Sobrecarga e qualidade de vida em cuidadores informais de pessoas com demência

RESUMO: Introdução: A sobrecarga do cuidador informal de pessoas com demência está associada à sua qualidade de vida. Objetivo: Analisar as associações entre qualidade de vida e sobrecarga familiar nestes cuidadores informais, assim como as relações entre estas variáveis e outros fatores. Materiais e métodos: Trata-se de um estudo transversal (descritivo e analítico). A amostra de conveniência foi composta de 33 cuidadores. O estudo foi realizado nos serviços de consultas externas de dois centros do Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus. Os dados foram obtidos através da aplicação das escalas: Entrevista de Sobrecarga de Zarit, WHOQOL-Bref, Escala de Atividades Instrumentais de Vida Diária de Lawton e Brody e Índice de Barthel. Na análise dos dados foram empregues estatísticas descritivas e testes não paramétricos. Os testes empregues consistiram no teste de Mann-Whitney e teste de Kruskal-Wallis. O nível de significância considerado em todas as análises foi de 5%. Todos os dados obtidos foram analisados com recurso ao programa estatístico SPSS 21.0. Resultados: Os cuidadores com menores índices de sobrecarga evidenciaram uma correlação negativa com todos os domínios da qualidade de vida (p≤0.002). Os cuidadores homens revelaram-se menos sobrecarregados enquanto cuidadores principais (p=0.023). A existência de um cuidador secundário foi indicador de uma melhor qualidade de vida dos cuidadores, nos domínios das relações sociais (p=0.034) e do meio ambiente (p=0.034). Quanto mais prolongado o tempo de cuidados para os cuidadores avaliados, menor a sua qualidade de vida, ao nível físico (p=0.003) e do meio ambiente (p=0.000). A situação de sobrecarga foi tanto maior quanto menor a idade do cuidador (p=0.003). A independência da pessoa com demência ao nível instrumental também se traduziu numa melhor qualidade de vida dos cuidadores, em todos os domínios desta variável e, numa menor situação de sobrecarga dos cuidadores (p=0.017). Conclusões: Uma maior sobrecarga dos cuidadores informais de pessoas com demência está associada a indicadores mais baixos de qualidade de vida, em todos domínios desta variável. No presente estudo, os principais fatores a ter em conta na avaliação dos cuidadores de pessoas com demência foram: o género, a existência de um cuidador secundário e a independência da pessoa cuidada nas atividades instrumentais da vida diária. Foi também possível analisar que as variáveis sobrecarga e qualidade de vida não se relacionam apenas entre si mas, concomitantemente, com diferentes situações da vida do cuidador. Uma intervenção mais atenta às características de cada cuidador poderia vir a repercutir-se numa menor sobrecarga e numa melhor qualidade de vida, quer do cuidador como, eventualmente, da pessoa cuidada.------------ ABSTRACT: Introduction and objectives: The overload of informal caregivers of people with dementia tends to be inversely associated with their life quality. This study aims to analyze the associations between the family overload and the life quality of these informal caregivers, as well as the relationships between these variables and other sociodemographic and functional factors. Population and methods: It’s a cross-sectional study (descriptive and analytical). The convenience sample was composed of 33 informal caregivers. The study was carried out in the external services consultations of two centers of the Institute of the Hospitable Sisters of the Sacred Heart of Jesus. The data were obtained by applying the following scales: Overload Interview of Zarit, WHOQOL-Bref, Scale of Instrumental Activities of Daily Living of Lawton and Brody, and Barthel Index. Results: We found a negative correlation between the family overload and every domains of life quality (p ≤ 0.002). The men caregivers proved to be less burdened than the main caregivers (p = 0.023). The existence of a secondary caregiver was an indicator of a better life quality in the fields of social relations (p = 0.034) and in the environment (p = 0.034). The evaluated caregivers, more prolonged time occupy to care, lower was their life quality on the physical level (p = 0.003) and on the environment (p = 0.000). The overload levels were bigger whereas the lower age of the caregiver (p = 0.003). The independence of the person with dementia on the instrumental level rendered a better life quality for caregivers in all domains of this variable and also provided a minor burden for the caregivers (p = 0.017). Conclusions: In this small sample, the higher burden to the informal caregivers of people with dementia is associated with lower indicators of life quality, in every domains of this variable. In this study, the main factors to keep in count in the evaluation to the caregivers of people with dementia were: the gender, the existence of a secondary caregiver and the independence of the person to be cared in his instrumental activities of daily living. We also observed that the overload and life quality variables do not relate only to each other but at the same time with different situations of the life of the caregiver. A closer intervention to the characteristics of each caregiver could reflect a lower overload and a better life quality of the caregiver and eventually as well as the person to be cared of.

