Sense Of Failure Research Articles

The Effects of Logotherapy on Distress, Depression, and Demoralization in Breast Cancer and Gynecological Cancer Patients: A Preliminary Study.

Globally, cancer is the second leading cause of death. Breast cancer and gynecological cancer can damage patients' body image and lead to psychological distress, depression, and demoralization syndrome. No studies have explored the effect of logotherapy in gynecological cancer patients' psychological distress, depression, and demoralization. To evaluate the effects of logotherapy on distress, depression, and demoralization in breast cancer and gynecological cancer patients. A quasi-experimental design was used in this study, involving 61 breast cancer and gynecological cancer patients: 31 in the experimental group and 30 in the control group. Participants in the experimental group received logotherapy 4 to 6 times during the 12 weeks of intervention. Outcomes were measured by the (1) Distress Thermometer, (2) Patient Health Questionnaire, and (3) Demoralization Scale Mandarin Version (DS-MV). Distress Thermometer did not differ between groups, but significant differences in favor of the intervention group were noted in the Patient Health Questionnaire (U = 674.500, P = .002); the DS-MV subcategories of loss of meaning (U = 706.500, P = .000), dysphoria (U = 673.000, P = .002), disheartenment (U = 670.000, P = .003), helplessness (U = 621.000, P = .022), and sense of failure (U = 629.500, P = .016); and the total score of the DS-MV (U = 728.500, P = .000). Logotherapy was effective in the reduction of breast cancer and gynecological cancer patients' depression and demoralization. Clinical professionals could add logotherapy to the treatment for breast cancer and gynecological cancer patients to reduce their depression and demoralization.

Compassion fatigue among oncologists: the role of grief, sense of failure, and exposure to suffering and death

PurposeOncologists cope with unique work characteristics that increase their risk of developing compassion fatigue—that is, burnout and secondary traumatic stress—and can result in reduced capacity and interest in being empathetic to the suffering of others (Stamm B. The concise ProQOL manual, 2010). At the same time, oncologists can experience compassion satisfaction—that is, the positive aspects of caring. This study explored the associations of compassion fatigue and compassion satisfaction with oncologists’ grief and sense of failure beyond their reported exposure to suffering and death.MethodsSeventy-four oncologists completed self-administered questionnaires examining compassion fatigue, compassion satisfaction, grief, exposure to suffering and death, and sense of failure.ResultsThe oncologists reported that they face the loss of approximately 50% of their patients, and that their patients suffer from profound emotional and physical pain. High levels of compassion fatigue and grief, and moderate levels of sense of failure, were reported. Findings showed a lack of association between exposure to suffering and death and compassion fatigue and satisfaction. However, grief and sense of failure were found to predict both aspects of compassion fatigue: secondary traumatic stress (p < 0.001, p < 0.003, respectively) and burnout (p < 0.002, p < 0.025, respectively).ConclusionsThese results highlight the importance of the oncologists’ subjective experiences of grief and sense of failure, beyond their reports of exposure to suffering and death, in terms of their levels of compassion fatigue. Implications of these findings include the need to develop interventions for oncologists that will allow them to acknowledge, process, and overcome negative experiences of failure and grief.

“It’s paradise there, I saw it on TV”: Psychological wellbeing, migratory motivators, and expectations of return among West African migrants

The main objective of the present quali-quantitative exploratory study was to analyze narrative data from in-depth interviews with returning West African migrants in the Agadez and Nyamey regions (Niger). Specifically, we out to investigate the complex set of reasons that had led the participants to leave their homes and move toward other countries, as well as their expectations concerning their return to their home country and the implications of return for their subjective wellbeing. Categorical analysis of the interview transcripts led us to identify two main first-order themes (internal and external factors underpinning the decision to migrate) and seven lower-order classes of reasons for migrating. We drew on a pragmatically informed Quantitative Textual Analysis approach to further explore the data, finding that experience strongly influenced migrants’ representations and aspirations, as well as their expectations surrounding their return migration. The more migrants encounter hardship and deprivation in the destination country, the more their subjective wellbeing can be undermined, and consequently, the more their expectations about return are catastrophic. Familial and personal aspirations surrounding the migratory project appear to increase these migrants’ sense of failure and despair on returning home without the economic and personal resources to support themselves and their families. We discuss the implications for practitioners and policy makers.

