Nurse Who Had MERS-CoV Complications with A Near-Death Experience during Pregnancy: A Narrative Analysis.

BACKGROUND: According to prevailing views in neuroscience, near-death experiences (NDE) occurring after severe head trauma, critical illness, or coma are often life-transforming experiences in which no awareness or sensory experience of any kind is possible. Although there are general patterns, each case is quite different from the other and requires accurate recording and reporting to potentially explain the phenomenon. AIM: This narrative study aimed to explore a pregnant woman's NDE due to complications from MERS-CoV. METHODS: This was a qualitative narrative study with the administration of two unstructured interviews. After the second interview, the participant completed the Greyson NDE scale, presented through descriptive statistics. Qualitative data were analyzed using Labov's model of narrative analysis through abstract, orientation, complicating action, evaluation, resolution, and coda. RESULTS: The Greyson scale resulted in a total score of 12, confirming that the patient had experienced an NDE. Labov's model of narrative analysis revealed that the patient's experience was not limited to the NDE but had implications for her recovery and life. The patient experienced all three types of NDEs: out-of-body, transcendental, including the transition of consciousness to another dimension, and a combined experience. She also suffered from prolonged hallucinations, neuropathy, and post-intensive care syndrome (PICS). At the same time, the patient experienced what is known as NDE aftereffects, which are caused by a change in beliefs and values; she began to lead a more altruistic life and became interested in the meaning of life. CONCLUSIONS: NDE survivors should be encouraged to talk more and share their stories with others if they wish. This study not only investigates the NDE but also considerably adds to the existing literature by integrating a unique cultural view from a country outside of the US and other Western nations, and it highlights the significant role of healthcare providers in NDEs and the importance of communication with comatose patients. It underscores the need for compassion when dealing with patients with NDEs.

Exploring the Nature of Near-Death Experiences in Iranian Experiencers: A Case Study of the Participants in the Life after Life TV Series.

Near-death experiences (NDEs) are complex and challenging. The development of research on NDEs helps to understand and recognize this complex human phenomenon more effectively. The present study sought to explore the nature of NDEs in the lived experiences of Iranian who experienced near-death incidents (NDErs) using a qualitative phenomenological approach. The participants were 34 persons selected from Iranian NDErs. The collected data were analyzed using Colaizzi's seven-step content analysis with MAXQDA software (version 2021). The data revealed 11 semantic codes about the nature of NDEs reported by Iranian NDErs. Overall, the results showed that the components of NDEs in many cases are similar to the nature of NDEs of the world. However, the type and quality of the positive and negative NDEs reported by Iranian people are different in terms of the feedback of actions and the return to the body compared to other NDEs reported by people in other countries.

Exploring near death experiences with children post intensive care: A case series.

Near death experiences (NDEs) can occur during life-threatening events. In this article, we present preliminary findings from a case study series. We highlight experiences of children that are synchronous with the basic elements of near death experiences (NDEs) and discuss how children describe their own experiences. Children reported unsolicited NDE type experiences that included out of body experiences, bright lights, bedside visions, bi-location and visiting celestial places. The aim of the article is to show that children are an important research population for the study of near-death experiences. Children's near-death experiences are simple and carry transcendental features such as a peaceful darkness, a knowing awareness and time alterations. Children assign a subjective reality to their near-death experiences. Younger children may demonstrate a visual NDE semiosis which warrants further investigation. The aim of the article is to demonstrate the value for involving children in NDE research through participatory and creative research methods.

AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest.