Para uma semiótica da luz. Da visão mítica aos regimes escópicos da contemporaneidade

Tese de Doutoramento em Ciências da Comunicação

Os sentidos da educação religiosa na construção do eu contemporâneo: espiritualidades juvenis

Dissertação de mestrado em Ciências da Educação (área de especialização em Sociologia da Educação e Políticas Educativas)

Traducció i estudi de documents demòtics datats del regnat d'Alexandre el Gran (332-323 aC)

Projecte de recerca elaborat a partir d’una estada a l’Oriental Institute de la University of Oxford, Regne Unit, entre juliol i octubre de 2007. Durant l’estada s’ha analitzat la documentació demòtica datada del regnat d’Alexandre el Gran com a faraó d’Egipte (332-323 aC). El conjunt de fonts que examinat està constituït per sis papirs (actes notarials que recullen diversos tipus de contractes o acords entre dues parts), un òstrakon fragmentari i una sèrie d’esteles provinents de la Necròpolis d’Animals de Saqqara Nord, en concret de la Catacumba de les Mares d’Apis. Aquesta documentació és fonamental perquè permet extreure conclusions importants sobre diversos aspectes relacionats amb l’administració i la religiositat egípcies en els moments inicials de la dominació grega d'Egipte. Cadascun d’aquests documents ha estat traduït, analitzat en profunditat i degudament contextualitzat històricament. D’una banda, en l’àmbit de l’administració, he pogut constatar la continuïtat existent amb el període històric immediatament anterior, és a dir, amb la Segona Dominació Persa del país; mentre que de l'altra, des del punt de vista religiós, l’anàlisi d’aquestes fonts m’ha permès verificar l'existència de tota una sèrie de canvis substancials, estretament vinculats a la voluntat expressa de la nova elit dirigent d'origen grec de distanciar-se dels seus predecessors aquemènides i de marcar amb força l’obertura d’una nova era que es caracteritzarà pel respecte a les tradicions autòctones i per la potenciació dels cultes nacionals.

War and National Renewal: Civil Religion and Blood Sacrifice in American Culture

Wars are often associated with a rhetoric of renewal or new beginnings. This essay explores this claim through the lens of civil religion and a recent book by Carolyn Marvin and David Ingle, Blood Sacrifice and the Nation, which combines Emile Durkheim with Réné Girard in proposing that modern national cohesion depends on blood sacrifice. I unpack some of the paradoxes raised by this theory of national renewal in the context of 9/11, with a special focus on the sacred status of the flag and the special attention given to uniformed serviceman in the American body politic.

Nuevos elementos escultóricos del recinto de culto del Concilium Provinciae Hispaniae Citerioris (Tarraco, Hispania Citerior)

The work of the Director Plan for the Cathedral of Tarragona has allowed us to make a revision regarding the knowledge, chronology and features of the sacred area of the Concilium Provinciae Hispaniae Citerioris. We present diverse elements of architectural and sculptured decoration recovered from constructive levels of 1st century A.D, and the 6th century A.D levels of re-use and transformation, in contemporary constructions. All these elements ratify the process of imitation of the Forum Augustum made in the capital of the Hispania Citerior.

