Tesis sobre el tema "Spiritual disease"

The purposes of this study were (a) to examine whether social support decreases as the person with HIV disease progresses from asymptomatic HIV to symptomatic AIDS and (b) to examine the extent to which general well-being might be mediated through a religious and/or spiritual support system.

This study sought to examine art’s ability to illuminate the biopsychosocial-cultural- spiritual impact of chronic medical disease. Chronic disease participants were self- selected and consisted of clinical supervisors, staff, and psychotherapy interns at a community-based mental health clinic in Los Angeles. Quantitative questionnaire data and art-based response data, both imagery and word descriptions, were examined. Data analysis combined with the synthesized literature revealed the complex biopsychosocial- cultural-spiritual interactions and interdependencies with chronic disease management. Findings supported art-based data’s potential to complement quantitative questionnaire data by providing additional insights into a holistic lived experience. Art and word analysis revealed themes and identified factors such as shame, uncertainty, and isolation, which affect health-related quality of life and treatment compliance. This research demonstrated arts-based data’s potential as a holistic healing, revealing, and diagnostic tool and exposes the need for further research into the benefits of integrating art therapy and including art-based data in the treatment and assessment of chronic disease. Keywords: chronic, persistent, medical disease, illness, syndrome, condition, disability, art as therapy, art therapy, creative arts therapy, art expression, arts-based research, clinical art psychotherapy, holistic questionnaire, art directive, art, adherence, compliance, biopsychosocial, biological, psychological, social, socio-environmental, cultural, spiritual, diabetes, asthma, cancer, medical model, medical art therapy, evidenced-based practice, complementary and alternative therapy, hospital, inpatient, outpatient.

Thesis (PhD)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: This qualitatively oriented Practical Theological research journey, informed by the philosophical ideas of postmodern, contextual, participatory and feminist theologies, postmodern and social construction epistemologies was based on a participatory action research through the therapeutic lens of narrative inquiry. The thesis is about the spiritual problems and spiritual needs of people living with HIV and AIDS and how they can be addressed as part of a holistic approach to their care within the primary healthcare delivery system in Zimbabwe. The research curiosity was prompted by the HIV and AIDS policy in Zimbabwe that advocates for a holistic approach to the care of HIV and AIDS patients within the primary health care delivery system. The recognition that healthcare has to be holistic for the best outcome for patients creates an expectation that spiritual care will also be incorporated into clinical practice. However there is a puzzling blind spot and a strange silence about the spiritual problems and spiritual needs of people living with HIV and AIDS within the HIV and AIDS policy. This has had the effects of reducing intervention programmes to purely medical, psychological and sociological. This research sought to correct such an approach by highlighting the role of spiritual care in the healing process of people living with HIV and AIDS as part of the holistic approach to their care. The core information, on which this research is based, comes from the experiences of people living with HIV and AIDS who are receiving care within the primary health care delivery system in Zimbabwe. It sweeps away statistics and places those questing for spiritual healing at the core of the study. All the participants in the study affirmed that the why me questions as a summation of their indescribable and unimaginable spiritual pain felt in the spirit were directed to God. They confirmed that their spiritual problem was spiritual pain and their spiritual need therefore was spiritual healing from the spiritual pain of which God is believed to be the healer. The belief that God is the ultimate healer of the spiritual pain stood out from the midst of problem saturated narratives of spiritual pain and suffering as the unique outcome to reconstruct the alternative problem free stories of healing. The research opted for an approach that is informed by the experiences of people living with HIV and AIDS. In the light of the stories shared by the participants in this study, it became evident that there is an existing need within the Primary Health Care delivery system in Zimbabwe to provide spiritual care to people living with HIV and AIDS. The research aimed at co-creating a spiritual care approach in which those living with HIV and AIDS as well as those working with them can be empowered to re-author the stories of patients‟ lives around their self preferred images. The narrative approach was explored in this research as a possible therapeutic approach that could be used to journey pastorally with people living with HIV and AIDS in a non-controlling, non-blaming, non-directive and not knowing guiding manner that would permit the people living with HIV and AIDS to use their own spiritual resources in a way that can bring spiritual healing to their troubled spirits. The research also emphasizes the position of the people living with HIV and AIDS which they can inhabit and lay claim to the many possibilities of their own lives that lie beyond the expertise of the pastoral caregiver. The strong suggestion emerging from this study is that a spiritual care approach to healing must of necessity be integrated into the holistic approach to the care of people living with HIV and AIDS in Zimbabwe. The wish of participants that their spiritual well-being be considered in their health care adds momentum to this suggestion. Hence the research argues for the inclusion of a spiritual and pastoral approach to spiritual healing which links the patient‟s spirituality and pastoral care. The research does not claim to have the solutions or quick fix miracle to the complicated spiritual pain of people living with HIV and AIDS and neither claims to have the power to bring any neat conclusions to the spiritual healing of people living with HIV and AIDS. However, the research has the potential to stimulate a new story of spirituality as a vital resource in the healing process of people living with HIV and AIDS and ignoring it may defeat the purpose of a holistic approach to the care of people living with HIV. The re-authoring of alternative stories is an ongoing process but like in all journeys, there are landmarks that indicate achievements, places of transfer or starting new directions or turning around. Hence this research process may be regarded as a landmark that indicated a new direction in the participants‟ journey towards spiritual healing.
AFRIKAANSE OPSOMMING: Hierdie kwalitatief-georiënteerde Praktiese Teologie navorsingsreis, geïnformeer deur die filosofiese idees van postmoderne, kontekstuele, deelnemende en feministiese teologie, postmoderne en sosiale konstruksie epistemologie, is gebaseer op deelnemende aksie-navorsing deur die terapeutiese lens van narratiewe ondersoek. Die tesis handel oor die spirituele probleme en navorsingsbehoeftes van mense wat met MIV en vigs leef en hoe dit aangespreek kan word as deel van ʼn holistiese benadering tot hul sorg binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die navorsing-belangstelling het ontwikkel na aanleiding van die MIV en vigs beleid in Zimbabwe wat ʼn holistiese benadering tot die sorg van MIV en vigs pasiënte in die primêre gesondheidsorg-diensleweringstelsel bepleit. Die erkenning dat gesondheidsorg holisties moet wees om die beste uitkoms vir pasiënte te bied, skep ʼn verwagting dat spirituele sorg ook by kliniese praktyk ingesluit sal word. Daar is egter in die HIV en vigs beleid ʼn raaiselagtige blinde kol, ʼn vreemde stilte oor die spirituele probleme en spirituele behoeftes van mense wat met MIV en vigs leef. Die gevolg is dat intervensie-programme gereduseer word tot slegs mediese, sielkundige en sosiologiese programme. Hierdie navorsing streef om dié benadering reg te stel deur die beklemtoning van die rol van spirituele sorg in die heling-proses van mense wat met MIV en vigs leef as deel van die holistiese benadering tot hul sorg. Die kerninligting waarop hierdie navorsing gegrond is, vloei voort uit die ervarings van mense wat leef met MIV en vigs en sorg ontvang binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Dit vee statistiek van die tafel af en plaas diegene wat soek na spirituele heling, in die hart van die ondersoek. Al die deelnemers aan die ondersoek het bevestig dat hul “Waarom ek?” vrae, as opsomming van hul onbeskryflike, ondenkbare geestelike pyn, aan God gerig is. Hulle het bevestig dat hul spirituele probleem spirituele pyn is, en dat hul spirituele behoefte dus spirituele genesing is van die spirituele pyn, die pyn waarvan geglo word dat God die geneser is. Die geloof dat God die opperste geneser is, het uitgestaan te midde van die probleem-deurdrenkte narratiewe van spirituele pyn en lyding as die unieke uitkoms om alternatiewe probleem-vrye verhale van heling te herkonstrueer. Die navorsing het ʼn benadering gekies wat geïnformeer is deur die ervarings van mense wat leef met MIV en vigs. In die lig van die verhale wat die deelnemers aan die studie gedeel het, het dit duidelik geword dat daar ʼn behoefte is dat spirituele sorg ook aan mense wat leef met MIV en vigs verskaf word in die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die doel van die navorsing was om saam ʼn spirituele sorg benadering te skep waarin diegene wat met MIV en vigs leef, sowel as diegene wat met hulle werk, bemagtig kan word om die stories van pasiënte se lewens te herskryf in terme van pasiënte se verkose beelde. Die narratiewe benadering is in hierdie studie ondersoek as ʼn moontlike terapeutiese benadering wat gebruik kan word om pastoraal te reis met mense wat leef met MIV en vigs op ʼn manier wat nie kontroleer, beskuldig, voorskryf of weet nie, maar wat mense wat met MIV en vigs leef eerder begelei en toelaat om hul eie spirituele bronne te gebruik op ʼn manier wat spirituele genesing vir hul gekwelde siele kan bring. Die navorsing beklemtoon ook die posisie van mense wat leef met MIV en vigs waarin hulle spirituele moontlikhede, areas van hul lewens kan eien en bewoon, moontlikhede wat buite die bereik van pastorale versorgers lê. Uit hierdie studie vloei ʼn sterk suggestie dat ʼn spirituele benadering tot genesing noodwendig geïntegreer moet wees in die holistiese benadering tot die sorg van mense wat leef met MIV en vigs in Zimbabwe. Deelnemers se wens dat hul spirituele behoeftes ook in hul gesondheidsorg oorweeg word, gee aan dié suggestie verdere momentum. Derhalwe argumenteer hierdie navorsing ten gunste van die insluiting van ʼn spirituele en pastorale benadering tot spirituele genesing wat die pasiënt se spiritualiteit en pastorale sorg verbind. Die studie maak nie daarop aanspraak dat dit antwoorde of ʼn wonderbare kits-oplossing bied vir die gekompliseerde spirituele pyn van mens wat leef met MIV en vigs nie, of spirituele genesing netjies afsluit nie. Die navorsing het egter wel die potensiaal om ʼn nuwe verhaal te stimuleer van spiritualiteit as ʼn deurslaggewende bron in die genesingsproses van mense wat leef met MIV en vigs. Om spiritualiteit te ignoreer, mag dalk die doel verydel van ʼn holistiese benadering tot die sorg van mense wat met MIV en vigs leef. Die herskryf van alternatiewe verhale is ʼn voortdurende proses, maar soos alle reise, is daar landmerke wat prestasies aandui, en ook punte van verplasing, rigtingverandering of selfs ommekeer. Hierdie navorsing kan beskou word as ʼn landmerk van ʼn verandering van rigting in deelnemers se reis na spirituele genesing.