INTRODUCTION: Cognitive activity and awareness during cardiac arrest (CA) are reported but ill understood. This first of a kind study examined consciousness and its underlying electrocortical biomarkers during cardiopulmonary resuscitation (CPR). METHODS: In a prospective 25-site in-hospital study, we incorporated a) independent audiovisual testing of awareness, including explicit and implicit learning using a computer and headphones, with b) continuous real-time electroencephalography(EEG) and cerebral oxygenation(rSO2) monitoring into CPR during in-hospital CA (IHCA). Survivors underwent interviews to examine for recall of awareness and cognitive experiences. A complementary cross-sectional community CA study provided added insights regarding survivors' experiences. RESULTS: Of 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED) 6/28(21.4%). In the cross-sectional arm, 126 community CA survivors' experiences reinforced these categories and identified another: delusions (misattribution of medical events). Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2 = 43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35-60 minutes into CPR. CONCLUSIONS: Consciousness. awareness and cognitive processes may occur during CA. The emergence of normal EEG may reflect a resumption of a network-level of cognitive activity, and a biomarker of consciousness, lucidity and RED (authentic "near-death" experiences).

Effects of Knowledge of Near-Death Experiences (NDEs) on Life Changes in People without NDEs.

Background and Objective: Near-death experiences (NDEs) greatly change the lives of Near-death experiencers (NDErs); however, the influence of the knowledge of these experiences on other people is unclear. Therefore, the present study aimed to investigate the effects of knowledge of NDEs on various aspects of life and the sleep quality of those without NDEs. Methods: The research population consisted of people aged 12-60 years living in a number of different cities in Iran during 2021. A total of 766 out of 800 individuals who met the inclusion criteria completed the self-report questionnaires. Also, 466 respondents (60.8%) were women. Results: The findings of the study indicated that 57.6%, 58.1%, 72.1%, 79.6%, and 70.9% of the respondents acquired knowledge about NDEs through reading books and articles, watching movies and clips, using social media and networks, listening to lectures, and chatting with friends, respectively. Data analysis showed that 40% of the respondents reported a drastic change in their views or feelings and 57% experienced positive effects in their lives after learning about NDEs. Overall, the data in this study confirmed that most individuals were profoundly affected after exposure to NDEs. Conclusion: Knowledge of NDEs improves the quality of life, mental health, sleep quality, and the understanding of the life and death of most individuals without NDEs. Although there are some changes that are not necessarily positive and in some cases changes have been associated with negative consequences, later in this paper, the relevant associations and cautions are discussed.

Near-death experiences are associated with rapid eye movement (REM) sleep intrusions in migraine patients, independent of migraine aura.

BACKGROUND AND PURPOSE: Migraine aura, near-death experiences (NDEs), and rapid eye movement (REM) sleep intrusions might share common mechanisms. Here, we investigated the prevalence of NDEs and REM sleep intrusions in people with migraine. We hypothesized that NDEs and REM sleep intrusions are more prevalent in migraine patients with aura than in those without. METHODS: We conducted a prospective cross-sectional cohort study at a tertiary headache center, based on a prespecified sample size (n = 808). Migraine patients completed a series of questionnaires, including questions about demographic and headache characteristics, the 16-item Greyson NDE scale, four questions about REM sleep intrusions, and the Depression, Anxiety, and Stress Scale 21 (DASS-21). RESULTS: Of 808 migraine patients (mean age 44.4 ± 13.3 years, 87.0% women), 353 (43.7%) had a current or previous history of migraine aura. Prevalence of NDE was 2.7% and not different in patients with and without aura (2.8% vs. 2.6%; p > 0.999). REM sleep intrusions were reported by 5.4% of participants and in a similar proportion of patients with and without aura (6.3% vs. 4.9%; p = 0.43). However, participants with REM sleep intrusions had had an NDE more often than participants without REM sleep intrusions (n = 5/44, 11.4% vs. n = 17/754, 2.2%; p = 0.005). Higher DASS-21 scores were associated with REM sleep intrusions (p < 0.001). CONCLUSIONS: In this tertiary center cohort study, the prevalence of NDE and REM sleep intrusions was not influenced by migraine aura status. However, we identified an association between NDE and REM sleep intrusions, which corroborates the notion that they might share pathophysiological mechanisms.

What happens in the brain when we die? Deciphering the neurophysiology of the final moments in life.

