Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 505
Filtrar
1.
BMJ Support Palliat Care ; 10(2): 136-144, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31481477

RESUMO

BACKGROUND: Palliative sedation for existential suffering (PS-ES) is a controversial clinical intervention. Empirical studies about physicians' perceptions do not converge in a clear position and current clinical practice guidelines do not agree either regarding this kind of intervention. AIM: To gain deeper insight into physicians' perceptions of PS-ES, the factors influencing it, the conditions for implementing it and the alternatives to it. DESIGN: Systematic review of qualitative, quantitative and mixed-methods studies following the Peer Review Electronic Search Strategies and Preferred Reporting Items for Systematic Reviews and Meta-analyses protocols; quality appraisal and thematic synthesis methodology. DATA SOURCES: Seven electronic databases (PubMed, CINAHL, Embase, Scopus, Web of Science, PsycINFO, PsycARTICLES) were exhaustively searched from inception through March 2019. Two reviewers screened paper titles, abstracts and full texts. We included only peer-reviewed journal articles published in English, French, German, Dutch, Spanish, Italian or Portuguese that focused on physicians' perceptions of PS-ES. RESULTS: The search yielded 17 publications published between 2002 and 2017. Physicians do not hold clear views or agree if and when PS-ES is appropriate. Case-related and individual-related factors that influenced physicians' perceptions were identified. There is still no consensus regarding criteria to distinguish between necessary and sufficient conditions for invoking PS-ES. Some alternatives to PS-ES were identified. CONCLUSIONS: To date, there is still no consensus on physicians' perceptions of PS-ES. Further research is necessary to understand factors that influence physicians' perceptions and philosophical-ethical presuppositions underlying this perceptions.


Assuntos
Sedação Consciente/psicologia , Existencialismo/psicologia , Cuidados Paliativos/psicologia , Médicos/psicologia , Estresse Psicológico/psicologia , Adulto , Sedação Consciente/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/terapia
2.
J Palliat Care ; 35(1): 13-20, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30757945

RESUMO

CONTEXT: Though palliative sedation has been recognized as an acceptable practice in Canada for many years now, there is a lack of clinical research and guidelines pertaining to its use as a treatment of existential refractory symptoms in the terminally ill. OBJECTIVES: This scoping review aimed to survey the literature surrounding palliative sedation and existential suffering and to inform research, policy, and practice. METHODS: To address the main research question: Is palliative sedation an acceptable intervention to treat existential refractory symptoms in adults aged 65 and older? a scoping review following Arksey and O'Malley's framework was performed, spanning electronic databases of the peer reviewed and grey literature. Articles were screened for inclusion, and a thematic content analysis allowed for a summary of key findings. RESULTS: Out of 427 search results, 71 full text articles were obtained, 20 of which were included. Out of these articles, four themes were identified as key findings. These included: (1) Ethical considerations; (2) The role of the health care provider; looking specifically at the impact on nurses; (3) The need for multidisciplinary care teams; and (4) Existential suffering's connection to religiosity and spirituality. CONCLUSION: Palliative sedation to treat existential refractory symptoms was labelled a controversial practice. A shortage of evidence-based resources limits the current literature's ability to inform policy and clinical practice. There is a need for both qualitative and quantitative multi-center research so health care professionals and regional-level institutions have firm roots to establish proper policy and practice.


Assuntos
Sedação Profunda/normas , Existencialismo/psicologia , Hipnóticos e Sedativos/normas , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Estresse Psicológico/tratamento farmacológico , Doente Terminal/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Inquéritos e Questionários
3.
J Relig Health ; 59(4): 1925-1932, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31471742

RESUMO

The elderly is a period of life when a person reaches the age of 65 years. This study aimed to determine the relationship between spiritual health and religious coping with the death anxiety in the elderly people. The study is a descriptive cross-sectional study: 180 Elderly according to similar studies. Data gathering tools are Paloutzain and Ellison SH questionnaire, religious coping questionnaire and death anxiety questionnaire. SPSS16 and descriptive and analytical tests were used; there was a relationship between religious health and religious coping with the anxiety (p < 0.05).The M(SD) religious health is 39.25 (11.67), existential health is 40.50 (11.29), total spiritual health is 79.75 (22.03), and also the M(SD) religious coping is 23.84 (5.02). Considering the relationship between RC and SH with DA in the elderly, it is necessary to make the necessary spiritual-religious arrangements to reduce DA.


