Phenomenological Study of Psycho-Socio-Spiritual Healing in the Context of Chronic or Life-Threatening Illness
We identify healing in the context of chronic or life-threatening illness as a
patient-reported outcome consisting of growth or benefit in psychological, social and/or
spiritual dimensions representing improvement well above the patient's pre-morbidity
baseline. This positive outcome often occurs despite substantial suffering during the
illness, even in terminal cases (Kearney 2000).
In previous phenomenological studies, qualitative descriptions of healing and the processes
by which it develops have not been structured in categories suitable for the development of
a fully validated and standardized psychometric instrument. Also, the relationship of
healing to psychometrically measurable constructs such as posttraumatic growth, resilience,
coping, and acceptance is not clear.
Objective: This program is to provide (1) a qualitative model of healing-related processes,
(2) phenomenological categories of healing suitable for a psychometric instrument
development, (3) the relationship of healing to other relevant constructs such as trauma,
coping, and adult development, and (4) questionnaire items for healing assessment and (5)
software tools that greatly increase the qualitative analysis speed and rigor of
phenomenological category building.
Study populations: Two populations of subjects who have experienced a life-threatening
disease or serious chronic illness (cancer or cardiac disease) will be recruited from three
sites. The first population (50 subjects) are individuals with exemplary healing
experiences (life-transforming positive outcomes connected to illness along psychological,
social and/or spiritual dimensions) or in the early stages of healing-related processes.
In-depth interview data from these subjects will empirically help identify endpoint markers
and process pathways of profound healing. The second population (400 subjects) consists of
current or past participants in structured healing or medical rehabilitation programs. In a
written interview, these participants will qualitatively evaluate questionnaire items for
identifying readiness for and progress toward healing using their first-hand,
Design: This protocol has a qualitative, phenomenological, natural history design - similar
to identifying features of a medical syndrome or psychological disorder. It has two formats
of data collection: in-depth individual interviews of the exemplary healing population, and
self-administered written interviews for current participants in formal healing or
rehabilitation programs. In-depth interview sessions have 2 1/4-hour duration with three
components: a 50-minute, in depth phenomenological interview, a 30-minute short-statement
interview (how subjects view healing-related short questionnaire statements), and a
25-minute related-constructs interview (how their positive outcomes, may be related to
personality). Interview and short-statement analyses consist of standard qualitative
methodologies including transcription, memo-writing, coding, categorization, and modeling.
Outcome measures: None (non-interventional)
Time Perspective: Retrospective
Ann M Berger, M.D.
National Institutes of Health Clinical Center (CC)
United States: Federal Government
|National Institutes of Health Clinical Center, 9000 Rockville Pike||Bethesda, Maryland 20892|
|Smith Farm Center for Healing and the Arts||Washington, District of Columbia 20009|
|Suburban Hospital - Cardiac Rehabilitation Service||Bethesda, Maryland 20814|