When do we die and what happens in the brain when we die? The mystery around these questions has engaged mankind for centuries. Despite the challenges to obtain recordings of the dying brain, recent studies have contributed to better understand the processes occurring during the last moments of life. In this review, we summarize the literature on neurophysiological changes around the time of death. Perhaps the only subjective description of death stems from survivors of near-death experiences (NDEs). Hallmarks of NDEs include memory recall, out-of-body experiences, dreaming, and meditative states. We survey the evidence investigating neurophysiological changes of these experiences in healthy subjects and attempt to incorporate this knowledge into the existing literature investigating the dying brain to provide valuations for the neurophysiological footprint and timeline of death. We aim to identify reasons explaining the variations of data between studies investigating this field and provide suggestions to standardize research and reduce data variability.

An Exploratory Study of ICU Pediatric Nurses' Feelings and Coping Strategies after Experiencing Children Death.

BACKGROUND: This study aims to explore the feelings and experiences of nursing staff when faced with the death of a pediatric patient in the ICU. METHODOLOGY: A qualitative study based on hermeneutic phenomenology was conducted through semi-structured interviews. Ten nurses (30% of staff) from the Pediatric Intensive Care Unit of a referral hospital were interviewed in April 2022. Text transcripts were analysed using latent content analysis. RESULTS: Content analysis indicated that the interviewees had feelings of sadness and grief; they had a misconception of empathy. They had no structured coping strategies, and those they practiced were learned through personal experience, not by specific training; they reported coping strategies such as peer support, physical exercise, or strengthening ties with close family members, especially their children. The lack of skills to cope with the death and the absence of support from personnel management departments were acknowledged. This can lead to the presence of compassion fatigue. CONCLUSIONS: The feelings that PICU nurses have when a child they care for die are negative feelings and sadness, and they possess coping strategies focused on emotions learned from their own experience and without institutional training support. This situation should not be underestimated as they are a source of compassion fatigue and burnout.

The Near-Death Experience and Suicidal Ideation.

The near-death experience (NDE) most generally refers to a state of altered consciousness with various features that can occur during real or presumed near-death circumstances and/or life-threatening incidents. Some NDEs are associated with a nonfatal suicide attempt. This paper discusses how a belief by suicide attempters that their NDEs are a true portrayal of objective spiritual reality can at least in some cases be positively associated with a persistence or increase of suicidal ideation and on occasion lead to further suicide attempts, while also exploring why at other times such a belief may reduce the risk of suicide. The formulation of suicidal ideation associated with NDEs among some of those who did not initially try to kill themselves is also explored. Various examples related to NDEs and suicidal ideation are provided and discussed. Furthermore, this paper also offers some theoretical insights related to this matter and points out some specific therapeutic concerns based on this discussion.

Shared Death Experiences: A Multicultural Survey.

BACKGROUND: Shared-death-experiences (SDEs) and after-death-communication-experiences (ADCEs) are non-ordinary mental experiences related to the death of a known or unknown person. METHODS: These experiences were investigated by surveying four samples with different cultural backgrounds: Italian, Mexican, Brazilian and Taiwanese people. One-hundred-twenty-one participants reported 146 experiences of this type. RESULTS: Among the main characteristics of these experiences, visual, visual-auditory and feeling experiences, which comprised 74% of all experiences, were experienced both in the dream state and a normal state of consciousness. Furthermore, most of these experiences were lived before (47.3%) or after (39%) the death of the person in relationship with the participants. More importantly, these experiences influenced the participants' death interpretation favoring the belief that death affects only the body, but the consciousness of the deceased persons survives in another reality and sometimes can communicate with relatives and friends still alive in this reality. No substantial differences were observed among the different subsamples. CONCLUSION: As to the origin of SDEs/ADCEs, we discuss that whereas for most of them, in particular those lived after the death of a relative or a friend, we can assume hallucinatory characteristics triggered by emotional needs, for others, for example those related to unknown individuals and/or those experienced before the death of the person still in good health, it is not possible to exclude their anomalous connections and a real encounter with a deceased person.