Serlianas durante el Renacimiento italiano y español: del triunfo de la religión católica al lenguaje imperial

This article presents a panoramic view of the development of the so-called serliana or Serlian motif throughout the Italian Renaissance, focusing on the most relevant examples in the architecture of that period. The use of this motif during the Early Renaissance was pioneered by Filippo Brunelleschi in religious buildings. As its employment become widespread in a range of different settings, architects frequently incorporated local building traditions. It was only during the last twenty years of the Quattrocento that Giuliano da Sangallo and Leonardo da Vinci adopted the Serlian arch in residential architecture designed for the ruling elites. Thanks to Bramante and other artists such as Raphael, Baldassare Peruzzi, Antonio da Sangallo the Younger and Giulio Romano, the motif was extraordinarily popular during the High Renaissance period. Ever-increasingly complex and monumental compositions eased the adaptation of the serliana to both exterior and interior spaces, and in works such as the design by Galeazzo Alessi in Genoa, the imperial connotation of the motif is clear. This process illustrates the progressive transfer from the religious to the courtly sphere, and, at the same time, the permeability between the sacred and the profane. During the sixteenth century, Spain too was at the European avant-garde, due to its contacts with Italy and the latest fashions, such as the employment of the serliana in residential architecture, were followed in the fortified palace at La Calahorra, the Vich palace in Valencia, or the palace of Charles V in Granada, as part of a complex iconography of power. Throughout the sixteenth century, the serliana featured in that specifically-Spanish typology, the monumental altarpiece or retablo, as well as in monumental tombs. Italy was certainly the leading force in the process and had an indisputable influence on Spanish art, but the latter would develop its own original solutions in the sixteenth century, which matched the innovative character of Italian creations.

Interventions présumées des scribes concernant le motif de l'arbre sacré dans le Pentateuque

Abstract: This article deals with several presumed scribal interventions which all concern the sacred tree motif. One finds deliberate changes in the MT, in the Septuagint, in Targum Onkelos and in the Vulgate. The Greek translators of Genesis and Samuel (1-2 Kingdoms) avoided rendering the word אשׁל "tamarisk" by its equivalent μυρίκη, chosing instead the word ἄρουρα "field". Similarly, the Greek translator of Genesis, in the passage of the death of Rebecca's nurse Deborah, passed over the motif of her burial under a grand tree. According to the hypothesis of the present article, all four changes are related to one other; they might be due to the translator's fear to connect the respective texts with traditions and customs concerning the Egyptian god Osiris. On the other side, a scribe of the proto-Massoretic tradition modified the readings mentioning the large tree of Mamre close to Hebron. By changing the noun's number from singular to plural the corrector tried to conceal the existence and importance of the sacred tree in the tradition of Abraham. By contrast, the scribe did not modify texts related to the sacred tree of Shechem. This disparity of treatment may be explained by the fact that, in the view of the Judean scribe, the tree of Shechem would put the Samaritans in a bad light. Finally, the authors of Targum Onkelos and of the Vulgate intervened almost systematically in Pentateuchal texts having the terms אֵלוֹן) אלון or אַלּוֹן ), which always designate a holy tree. The two expressions are rendered by terms referring to plains (Targum Onkelos) or a valley (Vulgate).