Darbe analizuojami onkologinių ligų dvasiniai aspektai sergančiųjų bei artimųjų gyvenimuose. Akcentuojami visi jausmai, emocijos ir išgyvenimai, su kuriais susiduria sergantieji ir jų artimieji. Paliečiama tema apie pagalbą, kuri suteikiama sergantiesiems ir artimiesiems bei suteikiamo ar nesuteikiamos pagalbos trūkumus. Paliečiama tema apie Dievą ir tikėjimą, jo įtaką susirgus onkologine liga ar būnant šalia sergančiojo. Analizuojama įvairi literatūra bei ţiniasklaidos šaltiniai, kuriuose pasakojama ne tik apie ligą, bet ir apie organizuojamas akcijas. Empirinėje dalyje pateikiama informacija, kuri gauta respondentų dėka. Tyrimu pagrindţiama teorinė dalis, kuri labai svarbi atskleidţiant temą. Remiantis tyrimo rezultatais galima teigti: Onkologinė liga pakeičia gyvenimą ne tik sergančiajam, bet ir jo artimiesiems. Pasikeičia ţmonių gyvenimo būdas, mąstymas, vertybės bei elgesys. Tikėjimas sergant daţniausiai lieka toks pat; būna išimčių, kad tikėjimas Dievu labai sustiprėja. Taip pat verta paminėti, kad jei ţmogus netikėjo, tai jis nepradeda tikėti, kai artimasis suserga arba kai ţmogus suserga pats. Dvasinė ir psichologinė būsena pasikeičia, kadangi ţmogus išgyvena labai didelį stresą, šoką, liūdesį ir daug įvairių emocijų, kurios pakeičia daugelį gyvenimo aspektų. Dvasinė – psichologinė pagalba neteikiama ir nesiūloma, jei ţmonės patys neieško. Tai didţiulė problema, kadangi tokia pagalba yra reikalinga sergantiesiems ir jų artimiesiems. Gerumo akcijos sergančiųjų ir... [toliau žr. visą tekstą]
The paper analyzes the spiritual aspects of oncological patients and loved ones lives. With emphasis on all the feelings, emotions and experiences faced by people with their relatives. Touched on the topic of advice given to patients and relatives, and granted or denied assistance gaps. Touched the subject of God and religion, its influence on suffering from cancer or being near sick. Analyzing diverse literature and media sources, which tells the story not only of the disease, but also about the promotions. The empirical part of the information obtained through the respondents. The study justified theoretical part, which is very important for revealing the subject. Based on the results of the study can be stated: • oncological disease changes your life, not only sick, but also his family. • A change in people's way of living, thinking, values and behavior. • Belief in patients usually remain the same and there is exceptions to a stronger faith in God. It is also worth noting that if a man did not believe, he does not start to believe when a loved one becomes sick or when a person gets sick himself. • The spiritual and psychological state changes as a person is going through a very high stress, shock, sadness and a lot of different emotions that replace many aspects of life. • Spiritual - not provided psychological support and fails if they themselves seek. This is a huge problem, because such aid is necessary for patients and their loved ones. • Kindness Shares patients and... [to full text]