Assuntos
Adaptação Psicológica , Ansiedade , Morte , Religião e Psicologia , Espiritualidade , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Estudos Transversais , Existencialismo/psicologia , Humanos
4.
Psychopharmacology (Berl) ; 237(1): 21-32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31784805

RESUMO

Psychedelic therapies can engender enduring improvements in psychological well-being. However, relatively little is known about the psychological mechanisms through which the salutary effects of psychedelics emerge. Through integrating extant research on psychedelics with contemporary existential psychology, we present a novel hypothesis that reduced death anxiety may be a key mechanism underpinning the therapeutic effects of psychedelics. In developing this hypothesis, we also provide a complementary review of mechanisms through which psychedelics may reduce death anxiety. We conclude that an awareness of the role of death anxiety in psychopathology has the potential to guide future research into psychedelic therapies.


Assuntos
Ansiedade/tratamento farmacológico , Morte , Existencialismo/psicologia , Alucinógenos , Alucinógenos/farmacologia , Alucinógenos/uso terapêutico , Humanos , Psicopatologia
5.
J Palliat Care ; 35(1): 8-12, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30968741

RESUMO

Existential suffering is commonly experienced by patients with serious medical illnesses despite the advances in the treatment of physical and psychological symptoms that often accompany incurable diseases. Palliative care (PC) clinicians wishing to help these patients are faced with many barriers including the inability to identify existential suffering, lack of training in how to address it, and time constraints. Although mental health and spiritual care providers play an instrumental role in addressing the existential needs of patients, PC clinicians are uniquely positioned to coordinate the necessary resources for addressing existential suffering in their patients. With this article, we present a case of a patient in existential distress and a framework to equip PC clinicians to assess and address existential suffering.


Assuntos
Existencialismo/psicologia , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Papel do Médico/psicologia , Espiritualidade , Estresse Psicológico/psicologia , Assistência Terminal/psicologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Atitude Frente a Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
7.
Int J Qual Stud Health Well-being ; 14(1): 1651171, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31411129

RESUMO

Aims and objectives: The aim was to gain in-depth understanding about individuals' existential experiences of living with obesity. Background: People living with obesity face great vulnerability and existential challenges. The different treatments offered do not seem to meet the individual needs of persons with obesity. A deeper understanding of existential experiences from an individual perspective is needed to individualize treatment. Design: An exploratory phenomenological-hermeneutical design was used to gain a greater understanding of the existential experiences involved in living with obesity. Methods: The participants represented a convenient sample. 18 qualitative interviews were conducted and subjected to phenomenological-hermeneutical analysis. Results: Four themes emerged: shaped by childhood; captured by food; depressed by the culture; and judged by oneself. Conclusions: The burden of being obese can be experienced as being objectified and alienated as a human being. We need to turn towards a life-world perspective, seeing each human being as a living body to overcome objectification and alienation, and then move them towards becoming subjects in their own lives, through giving space for self-love. Health care workers need to assist persons living with obesity to reduce objectification and alienation. It is important to develop intervention that has an individual, holistic approach.


Assuntos
Adaptação Psicológica , Existencialismo/psicologia , Obesidade/psicologia , Estresse Psicológico , Adulto , Idoso , Feminino , Hermenêutica , Humanos , Masculino , Pessoa de Meia-Idade
8.
Int J Qual Stud Health Well-being ; 14(1): 1658843, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31451104

RESUMO

Purpose: The aim of this study is to describe young women's (16-25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others. Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns. Results: The results show the essential meaning of the phenomenon of "existential concerns" that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one's vulnerability. Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice.


Assuntos
Atividades Cotidianas/psicologia , Adaptação Psicológica , Existencialismo/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Pesquisa Qualitativa , Suécia , Adulto Jovem
9.
Nurse Educ Today ; 80: 78-84, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31280009