Exploring demoralization in end-of-life cancer patients: Prevalence, latent dimensions, and associations with other psychosocial variables.

Demoralization is an existential distress syndrome that consists of an incapacity of coping, helplessness, hopelessness, loss of meaning and purpose, and impaired self-esteem. It can affect cancer patients, and the Demoralization Scale is a valid instrument to assess it. The present study aimed to investigate the prevalence of demoralization in end-of-life cancer patients and its associations with the medical and psychosocial variables. In addition, the latent dimensions of demoralization emerging in this distinctive population were explored. The study is cross-sectional. The sample consisted of 235 end-of-life cancer patients with a Karnofsky performance status (KPS) lower than 50 and a life expectancy of a few weeks. For each patient, personal and medical data was gathered by a palliative physician and a set of validated rating scales, assessing demoralization, anxiety, depression, physical symptoms, pain, spiritual well-being, and dignity, was administered by a psychologist during the first consultation. Sixty-four participants (27.2%) had low demoralization, 50.2% (n = 118) had medium demoralization, and 22.6% (n = 53) had high demoralization. Factor analysis evidenced a five-factor solution that identified the following demoralization factors: Emotional Distress and Inability to Cope, Loss of Purpose and Meaning, Worthlessness, Sense of Failure, and Dysphoria. All the considered variables were associated with demoralization, except for pain, nausea, breathing problems, and sociodemographic and clinical variables. End-of-life cancer patients showed higher levels of demoralization than has been reported in other studies with advanced cancer. These data could suggest that demoralization could increase in proximity to death and with impaired clinical condition. In particular, the five demoralization dimensions that emerged could represent the typical concerns around which the syndrome evolves in end-of-life cancer patients. Finally, spiritual well-being could play a protective role with respect to demoralization.

Minilaparoscopic Total Hysterectomy in Current Practice Feasibility and Benefits: A Unicentric, Randomized Controlled Trial

To investigate whether mini-instrumentation may be used for hysterectomy (HT) by all surgeons (assistants and seniors) without increasing the operative time or altering surgeon working conditions. A unicenter, randomized controlled, single blind, parallel, noninferiority trial comparing 2 surgical techniques. A tertiary referral center. Thirty-two patients undergoing HT for a benign gynecologic disease were enrolled in this study in our center between April 2, 2015, and June 1, 2018. Sixteen patients were randomized in group A and 16 patients in group B. HT with bilateral annexectomy or ovarian conservation using 3-mm instruments (group A) or conventional 5-mm instruments (group B). Concerning the primary outcome, the operative time for the HT 3-mm group was 128 minutes (range, 122-150 minutes) versus 111 minutes (range, 92-143 minutes) for the HT 5-mm group (i.e., δ = 17 [90% confidence interval, -6 to 39]), with rejection of the noninferiority threshold at 35 minutes. Thirty-one percent of HTs initially performed using 3-mm instruments were completed with conventional instruments. HTs performed with mini-instruments required more concentration (p = .02) with surgeons reporting higher levels of frustration (p = .009) and sense of failure (p = .006). Patients tend to experience greater satisfaction regarding scars with a significant difference noted during the postoperative visit both for scar pain (1 vs 4 patients with moderate pain [30-50 mm on the Patient Scar Assessment Scale) in the HT 3-mm group and the HT 5-mm group, respectively) and scar firmness (p = .021; 3 vs 7 patients with moderate firmness [30-50 mm on the Patient Scar Assessment Scale] in the HT 3-mm group and the HT 5-mm group, respectively). Total minilaparoscopic HT appears inferior to standard laparoscopy in terms of operative time and surgeon working conditions; only the short-term cosmetic appearance was in favor of the 3-mm approach.