Thesis (MTh)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: AIDS is stigma, disgrace, hatred, hardship, abandonment, isolation, exclusion, prohibition, persecution, poverty, privation. AIDS is a metaphor. It is a threat, a tragedy, a blight, a blot, a scar, a stain, a plague, a scourge, a pestilence, a demon, killer, rampant, rampaging, murderer. It is made moral. It is condemnation, deterrence, retribution, punishment, a sin, a lesson, a curse, rebuke, judgement (Pillay, 2008:21). The above quotation represents societal perceptions, discourses and responses to the AIDS pandemic. Sadly, in the early days of this pandemic, some theologians and churches held the above-mentioned perception, creating the fear in sufferers of the disease that they might be judged. Communities, families and people living with HIV/AIDS (PLWHA) also still hold this view. The aim of this study is to investigate the judgemental attitudes in pastoral care and spiritual counselling for women living with HIV/AIDS. One of the aspects that contribute to the spread of the HIV pandemic is the stigma attached to it as it is the stigma that causes the silence. This study aims to explore the definition of stigma and investigate its causes and results as well as looking into the judgemental attitudes of the community, church, society, family and counselling of the HIV/AIDS sufferer, their identity crisis and their question of meaning. Furthermore, the study aims to investigate the theological reflection on the notion of God, through the doctrine of judge ment (how God is presented as a judge in both the Old and the New Testaments), as well as Old and New Testaments’ views on illness. Using these sources, this study investigates whether or not HIV is a punishment from God. Using case studies, the resurrection of hope and the role of hope in a person was explored. This study also investigates how pastoral care and spiritual counselling can empower and bring hope and healing to PLWHA. This was done through the use of Louw’s five-phase model of counselling PLWHA, an externalising method from a narrative approach. This study seeks to determine the judgemental attitudes in pastoral care and counselling towards women living with the HI virus in the local township of Lwandle. It is said that the people most vulnerable to the HI virus and most infected are women and especially those living in the poor townships of South Africa. Their lack of education and poverty put these women in a more dangerous situation than their counterparts. In the township churches, women are in the majority. This study speculates about the role of pastoral care and counselling in empowering these women, in particular those living with HIV and AIDS and seeks to explore how the faith community, society and their families judge these women. It also investigates how pastoral care can dispute irrational and unrealistic constructs applied to the interpreta tion of the pandemic and how the Christian community can contribute to constructive pro cesses of de-stigmatisation. In the early days of the pandemic, the church regarded intercourse as intended solely for procreation (Van Dyk 2008:318). Therefore, since it is well established that HIV and AIDS is a desease that is mostly contracted through sexual activity, those who contracted the disease were regarded as being not morally sound or upright members of society. This resulted in pastoral counsellors finding it difficult to counsel without discussing the causes of this disease as when they did so, they often appeared to be condemning the infected persons by judging them. This study focuses on the judgemental attitudes and stigmatisation, a theological reflection on the notion of God, as well as on women living with the HI virus in a specific context. In order to determine the attitudes of pastoral care and counselling, an empirical study was done to assess the attitudes in the above-mentioned location to PLWHA in that community. The aim of the empirical research was not to create statistical evidence, but rather to reflect the stories of the women living with the virus in this community. For the study, a certain group of women was selected from the support group of women who are living with HIV/AIDS. The co-ordinator of the support group helped the researcher to access the people from the Ikhwezi clinic. A questionnaire was used for the findings. The study showed the pain, vulnerability as well as the bravery of these women. Through the case study, the researcher was able to demonstrate how hope can change the lives of PLWHA.
AFRIKAANSE OPSOMMING: Vigs is stigma, haat, swaarkry, verlating, isolasie, uitsluiting, verbod, vervolging, armoede, ontbering. VIGS is 'n metafoor. Dit is 'n bedreiging, 'n tragedie, 'n vloek, 'n klad, 'n letsel, 'n vlek, 'n plaag, 'n kastyding, 'n pestilensie, 'n demoon, 'n doodmaker, wild, vervloek, 'n moordenaar. Dit is sedelikheid gemaak. Dit is veroordeling, afskrikking, vergelding, straf, 'n sonde, 'n les, 'n vloek, teregwysing veroordeling (Pillay, 2008:21). Bostaande aanhaling verteenwoordig sosiale persepsies, gesprekke en reaksies betreffende die VIGS pandemie. Tragies om te sê, in die begin van die pandemie was bostaande persepsie die standpunt van sommige teoloë en kerke, wat die vrees by lyers van die siekte geskep het dat hulle veroordeel sou word. Gemeenskappe, gesinne en mense wat lewe met MIV/VIGS (MWLMV) huldig nog steeds hierdie seining. Die doel van hierdie studie is om die veroordelende houdings by pastorale sorg en berading van vroue wat lewe met MIV/VIGS, te ondersoek. Een van die kwessies wat bydrae tot die toename van die MIV- pandemie is die stigma wat daaraan kleef, omdat dat die stigma is wat die verswyging daarvan veroorsaak. Hierdie studie beoog om die definisie van sigma te verken, en om die oorsaak en die gevolg daarvan te ondersoek, asook as om ’n kykie te kry in die veroordelende houdings van die gemeenskap, die kerk, die samelewing, die familie en die berading van die MIV/VIGS-lyer, hulle identiteitskrisis en hulle soeke na betekenis. Verder beoog die studie om die teologiese besinning oor die idee van God n.a.v., die leerstelling van oordeel (hoe God voorgestel word as Regter in sowel die Ou en Nuwe Testament), sowel as die Ou Testamentiese en Nuwe Testamentiese sienings oor siekte, te ondersoek. Deur die gebruik van hierdie bronne will hierdie studie ondersoek of MIV ’n straf deur God is. Hierdie studie ondersoek ook hoe pastorale sorg en berading kan bemagtig en hoop kan bring vir MWLMV. Dit is gedoen deur die gebruik van Louw se vyf fase beradingsmodel vir MWLMW-’n eksternaliseringsmetode vanuit ’n narratiewe benadering. Deur gebruik te maak van gevallestudies is die opwekking van hoop en die rol van hoop in ’n persoon verken. Hierdie studie poog om die veroordelende houdings by pastorale sorg en beranding van vroue wat leef met die MI-virus in die plaaslike dorpie Lwandle, vas te stel. Daar word gesê dat die kwesbaarste vir die MI-virus en die mees geïnfekteerde persone die vroue is, en by uitstek die wat in die arm dorpies van Suid-Afrika woon. Hulle gebrek aan geletterdheid en hulle armoede bedreig hierdie vroue meer as hulle mans. In die dorpskerke is vrouens in die meerderheid. Hierdie studie besin oor die rol van pastorale sorg en berading in die bemagtiging van hierdie vroue, in besonder hulle wat met MIV/VIGS lewe in die studie poog om te verken hoe die geloofsgemeenskap, die samelewing en hulle gene hierdie vroue beoordeel. Dit ondersoek ook hoe pastorale sorg irrasionele en onrealistiese opvattings rakende die interpretasie van die pandemie kan betwis, en hoe die Christengemeenskap kan bydrae tot ’n opbouende proses van destigmatisering. In die vroeë dae van die pandemie het die kerk gemeenskap gesien as uitsluitlik bedoel vir voorplanting (Van Dyk 2008:318). Aangesien dit algemeen aanvaar word dat MIV en VIGS ’n siekte is wat meestal opgedoen word deur seksuele aktiwiteite, is hulle wat hierdie siekte opgedoen het, nie gesien as moreel, of as onkreukbare lede van die gemeenskap nie. Dit het daartoe gelei dat pastorale beraders dit moeilik gevind het om te beraad sonder om die oorsaak van die siektetoestand te bespreek indien hulle dit wel gedoen het, en het dit dikwels gelyk asof die geïnfekteerde persoon veroordeel is deurdat hulle geoordeel is. Hierdie studie fokus op die veroordelende houdings en stigmatisasie-op ’n teologiese besinning oor die idee van God, sowel as op die vroue wat met die MI-virus binne ’n bepaalde raamwerke leef. Ten einde die houdings van pastorale sorg en berading teenoor MWLMV te bepaal, is ’n empiriese studie in daardie gemeenskap gedoen. Die doel met die empiriese navorsing was nie om statistiese bewyse te skep nie, maar eerder om te besin oor die verhale van die vroue wat met die virus leef in hierdie gemeenskap. Vir die studie is ’n bepaalde groep vroue geselekteer uit die ondersteuningsgroep vroue wat met MIV/VIGS leef. Die koördineerder van die ondersteuningsgroep het die navorser gehelp om die mense van die Ikhwezi kliniek te bereik. ’n Vraelys is gebruik vir die bevindinge. Die studie het die pyn, verwondbaarheid, sowel as die moed van hierdie vroue getoon. Deur die gevallestudie het die navorser aangetoon hoe hoop die lewens van MWLMV kan verander.

