Sedation indicated?-rethinking existential suffering: a narrative review.

BACKGROUND AND OBJECTIVE: The indication "existential suffering (ES)" for palliative sedation therapy is included in most frameworks for palliative sedation and has been controversially discussed for decades. The appellative character of ES demands rapid relief and sedation often appears to be the best or only solution. ES is still poorly understood and so often neglected by health care professionals due to a lack of consensus regarding assessment, definition and treatment in the international medical literature. Based on a selective review of the literature on ES we propose a different view on the underlying processes of ES and the resulting consequences on medical treatment. METHODS: A narrative review was performed after PubMed search using key terms related to ES and sedation, covering the period from 1950 to April 2023, additionally a selective search in specialist literature on Existential Analysis. Reverse and forward snowballing followed. The language of analyzed publications was restricted to English and German. KEY CONTENT AND FINDINGS: ES is a multidimensional experience that tends to turn into despair and ultimately into a wish to die due to perceived hopelessness and meaninglessness. Pharmacological treatment or sedation do not meet the holistic needs of existential sufferers. The risk of harmful effects by continuous deep sedation seems to be significantly increased for existentially suffering patients. Professional caregivers are burdened by the appellative character of ES, limited treatment options and perceived empathic distress. Without a holistic understanding of the human condition in palliative care, ES cannot be fundamentally alleviated, and existential sufferers have no opportunity to transform and thus mitigate their condition. The recognition of underlying causes of suffering-moods is facilitated by the comprehensive approach of Existential Analysis. CONCLUSIONS: The presented concept of Existential Analysis and the triad of ES are useful instruments for health care professionals to recognize and support underlying moods of existentially suffering patients. Further studies are required. Comprehensive training for professional caregivers on ES is essential to enable them to reflect on their own existential concerns and finiteness as well as those of patients. Continuous deep sedation for ES must remain the exception, equivalent to a last resort option.

'I am just a shadow of who I used to be'-Exploring existential loss of identity among people living with chronic conditions of Long COVID.

Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being-in-the-world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard-to-express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly.

Existential meaning, spiritual unconscious and spirituality in Viktor Frankl.

There is robust evidence to support the relationship between spirituality and mental health, but the mechanisms of this association are not well-understood. The existential meaning provided by spirituality may be one of these mechanisms. This was the central theme of Viktor Frankl's psychology, which he explained using the notion of the spiritual unconscious. Thus, we sought to explain how Frankl understands this spiritual unconscious and the two pieces of evidence he presents for its existence: the phenomenological description of responsible action and the analysis of dreams. Lastly, we discuss his contribution to the current understanding of the relationship between having an overarching purpose and/or religious meaning and improvement in mental health.

Moving towards holistic rehabilitation - A qualitative study exploring how people diagnosed with cancer and cancer survivors experience a dance-like intervention.

BACKGROUND: Rehabilitation that supports the individual on the journey back to their usual selves after cancer treatment becomes increasingly important. Studies have shown that a focus on the connection between body and mind might be beneficial. Consequently, Whole Person Care and initiatives that fall in line with this holistic approach to health care, such as a dance-like intervention needs further examination. The aim of this study was to explore the qualitative aspects of 5Rhythms® as experienced by people diagnosed with cancer. METHOD: A total of 29 (17 in 2017) participants were recruited through purposeful sampling. Participants underwent one 5Rhythms® session per week for 2 months. This qualitative study with a phenomenological approach used diaries and individual interviews as its methods for data collection. Data were analysed using Giorgi's phenomenological framework and Maurice Merleau-Ponty's theoretical perspectives on phenomenological approaches to the body, perception and consciousness were applied. RESULTS: Three main themes ('(now) I sense my entire body', 'Something liberating is happening inside my body' and 'We travel together') and five connecting sub-themes were identified through the analysis process. CONCLUSION: Participating in 5Rhythms® contributed to reconnecting body and soul during or after battling cancer. It evoked thoughts and feelings of existential matter. Results suggest that participating in 5Rhythms® can assist in personal growth. The benefit of being among peers while on the path to recovery was also illuminated. In regard to rehabilitation, this study underlines the importance of being aware of the connection between body and mind.

Serviço-escola de psicologia da Unifesp: campos de estágio, ações e especificidades / UNIFESP's psychology service-school: internship field, actions, and specificities / Serviço-escola de psicologia de la Unifesp: campos de prácticas profesionales, acciones y especificidades

