Spiritual experiences of a seriously ill elderly: a case report

Objetivo: Relatar as experiências espirituais de uma idosa internada em uma enfermaria de cuidados paliativos. Método: As informações foram estruturadas a partir de revisão de prontuário, entrevista com a paciente e acompanhante e revisão de literatura. Conclusão: O caso relatado sinaliza a importância de maior discussão sobre a atenção aos aspectos espirituais dos pacientes no fim da vida. Neste caso, por apresentar-se de forma controlada, positiva e com insight presente, entende-se o exposto como uma experiência espiritual, livre de psicopatologia. Logo, observa-se a necessidade de pesquisas futuras que objetivem o incremento da abordagem espiritual com o intuito de instrumentalizar o profissional para a sua prática.Objective: To report spiritual experiences of an elderly woman admitted to a palliative care ward. Method: Information was structured from review of medical charts, interview with the patient and her caregiver, and literature review. Conclusion: The reported case highlights the importance of having a greater discussion on the attention to spiritual aspects of patients at end of life. In this case, due to the fact of presenting herself in a controlled manner, positive and with actual insight, one should understand the exposed as a spiritual experience, free of psychopathology. Therefore, one should observe the need for future surveys aimed at enhancing the spiritual approach with the purpose of training professionals for its practice

Experiência espiritual de um idoso em pré-operatório oncológico: relato de caso

Attention to the spiritual dimension is critical to understanding cancer patients as integral beings. Spiritual assessment can identify spiritual needs as purpose, faith and relationships in life to be addressed through specific guidelines. New studies have shown the high prevalence of spiritual experiences in subjects noncarriers of psychotic or dissociative disorders, usually in clinical and institutionalized samples. Such awareness changes have personal and communitarian value. Case report: M.A.C., 88 years old, man, widowed and living in Mauriti-CE, admitted in April 2015 at an oncologic ward. On admission, he showed intense desire to undergo surgery, despite the high cardiovascular and postoperative risks. When argued about comfort sources, he pointed out that his belief in God sustained him and reported a spiritual experience that took place the night before the admission: during sleep, he was alone in his room, when it is lit and three figures presented; the patient identified them as “Our Lady accompanied by two children,” and their presence relieved his anxiety and fear of surgery. Touched, he reported to believe that the same would accompany him during the procedure and alleviate his suffering. During his hospitalization the patient presented himself calm, oriented, without consciousness alterations, confusional state, hyperactivity or underactivity or positive symptoms. Clinical and laboratory tests did not suggest psychopathological or organic causes that could justify the reported experience, strengthening thus its vision as a spiritual experience. CONCLUSION: to provide comprehensive care to patients is to understand their experiences and goals and support their coping resources. Additional studies should deepen interventions to better access and watch these spiritual experiences, clarifying their non-pathological nature.A atenção à dimensão espiritual é fundamental para a visão do paciente oncológico como ser integral. A avaliação espiritual pode identificar necessidades como propósito, fé e relações na vida, a serem abordadas através de diretrizes específicas. Novos estudos têm demonstrado a alta prevalência de experiências espirituais em sujeitos não portadores de transtornos psicóticos ou dissociativos, em geral em amostras clínicas e institucionalizadas. Tais alterações de consciência possuem valor pessoal e comunitário. Relato de caso: M.A.C., 88 anos, homem, viúvo e procedente de Mauriti-CE, internado em abril de 2015 em enfermaria oncológica. Na admissão, demonstrou intenso desejo de submeter-se a uma cirurgia, a despeito dos elevados riscos cardiovasculares e pós-operatórios. Inquirido sobre fontes de conforto, apontou que sua crença em Deus lhe sustentava, e relatou uma vivência espiritual ocorrida na noite anterior ao internamento: durante o sono, viu-se a sós, em seu quarto, quando o mesmo se iluminou e três figuras se apresentaram; o paciente as identificou como “Nossa Senhora acompanhada de duas crianças”, e sua presença aliviou sua ansiedade e medo em relação à cirurgia. Emocionado, relatou acreditar que a mesma o acompanharia durante o procedimento e que e aliviaria seu sofrimento. Durante sua internação o paciente demonstrou-se calmo, orientado, sem alterações de consciência, estado confusional, hiper ou hipoatividade ou sintomas positivos. Exames clínico e laboratoriais não aventaram causas psicopatológicas ou orgânicas que pudessem justificar a vivência relatada, reforçando, pois, sua visão como experiência espiritual. CONCLUSÃO: Para fornecer um cuidado integral ao paciente é preciso compreender suas experiências e objetivos e dar suporte aos seus recursos de enfrentamento. Estudos adicionais devem aprofundar intervenções para melhor acessar e assistir a essas vivências espirituais, visando aprofundar o conhecimento da sua natureza

The Influence of Religiosity/Spirituality on Mental Health

Health care workers and researchers are increasingly recognizing the religiosity/spirituality great dimension in health

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost