M. Scherer-Rath

The effect of spiritual interventions addressing existential themes using a narrative approach on quality of life of cancer patients: a systematic review and meta-analysis

The aim of this study was to examine the effect of spiritual interventions on quality of life of cancer patients.

The life in sight application study (LISA): design of a randomized controlled trial to assess the role of an assisted structured reflection on life events and ultimate life goals to improve quality of life of cancer patients

BackgroundIt is widely recognized that spiritual care plays an important role in physical and psychosocial well-being of cancer patients, but there is little evidence based research on the effects of spiritual care. We will conduct a randomized controlled trial on spiritual care using a brief structured interview scheme supported by an e-application. The aim is to examine whether an assisted reflection on life events and ultimate life goals can improve quality of life of cancer patients.Methods/DesignBased on the findings of our previous research, we have developed a brief interview model that allows spiritual counsellors to explore, explicate and discuss life events and ultimate life goals with cancer patients. To support the interview, we created an e-application for a PC or tablet. To examine whether this assisted reflection improves quality of life we will conduct a randomized trial. Patients with advanced cancer not amenable to curative treatment options will be randomized to either the intervention or the control group. The intervention group will have two consultations with a spiritual counsellor using the interview scheme supported by the e-application. The control group will receive care as usual. At baseline and one and three months after randomization all patients fill out questionnaires regarding quality of life, spiritual wellbeing, empowerment, satisfaction with life, anxiety and depression and health care consumption.DiscussionHaving insight into one’s ultimate life goals may help integrating a life event such as cancer into one’s life story. This is the first randomized controlled trial to evaluate the role of an assisted structured reflection on ultimate life goals to improve patients’ quality of life and spiritual well being. The intervention is brief and based on concepts and skills that spiritual counsellors are familiar with, it can be easily implemented in routine patient care and incorporated in guidelines on spiritual care.Trial registrationThe study is registered at ClinicalTrials.gov: NCT01830075

Experience of contingency and congruent interpretation of life events in clinical psychiatric settings. A qualitative pilot study

Abstract This is a qualitative pilot study of congruence in narrative reconstruction of interpretations of life events by patients in a clinical psychiatric setting. It is based on the assumption that a coherent interpretive structure means that the interpretation of contingent life events by a person must be congruent with the conflict between these everyday events and the person’s embedded ultimate life goal. The pilot study confirms the assumption, provided the interpretation is based on ultimate life goals in order to integrate experience, severe mental disorder in these patients, with the person’s life story. If there is no clear embedded ultimate life goal, the person does not have a congruent angle on the contingent life event to assign it a position in her life story. As a result self-realisation, with or without a context of religious significance, becomes problematic. Whether patients with a severe mental disorder differ from persons without a disorder remains an open question and can not be answered by this study.

Images of Death as Perspectives in a Life Crisis

Images of death are reflections of ones own attitude to life, and in existential crises such as a suicide crisis, their meaning should therefore not be underestimated. This article describes the results of a research that has attempted to discuss attitudes, which people adopt towards death in times of a suicide crisis. The analysis of the data shows that death is looked upon from an immanentistic and religious viewpoint. Within this context the combination and the coexistence of the theistic and deistic image of God is striking, as well as the import of the deistic representation of death of the transition and of the faith in the immortality of the soul. The relevance of these two religious images of death is mainly found in the fact that they create a perspective beyond death for the assumption that there will be possibilities for modelling ones own identity.

An Instrument for Reconstructing Interpretation in Life Stories

This chapter analyzes the role of interpretation in the construction of personal identity by assuming that people create their personal identity by constructing a life story. It examines how personal interpretation functions in that life story irrespective of the persons worldview-related background. The chapter transcends the personal level by developing that knowledge at a more universal, abstract, nomothetic level. It outlines a model for reconstructing interpretation in life stories, and deals with the nature of a semi-structured interview. Then, the chapter reflects on an approach, based on narrative and motivation theory, to personal interpretations in everyday life. On the basis of the analytical model the author presents an observation instrument for data collection. The chapter concludes by reflecting on the observation instrument from two angles: its practical applicability to different target groups, and theorizing on religion. For this purpose contingent interpretation of life stories seems to be a promising approach. Keywords: life story; personal identity; personal interpretation; religion; semi-structured interview

