Nutrition, Chronic Care, Measurement Scales and COVID-19.

In the year of the Olympics (Paris, 2024), this issue of JORH explores nutrition and chronic care, offers a caution regarding the use of religiosity and spiritual measurement scales, and revisits the topic of COVID-19. While the latter has been rapidly declining in terms of its global impact, each of these areas of inquiry generate a great deal of research from which humanity still has much to learn.

Mild Cognitive Impairment, Religiosity, Spirituality and all-Cause Mortality Among Chinese Older Adults in Ethnic Minority Communities.

The relationship between mild cognitive impairment (MCI), religiosity and/or spirituality (R/S), and all-cause mortality among older adults has yet to be clarified. The current study aims to examine this relationship using a longitudinal cohort from ethnic minority communities in mainland China. The Cox proportional hazards regression modeling revealed that MCI predicted an increased risk of all-cause mortality, and high R/S buffered this association. Those findings suggest that a religious-spiritual integrated community intervention program may reduce the mortality risk in older adults with MCI in ethnically disadvantaged populations.

Exploring the Transformative Aftereffects of Religious Experiences on Pilgrims Along the Camino de Santiago in Spain.

This study examines religious experiences (REs) and their transformative aftereffects (TAs) among pilgrims on the Camino de Santiago. Analyzing 32 travelogue testimonies and survey data from 501 participants, it identifies three key dimensions of post-RE transformations: heightened Unity and Love, a strong commitment to the Apostolic Mission, and expanded Spirituality, Wisdom, and Detachment. Pilgrims report a shift toward greater love, unity with nature, and sharing insights, as well as increased spirituality and reduced materialism. The study finds significant correlations between TAs and individuals prioritizing their relationship with God and regular religious practices, highlighting REs' impact on societal values and beliefs.

The Spiritual Well-Being Scale in the Polish Catholic Setting: Construct, Structure, and Relationships with Psychological Well-Being.

The population of Poland could be of particular interest to researchers studying religion and spirituality. Catholicism has played a significant role in shaping the country's culture, history, and tradition and is considered a national religion. More recently, however, the processes of moving away from regular participation in religious services and loosening ties with the institution of the Catholic Church are marked (Polish Public Opinion Research Center, CBOS). The Polish Catholic setting may modify the associations between psychological variables that have been studied in their relationships with spirituality, which have been investigated in religious contexts differing from a Polish Catholic one. Given this context, we examined the internal structure of spiritual well-being in the sample of present-day Polish Catholics (Study 1) and how spiritual well-being is related to mental health (Study 2). The internal structure of the Spiritual Well-Being Scale was replicated in the Polish sample, but only positively worded items loaded on the Religious and Existential Well-Being subscales. Spiritual well-being was positively related to positive mood, satisfaction with life, and psychological well-being; it was negatively associated with negative mood, depression, and anxiety, thus remaining significantly related to psychological well-being among Polish Catholics.

Faith, Meaning, and Quality of Life: Unveiling the Spirituality of Muslim Patients with Advanced Cancer Undergoing Active Treatment in the Gaza Strip, Palestine.

OBJECTIVES: This study aimed to identify the level of spirituality, faith and meaning, and quality of life (QOL) among Muslim advanced cancer patients undergoing active treatment and to enhance the understanding of the relationships among clinical and socio-demographic factors, spirituality, and QOL of patients in the Gaza Strip. METHODS: A secondary analysis was conducted on a convenience sample of 298 advanced cancer patients. The Arabic versions of the Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used for data collection. Descriptive statistics and generalized linear regression were utilized for data analysis, performed using SPSS 25.0. RESULTS: Participants reported high spirituality well-being scores (Mean = 31.25, SD = 6.25) and relatively high scores on the subscales of meaning/peace (Mean = 19.15, SD = 4.11) and faith (Mean = 12.03, SD = 3.50). Most patients indicated that their faith and spiritual beliefs increased due to their illness. Furthermore, a significant positive relationship was found between spirituality (including its subscales of faith and meaning in life) and QOL. Despite the generally high level of spirituality, special attention should be paid to patients with lung, bladder, and thyroid cancer, lower education levels, and higher cancer grades. CONCLUSIONS: The Gazan Muslim patients with advanced cancer exhibit high levels of spirituality and faith. We acknowledged that spiritual well-being is a protective factor for QOL. The strong positive correlation between spirituality and QOL emphasizes the need to integrate spiritual care into cancer care. IMPLICATIONS FOR NURSING PRACTICE: It is imperative to incorporate spirituality into health practice and the daily routines of cancer treatment for patients whose spirituality is an important aspect of their identities. The incorporation of spirituality can contribute to the improvement of the quality of patients' life and quality of cancer care.