O Serviço-Escola de Psicologia (SEP) da Unifesp foi constituído com o intuito de transcender o tradicional funcionamento das clínicas-escola, superando a atomização da Psicologia em áreas e oferecendo serviços integrados à rede. Isso possibilita uma formação interdisciplinar, pluralista, generalista, não tecnicista, crítica, permitindo a compreensão e atuação do psicólogo em diversos contextos socioculturais. O objetivo do artigo é descrever, avaliar e problematizar as ações do SEP da Unifesp, em relação à oferta de campos de estágio e ações desenvolvidas neles. É um estudo transversal, baseado em metodologia predominantemente quantitativa e descritiva. O levantamento de dados foi realizado por meio de dois questionários online respondidos por todos os supervisores. Os dados quantitativos foram submetidos à análise estatística descritiva. Os resultados evidenciaram maior incidência das ações no município de Santos e, em menor grau, em outros municípios da Baixada Santista e na cidade de São Paulo. A maioria das atividades de estágios não se limita ao espaço físico de atendimento clínico do Serviço-Escola, ocorrendo junto às instituições públicas ou às instituições ligadas ao terceiro setor na região, relacionadas, direta ou indiretamente, com a promoção de políticas públicas. A pluralidade de recursos utilizados (grupos, atendimento individual, acompanhamento terapêutico, oficinas, matriciamento, entre outros) revela uma ampliação do repertório de competências e habilidades. A variedade de oferta de projetos e campos de estágio, públicos-alvo atendidos, assim como a diversidade e flexibilidade de ações e estratégias desenvolvidas, apontam um movimento de congruência em relação às diretrizes curriculares nacionais e ao inovador Projeto Pedagógico do curso.(AU)

UNIFESP's Psychology Service-School (SEP) was founded with the objective of going beyond the traditional functioning of school-clinics, overcoming the atomization of Psychology in areas and offering services integrated to the network. This enables an interdisciplinary, pluralist, generalist, non-technicist, and critical training, allowing psychologists' understanding and action in different sociocultural contexts. This article aims to describe, evaluate, and discuss the actions of UNIFESP's SEP regarding the offer of internship fields and the actions developed in those fields. It is a cross-sectional study, based on a predominantly descriptive and quantitative methodology. The data was surveyed with two online questionnaires answered by all supervisors. Quantitative data were submitted to descriptive statistical analysis. The results showed a higher incidence of actions in the municipality of Santos and, to a lesser extent, in other municipalities of the Baixada Santista and in the city of São Paulo. Most internship activities are not limited to the physical space of the service-school's clinical care and take place alongside public institutions or institutions linked to the third sector in the area, directly or indirectly related to the promotion of public policies. The plurality of resources (groups, personal care, therapeutic monitoring, workshops, matrix support, among others) reveals an expansion of competences and skills repertoire. The variety of projects and internship fields offers, of target audiences served, as well as the diversity and flexibility of the developed actions and strategies point to a congruence movement relating to national curricular guidelines and to the innovative pedagogical project of the course.(AU)

El Serviço-Escola de Psicologia (SEP) de la Unifesp (Universidade Federal de São Paulo, Brasil) buscó trascender el funcionamiento tradicional de las clínicas universitarias, superar la atomización de la Psicología en áreas y ofrecer servicios integrados a la red. Esto permite una formación interdisciplinar, pluralista, generalista, sin tecnicismos, crítica, lo que posibilita a los/las psicólogos/as comprender y actuar en diferentes contextos socioculturales. Este artículo pretendió describir, evaluar y problematizar las acciones del SEP Unifesp respecto a la oferta de campos de prácticas profesionales y acciones desarrolladas. Es un estudio transversal, con metodología predominantemente cuantitativa y descriptiva. Los datos se recolectaron de dos cuestionarios en línea respondidos por los/las supervisores/as. Se les aplicaron un análisis estadístico descriptivo. Hubo más acciones en la ciudad de Santos (Brasil) que en otros municipios de la región metropolitana de la Baixada Santista y en la ciudad de São Paulo. La mayoría de las prácticas profesionales no se limita a la atención clínica del SEP, ocurriendo en instituciones públicas o vinculadas al tercer sector en la región, directa o indirectamente, relacionadas con la promoción de políticas públicas. La pluralidad de recursos (grupos, atención individual, acompañamiento terapéutico, talleres, soporte matricial, entre otros) revela un amplio repertorio de competencias y habilidades. La variada oferta de proyectos y campos para prácticas profesionales, los públicos destinatarios atendidos, así como la diversidad y flexibilidad de acciones y estrategias desarrolladas apuntan a una congruencia respecto a los lineamientos curriculares nacionales y al innovador proyecto pedagógico del curso.(AU)

PsicoQuilombologia: escrevivência de uma psicologia das encruzilhadas em tempos pandêmicos / PsychoQuilombology: writexperience of a psychology of crossroads in pandemic times / PsicoQuilombología: escrivivencia de una psicología de la encrucijada en tiempos pandémicos

O texto é um relato de experiência da participação no Grupo de Estudos psicoQuilombologia ocorrida nos meses de setembro de 2020 a março de 2021, período atravessado pela segunda onda da pandemia de COVID-19 no Brasil. O objetivo do relato é apresentar o conceito-movimento de psicoQuilombologia como uma proposta epistemológica quilombola de agenciamento de cuidado e saúde, com base em uma escuta que se faça descolonial e inspirada no fecundo e ancestral acervo de cuidado dos povos africanos, quilombolas e pretos, preservado e atualizado em nossos quilombos contemporâneos. A metodologia utilizada é a escrevivência, método desenvolvido por Conceição Evaristo que propõe uma escrita em que as vivência e memórias estão totalmente entrelaçadas, imersas e imbricadas com a pesquisa. O resultado das escrevivências dessa pesquisa descortinam que os povos pretos desenvolveram práticas de cuidado e acolhimento às vulnerabilidades do outro, enraizadas no fortalecimento de laços e conexões coletivas de afetos e cuidado mútuos. Práticas de cuidado que articulam memória, ancestralidade, tradição, comunidade, transformação, luta, resistência e emancipação, engendrando modos coletivos de ser e viver. Nas quais cuidar do outro implica tratar suas relações e situar o cuidado como extensão de uma cura que se agencia no coletivo. O trabalho conclui apontando que o cenário pandêmico vigente acentua a pungência de se desenvolver estratégias de cuidado baseadas em epistemologias pretas e quilombolas, valorizando os sentidos de ancestralidade, comunidade, pertencimento e emancipação.(AU)