Sawing the branch of near-death experience research: A critical analysis of Parnia et al.'s paper.

In their recent paper, Parnia and colleagues propose a new label for the near-death experience (NDE): recalled experience of death. They claimed NDEs are "authentic" only when an objective danger is present and that authentic NDEs have a proven core phenomenology. We consider that these claims are insufficiently supported by empirical data. NDEs appear as a continuum of heterogeneous experiences of consciousness precipitated by the disjunction of processes usually combined in normal mental activity. The "core phenomenology" of NDEs is also opened to several criticisms. Closeness to "real" death does not appear to be a decisive criterion for characterizing NDEs. The author's adhesion to Raymond Moody's NDE model produces a biased partition of this field of research that is unable to provide the basis for a consensus.

Nurses' Perceptions on Good Death and Their Attitudes Towards the Care of Dying Individuals.

This study was conducted to determine the good death perceptions of intensive care and oncology inpatient unit nurses, their attitudes toward care of the dying and the correlation between them. The sample of this study consisted of 134 intensive care and oncology inpatient unit nurses. The data were collected using the Frommelt Attitudes Toward Care of the Dying Scale and the Good Death Scale. As the results of the study, the nurses had high good death perceptions. They had moderately positive attitudes toward care of the dying patients. As their good death perceptions increased, their positive attitudes toward care of the dying individual also increased. It is recommended to organize programs to raise awareness of nurses about good death and attitudes toward the dying patients and to strengthen their communication and coping methods.

Guidelines and standards for the study of death and recalled experiences of death--a multidisciplinary consensus statement and proposed future directions.

An inadvertent consequence of advances in stem cell research, neuroscience, and resuscitation science has been to enable scientific insights regarding what happens to the human brain in relation to death. The scientific exploration of death is in large part possible due to the recognition that brain cells are more resilient to the effects of anoxia than assumed. Hence, brain cells become irreversibly damaged and "die" over hours to days postmortem. Resuscitation science has enabled life to be restored to millions of people after their hearts had stopped. These survivors have described a unique set of recollections in relation to death that appear universal. We review the literature, with a focus on death, the recalled experiences in relation to cardiac arrest, post-intensive care syndrome, and related phenomena that provide insights into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We also identify issues and controversies related to the study of consciousness and the recalled experience of cardiac arrest and death in subjects who have been in a coma, with a view to standardize and facilitate future research.

Turkish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale.

The aim of the research was to conduct the Turkish validity and reliability study of the Frommelt Attitude toward Care of the Dying Scale. The study used a cross-sectional research design. The sample of the study consists of 236 intensive care nurses. The data were analyzed using SPSS 22.0 and SPSS AMOS 22.0 programs. Descriptive statistical methods, reliability analysis, exploratory and confirmatory factor analyses were used in the analysis of the data. According to the findings of the exploratory factor analysis, the scale was divided into six factors as in its original. According to results of the confirmatory factor analysis showed that the goodness of fit of the scale was acceptable level. Cronbach's alpha coefficients of the Frommelt Attitude toward Care of the Dying and subdimensions were found to be between 0.606 and 0.800. These results showed that the Turkish form of scale was valid and reliable and it had the necessary conditions for using Turkish form.

Remembering the Super-Typhoon: Some, but Not All, Qualities of First-Hand Survivor Memories of Natural Disaster Are Similar to Near Death Experience and Flashbulb Memory Accounts.