RESUMO

BACKGROUND: Effective communication by nurses is crucial to ensure patient safety. A structured communication program increases communication clarity, education satisfaction, and positivity during interprofessional collaboration among students. In an effort to facilitate effective communication between nurses and physicians, the well-known structured communication tool SBAR (Situation, Background, Assessment, and Recommendation) has been extensively used in clinical and educational settings. OBJECTIVES: The purpose of the study is to investigate the impact of an SBAR communication program on communication performance, perception, and practicum-related outcomes in senior-year nursing students. METHOD: The study employed a non-equivalent control group quasi-experimental design and implemented the tool in the pediatric nursing practicum of a nursing school. The experimental group participated in a SBAR program, where role playing using SBAR techniques for different scenarios was used to improve practical communication among nursing students. The SBAR program was developed based on Kolb's Experiential Learning Theory. Communication performance was assessed via the SBAR communication tool and the communication clarity scale. Communication perception was measured by handover confidence level. Practicum-related outcomes of clinical practice self-efficacy, perceived nurse-physician collaboration, and practicum satisfaction, were also evaluated. RESULTS: The experimental group demonstrated significantly higher SBAR communication (p < .001), communication clarity (p < .001), and handover confidence (p < .001) than the control group. Clinical practice self-efficacy, perceived nurse-physician collaboration, and practicum satisfaction did not differ. CONCLUSIONS: The SBAR program in a pediatric nursing practicum improves SBAR communication, communication clarity, and perceived handover confidence in senior-year nursing students.


Assuntos
Existencialismo/psicologia , Modelos Educacionais , Enfermagem Pediátrica/educação , Estudantes de Enfermagem/psicologia , Comunicação , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Humanos , Aprendizagem Baseada em Problemas/métodos , Autoeficácia , Estudantes de Enfermagem/estatística & dados numéricos
10.
Int J Palliat Nurs ; 25(5): 233-243, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31116658

RESUMO

BACKGROUND: Existential distress is a term used when patients who are coming towards the end of their lives exhibit profound suffering, related particularly to their thoughts on life and existence. The clinical expression of this phenomenon has not been widely researched, and so specialist palliative care nurses were asked how they identify and manage this patient cohort. AIMS: To explore how palliative-care nurses identify patients with existential distress and manage their needs. METHODS: A qualitative descriptive design with thematic content analysis of transcribed interviews. FINDINGS: Behavioural changes, agitation, social withdrawal and communication difficulties are identified as indicators of possible existential distress. Susceptible patient groups are identified. Nurses acknowledged that caring for patients with existential distress can be emotionally demanding. Being present and building relationships with patients are identified as enabling meaning-making. Sedation for refractory distress is seen as a last resort. CONCLUSION: Early identification of existential distress by carers could enable timely intervention (counselling, psychotherapy and or spiritual guidance) to improve the patients' quality of life in the terminal phase of their illness and avoid intractable or refractory existential distress that may necessitate palliative sedation.


Assuntos
Existencialismo/psicologia , Papel do Profissional de Enfermagem/psicologia , Cuidados Paliativos/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/enfermagem , Assistência Terminal/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Nurs Outlook ; 67(5): 540-557, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31040052

RESUMO

BACKGROUND: Attention to the existential dimension of an individual's experience during serious illness is important. However, existential concerns continue to be poorly defined in literature, leading to neglect in the clinical realm. PURPOSE: This concept analysis seeks to clarify the concept of the existential experience within the context of adults with advanced cancer. METHODS: Rodgers' evolutionary method of concept analysis was used. DISCUSSION: Existential experience in adults with advanced cancer is a dynamic state, preceded by confronting mortality, defined by diverse reactions to shared existential challenges related to the parameters of existence (body, time, others, and death), resulting in a dialectical movement between existential suffering and existential health, with capacity for personal growth. Personal factors and the ability to cope appear to influence this experience. CONCLUSION: These findings can drive future research and enhance clinician ability to attend to the existential domain, thereby improving patient experience at end-of-life.


Assuntos
Adaptação Psicológica , Existencialismo/psicologia , Neoplasias/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Support Care Cancer ; 27(12): 4713-4721, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30963295

