Structure and Meaning in Multidisciplinary Teamwork

The purpose of this study was to examine the relationship between structure and meaning in multidisciplinary long-term care teams. In-depth semi-structured interviews were conducted with 26 staff working on five multidisciplinary teams in the same long-term care facility in Metropolitan Toronto. Staff in different structural locations have differing meanings of work and teamwork. Direct caregiving nursing staff have simple role-sets, minimal involvement in team decision-making and ritualistic orientations towards their work and teamwork.
Multidisciplinary professionals have complex role-sets, greater involvement in team decision-making and organic orientations towards their work and teamwork. Supervisory nurses are in a contradictory structural location and shared aspects of both orientations to teamwork. The lack of shared meanings results in alienation from work and teamwork for staff in lower structural positions which, in turn, has considerable implications for team functioning.     

Trauma and anxiety: The cognitive approach

The purpose was to show how anxiety, the perception of the input and predisposing personality factors are interrelated in the generation of the post-traumatic stress disorder (PTSD). After a review of the role of each of these elements in regard to the PTSD, a new conception of anxiety, the core element of trauma, is introduced, grounded in an innovative system of meaning assessment. Two experiments are summarized demonstrating that anxiety is a pattern of meaning assignment tendencies of the individual and that changing these tendencies brings about the expected changes in the level of anxiety and of cognitive performance. The findings are applied to the treatment and prevention of the PTSD by showing how changing the meaning of specific inputs and of the relevant meaning assignment tendencies of individuals suffering from PTSD or at risk may help to reduce anxiety and increase coping abilities.     

Putting a puzzle together: making spirituality meaningful for nursing using an evolving theoretical framework

Aims and objectives. This paper addresses the need for a practical understanding of spirituality in nursing by means of a generic definition of spirituality, an emerging theoretical framework, and some general practice guidelines. Background. Spirituality is being addressed more frequently in nursing literature, but there is still lacking a professional understanding of the phenomenon that is useful as a basis for practice and research. Conclusion. The history of spirituality in nursing is recognized, and then its role in peoples’ and patients’ lives, health and healing is examined. Spirituality is clarified through its various definitions in the literature, and identification of component concepts: connectedness, meaning, transcendence, values and beliefs, energy and emotion. A working definition and the concepts are brought together into a framework. Guidelines for how to incorporate spirituality into practice are presented. Relevance to clinical practice. With this understanding of spirituality by means of a clarifying definition, a theoretical framework and six general guidelines, nurses may be better equipped to incorporate spirituality into their practice. This will fulfil professional and accrediting mandates and, more importantly, provide more holistic, ethical and balanced care for patients.     

East meets West: applying Eastern spirituality in clinical practice

Aims and objectives. The paper discusses the application of the Eastern body‐mind‐spirit approach in healthcare practice. Background. Traumas, sufferings and losses may induce immense distress in patients and their families, as well as apathy and exhaustion in healthcare workers. Over‐specialization and compartmentalization of services may provide a convenient shelter for healthcare workers to be detached and to simply focus on a narrowly defined scope of intervention. However, the existential problems are still there. Based upon eastern philosophies and holistic health practices, we propose the body‐mind‐spirit approach in healthcare settings. Methods. This is a review paper summarizing the application of the approach on various clinical populations. Results. The approach has been trialled with promising results in a number of health conditions and psychosocial predicaments. Spirituality is not restricted to any religious practices, nor is it narrowed to the pursuit of knowledge at a high level of abstraction. The interconnectedness of the body, mind and spirit presupposes that the practice of spirituality is multidimensional and multi‐levelled. Conclusions. Using the body–mind–spirit framework flexibly we can engage more clients while facilitating the important process of exploration and change. The key components include getting in touch with the inner self, coming back to our senses, connecting our body and mind and rebalancing our relationship with the natural and social environment. The ultimate goal is to move out of meaninglessness and to reach a state of mature spirituality of tranquillity and transcendence. Relavence to clinical practice. The practice of spirituality can be easily applied to daily life.     

