Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.

Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.

Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.

Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.

Is the value of community service measured in time or in effect? Is leadership the governing of people during an event or helping those in need, inspiring them to follow your lead. Through my experiences, I have concluded that in both situations it is the latter. I may be unable to fill out the sheets of community service and of leadership positions I've held in high school. But I am at no loss of providing invaluable services, of inspiring others to follow my lead and providing an invaluable service to the community.

Waiting…. We've all done it. We have all had that universal experience of waiting. Waiting for news; waiting in line; waiting in traffic. Waiting can be distressing, exciting, or a neutral experience. It all depends on the context. Waiting in line at the store is a rather neutral experience, especially if the line is short and you are not running late for something important. Waiting to see your child come off of the bus after a 3-day school trip can be exciting and full of joyous expectation. Waiting for the results of a biopsy, taken from your child's liver to determine if he has a life-threatening illness, is an experience filled with pain and fear. This last context of waiting is the subject of this brief essay.

Pain wilts away.

Leaving things tidy.

Clinical update: Literature abstracts.

Fear is born of knowledge.

A child will as innocently play with a snake as a teddy bear. A young adult as naively dabble with love as life itself.

Bearing a child is as close as we get to original Creation—something from nothing. Creating a child creates an iredeemable future and changes forever the fabric of life. Procreation can thereby come to symbolize immortality. A symbolic way of cheating our inevitable common-fate, if you like. Love, a mechanism to preserve this symbol, worms its way into the heart and settles there. It flourishes faithfully without fear or doubt, nourishing the parent-child dyad.

Objective: The aim of this research was to reveal, from the perspective of the “lived experience” shared by cancer patients and their nurses, how patients facing death create lived experience in the context of palliative care. This research also aims to elucidate the meaning nurses find in patients' experiences while caring for their patients.

Methods: The participants in this study were cancer patients who were given opportunities to discuss events and concerns in their daily lives, with the interactions guided by the researchers. Transcriptions of conversations with the patients were analyzed using the method for empirical data classification set forth by Giorgi (1985) with appropriate modification.

Results: This study found that when the nurse correctly interprets the meaning of the concerns (Heidegger, 1962) of the patient facing death and shares that meaning with the patient, fundamental questions naturally arise for the patient. Answering these questions becomes possible only through interactions that require the reexamination of the values of the patient and the nurse.

Significance of research: This research elucidates the spiritual pain experienced by cancer patients and discusses opportunities for nurses to address the spiritual care of these patients.

Palliative care clinicians are often challenged in this evidence-based world to find studies that are generalizable to our population. And yet, there is much to be learned from the unique situations that we encounter. This narrative reflects upon the application of palliative principles to one special rat model.

Calendar of events.

Dream carcass.

Clinical update: Literature abstracts.

Clinical update: Literature abstracts.

Gentle fluttered partings.

Calendar of events.

Calendar of events.

Upon hearing good news.

Psalm.

Clinical Update: Literature Abstracts.

Calendar of Events.