A social work contribution in end-of-life care: incorporating critical spirituality.

This article outlines how a framework for critical spirituality incorporated into a social work perspective, can contribute to work in end-of-life care. This is based on my experience of working in interdisciplinary teams, including pastoral care workers or chaplains, nurses, doctors, a range of carers and other allied health professionals. Traditionally, social workers have focused on the holistic well-being of the dying person and their families but tended not to actively include the spiritual. However, there is increased recognition in social work of the value of integrating critical spirituality: understanding the person's own sense of meaning and the social assumptions that might influence how this can be expressed. This might mean working with individuals and families on understanding how societal expectations of the dying process are undermining the person's desire to die in a particular way. To do this, workers must themselves recognise their own internalised societal assumptions and be willing to challenge these. The article explores the potential value of how such a social work approach can integrate critical, postmodern, green and relational theories as well as indigenous worldviews with key qualities of practice such as humility, deep listening and waiting, and the ability to be critically reflective. Key ideas are used to help focus practice and the inclusion of critical spirituality. These include (1) exploring the influence of the person's history and social context; (2) the value of particular relationships and networks, including community and environmental connections and activities and processes that are an intrinsic aspect of the person's well-being; (3) challenging workers to be critically and reflectively aware of their own assumptions and values to ensure the dying person can truly express their preferences related to death and dying. Examples from my experience are used to illuminate how such perspectives can be actively included in practice across professional boundaries to shift perceptions of 'how things are done here' to what can be more life enhancing for those in palliative care.

Age-Related Variation in Ecological Resources Among Veterans Seeking Treatment Related to Military Sexual Trauma.

Approximately 16% of Veterans experience military sexual trauma (MST), defined as sexual assault or harassment experienced during military service. Veterans across life stages may possess differing resources and face unique stressors that impact their ability to engage in mental health treatment or require additional liaison to services. The present study sought to characterize age-related differences in the socioecological contexts of Veterans seeking mental health treatment following MST in the domains of economic sufficiency, housing, spiritual coping, supportive relationships, and interpersonal violence. From 2009 to 2019, Veterans (N = 640) seeking mental health services following exposure to MST attended evaluation and treatment planning sessions at a Midwestern Veterans Health Administration posttraumatic stress disorder specialty clinic. Veterans completed semistructured interviews that included surveys and diagnostic screenings to assess psychosocial needs and resources. ANOVA and ordinal regressions were used to evaluate potential disparities in socioecological resources by age. No age-related differences in economic sufficiency and stable housing emerged, though most Veterans (57%) endorsed financial difficulties. Veterans who endorsed spiritual beliefs were significantly older than those who did not. Veterans who reported having a support system were significantly younger than Veterans who denied having a support system. Less than half (46%) of Veteran reported having peer relationships. Veterans who endorsed frequent interaction with their peers were significantly older than those who did not. Veterans who reported past-year exposure to interpersonal violence were significantly younger. Greater clarity about age-related differences in the socioecological contexts of Veterans can support clinicians in providing responsive mental health treatment and connecting Veterans to additional Veterans Health Administration resources following MST.

Improving Outcomes for ICU Family Members: The Role of Spiritual Care.

Having a family member hospitalized in the intensive care unit (ICU) can be a stressful experience for family members, encompassing both psychological and spiritual distress. With over 5 million ICU admissions annually in the United States, it is imperative to enhance the experiences and coping mechanisms of ICU family members. In particularly challenging situations, some family members even face psychological effects known as post-intensive care syndrome-family, which includes anxiety, depression, and posttraumatic stress. The distress may be worsened when patients and families experience poor communication or medical care, which has been shown to be more common among minoritized populations including Black and Hispanic patients and families. Family members' emotional and spiritual distress also has an effect on the medical decisions they make for the patient. While research has delved into the impact of spiritual care for ICU family members, further investigation is still needed to determine the most effective approaches for delivering such care. This narrative review will describe a conceptual model aimed at guiding future research in this endeavor. The model proposes that chaplains provide emotional, spiritual, and information support to ICU family members. This affects both their ICU experience, decision making, and outcomes for the patient and family. This process is also affected by characteristics of the family such as race, ethnicity, and economic status. This model helps identify gaps in research, including the need for randomized trials of spiritual care that identify mechanisms underlying outcomes and demonstrate impact of spiritual care, and consider race, ethnicity, and other characteristics.