The text is an experience report of the participation in the psicoQuilombology Study Group that carried out from September 2020 to March 2021, during the second wave of the COVID-19 pandemic in Brazil. The purpose of the report is to introduce the concept-movement of psicoQuilombology as a quilombola epistemological proposal for the development of care and health, based on a decolonial listening and inspired by the rich care collection of African peoples, quilombolas and Blacks, preserved and updated in our contemporary quilombos. The methodology used is writexperience [escrevivências], a method developed by Conceição Evaristo who proposes a writing in that the experiences and memories are totally involved with the research. The result of the writability of this research show that Black people have developed practices of care and acceptance of the other's vulnerabilities, based on the strengthening of ties and collective connections of mutual affection and care. Care practices that mix memory, ancestry, tradition, community, transformation, struggle, resistance and emancipation, outlining collective ways of being and living. The core idea is that taking care of the other means treating your relationships and maintaining care as an extension of a cure that takes place in the collective. The paper concludes by pointing out that the current pandemic scenario demonstrates the urgent need to develop care strategies based on black and quilombola epistemologies, valuing the senses of ancestry, community, belonging and emancipation.(AU)

Este es un reporte de experiencia de la participación en el Grupo de Estudio psicoQuilombología que ocurrió en los meses de septiembre de 2020 a marzo de 2021, periodo en que Brasil afrontaba la segunda ola de la pandemia de la COVID-19. Su propósito es presentar el concepto-movimiento de psicoQuilombología como una propuesta epistemológica quilombola para el desarrollo del cuidado y la salud, basada en una escucha decolonial e inspirada en el rico acervo asistencial de los pueblos africanos, quilombolas y negros, conservado y actualizado en nuestros quilombos contemporáneos. La metodología utilizada es la escrivivencia, un método desarrollado por Conceição Evaristo quien propone una escrita en que las vivencias y los recuerdos están totalmente involucrados con la investigación. El resultado de la escrivivencia muestra que las personas negras han desarrollado prácticas de cuidado y aceptación de las vulnerabilidades del otro, basadas en el fortalecimiento de lazos y conexiones colectivas de afecto y cuidado mutuos. Prácticas de cuidado que mezclan memoria, ascendencia, tradición, comunidad, transformación, lucha, resistencia y emancipación, perfilando formas colectivas de ser y vivir. El cuidar al otro significa tratar sus relaciones y mantener el cuidado como una extensión de una cura que tiene lugar en lo colectivo. El trabajo concluye que el actual escenario pandémico demuestra la urgente necesidad de desarrollar estrategias de atención basadas en epistemologías negras y quilombolas, y que valoren los sentidos de ascendencia, comunidad, pertenencia y emancipación.(AU)

A relação entre arte e vida em vigotski: uma análise conceitual / The relationship between art and life in vygotsky: a conceptual analysis / La relación entre arte y vida en vigotski: un análisis conceptual

Este trabalho teve como objetivo analisar a relação entre arte e vida segundo Vigotski. Para isso, foi realizada uma análise conceitual dos capítulos 1, 7, 9, 10 e 11 da Psicologia da Arte, do capítulo 13 da Psicologia Pedagógica e do texto O significado histórico da crise da Psicologia: Uma investigação metodológica. A pesquisa conceitual consiste na análise semântica dos principais conceitos de uma teoria com o intuito de elucidar seus sentidos ocultos ou confusos e desvendar possíveis contradições e ambiguidades no quadro teórico. Podemos observar que a arte é um fenômeno dialético tanto em sua criação como em seus efeitos. A influência da vida, isto é, da realidade sócio-histórica, na criação artística é indireta, pois ela é sempre mediada pelo psiquismo particular do artista. Já o efeito da arte sobre a vida possibilita que o ser humano se conscientize de sua realidade social e se engaje para mudá-la. A arte é, portanto, transformadora, pois reorganiza o psiquismo e possibilita uma mudança nas condições materiais dos seres humanos.(AU)

This study aims to analyze the relationship between art and life according to Vygotsky. Therefore, a conceptual analysis of chapters 1, 7, 9, 10, and 11 of Psychology of Art, chapter 13 of Educational Psychology and the text The Historical meaning of the Crisis of Psychology: A Methodological Investigation was carried out. Conceptual research consists of the semantic analysis of the main concepts of a theory to elucidate its hidden or confused meanings and to reveal possible contradictions and ambiguities in the theoretical framework. Results show that art is a dialectical phenomenon both in its creation and its effects. The influence of life, that is, of socio-historical reality, on artistic creation is indirect since it is always mediated by the artist's particular psyche. The effect of art on life, on the other hand, allows human beings to become aware of their social reality and engage to change it. Art is, therefore, transformative, as it reorganizes the psyche and enables a change in the material conditions of human beings.(AU)

