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Biomedical subjects

M T Dombeck

Publications and source records attributed to M T Dombeck.

9 recordsLinked to original sources
PubMed1995

Clinical supervision: a three-way mirror.

The principles and process of a model of clinical supervision for psychotherapy are presented and described through two cases. The model draws heavily from Bowen's family systems theory and Peplau's theory of interpersonal relations. The relationships in the client-family, client-therapist, and therapist-supervisor systems mirror each other, and changes in self-definition, and in the management of anxiety of persons in one system catalyzes changes in parallel systems. Two cases illustrate the model. In the first case, anxiety needed to be raised to levels optimal for learning. In the second case, no learning occurred until levels of anxiety were reduced.

Anxiety↗
PubMed1995

Dream telling: a means of spiritual awareness.

The article describes how a dream-sharing group facilitated by a nurse therapist can become the means by which the participants gain spiritual awareness. First, the characteristics of spiritual awareness are identified and discussed. Second, the practice, structure, and process of a dream-sharing group are described, with dream narratives and interactions from a particular group being used as illustrations. Finally, the attributes of a sensitive and caring listener and the leadership qualities of a nurse facilitator of such a group are outlined in the hope that nurses in different settings will be enabled and encouraged to provide this important aspect of nursing care.

Adult↗
PubMed1991

The contexts of caring: conscience and consciousness.

In this paper, I have maintained a distinction between person and self in order to describe and analyze contexts of caring in nursing encounters. As the nursed person's perspectives are examined in light of the nurse's capacity to engage his or her own experience, four contextual categories emerge: comprehension, consideration, concern, and communion. Such concepts can help us describe and analyze many situations in clinical nursing and in nursing education. The following paragraphs describe several of the possibilities for future research. It is important to study in which contexts in nursing personhood and selfhood are enhanced and when they are diminished. Diminishment of personhood leads to depersonalization which describes a condition of loss of agency and helplessness in a world where others are in control. This can happen to the nursed person and to the nursing person. When nurses are placed in contexts where they experience lack of agency and authority in their practice settings (even when they attempt to engage others with concern and compassion), they can start to feel and become depersonalized. Diminishment of self leads to dehumanization, which describes a loss of contact with one's own experience. Rules and relationships are oppressive or inflexible and the participants experience meaninglessness. For example, how long can nurses be in daily situations of administering painful procedures to patients without experiencing dehumanization? The same question can be asked of nurses at all levels in hierarchies, and in all relationships, for example, nursing instructors with students, nurse administrators with staff nurses, faculty in academic institutions, and staff nurses with each other. Depersonalization and dehumanization eventually lead to one another. Another significant question to explore could be this: In which of the four contexts defined above does the nurse experience most satisfaction, most dissatisfaction, and the condition we call burnout? We live in a world, a society, and a profession where depersonalization and dehumanization are the plight of many. How can personhood and selfhood be enhanced or even restored in our hospitals, clinics, classrooms, and academic institutions? I propose that investigations of the contexts of caring can help us explore, discover, describe, and analyze these questions.

Conscience↗
PubMedDate not supplied

Maternal assignment of fetal personhood to a previous pregnancy loss: relationship to anxiety in the current pregnancy.

The degree of personhood a mother assigns to her dead fetus (i.e., whether she felt she lost a pregnancy or a baby) may help explain the meaning of a perinatal loss and the amount of anxiety experienced in a subsequent pregnancy. This descriptive study of 72 multigravidas with a history of one or two perinatal losses was conducted to understand the relationships between the assignment of fetal personhood and the influence of that assignment on state anxiety and pregnancy anxiety in a subsequent pregnancy. Assignment of personhood was significantly related to pregnancy anxiety and to the gestational age of the first loss but not to state anxiety. Understanding and responding to women's perceptions of perinatal losses and their significance for women may be one way to support them in subsequent pregnancies.

Anxiety↗