RESUMO

PURPOSE: The purpose of this study was to examine the associations between self-reported spiritual/religious concerns and age, gender, and emotional challenges among cancer survivors who have completed a 5-day rehabilitation course at a rehabilitation center in Denmark (the former RehabiliteringsCenter Dallund (RC Dallund)). METHODS: The data stem from the so-called Dallund Scale which was adapted from the NCCN Distress Thermometer and comprised questions to identify problems and concerns of a physical, psychosocial, and spiritual/religious nature. Descriptive statistics were performed using means for continuous variables and frequencies for categorical variables. Odds ratios were calculated by logistic regression. RESULTS: In total, 6640 participants filled in the questionnaire. Among participants, 21% reported one or more spiritual/religious concerns, the most reported concerns related to existence and guilt. Having one or more spiritual/religious concerns was significantly associated with age (OR 0.88), female gender (OR 1.38), and by those reporting emotional problems such as being without hope (OR 2.51), depressed (OR 1.49), and/or anxious (OR 1.95). Among participants, 8% stated they needed help concerning spiritual/religious concerns. CONCLUSIONS: Cancer patients, living in a highly secular country, report a significant frequency of spiritual/religious and existential concerns. Such concerns are mostly reported by the young, female survivors and by those reporting emotional challenges. Spiritual/religious and existential concerns are often times tabooed in secular societies, despite being present in patients. Our results call for an increased systemic attention among health professionals to these concerns, and a particular focus on identifying and meeting the spiritual/religious and existential concerns of women, the young and those challenged by hopelessness, depression, and anxiety.


Assuntos
Sobreviventes de Câncer/psicologia , Existencialismo/psicologia , Neoplasias/psicologia , Secularismo , Espiritualidade , Adaptação Psicológica , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Dinamarca , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Religião , Inquéritos e Questionários
13.
Psychooncology ; 28(4): 854-862, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30762269

RESUMO

OBJECTIVE: Death acceptance may indicate positive adaptation in cancer patients. Little is known about what characterizes patients with different levels of death acceptance or its impact on psychological distress. We aimed to broaden the understanding of death acceptance by exploring associated demographic, medical, and psychological characteristics. METHODS: At baseline, we studied 307 mixed cancer patients attending the University Cancer Center Hamburg and a specialized lung cancer center (age M = 59.6, 69% female, 69% advanced cancer). At 1-year follow-up, 153 patients participated. We assessed death acceptance using the validated Life Attitude Profile-Revised. Patients further completed the Memorial Symptom Assessment Scale, the Demoralization Scale, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Questionnaire. Statistical analyses included multinomial and hierarchical regression analyses. RESULTS: At baseline, mean death acceptance was 4.33 (standard deviation [SD] = 1.3, range 1-7). There was no change to follow-up (P = 0.26). When all variables were entered simultaneously, patients who experienced high death acceptance were more likely to be older (odds ratio [OR] = 1.04; 95% confidence interval [CI], 1.01-1.07), male (OR = 3.59; 95% CI, 1.35-9.56), widowed (OR = 3.24; 95% CI, 1.01-10.41), and diagnosed with stage IV (OR = 2.44; 95% CI, 1.27-4.71). They were less likely to be diagnosed with lung cancer (OR = 0.20; 95% CI, 0.07-0.58), and their death acceptance was lower with every month since diagnosis (OR = 0.99; 95% CI, 0.98-0.99). High death acceptance predicted lower demoralization and anxiety at follow-up but not depression. CONCLUSIONS: High death acceptance was adaptive. It predicted lower existential distress and anxiety after 1 year. Advanced cancer did not preclude death acceptance, supporting the exploration of death-related concerns in psychosocial interventions.


Assuntos
Atitude Frente a Morte , Existencialismo/psicologia , Neoplasias/psicologia , Qualidade de Vida/psicologia , Idoso , Ansiedade/psicologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/psicologia
14.
J Psychosom Res ; 116: 93-99, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30655000

RESUMO

BACKGROUND: Felt security in close relationships may affect individual adaptation responses to existential threat in severe illness. We examined the contribution of attachment security to demoralization, a state of existential distress involving perceived pointlessness and meaninglessness in advanced cancer. METHOD: A mixed cross-sectional sample of 382 patients with advanced cancer (mean age 59, 60% female) was recruited from outpatient oncology clinics. Participants completed self-report measures of attachment security, demoralization, depression, and physical symptom burden. We used multiple linear regression to analyze the association between attachment security and demoralization, controlling for demographic factors and symptom burden and tested whether attachment security moderated the association of symptom burden with demoralization. Separate analyses compared the contribution of the dimensions of attachment anxiety and attachment avoidance. RESULTS: The prevalence of clinically relevant demoralization was 35%. Demoralization was associated with lower attachment security (ß = -0.54, 95%CI: -0.62 to 0.46). This effect was empirically stronger for attachment anxiety (ß = 0.52, 95%CI: 0.44 to 0.60) compared to attachment avoidance (ß = 0.36, 95%CI: 0.27 to 0.45). Attachment security also significantly moderated the association of physical symptom burden with demoralization, such that with less attachment security, there was a stronger association between symptom burden and demoralization. CONCLUSION: Attachment security may protect from demoralization in advanced cancer. Its relative lack, particularly on the dimension of attachment anxiety, may limit adaptive capacities to deal with illness burden and to sustain morale and purpose in life. An understanding of individual differences in attachment needs can inform existential interventions for severely ill individuals.