Psychiatric nurses' perspectives of spirituality and spiritual needs during an amalgamation

The purpose of this study was to explore the meaning of spirituality and how the spiritual needs of psychiatric nurses could be supported at work during a hospital amalgamation. Forty-six nurses completed the General Information Questionnaire and described the meaning of spirituality and how their spiritual needs could be supported. Data were analysed by the double-coding qualitative method. The themes identified for the meaning of spirituality included: being hopeful, having belief/belief systems, maintaining relatedness/connectedness and the expression of spirituality. The major themes identified to support nursing staffs' spiritual needs at work included communication, offering hope, being valued and support from spiritual sources. Nurses expressed the importance of spirituality in their lives and the need for spiritual support at work. Data for addressing staff spiritual needs are reported; however, further studies are needed to understand the spiritual needs of nursing staff at work during hospital amalgamations.     

Growing Older in Special Olympics: Meaning and Benefits of Participation—Selected Case Studies

As the population of persons with intellectual disabilities continues to age and to increase, so, too, has Special Olympics witnessed the growth of numbers of adults who have remained involved for years and are now in their 40s, 50s, and beyond. Data from 2005 showed 44.9% of Special Olympians in North America to be age 22 or older (Lenox, 2007 Lenox, D. 2007. Aggregate APS report by gender and age, 2005, Washington, DC: Author.  [Google Scholar]). Recent studies of motives and benefits of participation (Farrell, Crocker, McDonough, & Sedgwick, 2004 Farrell, R., Crocker, P., McDonough, M. and Sedgwick, W. 2004. The driving force: Motivation in Special Olympics. Adapted Physical Activity Quarterly, 21(2): 153–166. [Web of Science ®] , [Google Scholar]; Goodwin, Fitzpatrick, Thurmeier, & Hall, 2006 Goodwin, D. L., Fitzpatrick, D. A., Thurmeier, R. and Hall, C. 2006. The decision to join Special Olympics: Parents’ perspectives. Adapted Physical Activity Quarterly, 23(2): 163–183. [Web of Science ®] , [Google Scholar]) have noted issues related to the maturing of athletes. Case studies of three adult Special Olympians were used to explore meaning and benefits (8 categories) of participation. Adult athletes were selected to represent different stages of adulthood and differing health conditions. Age-related changes for parents were also noted. Similar to previous research, athletes confirmed the importance of benefits such as fitness, sport skills, friendships, and competition. Practical implications for coaches and administrators are discussed.     

癌症患者确诊初期生命意义寻求途径的质性研究

目的 了解确诊初期癌症患者寻求生命意义的途径.方法 运用现象学的质性研究方法选取10例处于确诊初期的癌症患者进行深度访谈.结果 对转录的访谈资料进行分析得出7个主题依次为：疾病归因、从失落中寻求获得、创造与行动、希望、爱、信仰和自我认同.结论 癌症患者确诊初期面临生存困境时,护理人员可以通过多种途径帮助癌症患者寻求生命意义,从而提升其精神健康.     

癌症患者生命意义干预的国内外研究进展

文章综述了国内外关于癌症患者生命意义于预的研究现状,列举了意义干预措施、生命回顾及群体生命意义心理疗法等常用的癌症生命意义干预措施。在此基础上,对我国癌症患者生命意义干预的研究前景进行了展望,以期为发展更适合国内癌症患者生命意义的干预措施提供参考。     

癌症患者生命意义内涵及干预需求的研究进展

文章对癌症患者生命意义的内涵、生命意义的测量工具及其干预需求的研究现状进行综述,以期为开展国内背景下生命意义干预的研究提供参考。     

Does perceived burdensomeness erode meaning in life among older adults?

Background: Identification of risk factors for the loss of meaning in life among older adults is needed. In this article, we test hypotheses derived from the Interpersonal Theory of Suicide concerning the role of perceptions that one is a burden on others as a risk factor for lower meaning in life.

Methods: A prospective design was used to examine the temporal associations between perceptions of burdensomeness on others and perceived meaning in life among older adults (n?=?65) seeking mental health treatment (primarily for depression and/or anxiety) at an outpatient geriatric mental health clinic. Participants completed self-report questionnaires within a month following intake. Follow-up questionnaires were completed over the phone two months later.

Results: Perceived burdensomeness predicted lack of meaning in life two months later, while accounting for depression severity. In contrast, baseline levels of meaning in life did not significantly predict the levels of burdensomeness at two months.

Conclusion: The findings suggest that burdensomeness may contribute to suicide morbidity and mortality in late-life by eroding meaning in life. Empirically supported treatments for late-life depression could be adapted to focus on perceptions of burdensomeness and its connections with meaning in life.