- Spiritual Well-Being in Cancer Patients Undergoing Chemotherapy in an Outpatient Setting: A Cross-Sectional Study. [Journal Article]
- JHJ Holist Nurs 2019 Jun 22; :898010119858269
- CONCLUSIONS: The SWBQ scores were reasonable. These results can guide nurses' clinical reasoning, as the assessment of SWB may precede the diagnosis of risk for spiritual distress, readiness for enhanced SWB, or spiritual distress. Thus, the use of this instrument may facilitate spirituality being effectively implemented in clinical practice, favoring holistic health care.
- Impact of moral injury on the lives of UK military veterans: a pilot study. [Journal Article]
- JRJ R Army Med Corps 2019 Jun 21
- CONCLUSIONS: This study provides some of the first evidence of the impact of MI on UK AF veterans' psychological, spiritual, social and day-to-day functioning all of which would pose challenges to clinicians aiming to manage such difficulties. These findings highlight several gaps in existing care provision for morally injured veterans, including addressing issues related to spirituality, employment and family functioning, which could ultimately improve veteran well-being.
- Inventory of Complicated Spiritual Grief 2.0 (ICSG 2.0): Validation of a revised measure of spiritual distress in bereavement. [Journal Article]
- DSDeath Stud 2019 Jun 19; :1-17
- Spirituality has long served as a source of solace for many grievers following a loss. For other mourners, whose bereavement experience has been significantly challenged by struggles in their relatio…
Spirituality has long served as a source of solace for many grievers following a loss. For other mourners, whose bereavement experience has been significantly challenged by struggles in their relationship with God and/or their faith community, the opposite is true. Complicated spiritual grief (CSG) is a spiritual crisis following the loss of a loved one. To assess CSG in samples of bereaved adults, a simple-to-use, multidimensional measure of spiritual crisis following loss called the Inventory of Complicated Spiritual Grief (ICSG) was previously developed and validated. However, subsequent research providing greater clarity about the construct of CSG supported the need to revise and update the ICSG. The goal of the present study was to establish the psychometric validity of a revised measure of CSG, called the Inventory of Complicated Spiritual Grief 2.0 (ICSG 2.0), with a large, diverse cohort of bereaved Christian adults (N = 440). Analyses of the bifurcated sample supported a three-factor model measuring insecurity with God, estrangement from the spiritual community, and disruption in religious practices. Further analyses supported the convergent and incremental validity of a 28-item scale relative to other theoretically similar instruments and measures of poor bereavement outcome, indicating the instrument's research and clinical usefulness.
- Plagues and artistic votive expressions (ex voto) of popular piety. [Journal Article]
- IMInfez Med 2019 Jun 01; 27(2):198-211
- In past centuries, epidemics, the scourge of humankind, caused pain, anger, uncertainty of the future, social as well as economic disorder and a significant impact on their victims, involving also th…
In past centuries, epidemics, the scourge of humankind, caused pain, anger, uncertainty of the future, social as well as economic disorder and a significant impact on their victims, involving also their spiritual sphere. The latter effect led to undoubted effects on participation in the religious and social life of communities. The custom of preparing artistic votive expressions has been lost in the mists of time and evidence of ex voto gifts, offered by believers to pagan gods, has been found in prehistoric archaeological sites. Furthermore, several finds from the Ancient Greek and Roman worlds may be observed in our museums. These remains are generally ceramic and metal artifacts, reproducing limbs and other body parts which had been healed. These elements, according to the belief of those making the offerings, had benefited from the miraculous intervention of a thaumaturgical deity. With the advent of Christianity, some pre-existing religious practices were endorsed by the new religion. Believers continued to demonstrate their gratitude in different ways either to miracle-working saints or to the Virgin Mary, because they thought that, thanks to an act of faith, their own health or that of a family member would benefit from the direct intervention of the divine entities to whom they had prayed. In the Ancient Greek world, it was believed that the god Asclepius could directly influence human events, as testified by the popularity of shrines and temples to the god, especially at Epidaurus. In the Christian world as well, particular places have been detected, often solitary and secluded in the countryside or in the mountains, where, according to tradition, direct contact was established between the faithful and Saints or the Virgin Mary Herself. Manifestations occurred by means of miracles and apparitions, thereby creating a direct link between the supernatural world and believers. Religious communities, in these extraordinary places, responded to the call through the building of shrines and promotion of the cult. Over time, the faithful reached these places of mystery, performing pilgrimages with the aim of strengthening their religious faith, but also with the purpose of seeking intercession and grace. In this case, the request for clemency assumed spiritual characteristics and also became a profession of faith. Accordingly, the shrines in the Christian world are places where supernatural events may occur. In these environments the believer resorted to faith, when medicine showed its limits in a tangible way. For the above reasons, while epidemics were occurring, the requests for clemency were numerous and such petitions were both individual and collective. In particular, by means of votive offerings (ex voto) the believers, both individually and collectively, gave the evidence of the received grace to the thaumaturgical Saint. Through the votive act, a perpetual link between the believer and the Saints or Holy Virgin was forged and a strong request for communion was transmitted. The aim of the present study is to describe the role played by votive tablets (ex voto) in the last 500-600 years, as visible evidence of human suffering. From this perspective, these votive expressions may assume the role of markers because, in accordance with the expressions of popular faith, they allow us to follow the most important outbreaks that have caused distress to Christian communities.
- Exploring demoralization in end-of-life cancer patients: Prevalence, latent dimensions, and associations with other psychosocial variables. [Journal Article]
- PSPalliat Support Care 2019 Jun 14; :1-8
- Demoralization is an existential distress syndrome that consists of an incapacity of coping, helplessness, hopelessness, loss of meaning and purpose, and impaired self-esteem. It can affect cancer pa…
Demoralization is an existential distress syndrome that consists of an incapacity of coping, helplessness, hopelessness, loss of meaning and purpose, and impaired self-esteem. It can affect cancer patients, and the Demoralization Scale is a valid instrument to assess it. The present study aimed to investigate the prevalence of demoralization in end-of-life cancer patients and its associations with the medical and psychosocial variables. In addition, the latent dimensions of demoralization emerging in this distinctive population were explored.
