Significance of Self-Transcendence for Rehabilitation and Relapse Prevention among Patients with Substance Use Disorder: A Qualitative Study

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).A complex variety of restrictive and promoting factors are in play when people with substance use disorder face challenges concerning rehabilitation and relapse prevention. Selftranscendence sources are strongly associated with meaningfulness, and meaningfulness is found to be associated with less alcohol and drug use severity and relapse prevention. The aim of the present qualitative study was to investigate self-transcendence among patients with substance use disorders and to discuss its significance for treatment and relapse prevention. An exploratory qualitative research design was employed, with individual interviews in a strategic sample of four patients with substance use disorder recruited from a religiously founded rehabilitation clinic in Southeast Norway. The transcribed material was analysed through systematic text condensation. A search for objects beyond immediate needs through self-transcendence was revealed, related to generativity and an unselfish prosocial commitment to family and the surroundings, strengthening the participants’ selfefficacy, confidence, and safety. Spirituality and confidence in a higher power or destiny generated order in life. The use of rituals contributed to tranquillity. Values gave new directions, and private confession helped to start over in life. For patients in rehabilitation aiming at relapse prevention, self-transcendence seems to be significant as part of the recovery process. Possible implications for rehabilitation and relapse prevention are discussed.publishedVersio

Relationships of sources of meaning and resilience with meaningfulness and satisfaction with life: A population-based study of Norwegians in late adulthood

Health-promoting initiatives incorporating meaning-making to enhance the well-being of people in late adulthood are important, particularly as the number of older people is increasing. Resilience and sources of meaning may be related to individuals’ experience of meaningfulness and satisfaction with life. However, few studies have investigated these relations among people in late adulthood. In the present exploratory study, we asked the following questions: What are the differences regarding scores on sources of meaning, resilience, meaningfulness, and satisfaction between people in late adulthood (≥65) and other adults (18–64)? What is the association between sources of meaning and meaningfulness, and between resilience and meaningfulness? What is the association between sources of meaning and satisfaction with life, and between resilience and satisfaction with life? A cross-sectional design was used. A population-based sample of 925 participants (aged 18–91 years) was recruited from the National Population Register in Norway. Of these, 219 participants were 65 years old and older (mean age 73 years). Additionally, sub-analyses for the age-group ≥ 75 (N = 71) were performed. Independent-samples t-tests, chi-square tests, one-way ANOVA, and linear regressions adjusted for demographics, anxiety, and depression were performed utilizing standardized questionnaires. It was found that people in late adulthood (≥65 years) scored significantly higher on meaningfulness compared to younger adults (18–64). Of the sources of meaning, vertical self-transcendence, including explicit religiosity and spirituality, had the strongest relation to meaningfulness for people in late adulthood, after adjusting for demographics, anxiety, and depression. For the same group, accomplishment, including generativity and unselfish engagement with the surroundings and future generations, also stood out as a prominent source of meaning when related to meaningfulness. No sources of meaning were associated with satisfaction with life in the older group. No associations between resilience and meaningfulness, nor between resilience and satisfaction with life, were found among people in late adulthood. However, positive associations were found between resilience and meaningfulness, as well as between resilience and satisfaction with life, in the 18– 64 age group. Longitudinal research and interventional studies are needed to confirm whether the designated sources contribute to meaningfulness in a Norwegian context. The implications of the findings are discussed.publishedVersio

Meaning-Making, Religiousness and Spirituality in Religiously Founded Substance Misuse Services—A Qualitative Study of Staff and Patients’ Experiences

