Religion, Spirituality, and Health Status in Geriatric Outpatients Essay Example for Free

Religion, Spirituality, and Health Status in Geriatric Outpatients Essay Daaleman, Perrera and Studenski wished to re-examine the effect of religiosity and spirituality on perceptions of older persons, operationalized as geriatric outpatients. The authors proceeded from two conceptual constructs.   The first is that self-reported health status is central to aging research.   The old know whereof they speak.   Self-ratings are valid because they correlate well with health status over time and, consequently, health service utilization.   The second construct is that, no matter how morally they lived as young adults, those in late middle age come to embrace religion and spirituality with more fervor. Prior research had scrutinized the relationship between religion and health perceptions.   Some results were inconclusive, an outcome that the authors attributed to failure to control for such covariates as spirituality. Definitions vary, the authors acknowledged, but they proposed defining â€Å"religiosity† as principally revolving on organized faith while â€Å"spirituality† has more to do with giving humans â€Å"meaning, purpose, or power either from within or from a transcendent source.†Ã‚   In turn, the dependent variable was measured by a single-item global health from the Years of Healthy Life (YOHL) scale, a self-assessment of general health (would you say your health in general is †¦) and a 5-item Likert response from excellent to poor. Fieldwork consisted of including a 5-item measure of religiosity15 and a 12-item spirituality instrument in a 36-month health service utilization, health status, and functional status study among 492 outpatients of a VA and HMO network, all residents of the Kansas City metropolitan area. The authors were remiss in not formally articulating their hypotheses for the study though one gleans that the alternative hypothesis could have stated, â€Å"Structured religion, a deep sense of spirituality, mental status and mobility, and personal and demographic variables materially influence measures of health status and physical functioning.† In the end, the data was subjected to univariate and multivariate best-fit statistics.   The key findings: Table 2. Predictors of Self-Reported Good Health Status (N = 277) Factor* Unadjusted OR (95% CL Adjusted OR (95% CI) Age 0.94 (0.89–0.99)†  Male 0.72 (0.41–1.25)†¡ White race 2.79 (1.51–5.17) § 3.32 (1.33–8.30) ¶ Grade school 0.1 (0.02–0.49) ¶ Some high school 0.28 (0.06–1.44)†¡ High school graduate 0.24 (0.05–1.14)†¡ Technical/business school 0.29 (0.06–1.43)†¡ Some college 0.31 (0.06–1.49)†¡ Not depressed (GDS) 32.4 (4.03–261) § Physical functioning(SF36-PFI) 1.04 (1.03–1.05) § 1.03 (1.01–1.04) § Quality of life (EuroQol) 1.69 (1.41–2.01)†  1.36 (1.09–1.70)†  Religiosity (NORC) 0.93 (0.85–1.02)†¡ Spirituality (SIWB) 1.15 (1.10–1.21) § 1.09 (1.02–1.16)†  OR = odds ratio; CI = confi dence interval; GDS = Geriatric Depression Scale; SF36-PFI = Physical Functioning Index from SF-36; NORC = National Opinion Research Center; SIWB = Spirituality Index of Well-Being. *Referent factors: age-1 year younger; female, nonwhite; college graduate; GDS score of 0-9; PFI-index of 1 less; EuroQol-score of 0.1 less; SIWB-score of 1 less. †  P = .01. †¡ P = NS.  § P .01.  ¶ P .05. After adjusting for all covariates, the authors tentatively concluded that spirituality was an important explanatory factor for perceptions of one’s own physical well-being.   That religiosity did not seem statistically relevant, the authors concede, could be due to having defined the variable partly as attendance at religious services, a behavior possible only if the patient was functional and ambulant.   Still, the authors argue, they did include other measures of religiosity and the regression model did hold being functional constant. While the study did establish a relationship between self-perceptions of health and spirituality, the authors themselves point out the possibility that the two variables are not independent.   The conceptual framework of the SIWB spirituality measure includes a â€Å"high degree of positive intentionality†, which strikes one as very similar to health optimism as independent variable. Article 2: Religious coping and psychological functioning in a correctional population Lonczak, Clifasefi1, Marlatt, Blume, . Donovan tested the relationship among religious upbringing, coping and mental health outcomes in the admittedly-stressful prison environment. This time, the authors do not mince words.   They preface the literature review with the majority’s belief in God (or some higher being) as the core aspect of religiosity.   Second, they point out that two separate meta-analysis carried out in 1983 and 2003 showed mixed results for a relationship between religiosity and coping.   Perhaps, they argue, this is because religious coping has negative-coping aspects, such as the conviction that all one’s troubles are due to abandonment by God. Since a search of the literature had revealed only one study concerning prisoners – the positive effect of meditation on recidivism psychological symptoms in India – Lonczak et al. thought to embark on this study of a neglected population.   Secondly, the authors hoped to advance theory by defining religious coping more specifically than had ever been done. There were multiple hypotheses attending this study: That the high degree of stress experienced by prisoners triggers an increase in religious coping behaviors (e.g., prayer, reading, spirituality, attendance in religious activities, etc.). That the positive coping encouraged by religiosity brings about comfort and solace and hence increases the likelihood of adaptive outcomes. That a religious upbringing provides individuals a repertoire of positive coping behaviors from which to draw strength. Coming to data processing and statistical â€Å"tests†, Longczak et al. employed principal component analyses using Varimax rotation.   