Sabrina Cipolletta

What is a Good Death? Health Care Professionals’ Narrations on End-of-Life Care

The present study explores how health professionals evaluate care at the end of life and what they consider to be a good death. We conducted four focus groups with 37 health professionals and used a grounded theory-based approach to analyze the transcripts of the discussions. A lack of organization, training, formalized procedures, and communication with dying persons and their families emerged. Difficulty in defining a good death derived from the ethical dilemmas that involved places to die, palliative care, and end-of-life decision making.

Caregivers of patients with cancer: anxiety, depression and distribution of dependency.

Assisting a patient with cancer implies assuming a role that may fit in with the previous role of the person or that may contrast with it, thereby provoking suffering. This research explores if it is possible to identify different profiles of caregivers on the basis of different levels of anxiety and depression as well as on different ways of distributing ones own dependency.

Auditory hallucinations as a personal experience: analysis of non-psychiatric voice hearers’ narrations

This exploratory research investigates the phenomenon of non-psychiatric auditory hallucinations from the perspective of the voice hearer, evaluating the possibility that this experience can contribute the maintenance and adaptation of the hearers personal identity system. A semi-structured interview was administered to 10 Italian voice hearers, six men and four women, aged 18-65 years, who had never been in contact with any mental health services because of the voices, even though some of them had been hearing voices for decades. Participants were not distressed or worried about the voices; on the contrary they developed their own understanding, personal coping resources and beliefs in relation to the positive functions of the voices. These results indicate that voices cannot be considered merely as symptoms, but may be seen also as adaptation systems. Consequently, we should avoid trying to helping voice hearers to eliminate or deny voices, and rather we should help them to feel allowed to preserve them.

Self-Construction and Interpersonal Distances of Juveniles Living in Residential Communities

Within the framework of constructivism, and more specifically personal construct psychology, the current research aims at exploring self-construction and interpersonal relationships of juveniles living in residential communities. It proposes a method of doing so that is coherent with the framework adopted. Repertory grids were used with 59 youths, ages 9 to 20 years, and 176 significant others (father, mother, houseparent, and a teacher or employer); interpersonal distances were measured. Identification with others and an authority, perceived change, self and social acceptance, social negativity, self-fulfillment, commonality, and sociality led to the discrimination of different profiles that indicate different (inter)personal configurations.

When Health Is an Attitudinal Matter: A Qualitative Research

Health and illness are complex constructs for which a biomedical approach alone is insufficient. The purpose of the present study was to explore how personal attitudes toward health and illness affect health experience. By adopting a constructivist perspective, we carried out individual semistructured interviews with 15 persons enrolled in a yoga class in northern Italy. We analyzed the interview data using interpretative phenomenological analysis and found that participants’ attitudes toward health and wellness were linked to their experiences and perceptions of health and illness, their somatic awareness, and their constructions of themselves and of their relations. The findings point toward the importance of people taking responsibility for their health. In addition, they suggest that health care should be personalized: approaching people as a complex unity and health and illness as inextricable parts of their lives.

A Psychological Perspective of Eye Floaters

Patients experiencing flashes and spots in their perceptive fields often resort to consulting an ophthalmologist without finding an answer, mainly because these symptoms are not necessarily associated with pathology of the eye. The purpose of our research study was to understand the experience of these patients, differentiate among them, and propose different ways of treating them. We carried out an eye examination and echography, individual semistructured interviews, and dependency grids with 11 patients at the ophthalmology department of a public hospital in northern Italy. We found that individuals’ ways of experiencing and reacting to eye floaters might be different and might depend on the perception of the disease, the personal explanation, the solutions tried, the trust placed in medicine, self-construction, and the dispersion of dependency. Understanding the experiences of patients suffering from eye floaters might help health care professionals to personalize their approaches to these patients.

Change in Psychotherapy: A Dialogical Analysis Single-Case Study of a Patient with Bulimia Nervosa

Starting from the critical review of various motivational frameworks of change that have been applied to the study of eating disorders, the present paper provides an alternative conceptualization of the change in psychotherapy presenting a single-case study. We analyzed six psychotherapeutic conversations with a bulimic patient and found out narratives “for” and “against” change. We read them in terms of tension between dominance and exchange in I-positions, as described by Hermans. These results indicate that the dialogical analysis of clinical discourse may be a useful method to investigate change from the beginning to the end of therapy.

Time experience during the assisted reproductive journey: a phenomenological analysis of Italian couples’ narratives

Objective: This study explores the time experience of Italian couples undergoing medically assisted reproductive procedures. Background: Research has mainly focused on the motivation for childbearing and the impact of infertility on women, with little attention given to the couple’s experience during assisted reproduction procedures. Methods: We conducted semi-structured interviews with nine women and seven men undergoing a medically assisted reproductive programme at a fertility clinic in Italy. An interpretative phenomenological analysis was used to analyse the transcripts. Results: Four main themes were identified: present moment, waiting, hope, and death. Each theme describes the experiences of the study participants and was linked to their personal identities and body perceptions. Conclusion: Time is a significant dimension in understanding participants’ experience because it represents the contradictory emotions and expectations that characterise a medically assisted reproductive journey. Health professionals might take into account the indications derived from these results to forge their approach to patients’ needs, and policymakers might adjust the organisation of the medically assisted reproductive system to patients’ time experience.

Transsexual parenthood and new role assumptions

This study explores the parental role of transsexuals and compares this to common assumptions about transsexuality and parentage. We conducted semi-structured interviews with 14 male-to-female transsexuals and 14 men, half parents and half non-parents, in order to explore four thematic areas: self-representation of the parental role, the description of the transsexual as a parent, the common representations of transsexuals as a parent, and male and female parental stereotypes. We conducted thematic and lexical analyses of the interviews using Taltac2 software. The results indicate that social representations of transsexuality and parenthood have a strong influence on processes of self-representation. Transsexual parents accurately understood conventional male and female parental prototypes and saw themselves as competent, responsible parents. They constructed their role based on affection toward the child rather than on the complementary role of their wives. In contrast, mens descriptions of transsexual parental roles were simpler and the descriptions of their parental role coincided with their personal experiences. These results suggest that the transsexual journey toward parenthood involves a high degree of re-adjustment, because their parental role does not coincide with a conventional one.

Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study

This study explored changes over time and in the internal standards of the quality of life, prolonged grief and family strain of informal caregivers of patients in vegetative state. Data obtained from 52 caregivers showed high levels of prolonged grief and family strain, and low quality of life. A decrease of caregivers’ quality of life and an increase of family strain were found by adopting a response shift procedure. Only prolonged grief did not change during time. Clinical intervention with the caregivers of vegetative state patients should be differentiated on the basis of the duration of the caring experience.