Search Results (25)

As individuals grow older, they experience notable shifts in their health conditions, social positions, and personal identity. Studies show that finding meaning in life correlates with healthier lifestyle choices and enhanced overall well-being. This sense of meaning functions as a protective factor against life’s challenges, strengthening resilience during later years. The research utilized thematic analysis within a qualitative methodology to investigate the subjective sources of meaning among elderly people living in Romanian institutional settings. The analysis revealed several interconnected themes. Religiosity and spirituality emerged as a fundamental anchor, with participants often mentioning God, Divinity, and Higher Power in their narratives. They typically conceptualized life as a sacred gift and emphasized the importance of religious practices such as prayer and church attendance as essential to their sense of purpose. The intergenerational transmission of values also proved significant, with elderly individuals finding meaning in passing down moral and spiritual principles to younger family members, viewing this as their enduring legacy. Interpersonal connections played a crucial role as well, with quality relationships with family and friends fostering a sense of belonging, while broken relationships or isolation negatively impacted well-being. Daily life objectives, including short-term goals like maintaining routines or anticipating family visits, along with preserving functional independence, provided structure and immediate purpose for many participants. The research distinguished between religiosity and spirituality as related but separate concepts: while formal religious rituals offered community-based meaning, those less engaged with organized religion discovered transcendence through personal spiritual experiences such as connecting with nature. This study highlights cultural specificities, particularly how Orthodox Christian traditions shape existential narratives among Romanian elderly, and proposes practical interventions for retirement facilities to incorporate activities focused on spiritual engagement, relationship building, and opportunities for elders to share their wisdom with younger generations. Full article

Few studies have examined how committing criminal acts of violence impacts the lives of perpetrators who were mentally ill at the time of offence and in which the act itself reflects behaviour that is uncharacteristic of the individual. Theoretical accounts and clinical reports describe a phenomenon termed moral injury, which profiles the deleterious emotional effects that can arise from actions that transgress moral beliefs and expectations. Shame, guilt, spiritual/existential conflict, and loss of trust are considered to be core symptoms of moral injury with growing empirical studies which examine moral injury in military and public safety worker samples. The extent to which these kinds of moral injury phenomena might be evident among mentally ill perpetrators was explored using a qualitative-methods approach in a sample of 19 adult participants hospitalized in a Canadian forensic programme inpatient service. The sample consisted of 13 male and 6 female patients, with a mean age of 36.2 years (SD = 10.8), and the majority diagnosed with schizophrenia or schizoaffective disorder. A qualitative interview was conducted where participants were asked to describe feelings about the index offence, the effect it has had on their well-being, and how they have coped with having committed the offence. Using a reflexive thematic analysis process, 5 themes and 23 subthemes were generated that relate to the various resultant impacts. The five themes which emerged were (1) Living with the Emotional Aftermath; (2) Trying to Make Sense and Coming to Terms; (3) My Eyes Have Opened; (4) Facing the Music; and (5) Moving On. The findings are discussed in terms of their implications for understanding forensic inpatients who may be attempting to come to terms with violence they committed while mentally ill and for informing moral injury intervention strategies which might be adapted for forensic mental health services and public health recidivism prevention programmes. Full article

Quantitative methodologies using questionnaires are widely utilised across the health and social sciences, including when assessing difficult-to-measure constructs such as existential, spiritual, or religious constructs. The validity of the questionnaire is crucial to secure good research. Qualitative methods are essential to assess the validity of questionnaires, including a range of measurement properties such as comprehensiveness, comprehensibility, and content validity—properties that quantitative measures have difficulty addressing. Cognitive and semi-structured interviews are the most common qualitative methods to evaluate these properties when testing questionnaires. However, the choice of interview method and subsequent analysis also reflects a negotiation between epistemologies, influencing how the data are interpreted and applied. Based on experience with cognitive and semi-structured interviews to test a questionnaire on existential, spiritual, and religious constructs, this paper critically discusses the opposing epistemological premises for cognitive and semi-structured interviews. It is a relevant methodological discussion for researchers working with questionnaires in health sciences, not the least in relation to religious studies broadly speaking. Full article

The recovery movement in mental health care has played an important role in the recent renewed and growing focus on understanding the function of meaning and spirituality in the context of severe mental illness. Current recovery thinking is firmly embedded in a body of thought according to which people have meaningful lives. It is characterized by various emphases, among which positive transformation. Though valuable and laudable in itself, this bias toward future-oriented improvement leaves our understanding of the nature and implications of a mental health crisis as a crisis in meaning underdeveloped. In this article, we approach recovery from a phenomenological angle and explore mental health crisis as an existential crisis characterized by disruption and radical alteration of sense-making and meaning. In particular, we show how themes of loss and grief are part of this existential crisis and its aftermath. It is argued that themes of loss and grief are crucial aspects of the recovery process. Several fruitful ways are suggested to incorporate those themes. This, it is maintained, provides a more thorough, realistic, integrated, and, therefore, more nuanced view of the complex process of recovery in the context of severe mental illness. Full article

