Biomedical subjects

Joan Engebretson

Publications and source records attributed to Joan Engebretson.

9 recordsLinked to original sources

PubMed2006

Neural and cognitive basis of spiritual experience: biopsychosocial and ethical implications for clinical medicine.

The role of patient spirituality and spiritual/liminal experience(s; SE) in the clinical setting has generated considerable equivocality within the medical community. Spiritual experience(s), characterized by circumstance, manifestation, and interpretation, reflect patients' explanatory models. We seek to demonstrate the importance of SE to clinical medicine by illustrating biological, cognitive, and psychosocial domains of effect. Specifically, we address where in the brain these events are processed and what types of neural events may be occurring. We posit that existing evidence suggests that SE can induce both intermediate level processing (ILP) to generate attentional awareness (ie, "consciousness of") effects and perhaps nonintermediate level processing to generate nonattentive, subliminal (ie, "state of") consciousness effects. Recognition of neural and cognitive mechanisms is important to clinicians' understanding of the biological basis of noetic, salutogenic, and putative physiologic effects. We posit that neurocognitive mechanisms, fortified by anthropologic and social contexts, led to the incorporation of SE-evoked behaviors into health-based ritual(s) and religious practice(s). Thus, these experiences not only exert biological effects but may provide important means for enhancing patients' locus of control. By recognizing these variables, we advocate clinicians to act within an ethical scope of practice as therapeutic and moral agents to afford patients resources to accommodate their specific desire(s) and/or need(s) for spiritual experiences, in acknowledgement of the underlying mechanisms and potential outcomes that may be health promotional.

Attitude of Health Personnel↗

PubMed2006

Photovoice as a social process of critical consciousness.

The reluctance of some communities to participate in research and researchers' lack of penetration into the community are major stumbling blocks to successful community-based approaches. The authors'purpose is to determine how a photovoice project in a lower income, African American, urban community was able to generate a social process that resulted in active grassroots participation in a community-campus partnership. Through this partnership initiative, the authors asked neighborhood residents to take photographs of things in the community of which they were proud and the things they wanted to change, and to tell the story of why these were important. The authors used strategies from visual anthropology to analyze the 54 photographs, stories, and dialogue produced. Their analysis identified three distinct levels of cognitive-emotional interpretations that moved participants out of helplessness toward authentic engagement and participation. The authors discuss implications and lessons learned for community-based participatory research.

Adaptation, Psychological↗

PubMed2005

Design and evaluation of an online teaching strategy in an undergraduate psychiatric nursing course.

Psychiatric nurse educators are challenged to prepare graduates in meeting the needs of individuals with a mental illness within an increasingly technology-based environment. This requires the development and evaluation of educational strategies that immerse students in web-based learning. This article presents an overview of a hybrid teaching design that includes classroom teaching and asynchronous threaded discussion in a teaching module in an undergraduate psychiatric nursing course. Evaluation of student preferences, advantages and disadvantages, and learning, as well as qualitative evaluation of students' description of critical thinking, supports the value of online teaching in psychiatric nursing education.

Attitude of Health Personnel↗

PubMed2005

Challenges to complementary and alternative medical research: focal issues influencing integration into a cancer care model.

Complementary and alternative therapies are increasingly used by cancer patients for palliative and postcancer preventive and/or wellness care. It is critical that evidence-based models be employed to both provide information for patients' use and informed consent and for physicians to advise patients and assess relative risk:benefit ratios of using specific complementary and alternative medicine (CAM) approaches within the cancer care paradigm. Research models for biomedicine have been somewhat limited when applied to broader, more holistic conceptualizations of health common to many forms of CAM. Thus, while numerous challenges to studying CAM exist, a fundamental question is not just what CAM practices should be studied but how CAM should be studied. The authors propose a model that emphasizes methodologic rigor yet approaches CAM research according to relative levels of evidence, meaning, and context, ranging from experimental, quantitative studies of mechanism to qualitative, observational studies of noetic/salutogenic variables. Responsibility for training researchers prepared to meet such challenges rests on both CAM and mainstream academic institutions, and care must be taken to avoid philosophical and practical pitfalls that might befall a myopic perspective of integration.