Formation of a Junior Doctor Wellbeing Steering Group

Reports by the British Medical Association, Royal College of Physicians and Health Education England have all raised concerns regarding the wellbeing of junior doctors. Working in an increasingly demanding, poorly resourced and underfunded healthcare system is associated with a triad of guilt, low self-esteem and sense of failure.1 Understandably, this not only affects the day-to-day working of individuals, but also extends detrimentally to affect home life and mental health. Wellbeing initiatives are numerous and of varying success. What is recognised is that there is an appetite for change and hospitals need …

Demoralization and associated features in an Italian sample of end-of-life cancer patients.

e23004 Background: Demoralization is an expression of cancer-related existential distress that emerges from feelings of loss and changes linked to a life-threatening clinical condition. It is characterized by subjective incompetence, sense of failure, hopelessness, loss of purpose/meaning and low self-esteem. The study aimed to explore prevalence, latent dimensions and associated features of demoralization in a sample of end-of-life cancer patients. Methods: Participants were recruited for a cross-sectional assessment. For each patient, demoralization, anxiety, depression, physical symptoms, pain, spiritual well-being, and dignity were evaluated through validated rating scales and personal and medical data were gathered by a clinician. Final sample consisted of 235 end-of-life cancer patients with a Karnofsky Performance Status (KPS) lower than 50 and a life expectancy of few weeks. Results: High levels of demoralization occurred in 22.6% (n = 53) of patients. Sixty-four participants (27.2%) had low demoralization and 50.2% (n = 118) had moderate demoralization. Emotional Distress and Inability to Cope, Loss of Purpose and Meaning, Worthlessness, Sense of Failure and Dysphoria were the five latent dimensions of demoralization emerged from the factor analysis. Demoralization was significantly associated with depression, anxiety, dignity, spiritual well-being and the physical symptoms except for nausea and breathing problems. Conclusions: Demoralization levels seem to be higher in this distinctive population than in advanced cancer patients. This could be due to the fact that end-of-life cancer patients are in a severe clinical condition and nearing death. The emerged demoralization dimensions could be five forms of expression of the existential distress typical of this illness phase. The considerable number of patients suffering from demoralization strengthen the need for psychological interventions in order to reduce the existential distress at the end of life, focusing on finding meaning and detecting spiritual concerns.

Parents' experiences of having an excessively crying baby and implications for support services

Evidence suggests that around 20% of healthy babies cry for long periods without apparent reason, causing significant distress to parents and a range of adverse outcomes. This study explored parents' experiences of having an excessively crying baby and their suggestions for improved NHS support. Focus groups and interviews with 20 parents identified three key themes: disrupted expectations and experiences of parenthood; stigma and social isolation; seeking support and validation of experience. Parents experienced shock, anxiety and a sense of failure, leading to self-imposed isolation and a reluctance to seek help. Other people's reactions sometimes reinforced their feelings. Parents need more support, including from health professionals, to cope with excessive crying, and recommendations for this support are given.

Weight Status and Mental Health in Italy: Evidence From EHIS2 Microdata

This paper tested the association between weight status (proxied by BMI) and mental health in Italy, using EHIS2 microdata, which provide the usual information (demographic, socio-economic, etc.), and also information on weight/height, and eight mental health variables (low interest, depression, sleep disorders, tiredness, eating disorders, sense of failure, low concentration, slow moving/speaking). The empirical results show that there is a strong positive association between weight status and all mental health variables (except of slow moving/slow speaking) with an interesting gender difference in the association between weight status and sleep disorders and eating disorders in that females suffer more than males. Moreover, the empirical results reveal that between weight status there is: a negative association with a high level of education, a high source of income and a high type of dwelling; a positive association with the marital status, a poor social network to count on in case of difficulty and a high degree of urbanization. Finally, the empirical findings sustain that a) there is a positive association between weight status and health variables (chronic anxiety and chronic diseases) and b) the association between weight status and the living area is negative when Northern italian regions are taken into account. The positive association between weight status and new emerging types of mental health problems such as sleep disturbances and eating disturbances suggests some considerations on the higher economic costs, at individual and social level, because of these new mental health problems associated to weight status. Moreover, the negative association between weight status and a high level of education suggests that educational policies could help individuals to raise barriers against obesity and sleep/eating disturbances associated to it.