The result was a four-factor model with their respective Cronbach alpha reliability estimates: Spirituality (0.97); â€Å"Good deeds† and active participation in coping related activities (0.89); Pleading (0.83); and, Discontentment (0.74). In addition, the researchers administered the Brief Symptom Inventory to measure four dimensions: depression, anxiety, somatization and hostility. At the first stage of analysis, relationships between religiosity on one hand and either gender or ethnic group on the other were tested for in bivariate correlations, t-tests, ANOVAs, or chi square tests. Subsequently analyses involved four hierarchical linear regressions (one for each outcome) including both gender and stressful life events by each of the five religion measures.   In order to examine the relationships between religion-focused predictors and outcomes with and without separate statistical adjustment for sociodemographic variables, variables were processed in a given sequence (below) and non-significant terms removed from later analyses. Religious upbringing, participation, spirituality, pleading and discontentment in the first block; Gender, ethnic group, age, education, and stressful life events in the second block; and, Interaction terms in the third and fourth blocks. The findings provided support for the hypothesis that an upbringing characterized by formal or structured religion has positive mental health ramifications, including less depression and hostility.   Secondly, women are more adversely affected by discontentment-based coping.   Religious pleading notwithstanding, thirdly, prisoners who had experienced stressful life events were more likely to evince depression and hostility. Article #4: Effect of religion on suicide attempts in outpatients with schizophrenia or schizo-affective disorders compared with inpatients with non-psychotic disorders Huguelet et al. also focused on religion, this time in relation to psychosis and, specifically the propensity to suicide. Among the 115 patients with schizophrenia or schizo-affective disorders covered by the study, 43% had previously attempted suicide.   Broadly speaking, the team wished to find out whether religion was a protective or impelling factor in these suicide attempts. Suicide deserves attention, the authors maintained, because over 9 in 10 suicides are accompanied by a diagnosis of psychiatric illness.   Over the lifetime of a schizophrenic, in particular, meta-analysis has shown a 0.049 probability of death by suicide. Given the importance of reducing suicidal behavior, it seemed encouraging that spirituality and religious activities had ameliorate the risk.   Prior research on piety and spirituality had suggested that the coping mechanisms could involve both a more positive world view and a shield against stress. HYPOTHESIS AND STATISTICAL ANALYSIS: No relationship could be found for religiousness and the tendency to attempt suicide.   Twenty-five percent of all the study subjects acknowledged that religion inhibited them from considering suicide versus only one in ten that articulated an â€Å"incentive† role for religion. Overview of Findings The four articles explored different facets of spirituality and religiosity.   Daaleman, Perrera and Studenski related spirituality to health perceptions.   Lonczak et al.turned their attention to whether a religious upbringing helped adults cope better with a stressful environment, imprisonment in this case.   In the case of Huguelet et al., the question was whether present religious beliefs encouraged suicide or strengthened coping mechanisms for resisting self-destructive compulsions. After adjusting for all covariates, Daaleman, Perrera and Studenski tentatively concluded that spirituality was an important explanatory factor for perceptions of one’s own physical well-being.   Religiosity was not a factor, for reasons already explained.   One doubts this will be the last word on the matter, however, since the study lacked rigor. Nonetheless, the finding about spirituality is helpful given that therapy is a way of expanding awareness and identity.   As well, Transactional Analysis â€Å"recognizes the spiritual dimension of each person as an important part of the therapeutic process† (Trautman, 2003).   On the other hand, one realizes the limitations of analyzing spirituality vis-à  -vis health perception when the two variables overlap, at least on the aspect of optimism. One is therefore led to wonder, might it not advance therapy theory and praxis if: a) Spirituality and religiosity were qualitatively tested as a compound, unified variable; and, b) Health-related research include objective measures of well-being as the realistic dependent variable? For Lonczak et al. the implications for counseling have more to do with discontent and religious pleading. Counseling might address the roots and implications of religious distress and assist patients in developing more adaptive coping strategies.   Notwithstanding the focus on a tightly defined population segment (older adults jailed for alcohol- and drug-related offenses), the authors are correct to point out the immense social good clinicians and prison administrators could foster if low-cost religious or spirituality-enhancing programs did contribute to â€Å"significant reductions in behavior management problems, psychological impairment, and subsequent recidivism.† Similarly, the findings of Huguelet et al. suggest that suicide rates among psychotic patients could well be reduced if therapy embraced reinforcement or revival of religious beliefs.   References Trautmann, R. (2003) Psychotherapy and spirituality. Transactional Analysis Journal, 33, (1) 32-36.

