Phenomenology of Illness and the Need for a More Comprehensive Approach: Lessons from a Discussion of Plato's Charmides.

Phenomenology informs a number of contemporary attempts to give more weight to the lived experience of patients and overcome the limitations of a one-sidedly biomedical understanding of illness. Susan Bredlau has recently presented a reading of Plato's dialogue Charmides, which portrays Socrates as a pioneer of the phenomenological approach to illness. I use a critical discussion of Bredlau's interpretation of the Charmides to show that the phenomenology of illness also has its shortcomings and needs to be complemented by still other approaches. While Bredlau does make a number of highly apt and relevant suggestions as to how a narrow biomedical approach to illness may be corrected, some (but not all) of which are related to phenomenology, the attribution to Plato's Socrates of a phenomenological approach is mistaken. Characteristically, Socrates shows little interest in the personal experience of a patient. He is more concerned with the patient's lifestyle and conduct and so suggests an alternative or complementary perspective, stressing the importance of education and prevention to health care.

The normativist-naturalist puzzle: Functions and assumptions of health assessment tools.

While there is no shortage in discussions of health assessment tools, little is known about health professionals' experience of their practical uses. However, these tools rely on assumptions that have significant impacts on the practice of health assessment. In this study, we explore health professionals' experiences with health assessment tools, that is, how they define, use, and understand these tools, and whether they take them to measure health and wellbeing. We combine a qualitative, interview-based study of the uses and understandings of health assessment tools among Danish health professionals with a philosophical analysis of these applications and perceptions. Our study shows that contrary assumptions are involved in the use of the tools, to the extent that one can speak of a normativist-naturalist puzzle: health professionals generally apply a normativist conception of health, find health assessment useful and valuable for their clinical practice, but believe that what the tools measure is basically not health proper but some proximal entity of a more naturalist kind. This result demonstrates the complexity of health assessment tools and suggests that they are used with care to ensure both that particular tools are used for the kinds of tasks they are most apt for, and that they are put to use in awareness of their limitations.

Keys to well-being in older adults during the COVID-19 pandemic: personality, coping and meaning.

PURPOSE: During the COVID-19 pandemic, older adults were portrayed as an at-risk group. While this may have been true in some respects, empirical studies on mental health, including well-being were conflicting. Some studies found that older adults demonstrated a notable emotional resilience against the impacts of the pandemic. In this study, we qualitatively examine how older adults understand well-being and how they approached pandemic's potential influence on their well-being. METHODS: 17 older adults participated in the study, out of which 14 were interviewed and three provided written responses to a set of questions. RESULTS AND CONCLUSIONS: Through Interpretative Phenomenological Analysis, three themes emerged:adaptation, control, and a sense of community. We use them to discuss three central questions within well-being theory and research: How far does well-being depend on personal traits and how far does it depend on the environment? How far do people adapt to changed circumstances, and how far is such adaption conducive to maintaining genuine well-being and not just a lowering of standards of comparison? How far does subjective well-being depend on individual and momentary experiences and how far does it depend on the larger temporal and social context of an individual?

Filial Piety, Generativity and Older Adults' Wellbeing and Loneliness in Denmark and China.

The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults' wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults' wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We apply the notions of filial piety, known from Confucian philosophy but often misinterpreted as conservative and conformist, and generativity, to qualitative studies of older adults in Denmark and China. The great potential of intergenerational ties is confirmed. Our study also shows that filial piety is still highly valued, in both China and Denmark, and can be maintained even in a highly individualized society. There is, however, considerable uncertainty among both older adults and their younger relatives as to what is required and what can be expected; realism, and an emphasis on the quality, rather than the quantity of interaction, may be sensible coping strategies, but can also lead to unnecessary acquiescence and self-abnegation. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships.

Are Long-Distance Walks Therapeutic? A Systematic Scoping Review of the Conceptualization of Long-Distance Walking and Its Relation to Mental Health.

Long-distance walking is an ancient activity practiced across cultures for many reasons, including the improvement of one's health. It has even been suggested that long-distance walking may be considered a form of psychotherapy. This scoping review examined the relationship between long-distance walking and mental health among adults. Publication trends and definitions were also examined, and the reason why long-distance walking may have therapeutic effects was discussed. Systematic searches in three online databases were performed using a selection of long-distance walking terms. Both quantitative and qualitative studies were included if they examined associations between long-distance walking and mental health in an adult population. Mental health was conceptualized in broad terms, including descriptions of mental states as well as more specific measurements or notions of mental health. A total of 8557 records were screened and 26 studies were included, out of which 15 were quantitative, 9 were qualitative, and 2 were mixed. The findings showed that long-distance walking was positively related to mental health. This was most consistent with regard to emotional distress compared to somewhat inconsistent findings regarding well-being. Therefore, long-distance walking may be more appropriately used to counter some personal or emotional struggle rather than to achieve hedonic pleasure.

Alcohol in long-term care homes: A qualitative investigation with residents, relatives, care workers and managers.

Introduction: Western societies are aging rapidly, and habitual use of alcohol is changing among older adults. Hence, care facilities are facing novel challenges regarding alcohol use. This pioneering qualitative study seeks to investigate the role of alcohol in care homes, as seen from the perspectives of residents, care workers, relatives, and institution management simultaneously. Method: Five residents, four care workers, three relatives, and two care home managers participated in semi-structured interviews lasting 60 minutes maximum. An interpretative phenomenological analysis framework were utilised for the analysis. Results: It seems that there is a positive attitude towards the use of alcohol in care homes across the four groups of participants. They find that the use of alcohol is presently low among the residents. Importantly there appears to be an important symbolic value in the rituals surrounding alcohol which is upheld by all four groups. Conclusion: While experiences between the four groups seem to converge regarding the use of alcohol, there are still some important differences. Importantly, we suggest that these unique views be utilised in developing methods for handling alcohol use in care homes in the future.