This is a peer reviewed, scientific article licensed under the Creative Commons Attribution License 4.0 (CC BY) and originally published Open Access in Religions. You can access the article by following this link: http://dx.doi.org/10.3390/rel6010092Dette er en vitenskapelig, fagfellevurdert artikkel som opprinnelig ble publisert Open Access i Religions. Artikkelen er publisert under lisensen Creative Commons Attribution License 4.0 (CC BY). Du kan også få tilgang til artikkelen ved å følge denne lenken: http://dx.doi.org/10.3390/rel6010092The Norwegian health authorities buy one third of their addiction treatment from private institutions run by organizations and trusts. Several of these are founded on religious values. The aim of the study was to investigate such value-based treatment and the patients’ experiences of spirituality and religiousness as factors of meaning-making in rehabilitation. The study was performed in an explorative qualitative design. Data were collected through focus-group interviews among therapists and in-patients at a religiously founded substance misuse service institution. The analysis was carried out by content analysis through systematic text-condensation. Through different activities and a basic attitude founded on religious values, the selected institution and the therapists facilitated a treatment framework which included a spiritual dimension and religious activity. The patients appreciated their free choice regarding treatment approaches, which helped them to make meaning of life in various collective and individual settings. Rituals and sacred spaces gave peace of mind and confidence in a situation that up to now had been chaotic and difficult. Sermons and wording in rituals contributed to themes of reflection and helped patients to revise attitudes and how other people were met. Private confessions functioned for several patients as turning point experiences influencing patients’ relations to themselves and their surroundings. Spirituality and religious activity contributed to meaning-making among patients with substance use disorder and had significance for their rehabilitation

Faglig forsvarlighet i barnevernet: En kvantitativ undersøkelse av forsvarlighet, internkontroll, avvik og arbeidskultur i den kommunale barnevernstjenesten

Denne rapporten er en presentasjon av en spørreundersøkelse om hvordan ansatte i kommunale barnevernstjenester erfarer at det arbeides med kvalitetssikring og internkontroll for å sikre forsvarlighet i sine tjenester. Undersøkelsen ble gjennomført i første halvdel av 2018. Det er totalt 1280 fagansatte og ledere i kommunale barnevernstjenester som har deltatt.publishedVersio

Therapists and the topic of meaning in life in their encounters with adolescents with developmental trauma: A qualitative study

This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Background: Meaning in life is important to achieve quality of life, psychological well-being and good mental health. Existential issues such as meaning in life have limited attention in mental health care and treatment for children and young people in Norway. People in crisis often ponder existential questions. We find little research on this topic in relation to therapists who work with adolescents with developmental trauma. The purpose of this study was to examine how meaning in life is understood and addressed from the perspectives of therapists working with adolescents struggling with trauma. Method: The study has a qualitative design, based on focus groups with therapists in mental health care for children and adolescents. The interviews were transcribed and analyzed using systematic text condensation. Results: Therapists had limited professional experience and competence to address and explore meaning as a topic in therapy. Yet there was interest in the topic and they thought that young people with trauma experience may benefit from the incorporation of meaning perspectives into therapy. Conclusion: Therapists at a mental health outpatient clinic for children and adolescents found the topic of meaning important but challenging to involve in the treatment of adolescents with developmental trauma. There is a need for more research to enhance understanding of what it means to include meaning as a topic in child and adolescent psychiatry, and what may be the specific benefit and challenges involved.publishedVersio

‘Existential’ in Scandinavian healthcare journals: An analysis of the concept and implications for future research

The concept of ‘existential’, used frequently in Scandinavian healthcare journals, is associated with various, often unclear, meanings, highlighting the need for a more accurate understanding of the concept. In this integrative review we analyse how the concept has been used in Scandinavian healthcare journals from 1984 to 2020, exploring the trajectory of the concept, its definitions and its applications. A secondary aim is to offer some clarity regarding how the concept may be used in future healthcare research and provide a definition of ‘existential’ based on our findings. Our findings show that while the concept is increasingly used, it is rarely defined, and there appears to be no consensus on the concept’s meaning. We categorise applications of the concept into five overarching themes: (1) Suffering and re-orientation, (2) Meaning and meaninglessness, (3) Existential philosophy in relation to health (4) Existential questions as approaches to care and (5) Usage and demarcation of existential, spiritual and religious concepts. Based on the findings, we propose a definition of the concept of ‘existential’ in the healthcare context. The study contributes to, and underscores advantages and limitations of, the use of the concept in healthcare research.publishedVersio