Den vårdande och helande bilden: möten med bildkonst i vårdandets värld

Denna vårdvetenskapliga avhandling syftar till att avtäcka och belysa en vårdande och helande dimension vid existentiellt lidande patienters möten med bildkonst inom vårdkontext. Kunskapssökandet sker i två studier. Den första (studie I) är en ikonografi sk tolkning av konstnären Matthias Grünewalds (ca 1460–1528) senmedeltida altarskåpsmålningar. I studien uttolkas lidandets uttryck och narrativa budskap samt symboliska gestaltningar av vårdande och helande i valda delar av detta s.k. Isenheimaltares bildprogram. Tolkningen utgår från rekonstruktionen av altarskåpets ursprungskontext, det medeltida Isenheimklostret, där svårt sjuka och döende patienter vårdades. I studie två (II) fortsätter sökandet i den moderna hospicevårdens kontext med hjälp av en kvalitativ intervjustudie som utforskar patienters meningsskapande vid möten med självvald bildkonst (oljemålningar och akvareller av fi nländska konstnärer som donerats till det sjukhus där intervjustudien gjordes). Forskningsansatsen är inspirerad av Hans-Georg Gadamers (1901–2002) hermeneutik. Vidare används några nyare tolkningsteoretiska ansatser inom bildkonstens område. Forskningens tolkningsresultat visar att bildkonsten har potentialer såväl på ett miljöestetiskt plan som på en djupare individuell symbolnivå. Som designkomponent i vårdmiljöns rumsliga gestaltning bygger bildkonsten in estetiska, etiska och andliga kvaliteter utifrån tidsmässiga och kulturella koder. I den medeltida klostervårdens kontext sammanföll bildkonstens dekorativa betydelse med andliga och helande syften. När det gäller självvalda konstverk i den moderna vårdkontexten bidrar de till det enskilda patientrummets atmosfär på ett unikt sätt utifrån patientens personlighet och behov. På en fördjupad mötesnivå, i samspel med bildens symboliska funktion, sker en inlevelsemässig förfl yttning in i bildens värld. Betraktarens inlevelse aktiveras till en transcenderande rörelse som går bortom det faktiska rummets och den reella tidens gränser. Vid resor i konstens bildvärld spelas minnesvärda händelser upp från det förgångna, men även framtiden kommer betraktaren till mötes. I en existentiell livssituation söker människan i konstverkets bildinnehåll efter symbolisk mening som kan ge svar på lidandets frågor. Bilderna iscensätter då helande motbilder som utgör korrektiv i symboliska former när olika existentiella förluster hotar. När livet förbleknats av sjukdom besvarar bildvärlden den lidandes blick med lysande violer som blommar upp, ger livskraft och bekräftar personens värdighet mitt i det förvissnande människolivet. När ångest och otrygghet nalkas inbjuds betraktaren till besök i landskap som utvidgar sjukhusrummets väggar mot hemgårdens trygghet. Där livet hotas av förgänglighet tar bildvärlden människan med sig till naturens eviga återfödelse. Upplevelsen av att vara delaktig i ett större och heligt sammanhang öppnar vägen ut ur lidandets avskurenhet. I medeltidens vårdkontext erbjöd den sakrala bilden en kollektiv och helande Symbolon som genom sin representationskraft synliggjorde det osynliga. Vid bildmöten i den moderna hospicevårdens kontext var det naturteman som gläntade på dörren till ”det hemliga rummet i djupet av hjärtat”. Forskningen antyder att även om meningsskapandet i ett bildmöte är avhängigt tidsepok, betraktarens förförståelse och kulturella kontext samt typen av bilder kan bildsymboliken, generellt förstådd som den saknade formen eller det saknade livssammanhanget, framvisa en helande och hoppingivande ordning i lidandets kaos.

Ekologiaa, teknologiaa ja feminismiä

Kirjallisuusarvostelu

Charles Larned letter, April 3, 1813.

