Niels Christian Hvidt

Research on meaning-making and health in secular society: Secular, spiritual and religious existential orientations

This article proposes a framework of concepts for the field of existential meaning-making in secular cultures such as those of Northern Europe. Seeking an operational approach, we have narrowed the fields components down to a number of basic domains and dimensions that provide a more authentic cultural basis for research in secular society. Reviewing the literature, three main domains of existential meaning-making emerge: Secular, spiritual, and religious. In reconfirming these three domains, we propose to couple them with the three dimensions of cognition (knowing), practice (doing), and importance (being), resulting in a conceptual framework that can serve as a fundamental heuristic and methodological research tool for mapping the field of existential meaning-making and health. The proposed grid might contribute to clearer understanding of the multidimensional nature of existential meaning-making and as a guide for posing adequate research and clinical questions in the field.

Six Understandings of the Word 'Spirituality' in a Secular Country

Spirituality is a growing research theme, especially in relation to health issues. The term is often poorly defined and ones understanding is often so broad that it becomes a mere frame word devoid of meaning. In this study, we asked 514 adult Danes about their understanding of the word ‘spirituality’. Factor analysis of the answers resulted in six different understandings of spirituality: (1) positive dimensions in human life and well-being; (2) New Age ideology; (3) an integrated part of established religious life; (4) a vague striving, opposed to religion; (5) selfishness; and (6) ordinary inspiration in human activities. It is concluded that a common understanding of the term spirituality does not exist, at least in a modern secular setting. Suggestion for future research is that the term spirituality is not used without an indication, notions or keywords of what is meant by the term in a specific context.

Making existential meaning in transition to motherhood—A scoping review

OBJECTIVE to provide a thematic overview of the existing literature on existential meaning-making related to transition to motherhood among mothers of full term born babies in Western oriented countries and to discuss the themes from a existential psychology perspective. DESIGN the review follows the approach of a scoping review. Systematic searches in the electronic databases PubMed, CINAHL and PsycINFO were combined with manual and electronic searches for related references. Studies published between 1990 and 2010 examining dimensions of existential meaning-making in transition to motherhood were selected. Eleven papers were included in the synthesis, all using qualitative interviews. The following data were extracted from each study: (a) author(s), year of publication, study location, (b) aims of the study, (c) participants, (d) research design, (e) data collection method, (f) outcome measures, and (g) results. MEASUREMENTS the studies were synthesised in a thematisation on the basis of the existential psychotherapist and philosopher Emmy van Deurzens concepts of four interwoven life dimensions, through which we experience, interpret, and act in the world: Umwelt, Mitwelt, Eigenwelt, and Überwelt. KEY CONCLUSIONS the findings in this review suggest that transition to motherhood is considered a pivotal and paradoxical life event. Through the lens of existential psychology it can be interpreted as an existentially changing event, reorganising values and what makes life worth living, and to some women also being interpreted as a spiritual experience. However, in present maternity services there is a predominant focus on biomedical issues, which sets the arena for motherhood transition, and the issues related to potentially existentially changing experiences, are not considered important. Without an integrative approach, where personal meaning-making issues are discussed, the potential for growth during existential authenticity is not utilised. Transition to motherhood raises existential questions about mortality and meaning of life, and we should explore this field in research and in clinical work.

Religion and reduced cancer risk – What is the explanation? A review

Several studies of members of Christian religious communities have shown significantly lower risks for certain cancers amongst members than in the general population. We identified 17 epidemiological studies of the risk for cancer amongst members of Christian communities published during the past 40 years. In the studies in which adjustment was made only for age and sex, reductions were observed in the risks for lifestyle-associated cancers, i.e. those associated with tobacco smoking, alcohol consumption, diet, physical activity and reproductive factors. In the studies in which adjustment was also made for healthy habits, no reduction in risk for cancer was observed. We conclude that the most important factor in the correlation between membership in a religious Christian community and risk for cancer is the healthy lifestyle inherent in religious practice in these communities. The epidemiological studies reviewed did not, however, differentiate the effect on cancer risk of the meaning that a certain lifestyle can give to an individual.

Blame and guilt – a mixed methods study of obstetricians' and midwives' experiences and existential considerations after involvement in traumatic childbirth

When complications arise in the delivery room, midwives and obstetricians operate at the interface of life and death, and in rare cases the infant or the mother suffers severe and possibly fatal injuries related to the birth. This descriptive study investigated the numbers and proportions of obstetricians and midwives involved in such traumatic childbirth and explored their experiences with guilt, blame, shame and existential concerns.

The Danish religious societies health study

National Research Center of Cancer Rehabilitation, Research Unit of General Practice,Institute of Public Health, University of Southern Denmark, Odense, Denmark*Corresponding author. Lau Caspar Thygesen, National Institute of Public Health, University of Southern Denmark,Oster Farimagsgade 5 A, 2nd Floor, DK-1353 Copenhagen K, Denmark. E-mail: lct@niph.dk

Personal Prayer in Patients Dealing with Chronic Illness: A Review of the Research Literature

Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1) why do people turn to prayer in times of illness?, (2) what are the main topics of their prayers?, and (3) how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1) participants in the study were patients dealing with an illness, (2) the study examined the use of private rather than intercessory prayer, and (3) the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1) disease-centered prayer, (2) assurance-centered prayer, (3) God-centered prayer, (4) others-centered prayer, and (5) lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness.