Narzeczona w tafli lodu, czyli jak kino mawia o nieprzeniknioności uczuć miłosnych („45 lat” Andrew Haigha)

The subject of analysis in the article is the 2015 British film 45 Years (dir. Andrew Haigh), which is an adaptation of David Constantine’s novel In Another Country. The film presents an intimate image that, in a subtle way, talks about the complexity of feelings of love, constantly oscillate between the desire for intimate closeness and exclusiveness, and the fear of disappointment (longing for emotional fullness and a sense of failure). Inscribing the problem of the dialectical complexity of the emotional life of a man in the context of old age and transience seems unconventional and, therefore, particularly valuable in this film. An important theme in 45 Years, emphasised by the title itself, is the past; invisible on a daily basis, it lurks under the surface of the present. Its iconic (though only imaginary) representation is connected with the plot of the first, lost fiancée of the hero, whose remains – after half a century – are unexpectedly found on a Swiss glacier. The author of the article argues that the fact that it concerns a young woman’s body (preserved in a transparent substance in a strange coincidence), by virtue of intertextual implications, brings an archetypal element to the essentially prosaic story; this archetypal element has then far-reaching consequences in the symbolic plan of the film. Skilful reference to the fairy-tale motif of the ‘glass coffin’ allowed the British director for portraying in this audio-visual story, which talks about the emotional dramas of two elderly people, an image of these internal experiences that in their intimate subtlety remain impenetrable and inexpressible.

Porządek kalendarza, porządek wyobrażenia. W stronę biogeografii Schulza

The paper proposes an approach to Schulz’s life in terms of biogeography. The author criticizes the stereotype of Schulz’s biography as that of a settled, provincial man who hardly ever left his hometown, and when he did, he suffered from anxiety and the sense of failure. That stereotype was created by Jerzy Ficowski, who brought into being the figure of Schulz as a weak, shy, hypersensitive, and anxious artist, who in his art found shelter from everyday reality. The paper presents some aspects of Ficowski’s approach to Schulz’s spatial experience (decontextualization, negligence of social life and the urban experience) to show how a critique of that approach may lead to a new, biogeographical version of the writer’s life.

Learning about Type 1 diabetes and learning to live with it when diagnosed in adulthood: two distinct but inter-related psychological processes of adaptation A qualitative longitudinal study.

To explore the experiences of adults with newly diagnosed Type 1 diabetes in order to understand the adaptive processes that occur in the early phase of the condition. We conducted longitudinal semi-structured interviews with 30 adults newly diagnosed with Type 1 diabetes (age range 20-67 years; 16 men; median diabetes duration 23.5 months), recruited from hospitals in Denmark and the UK. The data were analysed using a narrative approach. The narratives could be grouped into three thematic areas: the diagnosis; learning about diabetes; and learning to live with diabetes. Diabetes was characterized as a major disruptor to the established and future life plans of participants, causing significant emotional distress. The narratives showed how early experiences triggered the development of ongoing psychological problems (fear of complications or hypoglycaemia) and diabetes distress, and that navigating different social scenarios (relationships and employment) could be challenging, leading to suboptimal self-management behaviours. The narratives also showed that health professionals often did not attend effectively to participants' emotional needs after diagnosis, and that the language used frequently triggered negative feelings, such as fear or a sense of failure. Many of the common psychosocial problems associated with Type 1 diabetes seem to gestate in the early phase of life with the condition. There appear to be opportunities to enhance the support provided in this phase to minimize these problems.