Noma is a neglected non-contagious disease of the face and mouth affecting children living in extreme poverty. Due to the quick spread of the disease, the mortality rate is estimated at 90% when treatment is not started within two weeks of onset. Even though Hilfsaktion Noma e.V. (HAN) has been actively spreading awareness about the disease and offering treatment and reconstructive surgery, the mortality rate has not decreased. Moreover, patients reaching the noma centre often present severe sequela, affecting their speech, eating and drinking ability. Therefore, this study investigates the challenges faced by noma patients to seek medical care in Niger and how to overcome them. A mixed-method approach was performed; a survey among healthcare workers of HAN was supplemented with an interview with a key informant of the organisation in order to get a wider understanding of the possible challenges noma patients encounter. Accessibility to healthcare, as well as distance to the hospital and lack of transportation means were identified as the challenges with the highest impact on the health-seeking behaviour of noma patients. The lack of knowledge about noma and treatment costs were the second main challenge. This information gap is reflected in stigmatization, inadequate health care staff and seeking aid from traditional healers, which seriously endangers the life of patients. To overcome these challenges, a community-based surveillance system in combination with a multisectoral approach was proposed. This low-cost system can not only eliminate noma by facilitating the early detection of noma patients, but it can also contribute to sustainable health in Niger and other countries in the Noma belt.

Thesis (MTh (Practical Theology and Missiology))--University of Stellenbosch, 2009.
The basic premise of this study is that a spiritual approach to care and support of people living with HIV, by means of a holistic pastoral model, would provide the Reformed Church of East Africa's Plateau Mission Hospital with an integrated dimension in their community-based care programme for people living with HIV/AIDS. This will go a long way in assisting the RCEA's diversification of the existing medical model, particularly in the Plateau Mission Hospital’s catchment area with its ever-increasing cases of infections, deaths, rejections, church-related stigma, orphans and vulnerable children. The researcher proposes the use of a spiritual model in dealing with PLWH in the Plateau Mission Hospital because this will help to address some of the unresolved theological issues that come to the fore when addressing matters concerning the health and illness of people living with HIV and AIDS. The researcher does this with acute awareness of the importance of integrating other approaches in the care and support of PLWH. For a holistic approach to be effected, the social development, medical, psychological and holistic systemic approaches to care must be considered. The holistic systemic approach used by the biomedical personnel and other caregivers should regard the person as a relational and social being acting within a cultural context. On the other hand, the biomedical model serves us with accurate diagnoses and sophisticated methods of treatment within which modern medicine is practiced. Similarly, the psychosocial model considers the influence of the social environment not only to the challenges that PLWH face, but also on the care they should receive. However, research has shown that there is an increasing need for holistic care in health care systems. This calls for the inclusion of spirituality within the developing bio-psycho-social approaches in addressing health and illness, particularly for people living with HIV and AIDS, in order for them to attain holistic healing. Plateau Mission Hospital, being a church-based institution within the jurisdiction of the RCEA’s southern presbytery, can be an effective vehicle for pastoral care of people living with HIV and AIDS. The organization is strategically placed and has the capacity (resource persons) to engage in a holistic ministry. The paper also aims at unlocking the RCEA’s resources to become more involved in all rounded existential issues of PLWH in the hospital’s catchment area. In this study, it is presupposed that, although the Hospital has a history of medical and social development work and chaplaincy office, it lacks emphasis on the spiritual dimension, and yet this focal point is important in terms of the immediate HIV/AIDS context at Plateau. The researcher established that the training that the personnel at the medical facility have undertaken promotes a clinical approach to all issues of health (prevention and treatment after prescription), even to people living with HIV/AIDS. Methodology. The first methodology for data collection that the research employed was literature review. In this case, library and church documents were reviewed to gather information on related matters. The areas reviewed were related to spirituality, care and healing in the context of HIV, pastoral care and theology in the context of HIV, and biomedical approaches in relation to the care of PLWH, and documentation (Plateau Hospital Reports, the RCEA’s constitution and Care Departmental Reports) on the RCEA’s approach to Hospital care to PLWH by means of the CBHC programme at the Plateau Mission Hospital in Eldoret. The websites were also consulted for purposes of data collection. The second method was conducting specific oral and written interviews with the Hospital’s CBHC staff, PLWH, congregational and church leadership on matters of the proposed spiritual care of PLWA. The areas interviewed were for the spiritual needs, those involved in the care and support of PLWH, improving existing interventions, the challenges encountered in the care for PLWH, the unfulfilled needs of PLWH and how spiritual care could improve the quality of the lives of PLWH. The third method of data collection was participant observation. The researcher was involved in the activities being studied. This method entailed participant observation during normal diaconal care activities in the RCEA’s Plateau parish congregations that the researcher implemented, for instance visiting people living with HIV/Aids, taking gifts to children affected by HIV. In meeting with volunteer caregivers during visits, while joining the CBHC team during follow-up meetings with PLWH in their homes, data was collected. The researcher had patient consultation during days for voluntary counseling and testing and informal meetings with volunteer caregivers. Presentation of the Thesis - Outline of Research This study is divided into five parts. Chapter 1 will examine the background to the study considering the problem statement, research questions, research objectives, hypothesis, justification, the scope of the research, the methodology used, limitations and delimitations. In Chapter 2 the paper will explore The Kenyan Scenario: Medical work and the involvement of the church within the community. This will cover the Kenyan national HIV updates, Uasin Gishu updates, Ainabkoi divisional statistics, the background to the Reformed Church of East Africa, Plateau Mission HIV ministry covering the psycho-social approach to community-based care of CBHC in the Reformed Church of East Africa in the Plateau Hospital catchment area. The paper will examine the medical care offered to people living with HIV/AIDS, such as the treatment of opportunistic diseases, administration of anti-retroviral drugs and the prevention of mother-to-child transmission and voluntary counseling and testing. The paper will also examine the social and developmental activities and services rendered to PLWA and the orphans and vulnerable children by means of compassionate care. CBHC networking with congregations, and Moi Teaching and Referral Hospital will also be highlighted. The paper will also highlight the gaps experienced as a result of the focus on medical and social developmental approaches to the care and support of PLWA and OVCs. Chapter 3 is largely the analysis of interview responses, and presents the findings of field research at the RCEA Plateau Mission Hospital’s selected area of study. This will indicate the seriousness of the unattended needs in this case the spiritual needs and the magnitude of the problem in the health facility but, by implication, affecting the church. This will need a change of stance, namely that of regarding HIV as a medical problem that the hospital needs to address, and view it as a collective need for all key players in church, hospital and community. Chapter 4 will look at the challenge HIV poses to the spiritual care of PLWH in Plateau Mission Hospital. The chapter will contain a literature review on the holistic approach in the care and support of people living with HIV. The section will look at understanding the needs of people living with HIV, pastoral care of people living with HIV, practical theology, biomedical and bio-psycho-social models in the care of PLWH. The study will also examine the relevance of God-images, systems approach, the role of the church and a spiritual care approach in the holistic healing for PLWH by means of pastoral care. Chapter 5 will conclude the paper and will shed light on the importance of the proposed approach to be integrated into the current strategy (pastoral care model with a spiritual-care approach). It is hoped that the recommendations that will be made at the end will strengthen the high demand for a holistic-care ministry to people living with HIV and the affected families in the RCEA Plateau Mission Hospital.