Este proyecto tuve como objetivo analizar la relación entre el arte y la vida, según Vigotski. Para esto, fue realizado un análisis de los capítulos 1, 7, 9, 10 y 11 de Psicología del arte, del capítulo 13 de Psicología Pedagógica y del texto Él significado histórico de la crisis de la Psicología: una investigación metodológica. La pesquisa conceptual consiste en la analice semántica de los conceptos de una teoría, para aclarar sus significados ocultos o confusos y desvendar contradicciones y ambigüedades em el cuadro teórico. Pudimos observar que, el arte es un fenómeno dialéctico en su creación tanto como en sus efectos. La influencia de la vida, esto es, de la realidad socio-histórica, en la creación artística es indirecta, pues es mediada por el psiquismo particular de lo artista. Así, el efecto del arte sobre la vida habilita que lo ser humano adquiera conciencia de su realidad social y que se comprometa a cambiarla. El arte, consiguientemente, transformadora, pues reorganiza lo psiquismo y habilita un cambio en las condiciones materiales de los seres humanos.(AU)

Prevenção do suicídio: esquecimento do ser e era da técnica / Suicide prevention: forgetfulness of being and technical era / Prevención del suicidio: olvido del ser y la era de la técnica

Martin Heidegger, em sua ontologia, destaca uma característica específica da atualidade que atravessa o comportamento humano, na filosofia, na ciência ou no senso comum: o esquecimento do ser. O filósofo diferencia a época atual das demais épocas históricas. O horizonte histórico contemporâneo se desvela por meio do desafio e da exploração, da tentativa de controle e domínio dos acontecimentos, ao modo da disponibilidade e em função da produtividade. O filósofo esclarece que todo esse desenraizamento do homem atual está atrelado ao esquecimento daquilo que é o mais essencial, qual seja, a existência. A questão que norteia este estudo é apurar, por meio das referências de Heidegger e dos estudos sobre suicídio, o quanto a interpretação da morte voluntária nos dias atuais está atravessada por tal esquecimento. Pretendemos investigar o quanto as ações de prevenção desenvolvidas pela suicidologia se encontram atravessadas por tal esquecimento do ser do homem e, dessa forma, acabam por estabelecer relações entre ser e ente em uma consequente redução ao ente como invariante e atemporal. O caminho para investigar a questão iniciará por abordar, em maiores detalhes, a analítica existencial, a questão da técnica e o movimento de esquecimento do ser apontados por Heidegger a fim de problematizar as perspectivas científicas atuais sobre o suicídio em sua prevenção para, então, estabelecer uma compreensão fenomenológica e existencial sobre o referido fenômeno.(AU)

Martin Heidegger, in his ontology, highlights a specific characteristic of the present moment that crosses human behavior, in philosophy, science, or common sense: the forgetfulness of being. The philosopher differentiates the current age from other historical ages. The contemporary historical horizon is unveiled by the challenge and the exploration, from the attempt to control and dominate events, to the mode of standing reserve and in terms of productivity. The philosopher clarifies that all this uprooting of the current man is linked to the forgetfulness of what is the most essential, namely, the existence itself. The question that guides this study is to investigate, via Heidegger's references and studies on suicide, to what extent the interpretation of voluntary death today is crossed by such forgetfulness. We intend to investigate to what extent the prevention actions developed by suicidology are crossed by such forgetfulness of the human's being and, in this way, they end up establishing relationships between being and entity in a consequent reduction to entity as an invariant and timeless. The path to investigate the issue will start by addressing, in greater detail, the existential analytics, the question concerning technique and the movement of forgetting the being pointed out by Heidegger to problematize the current scientific perspectives on suicide and its prevention to, then, propose a phenomenological and existential understanding about the referred phenomenon.(AU)

Martin Heidegger en su ontología destaca una característica específica del presente que atraviesa el comportamiento humano, ya sea en la filosofía, la ciencia o el sentido común: el olvido del ser. El filósofo diferencia la época actual de otras épocas históricas. El horizonte histórico contemporáneo se devela el desafío y la exploración, el intento de controlar y dominar los eventos, en la modalidad de disponibilidad y en términos de productividad. Y así aclara que todo este desarraigo del hombre actual está involucrado en el olvido de lo más esencial, que es la existencia misma. A partir de las referencias a Heidegger y de los estudios sobre el suicidio, este estudio busca saber hasta qué punto la interpretación de la muerte voluntaria hoy está atravesada por este olvido. Pretendemos investigar en qué medida las acciones de prevención desarrolladas por la suicidología se encuentran atravesadas por el olvido del ser del hombre y, de esta manera, terminan por establecer relaciones entre el ser y el ente, en una consecuente reducción al ente como invariante y atemporal. Para investigar el tema se abordará inicialmente, con mayor detalle, la analítica existencial, la cuestión de la técnica y el movimiento del olvido del ser señalado por Heidegger para problematizar las perspectivas científicas actuales sobre el suicidio y su prevención y, luego, proponer una comprensión fenomenológica y existencial sobre el referido fenómeno.(AU)