The practice of spiritual care in health has included the goal of addressing the spiritual needs of healthcare staff. Spiritual-care practitioners have had some difficulty in fulfilling this goal, which has created the need for innovative approaches. Two approaches designed to address the spiritual and existential needs of staff are Value-Based Reflective Practice (VBRP) and Schwartz Rounds. Schwartz Rounds are a regular whole-hospital meeting where staff are invited to share and discuss the social and emotional aspects of their work. They are an evidence-based intervention to reduce psychological distress and improve staff wellbeing. This paper seeks to explore the role of spiritual care practitioners in addressing the spiritual and existential needs of staff. It then explores the synergy of these roles with the theory and practice of the above approaches, with a particular emphasis on Schwartz Rounds. The paper is grounded in the experience of the authors collaborating to establish Schwartz Rounds in a large and culturally diverse hospital while also playing a leadership role in the establishment and sustainability of Schwartz programmes in other settings. Full article

The COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant’s method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences. Full article

This phenomenological qualitative study explored how forced migrants in South Africa cope with violent, traumatic experiences and precarious resettlement conditions. Data came from a larger empirical project examining migration, psychological distress, and coping. In-depth interviews were conducted with 14 refugees and asylum seekers (M_age = 30.27, SD_age = 9.27; male = 71.43%) who migrated from five African countries to Durban, South Africa. Despite overwhelming stressors, participants described pathways to transcend victimhood and hardship through engaging character strengths in ways that promote post-traumatic growth. Qualitative analysis revealed five overarching domains: spirituality and religiousness, love and kindness, hope and optimism, persistence and fortitude, and gratitude and thankfulness. Findings are framed within positive existential psychology and dual-factor understandings of mental health, which attend to both human suffering and flourishing. Limitations, future research directions, and clinical and community implications are discussed, with attention to the role of character strengths in adaptive coping and psychological well-being. The intergenerational transmission of strengths is explored as one potential means of buffering intergenerational trauma impacts and promoting family post-traumatic growth. Full article

The Anthropocene epoch marks a critical phase in the history of humanity, where anthropogenic activities have profoundly impacted our planet. Alongside remarkable ecological crises, the Anthropocene worldview has raised existential questions, with a cultural and ethical discourse that recognizes the intrinsic value and calls for more responsible sustainable living. Addressing these collective challenges necessitates a broader perspective guided by a unified sense of purpose toward personal and planetary health. In this context, the role of religious leaders in shaping the social and environmental worldviews of their followers cannot be underestimated. Religious teachings provide a moral framework for promoting climate action, global ethics, the rights of Indigenous peoples, peace, and justice, and other aspects of planetary health. By examining the global ecological crises through the lens of Islam, the Religion of Nature, or Din al-Fitrah, and its environmental and spiritual teachings, we can gain valuable insights into humanity’s connection to the fabric of creation and its interaction with the world. These principles, rich in moral values, are intertwined with accountability and social cohesiveness. Therefore, the role of Muslim religious leaders considering the planetary-scale threats warrants further elucidation, recognizing that many other faiths and faith leaders can similarly contribute together for the common good. Full article

Religion and spirituality (R/S) provide possibilities for healing, resilience, meaning making, and posttraumatic growth (PTG) in the aftermath of trauma. Still, R/S may also be the precursors and/or sources of harm, resulting in experiences of spiritual distress (SD). While extensive research has examined the positive mental health impacts of R/S, its potential harms are under-investigated. Addressing this gap, this article draws on findings from an interpretative phenomenological analysis (IPA) study with four women of evangelical Christian (EC) backgrounds who have experienced SD. The women’s stories revealed SD as an isolating and profoundly tension-filled experience characterized by painful relational loss, fraught belonging, existential uncertainty, and acute spiritual pain. Several women used the term “trauma” to describe their experiences. This study evidences the tender and isolating complexity of SD. For the women, spirituality served as both a cause and a perpetuator of trauma, and as a vehicle for transcendent meaning making in response to wounding. Ultimately, spirituality is tangled in the women’s distress while also playing a role in their posttraumatic growth. Implications include a call for increased awareness and advocacy regarding SD, as well as a trauma-informed, spiritually sensitive, curious posture from practitioners supporting clients with SD to foster posttraumatic growth. Full article