Determination of Comfort Levels and Spiritual Care Needs of Gynecologic Cancer Patients with Abdominal Drains: A Cross-Sectional Descriptive Study in Turkey.

This study was conducted to determine the comfort levels and spiritual care needs of gynecologic cancer patients with abdominal drains. The study was conducted with 61 gynecologic cancer patients with abdominal drains at the gynecologic oncology surgery clinic of a state hospital in Turkey. Data were collected using the "Participant Information Form," "Perianesthesia Comfort Questionnaire (PCQ)", and "Spiritual Care Needs Inventory". Kolmogorov-Smirnov test and Mann-Whitney U test were used to analyze the data. It was found that the postoperative comfort of the patients in this study was above a moderate level. Patients who did not need spiritual care, did not fulfil religious rituals regularly and did not receive social support had a high level of comfort in the early postoperative period. Patients with gynecologic cancer were found to have high spiritual care needs. Patients without chronic diseases, possessing a single abdominal drain, familiar with the concept of spiritual care, expressing a need for spiritual care, engaging in regular religious rituals, and enjoying social support were identified as having elevated spiritual care needs. Within the framework of holistic nursing care provided to gynecologic cancer patients with abdominal drains, the results reveal the necessity of spiritual care and the importance of comfort.

Discussion of Spirituality in Family Conferences of Infants with Neurologic Conditions.

INTRODUCTION: Spirituality serves as a mechanism to understand and cope with serious illness, yet little is known about how families and clinicians incorporate spirituality in pediatric family conferences. OBJECTIVES: We sought to characterize the frequency and nature of spiritual statements in conferences between families and clinicians caring for infants with neurologic conditions. METHODS: In this descriptive qualitative study, we used an existing dataset of audio-recorded, de-identified, transcribed family conferences of infants with neurologic conditions. Inclusion criteria for infants were 1) age < 1 year, 2) presence of a neurologic condition, and 3) planned conversation about neurologic prognosis or goals of care. We used a content analysis approach to code the data. RESULTS: 68 family conferences were held for 24 infants and 36 parents. Most parents (n=32/36, 89%) self-identified as spiritual. References to spirituality occurred in the 32% of conferences (n=22/68). Spiritual discussion included 3 domains: 1) Spiritual beliefs and practices, 2) Spiritual support, and 3) Parent-child connection as sacred. Clinicians' responses to family member spiritual statements were inconsistent and included providing affirmation, exploring goals of care, and continuing discussion of clinical information. CONCLUSIONS: Spirituality was discussed in approximately one-third of family conferences. Clinician engagement with spirituality discussion was variable. These findings highlight a need for training on when and how to discuss spirituality in conversations with families of seriously ill infants.

Interpersonal and individual effects of an app-based Christian and Islamic heart meditation intervention in healthy adults: protocol of a stratified randomised controlled trial.

BACKGROUND: The academic development and widespread adoption of meditation practices for well-being and therapy have predominantly focused on secularised adaptations of Buddhist and Hindu techniques. This study aims to expand the field by investigating Christian and Islamic meditation that emphasize the spiritual significance of the heart through elements of visualisation and recitation. It compares the effects of spiritual heart-centred meditation with mindfulness meditation and a waitlist control, focusing on dimensions of social functioning, psychophysiology, cognition, and mental health. METHOD: This study employs a stratified 3-arm randomised controlled method with mixed-method repeated measures across three assessment time points: before intervention (T1), after an 8-week intervention (T2), and at a 3-month follow up (T3). The three conditions include spiritual meditation (either Christian or Islamic), mindfulness meditation (Mindfulness-Based Stress Reduction - MBSR), and a waitlist. Participants will be stratified into Christian and Muslim samples and randomly allocated to the spiritual meditation, MBSR, or waitlist control conditions. Importantly, participants assigned to the spiritual meditation condition will be matched to the spiritual meditation program corresponding to their religion. The intervention will be administered through a mobile phone app with daily 20-minute guided meditation sessions for eight weeks. Primary outcomes pertain to the domain of interpersonal functioning, focusing on prosociality, forgiveness, empathy, and perspective taking. Secondary outcomes include physiology: pain tolerance, pain intensity, stress reactivity assessed via heart rate (HR) and heart rate variability (HRV), psychophysiological reactivity associated with a forgiveness task as measured through HR and HRV, attention (alerting, orienting, and executive attention networks), and mental health (stress, depression, anxiety, subjective well-being, positive and negative affect). DISCUSSION: This trial aims to test the effects of an app-based Christian and Islamic meditation, compared to secular mindfulness and a waitlist, using a randomised controlled trial. If the results yield positive outcomes, this study will support the efficacy of these contemplations, offering practitioners a way to enhance their well-being within their religious framework. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06136676. Registered on 18 November 2023. https://clinicaltrials.gov/study/NCT06136676 .

