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Biomedical subjects

Maria Arman

Publications and source records attributed to Maria Arman.

12 recordsLinked to original sources
PubMed2006

Teenagers with type 1 diabetes--a phenomenological study of the transition towards autonomy in self-management.

BACKGROUND: Becoming autonomous is an important aspect of teenagers' psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support. OBJECTIVE: The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes. DESIGN AND METHOD: Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis. PARTICIPANTS: Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes. FINDINGS: The lived experiences of the transition towards autonomy in self-management were characterized by the over-riding theme "hovering between individual actions and support of others". The findings indicate that individual self-reliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme "confirmation of others" showed that parental encouragement increased the certainty of teenagers' standpoints; peers' acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers' self-esteem. CONCLUSION: In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations.

Adaptation, Psychological↗
PubMed2006

A Five-year Follow-up of Quality of Life in Women with Breast Cancer in Anthroposophic and Conventional Care.

Complementary and alternative medicine is used by many cancer patients in most parts of the world, and its use is increasing. The aim of the present study was to examine, over 5 years, the perceived quality of life/life satisfaction in two samples of women with breast cancer who were treated with anthroposophic care or conventional medical treatment only. Data from admission, after 1 year and after 5 years are used for the comparisons. On admission to the study the women in anthroposophic care perceived their quality of life to be lower than that of the women in the conventional treatment group, especially for emotional, cognitive and social functioning and overall quality of life. Sixty women who actively chose treatment with anthroposophic medicine and 60 individually matched women treated with conventional medicine participated. Quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire. Twenty-six women within anthroposophic care and 31 women within conventional medicine survived the 5 years. Effect size (ES) estimation favored the anthroposophic group in seven of the subscales mostly measuring emotional functioning. The ES for four of the subscales favored the conventional treatment group, mostly concerning physical functioning. After 5 years there were improvements in overall quality of life and in emotional and social functioning compared to admission for the women in anthroposophic care. The improvements took place between admission and 1 year, but not further on. Only minor improvements were found in the matching group.

Journal Article↗
PubMed2006

Family suffering related to war experiences: an interpretative synopsis review of the literature from a caring science perspective.

The aim of this study was to conduct a synopsis review of findings from families' experiences related to combat and war events and to interpret these findings from the perspective of theories of suffering. The method used in the study was a synopsis review of 12 articles dealing with family suffering related to war or combat experiences and an interpretation of the articles from a caring science perspective. Findings from the synopsis review were that the dominant part of the articles viewed suffering in general and post-traumatic stress disorders (PTSD) in particular from a medical, psychiatric or psychologically behaviouristic perspective. PTSD and other distress-related conditions were mainly described in terms of their symptoms and dealt with in terms of pathology. The interpretation of the articles from a caring science perspective generated three significant themes: first, interdependence as a spiritual dimension of dependence, secondly, familial communion as sharing moral and spiritual values and thirdly, familial suffering visualized by compassion. The study's conclusion is that, from a caring science perspective, the appearance of family suffering should be comprehended in terms of expressed compassion and that any disturbance within familial communion is likely to have an emotional impact on all of the family members, as a result of their interdependence.

Adaptation, Psychological↗
PubMed2005

Coping in women with breast cancer in complementary and conventional care over 5 years measured by the mental adjustment to cancer scale.

OBJECTIVE: Many patients with cancer, women more often than men, use complementary and alternative medicine (CAM) and care. Our aim was to examine coping over 5 years (November 1995 to January 1999) in two samples of women with breast cancer who were treated with anthroposophic care or conventional medical treatment. The present study is part of a larger study of the outcome of anthroposophic care for women with breast cancer. DESIGN: A nonrandomized controlled trial design was used with individual matching and repeated measurements on six occasions (at admission, 1 month, 3 months, 6 months, 1 year, and 5 years). The matching was based on the following variables: stage of disease at entry, age, treatment during the 3 months before entering the study, and prognosis. SETTING: An anthroposophic hospital and conventional hospitals in Sweden. SUBJECTS: Sixty (60) women treated with anthroposophic medicine and 60 women from an oncology outpatient department participated. Forty-nine (49) women in anthroposophic care and 51 in the outpatient group survived 1 year; 26 women in anthroposophic care and 31 in the outpatient group survived 5 years. INTERVENTION: An anthroposophic care program. OUTCOME MEASURE: Coping was measured using the Mental Adjustment to Cancer scale. Repeat measures of analysis of variance (ANOVA) were used for within-group comparisons, and effect size (ES) was used for between-group comparisons. RESULTS: The women in anthroposophic care showed more passive and anxious coping on admission, but this decreased over time. In the women in anthroposophic care, there were small ES improvements in fighting spirit and passive, anxious coping at 4 of the measured timepoints compared to admission. CONCLUSION: The choice of anthroposophic care could be seen as a possible way to cope with emotional distress in this group of women with breast cancer.

Adaptation, Psychological↗
PubMed2004

Evaluation of quality of life/life satisfaction in women with breast cancer in complementary and conventional care.

The aim was to study the perceived quality of life/life satisfaction in a sample of women with breast cancer who were treated in a hospital with alternative/complementary care and the same variables in individually matched patients who received only conventional medical treatment. A non-randomized controlled trial design with repeated measurements was used. Sixty women with breast cancer treated with anthroposophic medicine (ABCW) and 60 with conventional medicine (CBCW) were included and 36 matched pairs took part on all occasions. The quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire (LSQ). The comparisons were calculated as effect sizes (ES). The women in the ABCW group reported small or moderate effects, expressed as ES, on their quality of life/life satisfaction compared to their matched "twins" in the CBCW group at the 1-year follow-up in 15 out of 21 scales/factors. It was concluded that the women who had chosen anthroposophic care increased their perceived quality of life/life satisfaction according to the methodology of the study.