Indecision, Hesitation and Delay in Shakespeares Hamlet - Procrastinat

Hamlet – the Hesitation and Indecision  Ã‚        Ã‚  Ã‚   Is there a plausible explanation for the hesitation by Hamlet in carrying out the ghost’s request in Shakespeare’s Hamlet?    Lawrence Danson in the essay â€Å"Tragic Alphabet† discusses the hesitation in action by the hero; this is related to his hesitation in speech:    To speak or act in a world where all speech and action are equivocal seeming is, for Hamlet, both perilous and demeaning, a kind of whoring. The whole vexed question of Hamlet’s delay ought, I believe, to be considered in light of this dilemma. To a man alienated from his society’s most basic symbolic modes, who finds all speech and action mere seeming and hypocritical playing, comes an imperious demand to speak and act – to express himself in deed his father’s son. The ghost’s stress upon ritual modes indicates that the expression demanded must not be just â€Å"a kind of wild justice,† but an expression ordered and meaningful. Hamlet’s difficulties at the linguistic level – his puns and â€Å"antic disposition,† the lack of commensurate values between him and the rest of the court – are reflected in his difficulties at the level of action (72).    In â€Å"Acts III and IV: Problems of Text and Staging† Ruth Nevo explains how the protagonist is â€Å"confounded† in both the prayer scene and the closet scene:    In the prayer scene and the closet scene his [Hamlet’s] devices are overthrown. His mastery is confounded by the inherent liability of human reason to jump to conclusions, to fail to distinguish seeming from being. He, of all people, is trapped in the fatal deceptive maze of appearances that is the phenomenal world. Never perhaps has the mind’s finitude been better dramatized than in the praye... ...xcerpted from Stories from Shakespeare. N. p.: E. P. Dutton, 1956.    Danson, Lawrence. â€Å"Tragic Alphabet.† Modern Critical Interpretations: Hamlet. Ed. Harold Bloom. New York: Chelsea House, 1986. Rpt. from Tragic Alphabet: Shakespeare’s Drama of Language. N. p.: Yale University Press, 1974.    Levin, Harry. General Introduction. The Riverside Shakespeare. Ed. G. Blakemore Evans. Boston: Houghton Mifflin Co., 1974.    Nevo, Ruth. â€Å"Acts III and IV: Problems of Text and Staging.† Modern Critical Interpretations: Hamlet. Ed. Harold Bloom. New York: Chelsea House Publishers, 1986. Rpt. from Tragic Form in Shakespeare. N.p.: Princeton University Press, 1972.    Shakespeare, William. The Tragedy of Hamlet, Prince of Denmark. Massachusetts Institute of Technology. 1995. http://www.chemicool.com/Shakespeare/hamlet/full.html No line nos.      