Psychometric properties of a modification of the Safety Attitudes Questionnaire (SAQ) for child protection services

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http:// creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.The concept of a safety culture is crucial to improving organisational risk management in several sectors, including health and aviation. However, social and welfare services are also sectors where organisations should be aware of the risk in their daily practice. The aim of the present article is to confirm the usability of a modified Safety Attitudes Questionnaire (SAQ) in the Norwegian child protection services CPS by checking a number of its psychometric properties. The SAQ is an instrument that has been widely applied and understood as valid and trustworthy for mapping employees’ views of their organisation’s safety culture. A confirmative factor analysis of data from a national survey of Norwegian CPSs demonstrated that the modified questionnaire has a factor structure which is internally consistent and matches the structure of the widely used SAQ health care questionnaire. The results indicate that the CPS-modified SAQ questionnaire could help understanding and mapping safety culture in the child protection services.publishedVersio

Same but different: meaning-making among refugee and non-refugee youths

Purpose: There is substantial research on the experiences, needs and well-being of unaccompanied refugee adolescents, but less is known about existential aspects of their lives. The purpose of the current study is to explore existential meaning-making among unaccompanied refugee children. Design/methodology/approach: The informants in this study are young unaccompanied refugees (n = 30) living in Norway, and young Norwegians (n = 46). The authors undertook a secondary analysis of in-depth qualitative refugee interview data and a quantitative analysis of questionnaire data from Norwegian informants. Findings: Both the refugee youths and the Norwegian youths expressed that social relationships and connections to others were most important for meaning. Moreover, both groups emphasized the importance of relatedness and generativity, i. e. commitment to worldly affairs beyond one’s immediate needs. The main differences between the two groups were related to the significance attached to religion and to loneliness. Research limitations/implications: The comparison between the two groups is only possible to some degree. Secondary analyses have some limitations, as well as strengths. Practical implications: The findings may be useful for supporting young refugees, as they provide insights into less-studied aspects of their lives. Originality/value: The originality of this study lies in the focus on and broad interpretation of meaning, of secondary data analyses, and of comparisons between youths that are refugees versus non-refugees.publishedVersio

Patients at risk of suicide and their meaning in life experiences

Patients in specialist mental healthcare services who are at risk of suicide may experience their struggles as existential in nature. Yet, research on meaning in life has been relatively scarce in suicidology. This qualitative study aimed to explore how patients at risk of suicide perceived their encounters with specialist healthcare professionals after a suicide attempt (SA), with special reference to meaning in life experiences. The study was conducted in specialised mental healthcare services in Norway. Data were collected via individual interviews with eight patients aged 20–75 years. Using a four-step procedure, the interviews were analysed by systematic text condensation. The participants understood their feelings of shame, self-contempt and challenging life experiences as contributing factors to their SA. They perceived that existential themes in relation to financial difficulties, shame and trauma were resolved, while issues associated with the SA, such as death, loss and beliefs, were given less attention. The participants were either ambivalent about continuing to live or wished to rebuild a meaningful life. Overall, their experiences of meaningfulness were hampered. Assisting patients with meaning in life experiences may help them alter their life interpretations and increase their ability to rebuild their lives as meaningful. The present study should be seen as a contribution to meaning-informed approaches in specialist mental healthcare services. More research is needed to equip healthcare personnel in their overall aims of preventing suicide and supporting patients at risk in their efforts to live a meaningful lifePatients at risk of suicide and their meaning in life experiencespublishedVersio

Spatial fractionation of phosphorus accumulating biofilm: stratification of polyphosphate accumulation and dissimilatory nitrogen metabolism

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