Adaptation, Psychological↗
PubMed2004

Suffering related to health care: a study of breast cancer patients' experiences.

A previous study indicated that patient narratives include experiences of suffering caused or increased by health-care encounters. The aim of this study was to interpret and understand the meaning of patients' experiences of suffering related to health care from an ethical, existential and ontological standpoint. Sixteen women with breast cancer in Sweden and Finland took part in qualitative interviews analysed with a hermeneutic, interpretive approach. The outcome showed that suffering related to health care is a complex phenomenon and constitutes an ethical challenge to health-care personnel. The women's experiences of suffering related to health care tended to be of similar seriousness as their experiences of suffering in relation to having cancer. In an ethical, existential and ontological sense, suffering related to health care is basically a matter of neglect and uncaring where the patient's existential suffering is not seen and she is not viewed as a whole human being.

Adult↗
PubMed2003

The hidden suffering among breast cancer patients: a qualitative metasynthesis.

The aim of this study was to review literature on how the lived experience of breast cancer and suffering was described in nursing/caring literature between 1990 and 2000, and to interpret and discuss the result from the perspective of suffering. The frequent reports of changing courses, called by various names, such as transition, transformation, transcendence, and finding meaning, were found as paths whereby the person regained integrity, balance, and wholeness. When findings were interpreted from the perspective of suffering and an ontological health model, actions, values, and existential concerns were understood as both expedients for alleviating suffering and a sign of the patient's inner struggle.

Breast Neoplasms↗
PubMed2002

Significant others' experience of suffering when living with women with breast cancer.

This is an inquiry into how significant others experience being close to a woman suffering from breast cancer. In order to find this out, theme interviews were arranged with 17 women and 16 significant others from four different caring cultures in Sweden and Finland. A phenomenological case study methodology was adopted and in the analysis of the data a scientific teamwork model was employed, based on ideas developed at the Vancouver School of Doing Phenomenology. The findings show that the significant others experience deep often unrelieved suffering. They consider themselves prisoners of a situation of uncertainty and powerlessness when standing by the woman. They are torn between their own suffering and their desire to alleviate the woman's suffering. A vicious circle of mutual protection intensifies the suffering of the significant other, while actively sharing the suffering brings relief. The gravity of the situation creates an ethical urge in the significant other to assume responsibility for life in common with the woman.

Breast Neoplasms↗
PubMed2002

The face of suffering among women with breast cancer-being in a field of forces.

Through qualitative interviews, the suffering experiences of women with breast cancer and their significant others were disclosed. Seventeen women with different stages of breast cancer and 16 significant others from 4 different care cultures in Sweden and Finland participated. Five of the women had advanced metastatic breast cancer, and 12 had a localized disease. Mean age was 48 years. As a methodology, a team approach, inspired by the Vancouver School of Doing Phenomenology, was used. The findings elucidate how the suffering experience touched the women's inner existence and values. This can metaphorically be described as a "field of force" and affected everything in the women's lives, including their views of themselves and their relationships. Existential questions were raised about life and death and the meaning of life. In their suffering, the women's dependency upon significant others, as well as healthcare personnel, was prominent. Suffering related to healthcare was a strong theme. Different faces of suffering related to breast cancer may still be unknown by healthcare professionals working in cancer care.

Adaptation, Psychological↗
PubMedDate not supplied

Women's perceptions and beliefs about the genesis of their breast cancer.

A person's belief is seen as a set of assumptions, depending on perceptions, and formed with the influence of experiences and social culture. With the aim of understanding the beliefs about the genesis of their illness, 118 (59 + 59) women with different stages of breast cancer were interviewed. Half of the sample had chosen complementary care in an anthroposophical hospital, and the other half was a matched group. Qualitative content analysis was used. Three themes emerged: (1) belief in a link to life lived (71%), (2) heredity as the sole genesis (4%), and (3) rejection of the question (25%). Under beliefs in a link to life lived, external aspects to the patient's own life (eg, diet and lifestyle) were cited, as well as inner aspects such as psychosocial problems and stress. The findings show that women are well informed about medical facts, although their beliefs reveal a holistic approach. The women's beliefs, where inner psychosocial factors are uppermost, point to a reverse of the causal ranking of medical advisors. The difference between the groups was that the matching sample was more likely to reject the influence of possible causes from life lived. In a caring perspective, women's perceptions of the genesis of their illness are in some cases turned to creative health activities that may increase well-being.

Adult↗
PubMedDate not supplied

The presence of love in ethical caring.

Caring as a virtue and an act of ethics is from both a natural and a professional point of view inseparably related to love as a universal/ontological value. Love is shown, like suffering and death, to be a concept of universal or metacharacter. From current nursing/caring science as well as from ethical and philosophical perspectives, this paper explores how love can be visible in caring through virtue and that the art of caring creates its evidence. The ethical and existential practicing of love, particularly unselfish love, allows a caregiver to come distinctly closer to the essence of his or her own personality and to live in a more authentic manner. Obstacles and alienation in caregivers that induce a holding back of one's own natural impulses to give the suffering patient tender, dignified care are examined. Economy, paradigm, and caring culture are cited, but ultimately it is a question concerning every caregiver's decision and responsibility to come forward to serve those the caregiver is actually there to represent, the suffering patient. This does not always require new knowledge, rather, liberation of the inner life and authenticity in caregivers. Love, if viewed only as a phenomenon without connection to a universal or ontological philosophy, risks being a problematic concept for caring science. If, on the other hand, it is viewed as the ontological basis for caring and ethical acts, then we can look for and practice phenomenological expressions for love that can enhance the patient's understanding of life as well as giving relief from suffering.

Empathy↗