The strongest storm in Philippines history, super-typhoon Haiyan, barreled through central Philippines in 2013 and left a high death toll and extensive destruction in its wake. Past studies have investigated Fading Affect Bias (FAB) in extremely negative situations like the death of a loved one and found that the FAB generally occurs in those extreme situations, but this study is the first to assess FAB in first-hand memories for a natural disaster survival situation. The FAB phenomenon is the tendency for emotional intensity associated with negative memories for events to fade over time and emotional intensity for positive events stays relatively stable over time. Researchers collected memories for the super-typhoon from survivors three years after the event. Results showed that negative emotional intensity for the event faded after the event. Emotion in comparison positive memories for non-typhoon events did not fade, and emotion in comparison negative memories faded, following results in several other FAB studies. The Positive and Negative Affect Scale (PANAS) was used as an initial assessment of mood before the study began, and PANAS scores reliably predicted current emotional intensity scores. Memory vividness and emotional intensity in first-hand accounts of a natural disaster experience behave like vividness and intensity in flashbulb memories, but details in first-hand accounts are similar to the amount of details in memories of near-death experiences. How memory rehearsal behaves in relation to time elapsed since event has yet to be captured for first-hand survival experiences.

Death and Complexity / Muerte y complejidad / Morte e complexidade

Abstract: There is no such thing as a science of death, although there is a science of life, as it happens. Death is not so much the subject matter of science but an experience, and death experiences we find abundantly in the literature. Now, experience is told not so much in a scientific tenure but as a narrative. Within the framework of bioethics, death comes closer, particularly what is usually known as end-of-life dilemmas, i.e., palliative care, a most sensitive arena, if there is any at all. This paper argues about the interplay or dialogue between death and complexity science. It claims that the knowledge of death is truly the knowledge of life and provides three arguments that lead to the central claim. The first argument is very much close to a kind of heuristic for knowing about death, while the second shows the challenge of knowing death. The third one consists of a reappraisal of death within an extensive cultural or civilizing framework. Lastly, some open-ended conclusions are drawn.

Resumen: No existe cosa tal como una ciencia de la muerte, sin embargo si existe una ciencia de la vida, por suerte. La muerte no se trata de un asunto de ciencia sino de una experiencia, y experiencias de muerte abundan en la literatura. De hecho, la experiencia se cuenta no tanto en un tono científico sino más bien como una narrativa. Dentro del marco de la bioética, la muerte se aborda de una manera más cercana, particularmente en los que se conocen como dilemas del fin de la vida, por ejemplo, el cuidado paliativo, una arena muy sensible, si es que la hay. Este artículo discute sobre la interacción o el diálogo entre la muerte y la ciencia de la complejidad. Afirma que el conocimiento de la muerte en verdad es el conocimiento de la vida y da tres argumentos que llevan a esta afirmación central. El primer argumento es muy cercano a un tipo de heurística por conocer acerca de la muerte, mientras que el segundo expone el reto de conocer la muerte. El tercero consiste en una revaluación de la muerte dentro de un amplio marco cultural o civilizador. Por último, se esbozan algunas conclusiones abiertas.

Resumo: Não existe uma ciência da morte como tal, contudo sim existe uma ciência da vida. A morte não se trata de um assunto de ciência, mas sim de uma experiência, e experiências de morte abundam na literatura. De fato, a experiência se conta não tanto em um tom científico, mas sim como uma narrativa. No âmbito da bioética, a morte é abordada de uma maneira mais íntima, particularmente no que se conhece como "dilemas do fim da vida", por exemplo, no cuidado paliativo, uma arena muito sensível, sim é que a há. Neste artigo, discute-se sobre a interação ou o diálogo entre a morte e a ciência da complexidade. Afirma-se que o conhecimento da morte em verdade é o conhecimento da vida e são apresentados três argumentos que levam a essa afirmação central. O primeiro argumento é muito próximo de um tipo de heurística por conhecer sobre a morte, enquanto o segundo expõe o desafio de conhecer a morte. O terceiro consiste em uma reavaliação da morte dentro de um amplo referencial cultural ou civilizador. Por último, são esboçadas algumas conclusões abertas.

The Neurology of Death and the Dying Brain: A Pictorial Essay.