En 1849 dans La maladie à la mort, Kierkegaard voit la cause du mal spirituel qui affecte ses contemporains dans la séparation entre l'existence sociale, extérieure, et la vie spirituelle, intérieure, la seconde étant systématiquement dévaluée au bénéfice de la première. Dans son œuvre, Gogol adopte un point de vue anthropologique similaire, qui forme le socle de la thèse. Celle-ci s'articule en trois temps. D'abord, montrer que la maladie spirituelle se manifeste dans l'incapacité herméneutique qui forme le cœur thématique des Âmes mortes et du Révizor. Ensuite, identifier et analyser l’origine de cette incapacité herméneutique : une incapacité éthique, ce terme étant pris dans l'acception qu'il reçoit chez Emmanuel Lévinas – la prise en compte de la présence d'Autrui, manifestée dans son discours et irréductible à sa forme plastique ; l'incapacité éthique, manifeste dans les récits de Pétersbourg, mène à deux conséquences, la dissolution du Moi et la négation d'Autrui. Enfin, le troisième mouvement est consacré aux voies de la guérison. À la fin de la première partie des Âmes mortes, Gogol esquisse deux possibles pour le devenir de ses contemporains, l'affirmation d'une puissance physique ou le développement d'un potentiel spirituel. Si l'espace du texte, dans les Âmes mortes, concilie ces deux possibles, la voie de la puissance s'avère une illusion dans Taras Boulba et ne subsiste à l'époque moderne que sous une forme parodique ; c'est dans le développement du potentiel spirituel que Gogol place tous ses espoirs, dont les Passages choisis de ma correspondance constituent l'expression synthétique
In 1849, in The Sickness Unto Death, Kierkegaard sees the cause of the spiritual disease which affects his contemporaries in the separation between social, outer existence, and spiritual, inner life, the latter being systematically neglected in favour of the former. In his works, Gogol adopts an anthropological point of view which is similar, and which forms the starting point of this dissertation. The thesis follows a three-part development. First, the point is to show that the spiritual disease is manifested in hermeneutic disability, which forms the thematic core of both Dead Souls and The Inspector General. Then, identify and analyze this hermeneutic disability as a form of ethical disability – the term ‘ethics’ being understood here according to how it is defined by Emmanuel Lévinas : taking into account the presence of the Other, manifested through their speech and distinct from their physical manifestation. Ethical disability is manifest in the Petersburg stories, and it leads to both the dissolution of the Self and the negation of the Other. Finally, the third movement is dedicated to the ways of healing : at the end of the first part of Dead Souls, Gogol sketches two possible paths for the future of his contemporaries, either the affirmation of physical power or the development of spiritual potential. If the two options are intertwined in the text of Dead Souls, the first one turns out to be a mere illusion in Taras Bulba and survives in modern times as a parody. It is in the second option that Gogol places all his hopes, which find in Selected Passages from Correspondence with Friends their synthetic expression

碩士
長庚大學
護理學系
105
Parkinson's disease (PD) is a chronic and degenerative disorder of the central nervous system, which manifests itself as slowness of movements, rigidity, tremor and posture instability, causing irreversible motor dysfunction. The long-term duration of this disease is associated with a significant discomfort and multiple stress, medical and social cost, and decreased quality of life (QoL) for persons with Parkinson’s disease (PWPDs). Therefore, the purpose of this study was to explore the relationships among demographic variables, disease characteristics, and spiritual well-being and QoL in PWPDs. We hypothesized that spiritual well-being impacted QoL in PWPD. The study was a cross-sectional design with a convenient sampling method. We recruited 110 PWPDs from a neurological clinic of a teaching hospital in northern Taiwan. The test battery includes: Mini-Mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), Spirituality Index of Well-Being (SIWB) and 39-item Parkison's disease Quality of Life Questionnaire (PDQ-39). Significant value of α level was set at 0.05. The sample size was estimated to be 110 according to the previous attrition rate (10%) and the multiple regression analysis. The results were as follows: there were significant differences in quality of life between having a job and unemployment; the total scores of the Spirituality Index of Well-Being and its two sub-scores (Life Scheme and Self Efficacy) were negatively correlated with quality of life; UPDRS total score and quality of life was positively correlated. Finally, occupation, disease severity and self efficacy were the significant predictors of quality of life for PWPD, explaining 66.8% of the variance (adjust R2:65.8%). The results can help health care professionals to develop appropriate intervention for enhancing quality of life for Parkinson’s disease patients. Key words：Parkinson’s disease, spiritual well-being, QoL.

This dissertation explores ritual healing and the issue of efficacy in early medieval Japanese Buddhism through a study of The Ritual of Shōmen Kongō for Expelling Demons and Māras. Designed by monks of the Jimon branch of the Tendai school in the 1170’s and transmitted over the thirteenth century, this ritual stood out in the field of esoteric ritual healing at the time for two significant reasons. First, its therapeutic program was centered on moxibustion (kyū), a Chinese medical modality in which the healer burns dried mugwort on multiple locations on the patient’s body. Second, it was the earliest esoteric rite created in Japan to target a single, named affliction. That affliction was “corpse-vector disease” (denshibyō), a contagious wasting disorder known to Japan through transmitted classical Chinese medical texts as well as Buddhist scriptures. Until this time, esoteric ritual healing in Japan had never before featured direct engagement with the patient’s body so prominently. What was it about corpse-vector disease, an affliction that only became known in the late twelfth century, that spurred monks to reorient esoteric ritual healing around a technology for burning the body of the sick? Why, moreover, had Jimon monks made the unprecedented move of looking beyond the tried-and-true techniques of the esoteric ritual repertoire to instead adopt a non-Buddhist medical modality? Through an examination of the extant textual sources for the rite as well as medical texts, courtier diaries, tale literature, and other ritual sources, this dissertation investigates these questions in order to reconsider the issue of efficacy in the context of Buddhist ritual healing. Challenging the longstanding notion that esoteric ritual efficacy was the object of unquestioning belief throughout the early medieval period, I define efficacy as a site of uncertainty for both healers and patients, a nexus for the convergence of vexing questions and anxieties pertaining to disease, technology, and the body. Responding to new problems posed by the emergence of corpse-vector disease, Jimon monks—the most prominent therapeutic exorcists at court in the twelfth and thirteenth centuries—offered an unheard of solution that would thereafter transform healing culture in Japan for centuries. I examine how Jimon monks drew upon liturgical, doctrinal, and medical texts to reimagine the disease as well as moxibustion and the patient’s body, and consider the transformations the enactment of the rite’s prescriptions would have brought to performances of ritual healing. In so doing, I argue that efficacy cannot be understood solely through universal ascriptions of ritual power, common as those ascriptions may be throughout esoteric liturgical literature. Rather, the Jimon ritual demonstrates above all that esoteric healers had to negotiate efficacy through a specific constellation of images and material practices that engaged issues of affliction, technology, and body in compelling ways.

Dissertação de mestrado apresentada ao ISPA - Instituto Universitário
Este estudo pretendeu compreender a relação entre o bem-estar espiritual e a saúde mental em pessoas com doença oncológica. Foram seleccionados 30 participantes com doença oncológica de um Hospital central, sendo 22 do sexo feminino (73.3%). Os instrumentos utilizados neste estudo foram o MMPI-2 (Minesota Multiphasic Personality Inventory -2) que mede o nível de saúde mental e o SWBQp (Versão Portuguesa do Questionário de Bem-Estar Espiritual) que avalia o nível de bem-estar espiritual dos participantes. Dos resultados obtidos, salienta-se as escalas da depressão e paranóia como as mais elevadas no Mini-Mult; correlações significativas negativas entre o MMPI-2 e o SWBQp (quanto melhor o resultado na SWBQp, mais baixos são os resultados nas dimensões da Mini-Mult), assim como verificaram-se também diferenças significativas entre o sexo masculino e feminino nas escalas do Mini-Mult, tendo os homens apresentado resultados superiores às mulheres. Considera-se importante a realização de mais estudos que investiguem o papel protector do Bem-Estar Espiritual, principalmente, em situações em que a pessoa doente é confrontada com a sua própria morte.
ABSTRACT------This study sought to understand the relationship between spiritual well-being and mental health in people with oncological disease; 30 participants (22 - 73.3% were women) with oncological disease were selected from a central hospital. The instruments used were the MMPI-2 (Minnesota Multiphasic Personality Inventory -2) which measures the level of mental health and the SWBQp (Portuguese Version of the Questionnaire Wellness Spiritual) which assessed the participant’s level of spiritual well-being. The results show more problems in the scales of depression and paranoia (highest values in the Mini-Mult), significant and negative correlations between the MMPI-2 and SWBQp (the better the result in SWBQp, the lower the results in the dimensions of the Mini-Mult), and there were also significant differences between male and female in the scales of mini-Mult (men had a higher income than women). It is considered important to conduct further studies to investigate the protective role of the Spiritual Well-Being, especially in situations where the sick person is faced with his own death.

The human trait of entitlement, although currently very topical, has only recently come under serious scrutiny by behavioural psychologists (Campbell, Bonacci, Shelton, Exline & Bushman 2004:30). This study examines the modifying effects of these psychological elements on the spiritual aspects of disease and healing. Other modifiers are the personal spiritual beliefs or dogmas of the clergy within the paradigm of a particular denomination, and the beliefs and expectations of the adherents. Two Christian denominations were chosen for the study: The Methodist Church of Southern Africa, in particular the home church of the writer, The Bedfordview Methodist Church, and Afmin, an organisation that trains and equips students, mainly African, for Christian ministry. Structured face to face interviews were conducted with pastors and church leaders, interviews with medical professionals were conducted and a wide ranging review of relevant literature undertaken. It was found that while the trait of entitlement was a constant in human nature, there were modifying factors. These included the personal beliefs of pastors and youth leaders, often founded on personal experience instead of denominational dogma. The influence of Pentecostal / Charismatic teaching was very evident. It was also found that the church, in a drive to become increasingly relevant to current norms and social trends, tended to have a rather confused understanding of biblical healing and the role of God in disease and suffering. While the inevitability of death, suffering and disease cannot be denied, the role of the church is complex and controversial. Unrealistic expectations, based on teaching that encourages a sense of entitlement can lead to great challenges regarding faith in both the clergy and adherents.
Christian Spirituality, Church History & Missiology
D. Th. (Christian Spirituality)

The diploma thesis addresses in detail the issue of a terminally ill individual and things closely associated with this topic including spiritual direction of the bereaved after the death of a close relative. Based on information from the literature it tries to reflect the basic conditions of approach to an oncology patient and his relatives (including the necessity of truthful communication and abidance by basic ethic rules). In order to provide a comprehensive view of the topic, the work includes research among the patient?s relatives realized in 4 out of the 14 hospice centers in the Czech Republic. On the basis of this research some positive aspects have been revealed on one hand, which are worthy acknowledgement and appreciation. On the other hand, there are areas and restraints motivating and challenging both types of healthcare centres to take steps that would lead to a better quality of care provided in the future.

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica.
Introdução: As doenças autoimunes têm consequências psicológicas e sociais na vida de uma pessoa, exigindo uma adaptação por parte da mesma. A literatura nesta área é escassa mas tem vindo a mostrar a importância da adaptação nestas doenças uma vez que é necessário uma adaptação em vários domínios da vida. O principal objetivo desta investigação é avaliar o coping, o bem-estar subjetivo e o bem-estar espiritual no crescimento pós-traumático e na resiliência em doentes autoimunes. Método: A amostra é constituída por 316 participantes (M = 39,79 anos; DP = 12,43), portadores de doenças autoimunes. Os participantes preencheram um questionário online com os seguintes instrumentos: Brief Cope, Escala de Resiliência, Inventário de Desenvolvimento Pós-traumático, Escala de Satisfação com a Vida, PANAS e Questionário de Bem-Estar Espiritual. Resultados: O modelo final da resiliência foi significativo (F (79,98) = 5,310; p < 0,001) e teve como principal preditor a Componente Afetiva do BES – afeto negativo (β = -0,24; p= 0,001). O modelo final do CPT teve como principais preditores o BEE (ß= 0,35; p < 0,001) e a resiliência (ß= 0,33; p ≤0,001). Através do teste ANOVA One Way, os resultados indicamnos que o tipo tratamento tem um efeito significativo no CPT (F (7, 308) = 2,04; p = 0,050). Conclusão: Uma vez que existe pouca literatura na área, torna-se importante este tipo de estudos, de modo a que os doentes e profissionais de saúde possam ter mais conhecimento sobre a doença e assim melhorar a qualidade de vida dos mesmos
Introduction: Autoimmune diseases have psychological and social consequences to the patients. The research in this field is limited, however has been showing the importance of the adaptation processes in these diseases. The present work aims to evaluate the coping, subjective well-being, and spiritual well-being in post-traumatic growth and resilience, in autoimmune patients. Method: A sample of 316 participants (M = 39.79; SD = 12.43) with autoimmune diseases completed an online survey with the (1) Brief Cope Scale, (2) Resilience Scale, (3) Posttraumatic Development Inventory, (4) Life Satisfaction Scale, (5) PANAS Scale, and (6) Spiritual Well-Being Questionnaire. Results: The final model of resilience was significant (F (79.98) = 5.310; p < 0.001) and its main predictor was the Affective Component of the BES - negative affect (β = -0.24; p = 0.001). The final CPT model (F (33.18) = 5.310; p < 0.001), had BEE (ß= 0.35; p < 0.001) and resilience (ß= 0.33; p < 0.001) as the main predictors. Through a One Way ANOVA, the results showed that the type of treatment has a significant effect on CPT (F (7, 308) = 2.04; p = 0.050). Conclusion: Since there is little literature in the area, this type of study is important, so that patients and health professionals can have more knowledge about the disease and thus improve their quality of life.