Notas para decolonizar os estudos transpessoais no brasil: contribuições do pluriperspectivismo participativo / Notes for decolonizing transpersonal studies in brazil: contributions of participatory pluriperspectivism / Apuntes para la decolonización de los estudios transpersonales en brasil: aportes del pluriperspectivismo participativo

O campo dos estudos transpessoais tem avançado em diversas áreas no Brasil. Comemorou seus 40 anos com uma inserção ativa nas Instituições de Ensino Superior (IES) e uma ampliação de núcleos formativos e apoiadores de ensino, pesquisa e ações sociais, além de diálogos com o Sistema de Conselhos de Psicologia. Desafios são apresentados a partir do levantamento de uma série de questões importantes e ignoradas dentro da Psicologia Transpessoal no Brasil. Apresentamos o pluriperspectivismo participativo como possibilidade de decolonizar as matrizes eurocêntricas e estadunidenses, que dão suporte ao pensamento transpessoal brasileiro, buscando honrar nossas raízes históricas e incluir outras epistemologias e ontologias, que dão continuidade à crítica à lógica cartesiana moderna. Indicamos uma breve agenda de notas temáticas que carecem de um processo decolonizador no campo transpessoal: a) crítica às perspectivas de um pensamento hegemônico, em termos globais por meio da dominação Norte-Sul ou no campo das relações sociais; b) revisão das formas de "centrocentrismo"; c) questionamento da noção de universalismo das ciências e da ética; d) aprofundamento da análise crítica da supremacia restritiva da racionalidade formal técnico-científica em relação às formas de subjetividade, de vivências holísticas e integradoras e de valorização do corpo; e) revisão da noção de sujeito moderno desprovida da cocriação do humano com a comunidade, a história, a natureza e o cosmos.(AU)

The field of transpersonal studies has advanced in several areas in Brazil. It celebrated its 40th anniversary with an active insertion in Higher Education Institutions (HEI) and an expansion of training centers and supporters of teaching, research, and social actions, in addition to dialogues with the System of Councils of Psychology. Challenges are presented based on a survey of a series of important and ignored issues within Transpersonal Psychology in Brazil. We present participatory pluriperspectivism as a possibility to decolonize the Eurocentric and North American matrices that support Brazilian transpersonal thought, seeking to honor our historical roots and include other epistemologies and ontologies, which continue the critique of modern Cartesian logic. We indicate a brief agenda of thematic notes that lack a decolonizing process in the transpersonal field: a) criticism of the perspectives of a hegemonic thought, whether in global terms via North-South domination or in the field of social relations; b) review of the forms of "centrocentrism"; c) questioning of the notion of universalism of science and ethics; d) deepening of the critical analysis of the restrictive supremacy of the technical-scientific formal rationality in relation to the forms of subjectivity, of holistic and integrative experiences, and of valuing the body; e) review of the notion of the modern subject devoid of the co-creation of the human with the community, the history, the nature, and the cosmos.(AU)

El campo de los estudios transpersonales ha avanzado en varias áreas de Brasil. Se celebró su 40.º aniversario con una inserción activa en Instituciones de Educación Superior (IES) y una ampliación de los centros de formación y promotores de la docencia, la investigación y la acción social, además de diálogos con el Sistema de Consejos de Psicología. Los desafíos se presentan a partir de una encuesta de una serie de temas importantes e ignorados dentro de la Psicología Transpersonal en Brasil. Presentamos el pluriperspectivismo participativo como una posibilidad para decolonizar las matrices eurocéntrica y americana, que sustentan el pensamiento transpersonal brasileño, buscando honrar nuestras raíces históricas e incluir otras epistemologías y ontologías que continúan la crítica de la lógica cartesiana moderna. Indicamos una breve agenda de apuntes temáticos que carecen de un proceso decolonizador en el campo transpersonal: a) crítica de las perspectivas de un pensamiento hegemónico, ya sea en términos globales a través del dominio Norte-Sur o en el campo de las relaciones sociales; b) revisión de las formas de "centrocentrismo"; c) cuestionamiento de la noción de universalismo de la ciencia y la ética; d) profundización del análisis crítico de la supremacía restrictiva de la racionalidad formal técnico-científica en relación a las formas de subjetividad, de experiencias holísticas e integradoras y de valoración del cuerpo; e) revisión de la noción de sujeto moderno desprovisto de la cocreación de lo humano con la comunidad, la historia, la naturaleza y el cosmos.(AU)

Licentîa hypomnema: reflections and perceptions in teacher education / Licentîa hypomnema: reflexões e percepções na formação de educadoras(es) / Licentîa hypomnema: reflexiones y percepciones en la formación del profesorado

Student protagonism is paramount in the knowledge construction process. In this paper, we discuss a didactic-pedagogical resource called licentîa hypomnema (LH), inspired in portfolios and learning diaries in which student-teachers record their understandings and reflections regarding pedagogical topics learned at University in a meta-learning process on learning about teaching. The initial context of the research was a Psychological Development and Teaching course, offered in the Teacher Education program at Universidade de Brasília (UnB). Two of the authors, then Literacy and Languages Teaching students, produced their LH and peer assessed each other during the course. In their annotations, the student-authors recorded two pedagogical situations related to the use of LH in their own teaching practices, causing an impact on their formative path. These materials consist of the data for analysis and discussion. Moreover, we discuss possible uses of reflexive writing in teacher education and other learning contexts. Producing a LH supports knowledge production and allows students to connect theory and practice, which consequently influences the student's teaching practice. Since LH is a didactic-pedagogical resource and not a close-ended tool, both the context and individuals who use it should be considered.(AU)

O protagonismo de estudantes tem grande importância no processo de construção do conhecimento. Neste artigo, discutimos um recurso didático-pedagógico chamado licentîa hypomnema (LH), inspirado em portfólios e diários de aprendizagem, isto é, estudantes de licenciatura escrevem suas compreensões e reflexões acerca de assuntos pedagógicos vistos na universidade em um processo de meta-aprendizagem sobre aprender a ensinar. O contexto inicial da pesquisa foi um curso de Desenvolvimento Psicológico e Ensino, ministrado em cursos de Licenciatura da Universidade de Brasília (UnB). Duas das autoras eram estudantes do curso de Letras, elas produziram seus LH, realizando avaliação por pares entre si durante o curso. As estudantes-autoras trouxeram em seus registros duas situações pedagógicas relacionadas ao uso desse recurso em suas próprias práticas de ensino que causaram um impacto em suas trajetórias formativas. São esses relatos que compõem os dados para análise e discussão. Além disso, procuramos discutir possíveis desdobramentos para o uso do recurso da escrita reflexiva na formação docente e em outros contextos de aprendizagem. A produção do LH fornece suporte para a produção de conhecimento e permite ao aluno conectar teoria e prática, o que, consequentemente, reverbera na prática de ensino do aluno. O LH é um recurso didático-pedagógico e não uma ferramenta fechada, portanto, tanto o contexto quanto as pessoas que o utilizam devem ser considerados.(AU)

El protagonismo de los estudiantes tiene gran importancia en el proceso de construcción del conocimiento. En este trabajo, discutimos un recurso didáctico-pedagógico llamado licentîa hypomnema (LH), que se inspira en diarios de aprendizaje, es decir, estudiantes de profesorado escriben sus comprensiones y reflexiones sobre temas pedagógicos aprendidos en la universidad, produciendo un proceso de meta-aprendizaje sobre aprender a enseñar. El contexto inicial de la investigación fue un curso de Desarrollo Psicológico y Enseñanza, impartido en el programa de Formación de Profesores de la Universidade de Brasília (UnB). Dos de las autoras eran alumnas de la carrera de Letras que produjeron sus LH y realizaron una evaluación por pares mutua durante el curso. Las estudiantes autoras plantearon en su LH dos situaciones pedagógicas relacionadas con el uso de este recurso en sus propias prácticas de enseñanza, causando un impacto en su trayectoria formativa. Estos materiales constituyen los datos para el análisis y la discusión en esta investigación. Buscamos discutir posibles desdoblamientos para el uso del recurso de la escritura reflexiva en la formación docente y en otros contextos de aprendizaje. La producción de este recurso da soporte a la producción de conocimiento y permite al estudiante conectar teoría y práctica, lo que consecuentemente repercute en su práctica docente. El LH es un recurso didáctico-pedagógico y no una herramienta cerrada, por lo tanto, se debe considerar tanto el contexto como las personas que lo utilizan.(AU)

Living With Cardiovascular Disease: Existential Meaning of Lifestyle Change.

This study aims at exploring the perspectives of patients with cardiovascular disease (CVD) on the existential meaning of lifestyle change as an evidence base for spiritual care by nurses and other health professionals. This study has been carried out within the paradigm of phenomenological caring sciences. The sample of 18 participants was purposively selected. Data consisted of in-depth interviews among adults with an episode of CVD. Data analysis of transcribed audio recordings was done using the method of Reflective Lifeworld Approach. For patients with CVD, changing one's lifestyle is an experience of transition in self-image. This transition has a twofold dynamic. On the one hand, it entails alternating phases in what is meaningful for the patient: letting go (loss of the normal, of health, of bodily functions) and holding on (desire to be healthy and to be normal). On the other hand, through the vulnerability and loneliness patients often experience, patients report a need to be encouraged by and connected to others/the Other. Making brave choices and connecting to the patients' spiritual resources of inner strength are crucial for successful lifestyle changes and meaningful transition to a new lifestyle. Lifestyle change is not only a physical and psychological process for the patient with CVD but also an existential transition that involves fundamental views and values of being human. It is an experience that is in part socially influenced, that is, by encouragement from meaningful others. For the health care worker, knowledge of this experience may help provide spiritual care after CVD.

Exploring the Use of Psilocybin Therapy for Existential Distress: A Qualitative Study of Palliative Care Provider Perceptions.