Forgiveness and Religiosity Among Nurses: A Correlational Descriptive Study.

The purpose of the study was to explore how nurses' religious beliefs affect their ability to forgive themselves and others. Design: A descriptive correlational mixed methods approach was employed. Methods: The data were collected using an online survey via Qualtrics using three validated tools Enright Forgiveness Inventory - 30 (to measure forgiveness of others), Enright Self-Forgiveness Inventory (to measure forgiveness of self), and Duke University Religious Index (to measure religiosity). Findings: As hypothesized, there was a meaningful relationship between forgiveness of others and intrinsic religiosity. Nurses with intrinsic religiosity or internal beliefs of a higher being showed a higher level of forgiveness toward their offender. The nurse forgiving the offender chose to replace negative, hurtful feelings with positive emotions such as compassion and love. Conclusion: Stressed nurses become distracted, may miss effective job performance, and patient care may suffer. Emotional and spiritual health and better patient outcomes can be attributed to the nurse forgiving others and the self. Nurses must be self-aware to develop forgiveness strategies for their well-being and provide effective care. Faculty should teach "person-centered" care and educate students to forgive others and themselves for effective patient care.

Gerotranscendence as a Life Perspective Among Nursing Home Residents: A Qualitative Study Into Positive Ageing While Dependent on 24/7 Care.

AIMS: To examine whether and how older nursing home residents recognise characteristics of gerotranscendence, and to contribute to a critical and comprehensive view of gerotranscendence in this particular group. BACKGROUND: Gerotranscendence is a psychosocial, spiritual development theory within the field of positive ageing that represents: a shift in meta-perspective, from a materialistic and rational vision to a cosmic and transcendent life perspective, followed by an increase in life satisfaction. DESIGN: A qualitative study using a narrative hermeneutical approach. METHODS: Participants were 20 residents of a nursing home in the Netherlands, aged 77 to 105 (mean age: 90). The semi-structured interviews, conducted in April 2023, were based on Tornstam's 10-item Gerotranscendence Scale. Special attention was paid to the technique of interviewing these frail, older adults, some of them diagnosed with dementia. FINDINGS: All respondents recognised several characteristics of gerotranscendence, or signs of it emerged from the research data. There is a larger middle group with respondents who call themselves 'down-to-earth'. They mainly recognise the relational characteristics. Another group appears to be more contemplative and shows more affinity with the abstract, cosmic characteristics. They have developed a gerotranscendent wisdom: there is insight, contextualism and relativism, peace of mind, room for life's paradoxes, a high degree of (self-)acceptance and an ability to 'let go'. The data show considerable heterogeneity in thoughts, perspectives and degrees of gerotranscendence. DISCUSSION: Respondents found some questions difficult to answer, resulting in a critical assessment of how to understand the responses given. This puts pressure on data quality for this current study and for critical gerotranscendence research in general. Furthermore, interviewing older nursing home residents requires a custom setting and possibly a new interview methodology. REPORTING METHOD: This report adheres to the standards for reporting qualitative research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Children who claim previous life memories: A case report and literature review.

OBJECTIVE: Academic investigation of thousands of children who claim past-life memories has been developed worldwide for five decades. However, despite the scientific and clinical significance of this substantial body of research, most clinicians and scientists are not aware of it. This study aims to report a case of a child who claimed memories that match his deceased granduncle's life and to perform a literature review of the main characteristics and implications of children's past-life claims. METHOD: We investigated the case through interviews with the child and first-hand witnesses, and conducted a documental analysis to verify possible associations between the child's statements and facts from the deceased's life. We also performed a CT scan of the child's skull to verify possible associations between anatomical features and a fatal wound from the alleged previous life. RESULTS: The child presented most key features typical of such cases of claimed past-life memories. He made 13 statements about the previous life; nine were correct (e.g., the mode of death and a toy the granduncle had) and four were undetermined. The child demonstrated eight unusual behaviors that matched the previous personality´s habits, interests, and manners. The child has a birth defect (a rare occipital concavity) that is compatible with the firearm injury that caused the death of his uncle. CONCLUSIONS: The characteristics of the reported case fit the cross-cultural patterns of children who claim past-life memories, and it has scientific and clinical implications that need to be better known and investigated.