- Forgiveness and Spiritual Distress: Implications for Nursing. [Journal Article]
- JCJ Christ Nurs 2019 Jul/Sep; 36(3):185-189
- Spirituality, spiritual distress, and forgiveness are constructs relevant to nursing diagnoses and care planning. Forgiveness has significant implications, as it contributes to the spirituality of th…
Spirituality, spiritual distress, and forgiveness are constructs relevant to nursing diagnoses and care planning. Forgiveness has significant implications, as it contributes to the spirituality of the individual and has been linked to positive and negative health outcomes. In clinical practice, forgiveness facilitation, grief work facilitation, and spiritual growth facilitation are evidence-based nursing interventions to address Spiritual Distress. Need exists to enhance spiritual distress and forgiveness within nursing curricula, patient assessment, and research designs.
- Associations Among Exposure to Potentially Morally Injurious Experiences, Spiritual Injury, and Alcohol Use Among Combat Veterans. [Journal Article]
- JTJ Trauma Stress 2019; 32(3):405-413
- Potentially morally injurious experiences (PMIEs) are events that may violate deeply held values or belief systems. Combat engagement places service members at a heightened risk for PMIE exposure. Ex…
Potentially morally injurious experiences (PMIEs) are events that may violate deeply held values or belief systems. Combat engagement places service members at a heightened risk for PMIE exposure. Exposure to PMIEs may elicit internal conflict between moral beliefs and experiences and, if unresolved, conflict may manifest as feelings of guilt, shame, and spiritual or existential crisis. Further, distress caused by these experiences may promote harmful behaviors (e.g., excessive alcohol use), which may serve as attempts to cope with PMIEs veterans have witnessed or participated in. The present study examined a sequential mediation model in which combat exposure was associated with alcohol use (i.e., alcohol consumption, dependence symptoms, and alcohol-related problems) via PMIE exposure and spiritual injury (e.g., alienation from and/or anger towards respective higher power) in a community sample of 380 recent-era combat veterans. Multiple-group sequential mediation was then used to examine whether the model fit similarly across men and women. Exposure to PMIEs and spiritual injury sequentially mediated the association between combat and alcohol; higher levels of PMIE exposure and spiritual injury were associated with increased alcohol use, R2 = .17, f2 = 0.07. The multiple-group model showed that these associations significantly varied between genders such that the mediation was only significant among men. The results indicated that PMIEs and spiritual injury were associated with increased alcohol use, but these associations differed as a function of gender. Future research is needed to refine our understanding of moral and spiritual injury and explore possible risk and protective factors.
- Commentary on the Special Issue on Moral Injury: Advances, Gaps in Literature, and Future Directions. [Journal Article]
- JTJ Trauma Stress 2019; 32(3):459-464
- We contextualize and provide commentary on articles in the current issue that address the nature, measurement, and consequences of exposure to potentially morally injurious events (PMIEs) and moral i…
We contextualize and provide commentary on articles in the current issue that address the nature, measurement, and consequences of exposure to potentially morally injurious events (PMIEs) and moral injury (MI). PMIEs involve acts of commission or omission of oneself and others and can include perpetration of, and failure to prevent, harm; MI includes "the lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations" (Litz et al., 2009). New and informative research aims to characterize types of PMIEs among military service members and veterans, including in multinational samples. There are also ongoing efforts to devise outcome scales that reliably capture broad MI outcome themes. Further, several new measures of MI assess emotional, cognitive, and behavioral responses of wrong-doing; the nature of distress following PMIEs in civilians, servicemembers, and veterans; and interpersonal consequences in youth. These are promising efforts toward ecologically valid definitions of a potential MI phenotype. Notably, PMIEs may or may not meet DSM PTSD Criterion A, yet early longitudinal data reveal predictive and reciprocal effects of MI and PTSD on one another. Further, a growing literature on MI outcomes beyond PTSD is identifying ways in which MI is linked to alcohol misuse and self-injurious behaviors. The sum of these efforts has led experts to consider the utility and shortcomings of extant PTSD interventions for individuals with MI. We address clinical implications of this emerging research domain, gaps in the literature, and future directions for research.
- Perceived levels of collaboration between cancer patients and their providers during radiation therapy. [Journal Article]
- COCan Oncol Nurs J 2019; 29(2):110-115
- This study described the patterns within collaborative relationships between patients and health care professionals during radiation therapy (RT). A one-time survey was administered to cancer patient…
This study described the patterns within collaborative relationships between patients and health care professionals during radiation therapy (RT). A one-time survey was administered to cancer patients (N=130) receiving RT at one Ontario cancer centre. The key study variables were collaboration between patients and health care providers and participants' well-being. Participants reported higher levels of collaboration with nurses, radiation oncologists, and radiation therapists than with dietitians, social workers and spiritual support personnel [F(5, 760) = 430.42, p < .001]. Participants with more symptom distress collaborated more with some health care professionals than those with less distress, but this was only true for collaboration with social workers (p < .05) and dietitians (p < .05). We postulated that participants did not require services from dietitians and social workers when symptom burden was low. Future directions regarding integration of patient-centred measures (e.g., self-management education) into interprofessional models for cancer care are discussed.
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- How specialist palliative care nurses identify patients with existential distress and manage their needs. [Journal Article]
- IJInt J Palliat Nurs 2019 May 02; 25(5):233-243
- CONCLUSIONS: 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.