This article argues how the clinical psychology of religion can support mental health and mental health care. The starting point is an ecological–existential approach to mental health, that stresses the interactions between person and environment, with an emphasis on the existential dimension of interactions. This approach will be related to religion and spirituality (R/S) and the study of R/S and mental health. To show the added value of an ecological–existential approach, the emotion of shame will be discussed as an illustrative case. Finally, implications for clinical psychology of religion and mental health care will be outlined and a clinical case report will be presented. Full article

The concept of ‘existential’, used frequently in Scandinavian healthcare journals, is associated with various, often unclear, meanings, highlighting the need for a more accurate understanding of the concept. In this integrative review we analyse how the concept has been used in Scandinavian healthcare journals from 1984 to 2020, exploring the trajectory of the concept, its definitions and its applications. A secondary aim is to offer some clarity regarding how the concept may be used in future healthcare research and provide a definition of ‘existential’ based on our findings. Our findings show that while the concept is increasingly used, it is rarely defined, and there appears to be no consensus on the concept’s meaning. We categorise applications of the concept into five overarching themes: (1) Suffering and re-orientation, (2) Meaning and meaninglessness, (3) Existential philosophy in relation to health (4) Existential questions as approaches to care and (5) Usage and demarcation of existential, spiritual and religious concepts. Based on the findings, we propose a definition of the concept of ‘existential’ in the healthcare context. The study contributes to, and underscores advantages and limitations of, the use of the concept in healthcare research. Full article

Issues related to death are difficult areas of human existence and are most often considered in terms of ethical or non-ethical behaviour. The aim of the research was to examine the attitudes of Polish medical and nursing personnel towards death. The research was conducted among medical (110 people) and nursing staff (110 people) working in Polish hospitals and representing 16 regions. The Questionnaire About Attitudes to Death (DAP-R-PL) was used. The attitude of medical staff, taking into account the holistic approach to the patient in his existential–spiritual dimension, is an extremely important element of professional care. The study outlines the attitudes of medical and nursing staff towards death. Medical personnel under examination demonstrate a mature attitude towards death. In light of this research, health care workers show great commitment to helping dying people with existential and spiritual needs. Full article

It has been previously demonstrated that religiosity and spirituality can help support people living with HIV. Despite this, little work has been undertaken on this theme. Using the PRISMA methodology, we reviewed academic literature from 2008 to 2020 to summarize how people living with HIV define spiritual needs. We found fifty-nine distinct types of approach that were related to this theme and were grouped into four main categories: religious needs, social needs, existential needs, and emotional needs. Religious needs were more frequently cited, including individual prayers, the ingestion of miraculous medicines, and so on. The study calls attention to the concept’s multidimensionality and the cultural differences in the included papers. It reveals the need of each culture to research, to find an adequate meaning of spirituality, and to cater to the spiritual needs for people living with HIV as part of their healthcare, before setting health policies. Full article

Since 2009, the amount of literature focused on the psychological and social dimensions of the climate crisis has increased exponentially. This growing interest in the topic is signaled especially in the American Psychological Association (APA)’s multiple reports on the mental health impacts of climate change. More recently, across different disciplines, links have also been made between trauma theory and the climate crisis. These rich discussions include overlapping concerns, areas of potential fruitfulness and theological implications for all the practical theological disciplines, especially for pastoral theology and practices of care. Given the implicitly existential, theological and spiritual dimensions embedded in the realities of both trauma and the climate crisis, there is an important opportunity for pastoral theology in particular, and practical theology more generally, to engage, learn from and contribute to the interdisciplinary conversation. In this paper, I first offer a brief overview of the literature in pastoral theology related to the climate crisis. Second, I present literature specifically on trauma theory and the climate crisis, outlining several of the key themes emerging across the interdisciplinary discussion. Third, I reflect theologically on the presented content, discussing and drawing forward areas of theological, epistemological and practical fruitfulness for practical and pastoral theology. Full article

It has been widely proven that resettlement is associated with negative psychological effects (e.g., increased depression and symptoms of post-traumatic stress disorder) among refugees. Therefore, there is an urgent need to improve the psychosocial functioning of migrants. This study assessed associations between negative dysfunctional appraisal (perceiving experiences as stressful), spiritual needs, religious coping and wellbeing. Data from paper-and-pencil questionnaires were collected from 744 refugees (69.8% male) aged 18–67 years (M = 27.99) with diverse backgrounds (including from Mashreq countries) who were resettled in Germany. Bootstrapping mediation analysis revealed that the relationship of dysfunctional appraisal and wellbeing among refugees is mediated by spiritual needs (i.e., existential and religious needs). Additionally, negative religious coping mediates the relationship between spiritual needs and wellbeing. The data obtained suggest the need for practitioners to focus on psychological interventions that strengthen spiritual needs in order to improve mental health among refugees. Full article