ABSTRACT
Some scholars include changes in spirituality, such as a greater commitment to their religious beliefs or an enhanced understanding of spiritual matters, in the definition of posttraumatic growth; others conclude that questions of spirituality should be excluded from this definition. This article highlights the fundamental difference of religion to other domains of posttraumatic growth because religions are ideologies (and other domains of growth are not). As ideologies, it is argued that religions can affect different levels of identity in different ways. Based on testimonial evidence from Rwandan genocide survivors, the article demonstrates that although religious beliefs can bring existential comfort at the individual level, they can also lead to a state of false consciousness at the collective level. In Rwanda, the dominant religious ideology facilitated the spiritual and moral climate in which genocide became possible. Today, religious interpretations of the Rwandan Patriotic Front's (RPF) leadership provide spiritual backing to a government which has become increasingly authoritarian.
ABSTRACT
This article reviews adherence to medication in multiple sclerosis (MS) patients from the perspective of nurse and social worker authors. It reviews data on patient adherence and offers practical, evidence-based strategies that health-care providers can use to facilitate adherence. In addition, it examines how emerging MS therapies may affect patient adherence and associated interventions. To promote adherence, interventions need to incorporate new and creative approaches. A proactive approach includes assessing patient needs and lifestyle before the start of medication and selecting the most appropriate disease-modifying therapy for each individual patient. Including multidisciplinary expertise and services in the treatment plan can be part of a comprehensive, holistic approach to helping patients and families. Optimization of health-care provider roles is likely to facilitate improved adherence.
ABSTRACT
Psychotic symptoms are a common nonmotor complication in Parkinson's disease. Research exploring the impact of psychotic symptoms on coping by caregivers of people with Parkinson's disease is sparse. The aim of this study was to explore the experiences of individuals living with a partner with Parkinson's disease and psychotic symptoms. Ten female caregivers from the north west of England were interviewed and interpretative phenomenological analysis was used to identify themes within their accounts. Four themes emerged from the analysis: uncertainty and the search for understanding; adapting to symptoms over time; the contribution of psychosis to changing identities; and the use of social comparison as a coping strategy. These themes highlighted the changing identity of their partner as a person with Parkinson's disease and a number of strategies that caregivers had developed to cope with psychotic symptoms. The themes are explored in detail and clinical implications are considered.
