tactile sensations and resultant perceptions are fundamental to all sensory perception. Further, they argue that tactile sensation is fundamental for the ongoing constitution of 'my' self as a person and for the development and exercise of human intersubjectivity. If tactile interaction is crucial to the development of our very selves as persons and a significant aspect of our interaction with patients includes direct or observed tactile sensations and if further these sensations occur around the context of existential crises for our patients, then nurse's very selves as persons are being challenged by these interactions. Here, then I examine the philosophical argument for the role of tactile sensations in our human development and briefly look at contemporary neurophysiologic research that supports this philosophical account. I then suggest ways such physical intimacy can lead to a strengthening or weakening of the person of the nurse and the nursing interaction and end with some thoughts about ways to support nurses in these activities.

Intrusive mental imagery in patients with persecutory delusions.

Recent theoretical and experimental work indicates a close connection between anxiety and paranoia. Cognitive processes that lead to the persistence of anxiety disorders may have a similar role in persecutory fears. One factor identified as important in anxiety disorders are intrusive mental images. These negative images are common in anxiety disorders, and associated with symptom persistence. The aim of the current study was to examine intrusive mental images in individuals with persecutory delusions. The prevalence and characteristics of self-reported paranoia-related intrusive images, and relationships between image ratings and clinical symptoms were examined in 40 patients with persecutory delusions. It was found that 73% (n = 29) of patients reported paranoia-related, recurrent intrusive images (e.g. being attacked with a knife). The degree to which the images provoked anxiety was associated both with greater general anxiety and with more distressing persecutory delusions. It is concluded that intrusive images may be relatively common in patients with persecutory delusions and may contribute to the distress of paranoid experiences. Re-scripting such images and their associated memories might be a way of developing cognitive behavioural therapy for psychosis.

A comprehensive theory of the human person from philosophy and nursing.

This article explores a problem of the articulation of an adequate account of the human person in both philosophical and nursing theory. It follows the lead of philosopher Norris Clarke in suggesting that there has been a significant division in the way philosophers have looked at the human person and goes on to suggest that this division is paralleled in prominent nursing theories. The paper reviews and argues for the synthesis of two contemporary philosophic theories of the person that arise from the traditional philosophical division, and uses Clarke's account to show the ontological need for such a synthesis if we are to have a more adequate account of the human person. Next, accounts of the person identified in a number of the prominent theories of nursing are briefly reviewed revealing the vast complexity of the person encountered in nursing practice. It is suggested that each new theory of nursing is founded, at least in part, on the need to account for attributes of the person missing from prior nursing theories. It will be seen that the synthesized account of the person argued for here more adequately accounts for the various attributes identified in these nursing accounts and it is hoped that this synthesized account will serve as a somewhat more complete basis for a continued exploration of the persons encountered in nursing practice in its many and varied manifestations.