Periperformativity and Ethnicity in the Theater of Young Jean Lee

This essay offers a detailed analysis of playwright and director Young Jean Lee’s theatrical production Songs of the Dragons Flying to Heaven, which premiered in 2006 at HERE Arts Center in New York City, in relationship to J. L. Austin’s concept of “performatives” introduced in his 1955 lectures at Harvard University and Eve Kosofsky Sedgwick’s notion of the “periperformative.” This analysis attends to the play’s engagement with self-alienation, a sense of failure, and enacting whiteness in the absence of white persons and reveals that the falling away of certain conventions of ethnicity in the play alludes to the limits of the subject formation without enclosing a specific group within the established perception of epistemic categories. The appearance of ethnicity characterized as infelicitous in the play offers a new way to think, “How do those who feel a distance from dominant culture move around that culture in the contemporary United States?”

Measuring postnatal demoralisation: adaptation of the Demoralisation Scale-II (DS-II) for postnatal use

ABSTRACTObjective: To examine the psychometric properties of the Demoralisation Scale II (DS-II) and adapt it for use with women in the postnatal period.Background: Demoralisation is a psychological state characterised by a sense of incompetence and feelings of helplessness and hopelessness in response to a stressful situation. The postnatal period is a life stage of many disruptions. Women may lose their confidence and become demoralised if feeling unprepared for the tasks of motherhood. The DS-II is a 16-item scale developed among cancer patients, but with content that is also relevant postnatally, including items on sense of failure, helplessness, hopelessness, isolation, entrapment and loss of purpose.Methods: Rasch analysis was used to investigate the psychometric properties of the DS-II and refine the scale for postnatal use.Results: Participants were 209 women admitted with their babies to a residential early parenting programme. A 14-item revised scale was derived, the Postnatal DS-II, showing good psychometric properties, discriminant validity and sensitivity to change, and being well targeted to the sample.Conclusion: The Postnatal DS-II could have utility as an assessment tool, helping clinicians to understand better women’s postnatal experiences, assess the effectiveness of interventions and communicate with women in a meaningful and non-stigmatising way.

My Sea

The piece takes as its inspiration Jacques Derrida’s article ‘Like the Sound of the Sea Deep within a Shell: Paul de Man’s War’ (1988) through which Šimić understands her choice of the sea as her own ‘unforeseeable appeal’, a ‘matter of responding and of taking responsibilities’ (Derrida and Kamuf 1988: 595). The writing is also provoked by Emma Cox and Marilena Zaroulia’s conversation ‘Mare Nostrum, or On Water Matters’ in the ‘On Sea/At Sea’ edition of Performance Research which touches on the image of Aylan Kurdi, a Syrian boy, found dead on the beach in Bodrum, Turkey in September 2015. The writing opens with the author’s sense of loss and belonging to her birth country of Yugoslavia explored in her performance work Blood & Soil: we were always meant to meet … (2011, with Jennifer Verson). The piece looks at a series of contemporary artistic responses to the migration crisis and children’s deaths at sea. These include Ai Weiwei’s crude re-enactment of Aylan Kurdi’s death, graffiti artists Justus Becker (a.k.a. Cor) and Oğuz Şen (a.k.a. Bobby Borderline), Khaled Barakeh’s censored photographic images of drowned children on Facebook, Franko B’s carefully carved marble sculpture and the work of British-Iraqi hip-hop artist and political activist Kareem Dennis, better known as Lowkey. The writing closes with a remembering of Jill Greenhalgh’s performance Las Sin Tierra: 7 Attempted Crossings of the Straits of Gibraltar seen at Transit IV: Roots in Transit theatre festival in 2004, Holstebro, Denmark. This article discusses the unforeseeable appeals, many of which include an appropriate sense of failure and shame, when thinking about the sea as artists and academics.

Isidro Vanegas, ed. El siglo diecinueve colombiano.

Political history was fairly recently seen as a moribund field, the study of machinations among elites that had little connection to culture and society. Over the past couple of decades, however, political history has transformed itself by focusing on larger issues of the culture of politics and by incorporating the experience and agency of subalterns into the story of state and nation formation. This valuable volume of eight essays and an introduction reveals how much political history has changed and how these changes have revolutionized our understanding of the nineteenth century. For a collection of essays, the volume is unusually coherent in its themes, the essays as a whole sustaining an argument about the vibrancy and inventiveness of Colombian nineteenthcentury political culture. As Isidro Vanegas notes in his excellent introduction, the Colombian nineteenth century has long been seen as a failure, both in nation and state building. However, this sense of failure and stagnation was not the view of many in Colombia during the nineteenth century, especially before the Regeneration. Instead, many politicians, letrados, and even everyday people (Liberals especially, but also some Conservatives), saw Colombia as a political success in comparison with Europe and the United States.