In this dissertation the healing acts of Jesus in John are investigated against the ancient Mediterranean socio-religious and cultural background in which it realized. All sickness and healing realities realize within a particular socio-cultural context and may differ significantly within different cultures. For example, less than one hundred years ago depression was not diagnosed as an illness and there existed no therapeutic processes for the disease. When one investigates ancient healing narratives which tell of sickness realities almost 2000 years ago, before the dawn of the Western Bio-Medical research system and modernism, one must remember that the sickness realities of that time will differ to a great extent from the modern project‘s sickness realities and its constructs. The researcher must in other words be very sensitive about anachronistic misinterpretations and ethnocentrism - that is, a reductionistic view of sickness (and other) realities through your own worldview. For this reason the term sickness is used as an umbrella term, and a distinction is made between the curing of a disease and the healing of an illness. The word group curing and disease are words that are used in the Western Bio-Medical world, and are also deeply imbedded within the modernistic philosophical worldview. On the other hand the word group healing of an illness is more inclusive in the sense that it is sensitive to sickness realities as experienced and constructed in ancient Mediterranean societies. In the first century ancient Mediterranean temple oriented Judaism for example, a particular disease (like skin disease), unlike today, also had negative socio-religious implications for the afflicted person which sometimes resulted in marginalization and status deconstruction. Turning to John‘s healing narratives it should also be taken into account that his healing acts are presented as σημετα that is, signs which illustrate that Jesus is the Son of God, the source of life (cf. John 20:30-31; 10:32; 6:14). The question to be answered is, in what way does John present the healing narratives in order to illustrate that Jesus is the true source of Life (cf. John 1:4). The thesis is thus developed that John presents sickness realities that closely represent ¯"death”, crisis, disorientation, brokenness and loss of life possibilities within the ancient Mediterranean symbolic universe. John then presents Jesus as the divine transformation Agent, who restores and recreates life possibilities after a transformational interaction with the sick person. It is also argued that John‘s understanding of healing is not to be limited to the traditional Western Biomedical paradigm revolving around the curing of disease but also includes a view of Jesus‘ role as healer and restorer of spiritual brokenness, a tradition which originated in the Old Testament. The narrative regarding the discussion between Jesus and the Samaritan woman is used as an example of a situation in which Jesus offers someone the gift of life and spiritual restoration or healing which resulted in the representation of reality. Lastly it will be argued why the resurrection could be understood as a Johannine σημετον and also be interpreted as the culminating healing act in John‘s Gospel, illustrating that Jesus is the true source of life in abundance (cf. John 1:4; 10:10).
Thesis (PhD)--University of Pretoria, 2008.
New Testament Studies
PhD
Unrestricted

Dissertação de Mestrado apresentado no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia da Saúde
Introdução: Com base na literatura evidencia-se que, no processo de doença crónica, o cuidador familiar da criança é compreendido como um fator de proteção e auxílio para a mesma, e devido ao impacto da doença, na vida da criança, podem surgir reações positivas de enfrentamento da doença no cuidador. O principal objetivo desta investigação é compreender a adaptação dos cuidadores familiares à doença crónica da criança, avaliando a resiliência, bem-estar espiritual, bem-estar subjetivo e crescimento pós-traumático. Método: A amostra é constituída por 127 participantes (M = 40 anos,26; DP = 7,38), que são, ou foram, cuidadores de crianças com doenças crónicas. Os participantes preencheram um questionário online com os seguintes instrumentos: Escala de Resiliência, o Questionário de Bem-Estar Espiritual, a Escala de Satisfação com a Vida, a Escala de Afeto Positivo e Negativo e o Inventário de Desenvolvimento Pós-Traumático. Resultados: Os resultados evidenciam a manifestação das variáveis supracitadas na população de pais cuidadores de crianças com doenças cronicas e demonstram que o estado civil, internamentos e bem-estar espiritual estão relacionados com resiliência, bem-estar subjetivo, crescimento pós-traumático e resiliência predizem o bem-estar espiritual, o crescimento pós-traumático e o bem-estar espiritual são preditores de bem-estar subjetivo, e o bem-estar subjetivo e espiritual contribuem para o crescimento pós-traumático. Conclusão: Este estudo demonstra que os cuidadores tendem a manifestar ajustamento psicossocial na gestão da situação de doença crónica, percecionando as variáveis psicossociais supracitadas, e possibilita evidências empíricas importantes para a criação de um modelo teórico que explique a relação entre as mesmas.
Introduction: Based on the literature, it is evident that in the process of chronic disease, the family caregiver of the child is understood as a factor of protection and assistance to the child, and due to the impact of the disease on the child's life, positive reactions to confront the disease can arise in the caregiver. The main objective of this research is to understand the adaptation of family caregivers to the chronic disease of the child, assessing the child's resilience, spiritual well-being, subjective well-being and post-traumatic growth. Method: The sample consists of 127 participants (M age = 40;26 SD = 7.38), who are, or were, caregivers of children with chronic diseases. Participants completed an online questionnaire with the following tools: Resilience Scale, the Spiritual Wellbeing Questionnaire, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, and the Posttraumatic Growth Inventory Results: The results show the manifestation of the abovementioned variables in the population of parents caring of children with chronic illnesses and demonstrate that marital status, internments and spiritual well-being are related to resilience, subjective well-being, post-traumatic growth and resilience predict spiritual well-being, post-traumatic growth and spiritual well-being are predictors of subjective well-being, and subjective and spiritual well-being contribute to post-traumatic growth. Conclusion: This study shows that caregivers tend to manifest psychosocial adjustment in the management of the chronic disease situation, perceiving the aforementioned psychosocial variables, and provides important empirical evidence for the creation of a theoretical model that explains the relationship between them.

Chronic stress contributes to a global burden of disease that include mental illness, cardiovascular disease and early mortality. One pathway linking stress responses to health outcomes involves cardiovascular response to psychological stress. Specifically, vagal response as indexed by heart rate variability (HRV) can be used to examine autonomic processes, dysfunction of which can predict cardiovascular morbidity and mortality. The competitive academic climate on undergraduate campuses and insufficient time for recreation, rest and study, combined with inadequate coping skills can equate to consistent stressors that lead to subsequent stress and psychopathology among college students. Research demonstrates that reduced HRV can be observed among students during exam time, whereas increased HRV is observed in times of rest, suggesting that academic stress contributes to real-time physiological changes that, when prolonged, can be pathogenic in nature. Interventions aimed at influencing these processes via relaxation or other mind-body approaches have shown that enhancing meta-cognitive skills and other coping strategies have proven helpful in both improving perceived stress and psychological distress as well as improving HRV when compared with controls. This study investigates potential positive physiological effects of an eight-week Spiritual-Mind-Body (SMB) intervention, Awakened Awareness for Adolescents (AA-A), for undergraduate students. Specifically, we explore changes in HRV during resting, stress and recovery phases before and after the eight-week intervention. Additionally, we examine the association between change in self-report on measures of personal spirituality and psychological variables (pre-post AA-A), and changes across a host of HRV indices. Results include improvements in HRV recovery from stress and that a process of spiritual recovery is associated with these changes. SMB interventions that aim to improve spiritual and psychological functioning may promote psychophysiological resilience from stress.