Charles Larned (1791-1834) was a lawyer and American military officer who served during the War of 1812. He was the son of Simon Larned (1753-1817), who served as a captain in the Revolutionary War and was a member of the United States Congress from Massachusetts from 1804-1805. Charles studied law in the office of Henry Clay in Kentucky, and was dining with a group of prominent citizens when word was received that General William Henry Harrison could soon be overpowered by General Henry Proctor. Colonel Owen, a member of the group, organized a regiment to reinforce Harrison’s troops. Larned became a member and subsequently survived the River Raisin Massacre and was later present at the Battle of the Thames. He was also part of a group of men who learned of General William Hull’s plan to surrender Detroit to the British and planned to overtake him should this occur. However, the plan failed, Hull did surrender and the men became prisoners of the British. After the war, Larned became a lawyer, and served as Attorney General of Michigan Territory during the Black Hawk War. During the cholera epidemic of 1834, he worked tirelessly to assist others, but was stricken with the disease and died. Letter Transcription: Pittsfield, April 8, 1813 I think that by this time my dear Charles you will allow I have some reason to give you a gentle reprimand for breach of duty—but I will not censure you upon suspicion maybe you have substantial reasons—at any rate one cannot very graciously reproach the other for negligence I for one am healthy as ham & that we have so seldom exchanged letters during your absence & on my honor promise to be a better girl in future—but the truth is my Dear Charles I am secretary for the Family—Mama you know never writes & James but seldom & they are all dispersed in different directions, consequently I have many calls upon my time—this to be sure is a pleasant duty & I urge it only as a slight palliation for my remissness if you should consider it as such—now I have finished my preface—I will try to be more interesting & doubtless I succeed. Our dear Father we hope & trust is now in Green Bush, where he will probably remain a month perhaps & from thence he expects to go to Sacket’s harbor—at which place you know our troops are fast collecting-- We shall hope to see him either here or there before he goes. Brother George I believe is [still] at Plattsburgh but expects soon to be removed to some other military part perhaps with Papa (I hope so at least). We have just got letters from Brothers Sylvester & Joseph at Middlebury—they are in good health. Mama has for some weeks been afflicted with an inflammation in her eyes but seems now to be convalescing. Sister Martha has been somewhat unwell for a few weeks but is now tolerably recovered. James & myself are both in our usual good health & at this time seated by the same stand, one reading, the other writing. Thus my Dear Charles have I given you an abstract history of our Family—but here indeed is a wonderful omission; not a word about Miss Harriet Hunt, who in truth ought to have been noted first but the last she’s not the least in my memory. She is much grown since you saw her, but does not speak as fluently as we could wish—a few word she can say. Probably before this you have been informed of the great loss your friend Sherrill has sustained in the death of his mother—also of the revolution that has taken place in Hackbridge as it respects the religion & morality of the place that more than one hundred on the plain have become religious converts & c—indeed I am at a loss what to say that will afford your pleasure—a narrative at this time must be gloomy indeed. The distressing situation of our country at this time would make almost any recital melancholy. The prevailing epidemic has swept off many of your acquaintance no doubt. Mrs. Dewey of Williamstown, the sister of Mrs. Danforth, has left a Husband, Children & many Friends sincerely to lament her loss—some few have died in our village, but we have escaped astonishingly –it has raged in every town about us--If we are unwilling to acknowledge a God in his mercies. I fear she shall be compelled to do it in the awfulness of his judgments.--------I am much [pleased] with our new neighbors the Parsons Wife & a Miss Woodward her cousin is a fine girl, I think, Mrs. Allen has not a handsome face but something in her manner that interests one her person I think the handsomest I ever saw & the Parson seems well pleased with his selection—Mrs. Ripley is with them this winter & will probably remain thro the summer—Her husband at [Sackett’s Harbor] little or no alteration is apparent since her marriage—she seems as gay & fond of company as ever.-------Mrs. [McKnight] it is expected will commence housekeeping in about three weeks in the house formerly occupied by Mr…. [Report] says that Mr. Goodman & Clarissa Weller are soon to be married & many other things that I must omit to mention for Mama wants a… PS reserved--now my Dear Charles remember you are considerably… & I am confident you have as much leisure as I have –… be ceremonious but write whenever I find time not & I beg… the same – I tell James I shall not send his love for he must write himself. I shall anxiously expect you to write & do not disappoint your affectionate, sister--H One word my Dear Charles from your affectionate Mother who longs to see Her Dear son Charles—but being deprived of that rich blessing at present—begs Him so to conduct that she may hope for it ere long—do you search the Scriptures and keep the Sabbath holy unto the Lord—and all the sacred Commandments of God—it is my ardent desire…He would protect, support and provide for your soul and body and believe me your affectionate friend and Mother. R Larned.

Charles Larned letter - April 3, 1813

Letter Transcription: Pittsfield, April 8, 1813 I think that by this time my dear Charles you will allow I have some reason to give you a gentle reprimand for breach of duty—but I will not censure you upon suspicion maybe you have substantial reasons—at any rate one cannot very graciously reproach the other for negligence I for one am healthy as ham & that we have so seldom exchanged letters during your absence & on my honor promise to be a better girl in future—but the truth is my Dear Charles I am secretary for the Family—Mama you know never writes & James but seldom & they are all dispersed in different directions, consequently I have many calls upon my time—this to be sure is a pleasant duty & I urge it only as a slight palliation for my remissness if you should consider it as such—now I have finished my preface—I will try to be more interesting & doubtless I succeed. Our dear Father we hope & trust is now in Green Bush, where he will probably remain a month perhaps & from thence he expects to go to Sacket’s harbor—at which place you know our troops are fast collecting-- We shall hope to see him either here or there before he goes. Brother George I believe is [still] at Plattsburgh but expects soon to be removed to some other military part perhaps with Papa (I hope so at least). We have just got letters from Brothers Sylvester & Joseph at Middlebury—they are in good health. Mama has for some weeks been afflicted with an inflammation in her eyes but seems now to be convalescing. Sister Martha has been somewhat unwell for a few weeks but is now tolerably recovered. James & myself are both in our usual good health & at this time seated by the same stand, one reading, the other writing. Thus my Dear Charles have I given you an abstract history of our Family—but here indeed is a wonderful omission; not a word about Miss Harriet Hunt, who in truth ought to have been noted first but the last she’s not the least in my memory. She is much grown since you saw her, but does not speak as fluently as we could wish—a few word she can say. Probably before this you have been informed of the great loss your friend Sherrill has sustained in the death of his mother—also of the revolution that has taken place in Hackbridge as it respects the religion & morality of the place that more than one hundred on the plain have become religious converts & c—indeed I am at a loss what to say that will afford your pleasure—a narrative at this time must be gloomy indeed. The distressing situation of our country at this time would make almost any recital melancholy. The prevailing epidemic has swept off many of your acquaintance no doubt. Mrs. Dewey of Williamstown, the sister of Mrs. Danforth, has left a Husband, Children & many Friends sincerely to lament her loss—some few have died in our village, but we have escaped astonishingly –it has raged in every town about us--If we are unwilling to acknowledge a God in his mercies. I fear she shall be compelled to do it in the awfulness of his judgments.--------I am much [pleased] with our new neighbors the Parsons Wife & a Miss Woodward her cousin is a fine girl, I think, Mrs. Allen has not a handsome face but something in her manner that interests one her person I think the handsomest I ever saw & the Parson seems well pleased with his selection—Mrs. Ripley is with them this winter & will probably remain thro the summer—Her husband at [Sackett’s Harbor] little or no alteration is apparent since her marriage—she seems as gay & fond of company as ever.-------Mrs. [McKnight] it is expected will commence housekeeping in about three weeks in the house formerly occupied by Mr…. [Report] says that Mr. Goodman & Clarissa Weller are soon to be married & many other things that I must omit to mention for Mama wants a… PS reserved--now my Dear Charles remember you are considerably… & I am confident you have as much leisure as I have –… be ceremonious but write whenever I find time not & I beg… the same – I tell James I shall not send his love for he must write himself. I shall anxiously expect you to write & do not disappoint your affectionate, sister--H One word my Dear Charles from your affectionate Mother who longs to see Her Dear son Charles—but being deprived of that rich blessing at present— begs Him so to conduct that she may hope for it ere long—do you search the Scriptures and keep the Sabbath holy unto the Lord—and all the sacred Commandments of God—it is my ardent desire…He would protect, support and provide for your soul and body and believe me your affectionate friend and Mother. R Larned.

La signification des rites associés au décès de la personne soignée, pour des infirmières œuvrant en milieu hospitalier