Assuntos
Existencialismo/psicologia , Apego ao Objeto , Psicoterapia/métodos , Estresse Psicológico/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
J Relig Health ; 58(6): 1909-1924, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29948793

RESUMO

The present study aimed to explore the use of meaning-making coping mechanisms (existential, spiritual and religious coping) among ethnic Malay cancer patients in Malaysia and to investigate the impact of culture on their choice of coping methods. Twenty-nine participants with various kinds of cancer were interviewed. Four kinds of coping resources emerged from analyses of the interview transcripts: (1) relying on transcendent power, (2) supernatural or mystical beliefs, (3) finding oneself in relationships with others and (4) nature. In this article, the two first resources are in focus. The present findings suggest that Malay culture, which is imbued with Islamic belief, strongly influences cancer patients' coping methods and ways of looking at their experience of being cancer patients.


Assuntos
Adaptação Psicológica , Cultura , Existencialismo/psicologia , Islamismo , Neoplasias/psicologia , Religião e Psicologia , Adulto , Feminino , Humanos , Entrevistas como Assunto , Malásia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Religião e Medicina , Apoio Social , Espiritualidade
16.
Scand J Caring Sci ; 33(1): 136-143, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30152541

RESUMO

INTRODUCTION: This paper describes first-line department healthcare professionals' experiences of conversations with young adults (16-25 years) who express existential concerns. Existential concerns encompass questions about the meaning of life and the choices people must make, and they are sometimes expressed during the period in which a child is becoming an adult. Sometimes the transition to adulthood can be difficult, and many young adults seek support from people in first-line departments, such as primary care providers, youth guidance centre personnel and student health service employees in high schools and universities. Conversations in which existential concerns are recognised may be important for preventing mental illness in the future. AIM: The study aimed to describe healthcare professionals' lived experiences of conversations with young adults who express existential concerns. APPROACH AND METHODS: This qualitative study utilises thematic meaning analysis. Interviews were conducted with healthcare professionals working in first-line departments, and data were analysed based on the principles of reflective lifeworld research. The study followed ethical codes of conduct and conformed to the ethical guidelines adopted by the Swedish Research Council. FINDINGS: The results are presented in three themes of meaning: searching for innermost thoughts requires being present, uncertainty about the unpredictable and awakening of one's own existential concerns. CONCLUSIONS AND IMPLICATIONS: Healthcare professionals are affected when young adults express their existential concerns, and they need more support to strengthen their ability to stay present and create inviting atmospheres.


Assuntos
Comunicação , Existencialismo/psicologia , Pessoal de Saúde/psicologia , Relações Interpessoais , Pacientes/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Suécia , Adulto Jovem
17.
J Relig Health ; 58(4): 1115-1124, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29872943

RESUMO

The present paper looks at the influence of culture on Turkish cancer patients' use of meaning-making coping, paying particular attention to religious, spiritual, and existential coping methods. Data were collected using an interview study (n = 25, 18 women, age range 20-71). Individuals were recruited at an oncology center and a psychiatry clinic in Istanbul. The main focus of the study has been on existential meaning-making coping, which is characterized by finding power inside oneself, altruism, family love, a search for meaning by contemplating philosophical issues, and having a positive life perspective (shukran-thankfulness). In contrast to findings from similar studies conducted in other countries (studies included in the same project), in Turkey religious belief directly determines the coping methods used, including the non-religious methods.


Assuntos
Adaptação Fisiológica , Adaptação Psicológica , Existencialismo/psicologia , Neoplasias , Religião , Senso de Coerência , Espiritualidade , Adulto , Idoso , Cultura , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/etnologia , Neoplasias/psicologia , Qualidade de Vida , Turquia , Adulto Jovem
18.
Nurs Ethics ; 26(5): 1310-1325, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29471724

RESUMO

BACKGROUND: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients' values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. AIM: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. METHOD: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. RESULTS: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. CONCLUSION: In order to meet patients' needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them.


