Fatigue and psychospirituality of multi-sensory leisure

Abstract

This pilot-study has highlighted psychospirituality, a dimension of wellbeing, in three case studies with or without fatigue secondary to chronic conditions (FSCC). A rationale of this study was that fatigue management in multi-sensory leisure may improve self-efficacy, an indicator of psychospiritual well-being, in those case studies. The FSCC is the least well-managed symptom in relation with reducing well-being (Sharpe Wilks, 2002). Aaronson et al. (1999, p. 46) defined the FSCC as “the awareness of a decreased capacity for physical and/or mental activity due to an imbalance in the availability, utilization and/or restoration of resources needed to perform activity.” This definition has shown the resources or environments prepared for individual and purposeful activities of daily livings, particularly in leisure which is defined as a free time at non-working or life-sustaining activities (Leitner and Leither, 2004). Moreover, an effective resource of leisure has been reviewed that it should be consisted of multi-sensory environment, activity choices of interest, and individual participation. This statement is based on the self-determination theory (SDT) (Deci and Ryan, 1985; Ryan and Deci, 2000) focusing on the degree of motivation related to psychospiritual learning, performance, and experience of human. Coleman and Iso-Ahola (1993) also agreed with the SDT that leisure activities designed in various forms of self-determination and social participation may reduce life stress of the individuals. Life-stress is accumulated when people have experienced FSCC, such as: cancer or rheumatoid arthritis. Many health professionals use the self-management model of chronic care in people with FSCC by giving medication and therapeutic activities, teaching coping skills with depression or other emotional consequence, and changing the client’s self-efficacy or confidence of performance (Corbin Strauss, 1988 cited in Lorig Holman, 2003). Importantly, the confident behavior of the individuals is intrinsically expressed in self-determination and life choices of satisfaction (Hammell, 2001). While the individuals are living with chronic conditions (e.g., hypertension, heart disease, cancer) their confident behaviors need different connections of spiritual/mental well-being and religious commitment (Hassed, 2000). Fitchett, Brady, Hernandez, Cella (2002) found a positive effect of religious beliefs on spiritual well-being of people with cancer, but the sense of spiritual well-being may be explained in an abstract dimension toward health 692 Global Recovery : through Mental Well-being benefits. This study also mentioned gaps of connection among the self-management upon chronic conditions, the religious beliefs (institutional practice) and the measurable spirituality (meaningfulness of life experience). In order to fill those gaps, Kang (2003) reviewed many conceptual frameworks in various fields including occupational therapy, occupational science, behavioral medicine, and religious studies. A model of psychospiritual integration or PSI (Kang, 2003, p. 97) is created in order to articulate personal performance of life activities, community, environment, and spirituality (self-observation of the nature and organized feeling based on the Buddhist ‘enlightenment’ or samma sambodhi). This model has reported that the human organizes meaningful behaviors by physical and psychosocial components in leisure and non-leisure activities. The human has goal-directed consciousness through leisure experiences in various forms of sensation and perception (Csikszentmihalyi, 1993) which I would name as multi-sensory leisure. This consciousness could be qualitatively expressed into six components of spiritual behaviors: becoming, meaning, being, centeredness, connectedness, and transcendence (Kang, 2003). However, those PSI components may explain the psychospirituality of multi-sensory leisure for people experiencing self-management of FSCC. Therefore, this study aimed to understand fatigue and psychospirituality of multi-sensory leisure by using a single-subject design over 5-week course, 2 hours per session -1 session a week (modified fatigue management course which is originated by Packer, Brink, Sauriol, 1995 and its previous studies). The course contents include fatigue in daily lives, banking energy, body communication, activity schedule, and balancing activity domains combined with client’s feedback. The researcher made a small group discussion with three volunteers: a client with cancer (A), a client with rheumatoid arthritis (B), and a client preferred Buddhist and spiritual health (C). The fatigue impact scale or FIS (Fisk, Ritvo, Ross, Haase, Marrie, Schlech, 1994) was used in order to differentiate the participants’ fatigue experiences. The perceptions of multi-sensory leisure and a rating scale of self-efficacy (an indicator of psychospirituality scored from 1 to 10) were qualitatively interviewed among three volunteers with and without FSCC. Content analysis was conducted using the PSI model (Kang, 2003) as the occupational therapy perspective and the Four Noble Truths of Buddhism (Rahula, 1997; Ekman, Davidson, Ricard, Wallace, 2005).