As neurologists earn their living with the preservation and restoration of brain function, they are also well-positioned to address the science behind the transition from life to death. This essay in pictures highlights areas of neurological expertise needed for brain death determination; shows pitfalls to avoid during the clinical examination and interpretation of confirmatory laboratory tests in brain death protocols; illustrates the great variability of brain death legislations around the world; discusses arguments for the implementation of donation after circulatory death (DCD); points to unresolved questions related to DCD and the time between cardiac standstill and organ procurement ("hands-off period"); provides an overview of the epidemiology and semiology of near-death experiences, including their importance for religion, literature, and the visual arts; suggests biological mechanisms for near-death experiences such as dysfunction of temporoparietal cortex, N-methyl-D-aspartate receptor antagonism, migraine aura, and rapid eye movement sleep; hypothesizes that thanatosis (aka. death-feigning, a common behavioral trait in the animal kingdom) represents the evolutionary origin of near-death experiences; and speculates about the future implications of recent attempts of brain resuscitation in an animal model. The aim is to provide the reader with a thorough understanding that the boundaries within the neurology of death and the dying brain are being pushed just like everywhere else in the clinical neurosciences.

Burn Survivors' Near-Death Experiences: A Qualitative Examination.

Persons who come close to death but survive catastrophic accidents sometimes report very vivid experiences during times when their survival was in doubt, when they were believed to be dead, and during resuscitation efforts. This qualitative study builds upon existing research on near-death experiences (NDEs) by focusing on the oral accounts from a sample of individuals with large and life-threatening burns. The NDE accounts were obtained from burn survivors attending the Phoenix Society's World Burn Congress and are similar to reports by notable researchers ( Greyson, 2003 ; Moody, 1975 ; Ring, 1980 ) while reflecting the uniqueness of the individual survivor's experiences. Six major themes are reported. Counselors and health professionals need to be aware of and educated about NDEs as these experiences can have profound effects upon the individual. Patients who have had NDEs may need to discuss them but fear professionals will reject their stories as being crazy.

A systematic analysis of distressing near-death experience accounts.

Near-death experiences (NDEs) are usually associated with positive affect, however, a small proportion are considered distressing. We aimed to look into the proportion of distressing NDEs in a sample of NDE narratives, categorise distressing narratives according to Greyson and Bush's classification (inverse, void or hellish), and compare distressing and "classical" NDEs. Participants wrote down their experience, completed the Memory Characteristics Questionnaire (assessing the phenomenology of memories) and the Greyson scale (characterising content of NDEs). The proportion of suicidal attempts, content and intensity of distressing and classical NDEs were compared using frequentist and Bayesian statistics. Distressing NDEs represent 14% of our sample (n = 123). We identified 8 inverse, 8 hellish and 1 void accounts. The proportion of suicide survivors is higher in distressing NDEs as compared to classical ones. Finally, memories of distressing NDEs appear as phenomenologically detailed as classical ones. Distressing NDEs deserve careful consideration to ensure their integration into experiencers' identity.

Near-death experiences in medicine.

Near-death experiences (NDEs) have been a source of controversy within academia and the public. NDEs occur in 10% to 20% of patients who have come close to death and consist of vivid, subjective experiences that occur during life-threatening emergencies. Specifically, NDEs include out-of-body experiences, pleasant feelings, seeing deceased relatives, a life review, or a conscious return into the body. Although alternate psychological and physiological theories have been proposed, several methodological and neuroscientific limitations prevent their verification. Despite these limitations, counselors trained with NDE literature reduced suicidal thoughts, bereavement, and posttraumatic stress disorder among their patient populations. In addition, patients who have experienced an NDE showed significant transformation in their spiritual and emotional lives, with many stating a renewed sense of meaning, existential awareness, and mystical experiences. Family and friends of patients who have experienced an NDE also report increased comfort, hope, and inspiration. Overall, NDEs have positively impacted the medical profession and physician-patient interactions and represent a growing paradigm shift beyond the naturalistic interpretations of science and medicine.