Assuntos
Formação de Conceito , Existencialismo/psicologia , Solidão , Humanos , Pacientes/psicologia
19.
Aval. psicol ; 18(2): 176-182, jan,-mar. 2019. tab
Artigo em Português | LILACS | ID: biblio-1019491

RESUMO

O sentido de vida é o pressuposto fundamental da Logoterapia e Análise Existencial, e o PIL-Test (Teste Propósito de Vida) tem se consolidado como um dos instrumentos mais relevantes para sua mensuração. Este estudo analisou a estrutura fatorial desse instrumento, cujas análises ainda sustentam uma controvérsia quanto ao modelo mais consistente para sua explicação. Participaram da pesquisa 200 acadêmicos de Psicologia, com média de 23,62 anos (DP = 7,071). Além do poder discriminativo, homogeneidade e consistência interna dos itens do instrumento, realizou-se uma análise fatorial exploratória a partir de matriz de correlações policóricas, com o estimador DWLS. O estudo reuniu evidências psicométricas satisfatórias e de uma estrutura de um fator para a matriz dos itens, com índices de ajuste adequados, além de corroborar sugestões prévias quanto à exclusão de certos itens para uma estrutura mais reduzida e parcimoniosa. (AU)


The meaning of life is the central assumption of Logotherapy and Existential Analysis and the PIL-Test (Purpose in Life Test) has been consolidated as one of the most relevant instruments for its assessment. This study examined the instrument's factorial structure, whose analyses still sustain a controversy on the most reliable fit to explain it. A total of 200 Psychology students participated in the study, with average age of 23.62 years (SD = 7.071). Besides investigating the discriminant power, homogeneity and internal consistency of the instrument's items, an exploratory factorial analysis was conducted based on the polychoric correlation matrix and the DWLS estimation. The study gathered satisfactory psychometric evidence, indicating a one-factor structure for the matrix of the items with acceptable fit indices, as well as corroborating previous suggestions regarding the exclusion of certain items aimed at a smaller and more parsimonious structure. (AU)


El sentido de vida es el supuesto fundamental de la Logoterapia y el Análisis Existencial y el PIL-Test (Test de Propósito Vital) viene siendo consolidado como uno de los instrumentos más relevantes para su medición. Este estudio averiguó la estructura factorial de ese instrumento, cuyas análisis aún sostienen una controversia en cuanto al modelo más consistente para su explicación. Participaron de la investigación 200 académicos de Psicología, con promedio de 23,62 años (DS = 7,071). Además del poder discriminatorio, homogeneidad y consistencia interna de los ítems del instrumento, se realizó un análisis factorial exploratorio a partir de matriz de correlaciones policóricas, con el estimador DWLS. El estudio reunió evidencias psicométricas satisfactorias y de una estructura de un factor para la matriz de los ítems, con índices de ajuste adecuados, además de corroborar sugerencias previas en cuanto a la exclusión de ciertos ítems para una estructura más reducida y parsimoniosa. (AU)


Assuntos
Humanos , Feminino , Adulto , Existencialismo/psicologia , Reprodutibilidade dos Testes , Análise Fatorial
20.
Psychooncology ; 27(11): 2525-2530, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30307088

RESUMO

A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a long-standing idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes. Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity-related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern about autonomy, suffering, or being a burden to others; a sense of profound loneliness, pointlessness or hopelessness; grief, regret, or embitterment about what has been missed in life; and shame if dignity is lost or expectations about coping are not met. We provide an overview of conceptual issues, diagnostic approaches, and treatments to alleviate existential distress. Although the two meta-analyses featured in this special issue indicate the progress that has been made, many questions remain unresolved. We suggest how the field may move forward through defining a threshold for clinically significant existential distress, investigating its comorbidity with other psychiatric conditions, and inquiring into adjustment processes and mechanisms underlying change in existential interventions. We hope that this special issue may inspire progress in this promising area of research to improve recognition and management of a central psychological state in cancer care.


Assuntos
Atitude Frente a Morte , Existencialismo/psicologia , Medo , Neoplasias/psicologia , Estresse Psicológico , Adaptação Psicológica , Humanos , Neoplasias/mortalidade , Cuidados Paliativos/psicologia , Autoimagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA