Replenishing the spirit by meditative prayer and guided imagery

Increased self-transcendence in patients with intractable diseases

AIMS

Patients with intractable disease require long-term treatment and experience repeated bouts of progressive symptoms and resolutions, which cause them severe suffering. The aim of this study was to elucidate the concepts of self-transcendence and subjective well-being in patients with intractable disease.

METHODS

Forty-four patients with intractable disease (men/women: 22/22) participated. The diseases of the participants were classified into five systems: (i) neural/muscle system; (ii) digestive system; (iii) immunity/blood system; (iv) visual system; and (v) bone/joint system. The controls were 1854 healthy individuals (men/women: 935/869). Participants completed the Self-Transcendence Scale (STS) and the Japanese version of the World Health Organization-Subjective Inventory. The Japanese version of the Mini-International Neuropsychiatric Interview was also used for the intractable disease group.

RESULTS

Analysis of covariance found a significant increase in STS score among the intractable disease group (P < 0.001). Multiple regression analysis showed that the positive affect measured by the World Health Organization-Subjective Inventory showed the greatest effect on the STS score for the intractable disease group (β = 0.539, P < 0.001).

CONCLUSION

As a life-changing experience, an intractable disease may influence an increase in self-transcendence. The results also showed that there was a strong correlation between self-transcendence and respondents' subjective well-being. Our results suggest that patients with life-changing intractable disease can have a high level of self-transcendence, which may lead them to regain mental well-being, and increase their psychological health even in situations that cause physical and mental suffering.

Mind-body medicine and cancer

Mind-body medicine, grounded in a respectful, therapeutic partnership, should be a central element in the care of every person diagnosed with cancer. This article reviews some of the physiologic foundations of mind-body medicine, the introduction of mind-body approaches to cancer care in the 1970s, the specific mind-body approaches that have been used, and the evidence that supports their use. The importance of group support for enhancing the effectiveness of these approaches is discussed. Guidelines are offered for integrating mind-body approaches and perspectives in the care of people who have cancer.

Factors associated with complementary therapy use in people living with HIV/AIDS receiving antiretroviral therapy

OBJECTIVES

This study examined the extent to which people living with HIV/AIDS (PLWHIV) taking combination antiretroviral therapy used complementary therapy, and the relationship of their reported symptoms to the use of complementary therapy and health-related outcomes.

DESIGN

A descriptive design was used in which data were obtained from individual interviews and medical records.

SETTINGS

PLWHIV were identified through flyers distributed in five HIV clinics in urban and suburban locations in a Western state of the United States.

SUBJECTS

The sample consisted of 182 people living with HIV/AIDS, self-identified as white (24.12%), black (44%), and Hispanic (31.88%) with a mean age of 38 (range, 22-66) years. The majority (n = 160; 87.91%) was using as least one category of complementary therapy. Approximately 56% were experiencing symptoms from HIV or their treatment, and 51% discussed their complementary therapy therapies with their health care providers.

OUTCOME MEASURE

Three categories of complementary therapy--physical/body-mind therapies, religion, herbs and supplements--and two health-related outcomes--CD4 count and viral load--were explored.

RESULTS

Complementary therapy use was associated with higher education, being Christian, white or black, and working part or full time. Significantly more PLWHIV with symptoms used physical/body-mind therapies than those without symptoms. No differences were found between users and nonusers of complementary therapy with respect to CD4 count and viral load. The use of herbs/supplements was significantly associated with the use of protease inhibitors. Among the categories of complementary therapy, religion, especially prayers, were most frequently used.

CONCLUSIONS

A substantial proportion of PLWHIV reported using complementary therapy, most predominantly religion (specifically prayers). Further study is recommended to explore the PLWHIV's perceived benefits of using complementary therapy, and to examine the effect of complementary therapy on the patients' symptoms and disease progression. Health care providers need to be alert to potentials of interactions between combination antiretroviral therapies and specific complementary therapy in PLWHIV.

A comparison of three views of spirituality in oncology nursing

This article compares three views of spirituality with specific consideration for persons who live with cancer. These views represent theological, psychological, and nursing perspectives. Three dimensions of theologically inspired spirituality are discussed: institutional religious approaches, intellectual questioning, and mystical experiences. The authors review numerous psychological perspectives on the topic of spirituality, particularly from the analytic, humanistic, and existential schools of thought. A human becoming nursing theory perspective is also offered. The authors, who were friends, one a nurse and the other a person with cancer, suggest that nurses, who are able to offer true presence from a place of hope and fulfilled-emptiness, bear witness to persons in a way that can help them transfigure the experience of living with cancer.

The impact of premature menopause on women's experience of self

Surgically or chemically induced premature menopause may have an impact on women's sense of self: the physical, psychological, social, and spiritual sense of self. This ethnographic research study explores the major factors that assaulted prematurely menopausal women's concept of self and the ways in which they attempted to readjust that concept. A unifying domain, evolution of self, and three constitutive themes emerged: change/loss, connectedness/disconnectedness, and transcendence/transformation. A holistic nurse-client relationship that transcends the hospital experience and extends into the community may help prematurely menopausal women to move toward a more synthesized sense of self and a greater degree of self-actualization.

The willingness of family members of critically ill adults to learn the coping technique of imagery

Critical care nurses face the challenge of helping anxious families cope with the critical illness of one of their members. The purposes of this exploratory descriptive pilot study were to identify whether adult family members of surgical intensive care unit (SICU) patients were willing and able to learn imagery during the time of their family member's critical illness, and which factors facilitate the learning. Of the 139 persons invited, 26 (18.7%) indicated willingness to participate, but only 10 participants completed both learning sessions. All 10 subjects achieved increased relaxation with the imaging. Facilitators of their learning were the quiet environment, the investigator's voice, and the breathing aspect of the technique. Those who participated found imagery beneficial, but further study is needed regarding the basis of both willingness and reluctance to learn relaxation techniques such as imagery to assist with coping during the SICU vigil.