Summaries in German, English and Zulu
Text in German
Die praktisch-theologische Studie untersucht spirituelle Bedürfnisse von ambulanten Palliativpatienten. Dazu wurden Fokusgruppendiskussionen mit Teams aus der ambulanten Palliativversorgung in Nordhessen durchgeführt und diese nach ihren Erfahrungen und Beobachtungen gefragt. Theoretische Grundlagen zur Spiritualität im Kontext der Palliativversorgung bilden den Rahmen zur Auswertung der empirischen Masterarbeit mittels qualitativer Inhaltsanalyse. Der Befund zeigt, dass das Erkennen von spirituellen Bedürfnissen bei Patienten die Teammitglieder mehrheitlich vor Herausforderungen stellt und multiple Verunsicherung sowie Probleme im Umgang bestehen. Außerdem prägen persönliche Überzeugungen ihre Wahrnehmung maßgeblich. Die beobachtete Spiritualität ist überwiegend kirchlich geprägt und beruht auf christlichen Elementen wie Gebete, Glauben oder Begleitung durch PfarrerInnen. Teammitglieder sprechen zudem Begegnungen, „Dasein“ und (Kirchen)Musik eine spirituelle Dimension zu. Es gibt auch Patienten, die keine spirituellen Bedürfnisse haben oder derartiges ablehnen. Die Praktische Theologie könnte zukünftig als bedürfnisorientierte Kompetenzgeberin dienen, damit Mitarbeitende aus dem Gesundheitssystem befähigt werden, spirituelle Bedürfnisse ihrer Patienten wahrzunehmen, zu reflektieren und ihnen angemessen zu begegnen.
This practical theological study examined the spiritual needs of outpatient palliative care patients. Focus group discussions were conducted with outpatient palliative care teams. They were asked about their experiences and observations. Theoretical foundations of spirituality and palliative care formed the framework for the evaluation of empirical research by using qualitative content analysis. Findings show that recognition of spiritual needs in patients poses a challenge to the majority of team members, as well as insecurities and problems in dealing with them. The observed spirituality is predominantly ecclesiastical and based on Christian elements such as prayers, faith and accompaniment by pastors. Team members address encounters, "being" and music as spiritual dimensions. There are also patients who have no spiritual needs. In future, practical theology could serve as a needs-based provision of competences, so that employees of health systems can be empowered to perceive, reflect on and adequately respond to the spiritual needs of their patients.
Boithuto jwa thutobomodimo bo tlhatlhobile ditlhokwa tsa semoya tsa balwetse ba tlhokomelo ya malwetse a bofelelo ya kalafo ya balwetse ba kwa ntle. Dipuisano tsa setlhopha tsa tsepamo di ne tsa dirwa ka ditlhopha tsa tlhokomelo ya malwetse a bofelelo a kalafo ya balwetse ba kwa ntle. Ba ne ba bodiwa ka maitemogelo le ditemogo tsa bona. Metheo ya thutobomodimo le tlhokomelo ya malwetse a bofelelo di bopile letlhomeso la tlhotlhwafatso ya patlisiso ya mmatota ka go dirisa tshetshereganyo ya diteng tsa boleng. Dipatlisiso di bontsha fa kamogelo ya ditlhokwa tsa semoya mo balwetseng e tlisa kgwetlho mo bontsing jwa ditokololo tsa setlhopha, ga mmogo le go sa itshepeng go gontsi le mathata a go samagama le tsona. Bosemoya jo bo bonwang bontsi ke jwa sekeresete, mme bo ikaegile ka dielemente tsa Bokeresete jaaka dithapelo, tumelo le tshwaragano le baruti. Ditokololo tsa setlhopha di bua ka ga dikgolagano, "go nna" le mmino jaaka ditekanyo tsa semoya. Gape go na le balwetse ba ba se nang ditlhokwa tsa semoya. Mo bokamosong, thutobomodimo ya tiriso e ka dira jaaka kabelo e e ikaegileng ka ditlhokwa tsa dikgono, gore bathapi ba dithulaganyo tsa boitekanelo ba maatlafadiwe go lemoga, go supa tshwano le go tsibogela ditlhokwa tsa semoya tsa balwetse ba bona.
Philosophy, Practical and Systematic Theology
M. Th. (Practical Theology)

Text in German, with German, English and Southern Sotho summaries
Includes bibliographical references (leaves 149-153)
Die praktisch-theologische Studie untersucht spirituelle Bedürfnisse von ambulanten Palliativpatienten. Dazu wurden Fokusgruppendiskussionen mit Teams aus der ambulanten Palliativversorgung in Nordhessen durchgeführt und diese nach ihren Erfahrungen und Beobachtungen gefragt. Theoretische Grundlagen zur Spiritualität im Kontext der Palliativversorgung bilden den Rahmen zur Auswertung der empirischen Masterarbeit mittels qualitativer Inhaltsanalyse. Der Befund zeigt, dass das Erkennen von spirituellen Bedürfnissen bei Patienten die Teammitglieder mehrheitlich vor Herausforderungen stellt und multiple Verunsicherung sowie Probleme im Umgang bestehen. Außerdem prägen persönliche Überzeugungen ihre Wahrnehmung maßgeblich. Die beobachtete Spiritualität ist überwiegend kirchlich geprägt und beruht auf christlichen Elementen wie Gebete, Glauben oder Begleitung durch PfarrerInnen. Teammitglieder sprechen zudem Begegnungen, „Dasein“ und (Kirchen)Musik eine spirituelle Dimension zu. Es gibt auch Patienten, die keine spirituellen Bedürfnisse haben oder derartiges ablehnen. Die Praktische Theologie könnte zukünftig als bedürfnisorientierte Kompetenzgeberin dienen, damit Mitarbeitende aus dem Gesundheitssystem befähigt werden, spirituelle Bedürfnisse ihrer Patienten wahrzunehmen, zu reflektieren und ihnen angemessen zu begegnen.
This practical theological study examined the spiritual needs of outpatient palliative care patients. Focus group discussions were conducted with outpatient palliative care teams. They were asked about their experiences and observations. Theoretical foundations of spirituality and palliative care formed the framework for the evaluation of empirical research by using qualitative content analysis. Findings show that recognition of spiritual needs in patients poses a challenge to the majority of team members, as well as insecurities and problems in dealing with them. The observed spirituality is predominantly ecclesiastical and based on Christian elements such as prayers, faith and accompaniment by pastors. Team members address encounters, "being" and music as spiritual dimensions. There are also patients who have no spiritual needs. In future, practical theology could serve as a needs-based provision of competences, so that employees of health systems can be empowered to perceive, reflect on and adequately respond to the spiritual needs of their patients.
Boithuto jwa thutobomodimo bo tlhatlhobile ditlhokwa tsa semoya tsa balwetse ba tlhokomelo ya malwetse a bofelelo ya kalafo ya balwetse ba kwa ntle. Dipuisano tsa setlhopha tsa tsepamo di ne tsa dirwa ka ditlhopha tsa tlhokomelo ya malwetse a bofelelo a kalafo ya balwetse ba kwa ntle. Ba ne ba bodiwa ka maitemogelo le ditemogo tsa bona. Metheo ya thutobomodimo le tlhokomelo ya malwetse a bofelelo di bopile letlhomeso la tlhotlhwafatso ya patlisiso ya mmatota ka go dirisa tshetshereganyo ya diteng tsa boleng. Dipatlisiso di bontsha fa kamogelo ya ditlhokwa tsa semoya mo balwetseng e tlisa kgwetlho mo bontsing jwa ditokololo tsa setlhopha, ga mmogo le go sa itshepeng go gontsi le mathata a go samagama le tsona. Bosemoya jo bo bonwang bontsi ke jwa sekeresete, mme bo ikaegile ka dielemente tsa Bokeresete jaaka dithapelo, tumelo le tshwaragano le baruti. Ditokololo tsa setlhopha di bua ka ga dikgolagano, "go nna" le mmino jaaka ditekanyo tsa semoya. Gape go na le balwetse ba ba se nang ditlhokwa tsa semoya.
Philosophy, Practical and Systematic Theology
M. Th. (Practical Theology)