Experience of gratitude, awe and beauty in life among patients with multiple sclerosis and psychiatric disorders

BackgroundFeelings of gratitude and awe facilitate perceptions and cognitions that go beyond the focus of illness and include positive aspects of one’s personal and interpersonal reality, even in the face of disease. We intended to measure feelings of gratitude, awe, and experiences of beauty in life among patients with multiple sclerosis and psychiatric disorders, particularly with respect to their engagement in specific spiritual/religious practices and their life satisfaction.MethodsWe conducted a cross-sectional survey with standardized questionnaires to measure engagement in various spiritual practices (SpREUK-P) and their relation to experiences of Gratitude, Awe and Beauty in Life and life satisfaction (BMLSS-10). In total, 461 individuals (41 ± 13 years; 68% women) with multiple sclerosis (46%) and depressive (22%) or other psychiatric disorders (32%) participated.ResultsAmong participants, 23% never, 43% rarely, 24% often, and 10% frequently experienced Gratitude. In contrast, 41% never, 37% rarely, 17% often, and 6% frequently experienced Awe. Beauty in Life was never experienced by 8% of the sample, and 28% rarely, 46% often, and 18% frequently experienced it. Gratitude (F = 9.2; p = .003) and Beauty in Life (F = 6.0; p = .015) were experienced significantly more often by women than men. However, the experience of Awe did not differ between women and men (F = 2.2; n.s.). In contrast to our hypothesis, Gratitude/Awe cannot explain any relevant variance in patients’ life satisfaction (R2 = .04). Regression analyses (R2 = .42) revealed that Gratitude/Awe can be predicted best by a person’s engagement in religious practices, followed by other forms of spiritual practices and life satisfaction. Female gender was a weak predictor and underlying disease showed no effect.ConclusionsGratitude/Awe could be regarded as a life orientation towards noticing and appreciating the positive in life - despite the symptoms of disease. Positive spirituality/religiosity seems to be a source of gratitude and appreciation in life, whereas patients with neither spiritual nor religious sentiments (R-S-) seem to have a lower awareness for these feelings.

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark.

Abstract Objective: The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP–patient encounter. Design: A qualitative methodology with semi-structured focus group interviews was employed. Setting: General practice setting in Denmark. Subjects: Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews. Results: Although understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains. Conclusion: GPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients’ multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. Key points Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP–patient encounter. The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects. The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient symptoms occur. Integration of the existential dimension happens in unsystematic and intuitive ways. Cultural barriers such as shyness and lack of existential self-awareness seem to hinder GPs in communicating about issues related to the existential dimension. Educational initiatives might be needed in order to lessen barriers and enhance a more natural integration of communication about existential issues.

Psychosocial health and well-being among obstetricians and midwives involved in traumatic childbirth

OBJECTIVE this study investigates the self-reported psychosocial health and well-being of obstetricians and midwives in Denmark during the most recent four weeks as well as their recall of their health and well-being immediately following their exposure to a traumatic childbirth. MATERIAL AND METHODS a 2012 national survey of all Danish obstetricians and midwives (n=2098). The response rate was 59% of which 85% (n=1027) stated that they had been involved in a traumatic childbirth. The psychosocial health and well-being of the participants was investigated using six scales from the Copenhagen Psychosocial Questionnaire (COPSOQII). Responses were assessed on six scales: burnout, sleep disorders, general stress, depressive symptoms, somatic stress and cognitive stress. Associations between COPSOQII scales and participant characteristics were analysed using linear regression. RESULTS midwives reported significantly higher scores than obstetricians, to a minor extent during the most recent four weeks and to a greater extent immediately following a traumatic childbirth scale, indicating higher levels of self-reported psychosocial health problems. Sub-group analyses showed that this difference might be gender related. Respondents who had left the labour ward partly or primarily because they felt that the responsibility was too great a burden to carry reported significantly higher scores on all scales in the aftermath of the traumatic birth than did the group who still worked on the labour ward. None of the scales were associated with age or seniority in the time after the traumatic birth indicating that both junior and senior staff may experience similar levels of psychosocial health and well-being in the aftermath. KEY CONCLUSIONS AND IMPLICATIONS: this study shows an association between profession (midwife or obstetrician) and self-reported psychosocial health and well-being both within the most recent four weeks and immediately following a traumatic childbirth. The association may partly be explained by gender. This knowledge may lead to better awareness of the possibility of differences related to profession and gender when conducting debriefings and offering support to HCPs in the aftermath of traumatic childbirth. As many as 85% of the respondents in this national study stated that they had been involved in at least one traumatic childbirth, suggesting that the handling of the aftermath of these events is important when caring for the psychosocial health and well-being of obstetric and midwifery staff.