Elizabeth D. Smith

Spiritual awareness, personal perspective on death, and psychosocial distress among cancer patients: An initial investigation

This study examined the relationship between transpersonal development and psychosocial distress of cancer patients. The study was based on a theoretical model of transpersonal development conceptualized as a relationship between ones personal perspective on death and ones level of spiritual awareness. A cross-sectional survey design was used to collect data during a single interview. A random sample of 116 men and women with cancer who were being seen in the oncology outpatient department of a regional cancer center participated in the study. Data was collected with the following: a brief questionnaire concerning demographic and oncologic information, the Transpersonal Development Inventory (developed by the first author), and the Death Attitude Profile and the Brief Symptom Inventory, which have established validity and reliability. A significant negative correlation between level of transpersonal development and level of psychosocial distress supported the major hypothesis. Twenty-four percent of the...

The needs and supportive networks of the dying: An assessment instrument and mapping procedure for hospice patients

If institutional systems that provide end-of-life care are to survive the demands of managed care, they will need to tie together methods of assessing the needs of the dying, leading to a new understanding of the functioning of a patient’s existing helping networks. This paper presents the preliminary findings of a research project conducted at a Midwest hospice. The study utilized a cross sectional correlational survey of patients’ needs via the Early Risk and Resiliency Inventory (ERRI), while mapping their helping networks with a Circles of Care Ecomap. It addressed the question, “What is the relationship between the needs of the dying and the formal and informal support provided?” Study findings supported the contention that higher need patients utilized the more expensive institutional services rather than relying on available natural networks; and statistical analysis of the study instrument suggested the creation of a new conceptual domain of psychospiritual need.

Alleviating suffering in the face of death : Insights from constructivism and a transpersonal narrative approach

Summary Confronting ones mortality is at the heart of much human suffering. Building upon her previous development and testing of an exploratory model of psychospiritual distress, the author explores the confrontation of death in light of a transpersonal narrative with four new dimensions: (a) normalization of death, (b) divine intention, i.e., a belief in a supernatural force of higher power that provides a cosmic order, (c) surrender, i.e., the ability to let go of the outcome of events and to accept the unknown, and (d) transpersonal existence, i.e., a belief in a continued existence beyond the known mortal self. Through a constructivist perspective on this transpersonal narrative, one can understand how personal reality is constructed and how affect flows from core beliefs that mediate events. This offers an explanatory model of how annihilation vulnerability of personhood can be mediated, resulting in diminished suffering. It suggests implications for practice to alleviate the actual suffering a person experiences.

Depressive symptomatology and specificity of social support.

Psychosocial interventions should be based on research which reflects the multidimensionality of psychosocial constructs. This study investigated six categories of social support which were associated with depressive symptomatology in a sample of 531 college students. The Social Provisions Scale was used to measure social support while the Center for Epidemiological Studies–Depression Scale was used to measure depressive symptomatology. Standard multiple regression analysis was used to analyze the variance contributed by each of the six categories of social support found on the Social Provisions Scale to depressive symptomatology. Specifically, the following categories of social support were significantly associated with depressive symptomatology: Reassurance of Worth (for male and female respondents) and Attachment (for females only). Implications for practice and research are discussed.