Nursing Theorist Grid Essay

Madeleine Leininger’s theory is call The Theory of Culture Care Diversity and Universality. Because Leininger had degrees in nursing and anthropology, her theory had a combination of derivatives of both disciplines (Bibb, 2006). While working as a nurse in the 1950s, Leininger became disturbed by nurses who could not understand nor respect the culture variations. She then set out to bridge the knowledge gap between nursing and cultures. Leininger became the authority on cultural diversity in healthcare. The key points of her theory include honoring a state of holistic well-being that is culturally defined, valued, and practical. Cultures include technology, religion, philosophy, kinships, socioeconomics, politics, and education. Term Definition Applied to Nursing Practice Applied to Nursing Education Applied to Nursing Research Person Culture-dependent and holistic and sometimes includes families, groups, and communities Nurses can establish individualized care plans and care by respecting and honoring the diversity of the patients. Nurses are continually educated on transcultural nursing. In nursing school and in the workplace, cultural diversity is taught. Continued research to increase the knowledge of the nurses to assess the â€Å"person† in different cultures. Health A state of well-being that is culturally defined, valued, and practiced After appropriate nursing education has been done, nurses have to assess and respect the individual’s decisions on health. Everyone will not accept smoke cessation and weight loss as a part of health. As we learn cultural health  preferences, it is imperative that nurses pass this information on to other nurses. Employee in-services are important to pass on these diversities. Continued research to increase the knowledge of the nurses to assess the idea of health in different cultures. Nursing A transcultural, humanistic, and scientific care discipline and profession with the central purpose to serve humans worldwide Care is still essential in the nursing process. Care is now individualized and culturally congruent by respecting preferences of diverse cultures. We continue to learn through formal education and staff development how to care for persons of different cultures. We honor the research on different groups. This is also used to educate nurses on cultural diversity. Environment A combination of physical, ecological, socioeconomical, and cultural settings. We learn to respect a person’s space even if it is very different from what we are accustomed to. Especially important in home health settings. Be careful of facial grimaces and nonverbal actions. Important to learn and teach others that our impression of a livable and decent environment are not the same as others. Research empowers and teaches nurses how to respect and interact in the patients’ personal environment. From the old adage, â€Å"When in Rome, do what the Romans do†. Research helps to dissect what the Romans actually do. Bibb, S. C. G. (2006). Leininger’s theory of culture care diversity and universality. New York: Springer Publishing Company.

Human Euthanasi An Ethical Dilemma - 1858 Words

Abstract The right to die act is referred to as physician-assisted suicide or human euthanasia. The concept allows a person to choose to end his or her own life with medication, prescribed by a physician. This act has recently been implemented into the State laws of Oregon, Washington, California, and most recently, Colorado. As a result, the topic of human euthanasia has increasingly become an ethical dilemma. Supporting and opposing arguments have been stated and continue to be analyzed without any resolution. The present paper is intended to give an overview of such arguments regarding human euthanasia, ethically and legally. In addition to the ethical dilemma, the importance of patient rights, advocacy, and sensitive nursing care is†¦show more content†¦Those who disagree with human euthanasia, argue that if one chooses the right to die with dignity, they will be displaced from civilized society (Math Chaturvedi, 2012). Contrary to this view, palliative care is an active, compas sionate, and creative option for caring for the dying (Math Chaturvedi, 2012). As a result of the recent 2016 election, Colorado has approved Proposition 106, the End of Life Options Act that has further brought light to the controversy. Interestingly, fifty-six percent of Colorado physicians and seventy percent of Colorado residents support the option (deathwithdignity.org). The decision to end life during a suffering illness has become more widely accepted for many reasons. For example, those who are suffering choose to end their own life so their family is not burdened. In addition, it is not uncommon for a person with a terminal illness to accept that they are dying, wishing to end their suffering along with spare their loved ones from having to suffer too. One may argue the right to life. By deciding to medically end their life provides a spiritual opportunity to donate their organs, hence, the right to life (Math Chaturvedi, 2012). In an article, one argument in favor of th e right to die states that physician-assisted suicide; for its purpose is human euthanasia and one must not be confused with the term â€Å"suicide.† Such terminology can mislead a person