There is a growing body of research suggesting that palliative care patients coping with existential distress may benefit from psilocybin. However, there is a large gap regarding the perceptions of palliative care providers who may provide education, counseling services, recommendations, and/or prescriptions for psilocybin if it is decriminalized, commercialized, and/or federally rescheduled and legalized. The aim of this study was to explore the experiences and perceptions of interdisciplinary palliative care providers regarding existential distress and the use of psilocybin therapy. Five (n = 5) health care providers from a hospital-based palliative care team completed a semi-structured interview related to their experiences supporting patients with existential distress and their beliefs and attitudes related to psilocybin as a possible treatment modality. A qualitative descriptive approach was used to identify key themes which included: 1) multiple barriers to addressing existential distress at the cultural, institutional/organizational, relational, and individual levels, 2) the duality and power of presence, 3) suffering as an intrinsically subjective phenomenon, and 4) uncertainty about the risks and benefits of psilocybin. To inform an inclusive, safe, and holistic approach, more research is needed regarding the possible integration of psilocybin therapy within palliative care for the treatment of existential distress.

Spiritual Needs of the Muslim Elderly Living in Nursing Homes: A Qualitative Study.

Paying attention to and meeting the needs of people who are elderly helps to improve their health. Caring for the elderly includes addressing their spiritual needs which has been less investigated. This study aimed to examine the spiritual needs of the Muslim elderly living in nursing homes. A qualitative study was conducted using conventional content analysis. Seventeen elderly people (nine women and eight men) were selected from four nursing homes in Iran using purposive sampling. The subjects were asked to participate in semi-structured interviews. The interview transcripts were analyzed using content analysis. First, semantic units were identified and then related codes were extracted and classified into categories and subcategories based on their similarities. Finally, themes were extracted from the data. The elderly's spiritual needs were classified into three main themes: religious needs, existential needs, and communication needs. Religious needs were divided into religious beliefs, individual religious practices, and collective religious practices. Existential needs were categorized as meaning of life, purpose of life, and need for peace. Communication needs were conceptualized to include relationship with God and relationship with others. It is argued that caregivers of the elderly should recognize the elderly's spiritual needs, including religious, existential, and communication needs, and attempt to maintain and promote the elderly's spiritual health.

Meanings of "the existential" in a Secular Country: A Survey Study.

"The existential" is a concept that many people use albeit associated with different meanings. In order to increase research-based insight into the meaning of "the existential," we conducted a questionnaire study in Denmark in 2018 in which we asked 1.106 Danes of various age, gender, educational and geographical background about personal associations linked to "the existential." Factor analysis of the answers resulted in three different groups of meaning: (1) essential meanings of life, (2) spirituality/religiosity and (3) existential thinking. The findings show that "the existential" serves well as an overarching construct potentially including secular, spiritual and religious meaning domains, at least within the European context.

The CASH assessment tool: A window into existential suffering.

Spiritual beliefs and practices have long served as a critical component of treating or managing serious illness. There is evidence to suggest that patients would like healthcare professionals to address their existential and spiritual needs. The CASH Assessment Tool focuses on four key areas of spiritual concern: Care, Assistance/Help, Stress, and Hopes/Fears. In this QI Project, a palliative care team within an urban, safety net, tertiary-care, and academic healthcare setting sought to elicit themes from the CASH assessment used by chaplains caring for patients with serious illnesses. Thirty patients were included in the pilot. Themes identified included knowing the patient as a person, concern about loved ones, concern about pain, and fear of death. We found that the CASH Assessment Tool was able to demonstrate the existential concerns of patients and serve as a framework for discussion about concerns and hopes of patients with serious illness.

Spiritual Well-Being and Its Association with Coronary Artery Disease.

Cardiovascular diseases are the main cause of mortality in the world, generating important socioeconomic and cultural impacts. Spirituality has been associated with the main risk factors for acute myocardial infarction, influencing lifestyle, and drug treatment compliance. Estimate the level of spiritual well-being and its association with coronary artery disease. We conducted a case-control study with 88 adults (42 cases and 46 controls) individually interviewed. Using a spiritual well-being scale and collecting socioeconomic and demographic information. We compared groups by Chi-square and Mann-Whitney tests. Friedman's analysis of variance was used to evaluate the differences between the values assigned to the scale items in each group. Statistically, there was no significant difference between categories and levels of spiritual well-being in any of the groups. Both had high rates, driven by the high level of religious well-being. There was no difference between the rates attributed to the items on the subscale of religious well-being, in the case or control groups (p = 0.959 and p = 0.817). However, the existential well-being subscale revealed variability between the scores attributed to each item in both groups (p < 0.001). The results revealed a high level of spiritual well-being in the analyzed sample. There was no correlation between the levels of spiritual, religious, and existential well-being with coronary artery disease, possibly due to the reduced ability of the religious well-being subscale to discriminate between groups.