Advances in the Understanding of Demoralization in Oncology and Palliative Care

Over the last decade, psychosocially-oriented assessment methods, rather than nosological psychiatric systems, have been used in oncology and palliative care to detect clinically relevant dimensions with prognostic and therapeutic implications. Demoralization has emerged as one of the most important constructs, a clinical syndrome distinct from other psychiatric disorders (e.g., major depression, dysthymia, adjustment disorders, post-traumatic stress disorder [PTSD]). A number of recent studies have shown that demoralization in cancer patients is related to confrontation with existential stressors that impair the sense of mastery and competence of the individual throughout the illness and across all disease stages. Clinically, demoralization is characterized by feelings of subjective incompetence in dealing with stress, a sense of failure to meet the expectations of others, a sense of being trapped, accompanied with feelings of impotence, isolation, and despair, hopelessness or loss of meaning and purpose in life. Demoralization has a remarkable role in negatively influencing a patients’ quality of life, coping styles, and dignity and in increasing the risk for suicidal ideation. This article presents and discusses the most recent emerging issues related to demoralization in oncology and palliative care in terms of prevalence, diagnostic boundaries, and consequences to clinical practice. Important tools for the assessment of demoralization are also summarized and implications for future research are discussed.

Demoralization in Parkinson Disease

Symptoms of demoralization include feeling helpless and hopeless and a sense of failure. When demoralized, patients may not respond appropriately to

The complexity of food for people with multiple long-term health conditions.

INTRODUCTION The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs. METHODS The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis. RESULTS There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective. DISCUSSION The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people's needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs.

Identifying and addressing barriers for insulin use in patients with type-2 diabetes mellitus

Background: DM type-2 is characterized by gradual decrease in insulin sensitivity within the peripheral tissues and liver (insulin resistance), followed by gradual decline in β-cell function and insulin secretion. Thus, patients with poor glycemic control require the utilization of insulin therapy to realize the target of yank Diabetes Association, recommending HbA1c to be but 7% (≥8% despite of optimal doses of anti-diabetic drugs). Aim: This study aimed to guage and addressing the barriers to be used of insulin in type-2 DM patients, where their glycemic control is poor, i.e., HbA1c is ≥8% despite of optimal doses of anti-diabetic drugs. Research Design & Method: We surveyed 200 patients with type-2 diabetes mellitus, i.e., cross-sectional quantitative study; patients showed poor glycemic control HbA1c≥8%, already treated with one or more oral agents, who recently prescribed insulin to regulate their metabolic status. Data were obtained by patient’s interview employing a validated questionnaire. The place of the study was in DM clinic in Farwaniyah Primary Health Care Center in Kuwait. Result: Patients with type-2 diabetes failing to initiate the prescribed insulin therapy have reported misconception regarding fear of hypoglycemia in 49% of the entire sample, pain from injections in 68% and self-blame about need for insulin i.e., sense of failure in 61% of total sample of study. Other factors were addressed like sensation by getting more severity of the disease, weight gain fear and other negative self-perceptions and attitudinal barriers were studied. Conclusion: Reducing the negative influence of psychological insulin resistance (PIR) on treatment outcomes should be a clinical priority. Approaching and understanding the multifaceted and sophisticated nature of PIR and discussing the etiology of each patient’s PIR is that the first important step. The incorporation of well-validated clinical measures assessing these barriers, also as further research should be conducted on the impact of interventions to beat such barriers. Clinicians should prescribe simple insulin regimen to decrease their patients’ fear from dependency of insulin and therefore the use of recent insulin analogs and insulin pen services, may greatly reduce PIR by mitigating the fear of life style changes and side effects, also as social stigma related to using insulin during a vial and syringe.