Part I: meeting challenges.

By Wiklund L

[Journal Article, Research Support, Non-U.S. Gov't]

J Clin Nurs 2008 Sep; 17(18):2426-34.

AIM: This paper aims to explore the existential aspects of living with addiction.

BACKGROUND: This study arises from data from a previous research project carried out by the author and takes as its point of departure the patient's perspective.

Addiction is described as being related to traumatic experience and to loss of control, shame, guilt and low self-esteem, but also to spirituality. This causes profound suffering and drugs are used as a means of handling this suffering.

DESIGN: Hermeneutic inquiry was used to explore peoples experiences of living with addiction.

METHOD: The first study was based on interviews with people with rich, personal experience of addiction. This study constitutes a secondary analysis of the same data and was conducted using a hermeneutic approach.

RESULTS: On an existential level the experiences of living with addiction can be understood as a striving to meet and resolve challenges associated with spirituality caused by a person's suffering and, paradoxically, also by his/her efforts to relieve that suffering through the use of drugs.

These challenges are presented as themes focusing on the conflict that must be met; meaning - meaninglessness, connectedness - loneliness, life - death, freedom - adjustment, responsibility - guilt, control - chaos.

CONCLUSION: Living with addiction appears as being in the midst of a struggle with existential challenges. Furthermore, the use of drugs is paradoxical as it momentarily relieves suffering but at the same time increases it.

RELEVANCE TO CLINICAL PRACTICE: Addressing the challenges will facilitate nurses interaction with addicted persons. When facing challenges, including the motivational aspects, instead of focusing on problems, health can be promoted and suffering relieved.

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Part II: caring needs. A hermeneutic expansion of qualitative findings.

[Journal Article] J Clin Nurs 2008 Sep; 17(18):2435-43.

AIM: This paper aims to describe caring needs associated with existential aspects of living with addiction.

BACKGROUND: Spirituality is considered a driving force within and the concept relates to self, others and God and the relationships between them. The spiritual dimension is of great importance in both the addiction itself as well as in recovery and addressing caring needs relating to spirituality is important in nursing.

DESIGN: Hermeneutic inquiry was used to explore caring needs related to peoples experiences of living with addiction.

METHOD: This paper is a hermeneutic expansion of findings presented in Part I. Existential themes in the form of spiritual challenges and caring needs are reflected upon as a process between figure and background.

RESULTS: The themes presented are: meaning - meaninglessness, connectedness - loneliness, life - death, freedom - adjustment, responsibility - guilt, control - chaos.

Caring needs associated with them are identified as; the need to create a new frame of reference for interpreting of life, the need to experience coherence in life, a restored dignity as well as the need for a sense of community and attachment, confirmation and acceptance.

The caring need for forgiveness and reconciliation is also identified as well as the need for continuity, comprehensibility and manageability.

CONCLUSIONS: When caring for patients suffering from addiction nurses should address patients' spirituality. The caring communion is vital, as it is the foundation for meeting the patients' needs. Intervention by nurses should focus on aspects that will help patients feel alive and in communion with others.

RELEVANCE TO CLINICAL PRACTICE: Understanding and being able to identify patients' caring needs associated with existential aspects of living with addiction will enable nurses to provide professional care and promote patient's recovery.

Source: Abstract [Part I] from Unbound Medicine