Spirituality as a Life Line: Women Living With HIV/AIDS and the Role of Spirituality in Their Support System

For many women living with HIV/AIDS, incorporating spirituality into their lives helps them organize their experience, empower self-reconstruction, and manage stigma. (Stanley, 1999). Because of the potential relationship of spirituality and social support, the specific aim of this study is to examine the role of spirituality in the support experiences of women living with HIV or AIDS. In this case, spirituality or a connection to God, offered the women an opportunity to develop meaning and perspective taking, to have a source of support, to provide control through a more powerful being, and to offer a path to community

Can You Hear Me Now?: Doctor-Patient Communication and Applications of Neurosurgery in Telemedicine

This research project explored patient\u27s perceptions of telemedicine. This is a new technology that allows doctors and patients to meet in two different locations and have their medical appointments through videoconferencing equipment. Three research questions were posed dealing with telemedicine, bad news delivery, and perceptions of doctor\u27s competence. Qualitative methods were used to engage in five in-depth-interviews to understand patients\u27 stories of their health. Narrative theory was the framework used to analyze data. Five neurosurgical patients were interviewed in this study. The data were compiled through a case study for each patient\u27s experiences and then analyzed for themes. Results showed two main themes, age in relation to identity and social support, with underlying tones of uncertainty throughout the process. The older patients talked about how at their age their health had been a long journey. Evidence of family members as a social support system became evident in patient\u27s stories as patients and family members began to share the same story of health experiences and pain. Uncertainty was also a component that showed up consistently throughout the data in the language and hesitation to ask and answer questions and the understanding of the new technology. Results showed that patient\u27s perceptions of the new technology were positive and deemed beneficial in certain situations

Reflexiones de los marines sobre la comunicación al final de la vida útil: Conectando la resiliencia y el diálogo difícil

The goal of this article is to highlight the perceptions of military personnel surrounding a particularly challenging set of conversations: those that occur at end of life (EOL). The authors conducted exploratory, semi-structured interviews with military students at Marine Corps University and interpreted their responses through the lens of Buzzanell’s (2010) communication theory of resilience. Participants’ use of discursive tensions were explored to understand the potential connection between resilience and difficult dialogue about death.El objetivo de este artículo es destacar las percepciones del personal militar en torno a un conjunto de conversaciones particularmente desafiantes: las que ocurren al final de la vida (EOL). Los autores realizaron entrevistas exploratorias semiestructuradas con estudiantes militares de la Universidad del Cuerpo de Marines e interpretaron sus respuestas a través de la lente de la teoría de la comunicación de la resiliencia de Buzzanell (2010). Se exploró el uso de las tensiones discursivas por parte de los participantes para comprender la posible conexión entre la resiliencia y el diálogo difícil sobre la muerte

Reflexiones de los marines sobre la comunicación al final de la vida útil: Conectando la resiliencia y el diálogo difícil

El objetivo de este artículo es destacar las percepciones del personal militar en torno a un conjunto de conversaciones particularmente desafiantes: las que ocurren al final de la vida (EOL). Los autores realizaron entrevistas exploratorias semiestructuradas con estudiantes militares de la Universidad del Cuerpo de Marines e interpretaron sus respuestas a través de la lente de la teoría de la comunicación de la resiliencia de Buzzanell (2010). Se exploró el uso de las tensiones discursivas por parte de los participantes para comprender la posible conexión entre la resiliencia y el diálogo difícil sobre la muerte

Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective

The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member’s perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues. The second theme, (dis)continuity of care, includes categories of place of care, knowledge of family member dying and moment of death. Both of these themes lead to perceptions of either a good or bad death, which influences the bereavement process. We argue the main contribution of the model is the ability to identify moments throughout the interaction where family members can be present to the EOL process. Recommendations for healthcare participants, including patients, family members and clinical care providers are offered to improve the quality of experience throughout the EOL process and limitations of the study are discussed

Survivors’ perspectives on saying goodbye: Implications for end-of-life engagement across the lifespan and grieving process

Family members are often unaware of their loved ones’ final wishes and underestimate the need to talk about them before parents reach end-of-life (EOL). The benefits of engaging in EOL conversations alleviate needless suffering and can allow an opportunity to say goodbye in a meaningful way. We examined final conversations 13 adults recalled having with their aging parents through the lens of the opportunity model for presence (OMP) during the EOL process, a communication process model based on engagement in the dying process from diagnosis through bereavement, to understand the process from the survivor’s perspective, looking at content of conversations and where they occurred in the dying process. Findings illustrate final conversations that align with the socio-cultural space of the OMP before the knowledge that a parent was dying, and when entering imminent death engaging in the critical moments, have implications for the grief and bereavement

Exploring Web-Based Twitter Conversations Surrounding National Healthcare Decisions Day and Advance Care Planning From a Sociocultural Perspective: Computational Mixed Methods Analysis

BackgroundWithin the cultures and societies of the United States, topics related to death and dying continue to be taboo, and as a result, opportunities for presence and engagement during the end of life, which could lead to a good death, are avoided. Several efforts have been made to help people engage in advance care planning (ACP) conversations, including completing advance care directives so that they may express their goals of care if they become too sick to communicate their wishes. A major effort in the United States toward encouraging such challenging discussions is the annual celebration of the National Healthcare Decisions Day. ObjectiveThis study aimed to explore ACP from a sociocultural perspective by using Twitter as a communication tool. MethodsAll publicly available tweets published between August 1, 2020, and July 30, 2021 (N=9713) were collected and analyzed using the computational mixed methods Analysis of Topic Model Network approach. ResultsThe results revealed that conversations driven primarily by laypersons (7107/7410, 95.91% of tweets originated from unverified accounts) surrounded the following three major themes: importance and promotion, surrounding language, and systemic issues. ConclusionsOn the basis of the results, we argue that there is a need for awareness of the barriers that people may face when engaging in ACP conversations, including systemic barriers, literacy levels, misinformation, policies (including Medicare reimbursements), and trust among health care professionals, in the United States. This is incredibly important for clinicians and scholars worldwide to be aware of as we strive to re-envision ACP, so that people are more comfortable engaging in ACP conversations. In terms of the content of tweets, we argue that there is a chasm between the biomedical and biopsychosocial elements of ACP, including patient narratives. If used properly, Twitter conversations and National Health Care Decision Day hashtags could be harnessed to serve as a connecting point among organizations, physicians, patients, and family members to lay the groundwork for the trajectory toward a good death