Attitude of Health Personnel↗

PubMed2005

Participation in community health screenings: a qualitative evaluation.

Community health screenings and education programs have been widely used to identify individual health risks and promote early diagnosis and treatment of disease. Participation in these community activities is dependent on the initial health-seeking behaviors of the individual. Focus group interviews1 were conducted with both attendees and nonattendees of a program offering health education and screenings in various settings in a semirural area. The purpose of these group interviews was to better understand issues associated with participation. A domain analysis of the qualitative data revealed that multiple aspects of self-care orientations as well as interpersonal and environmental factors influenced participation. A paradoxical facilitator-inhibitor effect was apparent. The companionship and support inherent in a community setting was an incentive for participation, but also presented concerns about confidentiality. However, concern about getting knowledge about self-care and the fear and anxiety of learning the results of screening tests creates a push-pull dilemma that is a challenge for health care providers. Factors that influence participation in semirural community health screenings are varied and complex and suggest multidimensional approaches be used in designing programs.

Anxiety↗

PubMed2003

Cultural constructions of health and illness. Recent cultural changes toward a holistic approach.

Nurses have defined their domain as holistic with a focus of promoting health. Cultural conceptualizations of health and illness have been changing toward a more complex understanding enriched by perspectives from many disciplines. Health, a more holistic concept than disease, has invited expanded cognitive constructions that accommodate an understanding of the biology, environment, social position, and the role of the mind, culture, spirituality, race, and sex. These have changed our metaphors of the body and expanded the focus to the health-illness experience. These areas are discussed with implications for nursing.

Attitude to Health↗

PubMed2002

Culture and complementary therapies.

Complementary therapies are becoming increasingly popular in cultures dominated by biomedicine. Modalities are often extracted from various healing systems and cultural contexts and integrated into health care, expanding the focus from treatment of disease to the promotion of health. The cultural aspects of biomedicine are presented and compared and contrasted with other healing systems. Three healing systems; traditional Chinese medicine, Yoga, with roots in Ayurvedic medicine and Shamanic healing illustrate these fundamental differences in approaches to healing. A reverse example of isolating one healing intervention from biomedicine and interpreting it through other cultural lenses is presented. Implications are drawn for practice and research.

Complementary Therapies↗

PubMed2002

Hands-on: the persistent metaphor in nursing.

The metaphor "hands-on" has been used throughout the history of nursing, highlighting internal conflict and reflecting the centrality of patient care. Connection with the intent to heal suggests the deeper meaning of the metaphor. Nurses have struggled to maintain a holistic approach to patient care while reflecting larger social values. Some nurses have moved from holistic care of the client to a holistic use of self as healer. This unified approach of head, heart, and hands is exemplified in healers using touch therapies. Head and heart unite with the action of the hand with intent to heal.

Gender Identity↗

PubMedDate not supplied

Experience of a Reiki session.

CONTEXT: Touch therapies, including Reiki, are increasingly popular complementary therapies. Previous studies of touch therapies have yielded equivocal findings. OBJECTIVE: Exploring the experiences of Reiki recipients contributes to understanding the popularity of touch therapies and possibly elucidates variables for future studies. DESIGN: Descriptive study with quantitative and qualitative data. This report focuses on qualitative interview data. Thematic analysis was used to discern patterns in the experience. SETTING: All Reiki treatments were given in a sound proof windowless room by one Reiki master. Audiotaped interviews were conducted immediately after the treatment in a quiet room adjoining the treatment room. PARTICIPANTS: Generally healthy volunteers (N=23) who were naive to Reiki. INTERVENTION: Standardized, 30-minute Reiki session. MAIN OUTCOME MEASURES: Interview data supported by quantitative data. RESULTS: Participants described a liminal state of awareness in which sensate and symbolic phenomena were experienced in a paradoxical way. Liminality was apparent in participants' orientation to time, place, environment, and self Paradox also was seen in participants' symbolic experiences of internal feelings, cognitive experience, and external experience of relationship to the Reiki master. CONCLUSIONS: Liminal states and paradoxical experiences that occur in ritual healing are related to the holistic nature and individual variation of the healing experience. These findings suggest that many linear models used in researching touch therapies are not complex enough to capture the experience of participants.

Adult↗