Suffering is a particularly human experience that often brings with it loneliness or alienation from others. The theory described in this article explains the mechanisms through which suffering affects an individual's sense of community and connectedness with others. The intricate patterns are explained to provide a basis for prescriptive nursing to prevent or reverse this loss of connectedness. First, the article develops the concept of suffering and its influences on relationship with the self and with others and the relationship of others with the sufferer. Then, the concept of alienation is developed in this context, its philosophical roots explored, and a continuum described that encompasses alienation through connectedness. Related concepts of separation, shame, and stigma are briefly described as partial cases of alienation of the sufferer that also show the pervasiveness of the phenomenon. Next, the personal characteristics of an individual who might help are developed through the concept of wisdom. Last, an explanation is given as to why care is the contextual framework through which alienation is reversed and connectedness achieved. Although suffering, alienation, and care have gone by many names, the essences of these phenomena have been recurrent theme in descriptions of human response.

We find that basic nursing care in the neonatal intensive care unit is missed and that system factors may contribute to missed care in this setting.

Objectives:Abuse against women causes a great deal of suffering for the victims and is a major public health problem. Measuring lifetime abuse is a complicated task; the various methods that are used to measure abuse can cause wide variations in the reported occurrences of abuse. Furthermore, the estimated prevalence of abuse also depends on how abuse is culturally defined. Researchers currently lack a validated Arabic language instrument that is also culturally tailored to Arab and Middle Eastern populations. Therefore, it is important to develop and evaluate psychometric properties of an Arabic language version of the newly developed NorVold Domestic Abuse Questionnaire (NORAQ).Design and methods:The five core elements of the NORAQ (emotional abuse, physical abuse, sexual abuse, current suffering of the abuse, and communication of the history of abuse to the general practitioner) were translated into Arabic, translated back into English, and pilot tested to ensure cultural sensitivity and appropriateness for adult women in the Eastern Mediterranean region. Participants were recruited from the Jordanian Ministry of Health-Maternal and Child Health Care Centers in two large cities in Jordan.Results:A self administered NORAQ was completed by 175 women who had attended the centers. The order of factors was almost identical to the original English and Swedish languages questionnaire constructs. The forced 3-factor solution explained 64.25% of the variance in the measure. The alpha reliability coefficients were 0.75 for the total scale and ranged from 0.75 to 0.77 for the subscales. In terms of the prevalence of lifetime abuse, 39% of women reported emotional abuse, 30% physical abuse, and 6% sexual abuse.Conclusion:The Arabic version of the NORAQ has demonstrated initial reliability and validity. It is a cost-effective means for screening incidence and prevalence of lifetime domestic abuse against women in Jordan, and it may be applicable to other Middle East countries.

Hardiness, ways of coping, social support and burnout in 103 critical care nurses were addressed in this study. Work-related and nonwork-related social support and hardiness were negatively related to burnout. Use of emotion-focused coping was positively correlated with burnout while hardiness was negatively related to the use of emotion-focused coping and positively related to both types of social support. After controlling for working nights, social support, hardiness, emotion-focused coping and problem-focused coping accounted for 44% of the variance in burnout scores.

Purpose in life was more important than were laboratory markers of disease progression for predicting depressive co-morbidity. Results from this study indicate the need for routine assessment of depressive symptoms in PLWHIV. Purpose in life should be explored as a potential buffer for depressive symptoms.