Validation of Two Questionnaires Assessing Nurses' Perspectives on Addressing Psychological, Social, and Spiritual Challenges in Palliative Care Patients.

BACKGROUND: Palliative care provides holistic support, addressing physical, psychological, social, emotional, and spiritual dimensions of suffering, known as "total pain", to improve patients' quality of life. Patients often rely on healthcare professionals, particularly nurses, for support. This study aimed to develop and validate questionnaires assessing nurses' perceptions of psychological, social, and spiritual issues in palliative care and their effectiveness in managing them. METHODS: Two self-rated questionnaires were created: the Psychological, Social, and Spiritual Problems of Palliative Patients' Questionnaire and the Effectiveness in Coping with the Psychological, Social, and Spiritual Challenges of Palliative Care Patients. The study surveyed 237 nurses caring for palliative patients in Split Dalmatian County, Croatia. RESULTS: The questionnaires demonstrated high reliability with Cronbach's α values of 0.98 and 0.99. Factor analysis revealed four factors for the first questionnaire and three for the second. Nurses primarily perceived patients as experiencing fear and emotional/spiritual suffering, with the greatest difficulty coping with the fear of the disease outcomes. Nurses acknowledged the need for improvement in addressing patient challenges, highlighting gaps in the Croatian system. CONCLUSIONS: Ongoing efforts are crucial to prioritize palliative care globally, with nursing professionals playing a vital role in symptom management.

The Mediating Role of Spirituality in Delineating the Interconnection Between Self-Efficacy and Resilience Among the Parents of Children With Newly Diagnosed Diabetes: A Community Nursing-Led Cross-Sectional Study.

AIM: This study examined the interplay among spirituality, self-efficacy and resilience in this context. DESIGN: A cross-sectional study. METHOD: A total of 178 parents of children newly diagnosed with diabetes mellitus; the instruments used for data collection were the Parental Self-Efficacy Scale for Diabetes Management, The Arabic version of The Walsh Family Resilience Questionnaire and the Spiritual Perspective Scale. RESULTS: Self-efficacy had a significant positive direct effect on family resilience. Spirituality also had a significant positive direct effect on family resilience. Additionally, self-efficacy had a significant positive indirect effect on family resilience through its effect on spirituality. CONCLUSION: The findings underscore the impact of spirituality and self-efficacy on a family resilience. IMPLICATIONS FOR THE PROFESSION: Nurses should prioritise self-care and personal reflection to enhance their spiritual well-being. This can help them better understand and empathise with their patients' spiritual needs, allowing for more effective and compassionate care. IMPACT: Upon the initial diagnosis of diabetes in a child, parents undergo a profound emotional and psychological upheaval. They are faced with the daunting task of managing their child's condition while also coping with their feelings of distress, uncertainty and fear. Amidst these challenges, factors such as self-efficacy and resilience play pivotal roles in determining how parents adapt to and navigate this new reality. Nurses can use spiritual care to give parents a sense of meaning, purpose and hope, bolstering their self-efficacy and resilience. REPORTING METHOD: The relevant reporting method has been adhered to, that is, STROBE. PATIENT OR PUBLIC CONTRIBUTION: In our research, data collection is assisted by nurses working in community-based settings.

The role of spirituality in the well-being of families with children with congenital heart disease: scoping review.