Professional identity at stake: a phenomenological analysis of spiritual counselors' experiences working with a structured model to provide care to palliative cancer patients

BackgroundGood palliative care requires excellent interprofessional collaboration; however, working in interprofessional teams may be challenging and difficult.AimThe aim of the study is to understand the lived experience of spiritual counselors working with a new structured method in offering spiritual care to palliative patients in relation to a multidisciplinary health care team.DesignInterpretive phenomenological analysis of in-depth interviews, was done using template analysis to structure the data. We included nine spiritual counselors who are trained in using the new structured method to provide spiritual care for advanced cancer patients.ResultsAlthough the spiritual counselors were experiencing struggles with structure and iPad, they were immediately willing to work with the new structured method as they expected the visibility and professionalization of their profession to improve. In this process, they experienced a need to adapt to a certain role while working with the new method and described how the identities of the profession were challenged.ConclusionsThere is a need to concretize, professionalize, and substantiate the work of spiritual counselors in a health care setting, to enhance visibility for patients and improve interprofessional collaboration with other health care workers. However, introducing new methods to spiritual counselors is not easy, as this may challenge or jeopardize their current professional identities. Therefore, we recommend to engage spiritual counselors early in processes of change to ensure that the core of who they are as professionals remains reflected in their work.

Narrative reconstruction as creative contingency

This chapter looks at context as an experiential world in which people seek to discover their identity. It concerns growing awareness of the tragic contingency of the late modern era. The chapter explores narrative identity and narrative reconstruction of events as possible or necessary means of answering the identity question in a contingent world. It translates the insight into epistemological, methodological conclusions for further empirical studies of narrative reconstructions of experience as constructions of narrative identity. Empirical research into life stories must take into account both creativity and the structures necessary for such creativity. Ultimately qualitative research into diverse interpretations of life events seeks to determine the creative contingency of the dialogue partners. Contingent rationality is applicable mainly when the aim is creative research, which is certainly the case in the narrative approach. Keywords: creative contingency; dialogue partners; empirical research; late modern era; narrative identity; narrative reconstruction; qualitative research

Religious Stories We Live By

This is the introductory chapter presents an overview of how the other chapters in the book are organized. The book contains four sections: biblical studies, empirical studies, systematic studies and historical studies. The first section focuses on the Old Testament, novel Cain , which is a gruesome story of gang rape, and the women in the Samson narratives. The second section deals with personal stories and the (religious) identities people construct through those stories, narrative construction of identity among Muslim women and interpretation of life stories. The third section offers an introduction to narrative approaches in systematic theology and passion narrative. The final section presents a parallel description of a protestant narrative community, that of Reformed Pietism, conflicting story-telling between individual, community, and society, and the artwork and texts by Charlotte Salomon. Keywords: Charlotte Salomon; Muslim women; Old Testament; passion narrative; Reformed Pietism; religious stories; Samson narratives; systematic theology

Religious Narrative and the Body

This chapter describes the four dimensions (prosody, thymic dimension, rituality and intentional action) which can be distinguished in the embodiment of religion and clarifies how the semiotic approach contributes to a broader insight into religiosity. Prosody deals with the shape given to the act of speaking. The thymic dimension concerns the way in which the interview-transcripts deal with the bodily aspect. Religious rituals are characterized by the fact that the periphery of personal life is transcended through the ritual praxis. It is noteworthy that religious rituality fades after a generation of commitment to the church. The fourth dimension of bodily religiosity concerns action; especially action that is not immediately recognizable as religious praxis, but that is however religiously motivated or based. The semiotic approach has proved itself a valid method for analyzing this bodily expressed religiosity. Keywords: bodily religiosity; prosody; rituality; semiotic approach; thymic dimension

Narrative meaning making and integration: Toward a better understanding of the way falling ill influences quality of life:

Falling seriously ill is often experienced as a life event that causes conflict with people’s personal goals and expectations in life and evokes existential questions. This article presents a new humanities approach to the way people make meaning of such events and how this influences their quality of life. Incorporating theories on contingency, narrative identity, and quality of life, we developed a theoretical model entailing the concepts life event, worldview, ultimate life goals, experience of contingency, narrative meaning making, narrative integration, and quality of life. We formulate testable hypotheses and describe the self-report questionnaire that was developed based on the model.