Saúde mental e a enfermagem fundamentada na teoria de Viktor Frankl: revisão integrativa / Mental health and nursing based on Viktor Frankl's theory: an integrative review

Objetivo:analisar a produção científica de enfermagem em saúde mental fundamentada na teoria de Viktor Frankl no período de 2011 a 2021. Método:revisão integrativa desenvolvida com seis artigos que abordam enfermagem em saúde mental com uso da teoria de Viktor Frankl. Para a busca, utilizou-se portal Capes, Biblioteca Virtual de Saúde, PubMed e Biblioteca do Conhecimento on-line. Os estudos foram avaliados a partir do checklist proposto pelo Critical Appraisal Skills Programme, e descritos suas principais características, resultados, convergências e conclusões. Resultados:todos os estudos analisados têm metodologia fenomenológica, cinco obtiveram classificação alta conforme checklist Casp, e tiveram abordagens como o cuidado a pessoa idosa, àquelas com doenças crônicas hospitalizadas, cuidado paliativo e o processo de ajuda ao familiar dessas pessoas. Houve convergências entre os estudos nos aspectos de espiritualidade, sentido de vida, sacralidade, fé, adoecimento, diagnóstico, sofrimento, possibilidades de cura, família e resiliência. Conclusão:o enfermeiro tem produzido conhecimento na perspectiva do referencial frankliano, fundamentando sua prática em teoria e contribuído com a saúde mental das pessoas sob sua responsabilidade, contudo evidencia-se a necessidade de capacitação desse profissional quanto a espiritualidade e saúde mental para assistir as pessoas em contextos variados de cuidado

Objective: analyzing the scientific production of mental health nursing based on Viktor Frankl's theory, from 2011 to 2021.Method: anintegrative review developed with six articles that address mental health nursing using Viktor Frankl's theory. Capes portal, Virtual Health Library, PubMed and online Knowledge Library were used for the search. The studies were evaluated from the checklist proposed by the Critical Appraisal Skills Programme, and described its main characteristics, results, convergences and conclusions.Results: all studies analyzed have phenomenological methodology, five obtained high classification according to Casp checklist, and had approaches such as care for the old person, those with hospitalized chronic diseases, palliative care and the process of helping the family members of these people. There were convergences between studies in the aspects of spirituality, meaning of life, sacrality, faith, illness, diagnosis, suffering, possibilities of healing, family and resilience. Conclusion: nurses have produced knowledge from the perspective of the Franklian framework, basing their practice on theory and contributing to the mental health of the people under their responsibility; however, it is evident the need for training of this professional regarding spirituality and mental health to assist people in a varied context of care.

Existential transformations in the process of facing amyotrophic lateral sclerosis by the family caregiver.

OBJECTIVE: To understand the existential transformations of the family caregiver of a person living with Amyotrophic Lateral Sclerosis. METHOD: Qualitative study based on assumptions of Martin Heidegger Existential Phenomenology, with 12 family caregivers of the person with Amyotrophic Lateral Sclerosis, in Alagoas. The testimonies were obtained from June 2019 to March 2020 and analyzed, categorized, and discussed based on the theoretical-philosophical framework adopted and thematic literature. RESULTS: Phenomenological sense of the existential transformations of the family caregiver of a person living with Amyotrophic Lateral Sclerosis, unveiled with the categories: Being the caregiver of the person living with ALS; Being responsible for decision making; Resignifying the existence in view of the possibility of loss; Spirituality influencing the transformation process. CONCLUSIONS: The family caregiver has an appropriate life due to the inherent vicissitudes of the disease, which provides moving moments that lead him to rethink his existence and to value life.

Shades of hope: Marcel's notion of hope in end-of-life care.

This article examines the compatibility and relevance of Gabriel Marcel's phenomenology of hope in interdisciplinary research on the role of hope in end-of-life (EOL) care. Our analysis is divided into three thematic topics which examine the various shades of hope observed in Marcel's phenomenology of hope and in the collection of 20 EOL studies on hope as experienced by adult palliative care (PC) patients, health care professionals (HCP) and parents of terminally ill children. The three topics defining the shades of hope are: the meaning of hope in its dynamic aspects, the dialectics of hope and despair, and the transcendent facets of hope. We analyse how Marcel's understanding of hope is reflected in EOL studies, and how this perception can enrich the philosophy of PC and significantly deepen and broaden HCPs' understanding of hope. Our findings prove that despite terminological differences between Marcelian phenomenology and the concepts of hope in the 20 EOL studies, hope emerges as a resourceful movement towards being. Implementing Marcelian hope within communication in EOL care could help in HCPs' interpersonal approach to patients as his concept harbors a holistic perception of the existential situation of a person. Equally, introducing Marcel's phenomenology of hope into the clinical encounter could play a beneficial role in improving the ability of patients to adapt to the difficult conditions of their disease and PC treatment.

Reflection on the phenomenology of Merleau-Ponty and its contributions to nursing research.

OBJECTIVE: To elaborate a reflection on the phenomenology of Merleau-Ponty and her contributions to nursing research. METHODS: This is a reflective theoretical study based on one of Merleau-Ponty's works and recent scientific literature on the subject. RESULTS AND DISCUSSION: Three themes were developed that combine the contribution of Merleau-Ponty's phenomenology, starting from the central concepts of philosophy and nursing care. The approach to the body not only from a biological expression, but from the phenomenology of the lived body provides an existentialist vision of the understanding of the human being immersed in the world and its relations with holistic care. FINAL CONSIDERATIONS: Merleau-Ponty's philosophical reference is very useful in the generation of nursing knowledge, constituting a support for phenomenological research since it allows the understanding of the subjective phenomena of care through the body.