Background: Congenital heart disease (CHD) is the leading cause of death from malformations in infants and has a significant psychological impact on families. This scoping review explored the role of spirituality in supporting families of children with CHD. It also sought to identify gaps in the existing literature and suggest directions for future research. Methods: A synthesis review was conducted following the framework of Arksey and O'Malley, incorporating the principles of the Joanna Briggs Institute. We systematically searched four databases-Medline, Embase, Lilacs, and Scielo-selecting studies based on inclusion criteria focused on spirituality in families of children with CHD. Articles without full text, book chapters, lectures, conference abstracts, review articles, and editorials were excluded. We analyzed the year of publication, study location, objectives, methodology, participants of the study, and main results. Results: A total of 17 studies were included in the review, most of which were conducted in the past 10 years. The studies were conducted in various regions of the world, including Japan, the USA, China, Iran, Sweden, and Brazil, and they examined different religious traditions, including Christianity, Islam, Buddhism, and non-denominational spiritual practices. Twelve qualitative studies, three descriptive studies, one cross-sectional study, and one case report were included. The articles were categorized based on several themes: the influence of spirituality on mental and emotional well-being, cultural and religious diversity, integration of spirituality into health care, and its assistance in decision-making. Conclusions: Spirituality plays a crucial role in addressing the emotional and psychological challenges of CHD. There is a need for structured models of spiritual counseling and more research in diverse cultural and socioeconomic contexts. Identifying these gaps can help guide future studies to enhance our understanding and improve the support provided to these families, thereby promoting more holistic and patient-centered healthcare.

What enhances the quality of death and dying? A perspective from patients with terminal cancer.

AIM: This study aimed to determine which factors improve the quality of dying and death from the point of view of patients with cancer who are nearing the end of their lives. The goal was to find out what they think are necessary conditions for a good death and how they would like to be cared for and supported at the end of their lives. METHODS: This study used an exploratory research approach. Purposive sampling was used to select 21 participants from two hospices in Bengaluru and Hyderabad (Karunashraya and Sparsh), and Karnataka Cancer Hospital in Bangalore, India. Semi-structured interviews were undertaken to obtain data from the patients. Thematic analysis was used to examine the data. RESULTS: Four themes were identified: 1) Spirituality and religiosity, 2) socioemotional support, 3) Breaking silence about the stage of the disease and 4) Preparation for and embracing death. There were distinct sub-themes within some of these that were highlighted using quotes from the participants. CONCLUSIONS: The study provided a comprehensive understanding of end-of-life care, the criteria for a high-quality end of life, strategies for achieving it, and the quality of the dying process and death in advanced cancer patients. Studying patients' experiences will help inform a more robust intervention strategy and action plan to improve the quality of end-of-life care in the Indian community.

Predictors of quality of professional life and well-being of medical residents and interns: Role of gender and workplace spirituality.

Background and Aims: The well-being of physicians in their professional lives has a major influence on the quality of medical care and patient outcomes. This study explored how Professional Quality of Life (ProQOL) and psychological well-being are connected to workplace spirituality (WPS) and demographic factors like age and gender. It also compared the average levels of ProQOL, psychological well-being, and WPS between medical residents and interns. Methods: In a cross-sectional study, 230 medical residents and interns completed three questionnaires, including ProQOL, Ryff Scale Psychological Wellbeing-Short Form, and WPS. The data was analysed using Pearson correlation, independent t-test, ANOVA, and multiple linear regression modeling. Results: Residents and interns had moderate ProQOL levels and higher work spirituality. However, medical residents scored lower in occupational spirituality and compassionate care fulfillment compared to interns while experiencing higher levels of emotional exhaustion and secondary mental strain. Gender disparities were significant, with women scoring higher in compassionate care fulfillment but lower in secondary mental strain. Regression analysis showed that occupational spirituality positively predicted professional, compassionate care fulfillment (B = 0.910, p < 0.001) but negatively predicted emotional exhaustion in both groups. Conclusions: These findings underscore the importance of understanding factors like gender and work spirituality to enhance the well-being and quality of care provided by medical residents and interns.

From Hinengaro to Hineora: Tracing the origins of Intergenerational Trauma to attain Intergenerational Healing.

In Aotearoa New Zealand, colonisation continues to impact Indigenous Maori lived realities. However, Maori have been steadily progressing towards reclamation of all that was suppressed during colonisation, including tupuna (ancestor) understandings of trauma and healing, of which wairua (referring to spirit) is at the centre. My research aimed to understand the role of wairua in the intergenerational transmission of trauma and healing through exploring my own lived experiences of trauma and healing. My methodology was developed based on tupuna knowledge, resulting in the implementation of a Rongo-a-Wairua Framework, a Whakapapa Methodological Approach, Whakapapa Wananga and Te Putake: An Origin Analysis. Through this application of tupuna knowledge and the centring of wairua within the research process, I uncovered the origins of the soul wounds I had inherited, enabling me to transform from Hinengaro, The Obscured Daughter into who I am now - Hineora, The Daughter of Healing.