Le phénomène de la mort a été et sera toujours présent au sein des sociétés. Bien que la mort soit une étape triste et pénible à vivre, elle n’en demeure pas moins un événement inévitable et bien réel. Cependant, il existe des moyens, comme la pratique des rites, permettant d’atténuer la souffrance causée par un décès. Malgré tout, il n’est pas rare de constater l’absence ou le peu de temps consacré aux rites lors d’un décès en milieu hospitalier (O’Gorman, 1998; Lemieux, 1991; Leonetti, 2004; Hamonet, 1992; Piquet, 1999; Hanus, 1999; Vachon, 2007; Hasendhal, 1998). Les raisons susceptibles d’être à l’origine de cette situation peuvent découler du fait que les progrès de la médecine et des technologies amènent à croire que l’être humain est invulnérable face à la mort et que celle-ci représente un échec vis-à-vis la maladie. Le manque de formation des soignants par rapport à la mort (Leonetti, 2004; Goopy, 2005; Blum, 2006) est aussi à considérer. Finalement, la tendance de certaines sociétés occidentales qui occultent et nient la mort (O’Gorman, 1998; Piquet, 1999; Matzo et al., 2001; MSSS, 2004; Leonetti, 2004; SFAP, 2005; Goopy, 2005) constitue une autre possibilité. Pourtant, offrir la possibilité aux familles de réaliser leurs rites en signe d’amour pour le défunt fait partie de la composante du soin spirituel lequel, est intégré dans les soins infirmiers. À notre connaissance, peu d’études ont exploré les rites dans un contexte de décès en milieu hospitalier, d’où la pertinence de s’y attarder. Ainsi, le but de la recherche consistait à décrire et à comprendre la signification des rites associés au décès de la personne soignée, pour des infirmières œuvrant en milieu hospitalier. Pour ce faire, l’étudiante-chercheuse a réalisé auprès de neufs infirmières, une étude qualitative de type phénoménologique, ayant comme perspective disciplinaire, la philosophie du caring de Watson (1979, 1988, 2006, 2008). L’analyse des verbatim, réalisée selon la méthodologie de Giorgi (1997), a permis d’obtenir 28 sous-thèmes émergeant des six thèmes suivant soit : a) accompagnement empreint de caring; b) respect incontesté de la dignité humaine et du caractère sacré des rites; c) réconfort spirituel des personnes, des familles et du personnel; d) conciliation des croyances culturelles et religieuses; e) mort comme phénomène existentiel; f) barrières face aux rites. Par la suite, a émergé de ces thèmes, l’essence de la signification des rites associés au décès de la personne soignée, pour des infirmières œuvrant en milieu hospitalier. L’essence correspond à : un hommage essentiel envers le défunt et sa famille, en dépit des nombreuses barrières qui freinent sa pratique. Plusieurs thèmes et sous-thèmes corroborent les résultats de quelques études et les propos théoriques de différents auteurs. Toutefois, le caractère inédit de quelques unes de nos conclusions révèle la nature novatrice de la présente recherche. Par conséquent, les résultats de cette étude peuvent sensibiliser les infirmières à comprendre les rites en milieu hospitalier et offrir des pistes d’interventions pouvant contribuer au renouvellement des pratiques de soins offerts en fin de vie. Enfin, accompagner les familles dans leur pratique des rites concourt certainement à promouvoir l’humanisation des soins.

Figures de l'esprit : le soi et l'autre dans l'écriture de la séduction

Cette thèse pense la place des figures littéraires (le Cantique des cantiques, Kierkegaard, Hofmannsthal) et cinématographiques (Matador d'Almodóvar) de la séduction dans la relation entre le soi et l'autre. Elle interroge le rapport au sacré et à la transcendance que pose l'écriture de la séduction. Dans le premier chapitre, les frontières établies entre littérature et philosophie (personnage conceptuel, figure esthétique) sont interrogées à travers les figures de la séduction. À ces figures sont associées les figures de matadors, qui permettent de penser la violence extrême de la séduction et l'instant au cours duquel la conscience ne peut plus se dédoubler. Le deuxième chapitre est une réflexion, à partir des figures du maître et de l'esclave, sur le désir et la conscience de soi et de l'autre dans la séduction. Les figures tauromachiques exposent le sacrifice à l'œuvre dans la séduction. Le dialogue est ici pensé au sein de la séduction, pour saisir la place de celle-ci dans la formation de la pensée. Le troisième chapitre développe le rapport entre le soi, l'autre et le monde qu'établit la séduction. Le dandysme permet d'approcher la tension entre la matière et l'esprit que posent la séduction et son écriture. Le dialogue à l'œuvre dans la séduction est présenté comme un espace de formation. La séduction est envisagée comme séduction éthique, quête de la bonne distance, exercice spirituel. La syncope, le duende, l'extase sont décrits comme des états de conscience où la distance entre le soi et le monde, le soi et l'autre, l'esprit et la matière s'abolit. À partir de ces états, l'ouverture vers l'infini et vers la transcendance que peut poser la séduction est exposée. Dans le quatrième chapitre, la séduction est pensée comme le parfum du sacré, à travers une lecture du Cantique des cantiques. Par la séduction, l'importance du corps dans le sacré est soulignée. La place du secret et de la foi dans la séduction, dans le sacré et dans le littéraire est étudiée. La séduction permet une plongée érotique dans le monde et dans le réel, par les figures et par les images qu'elle déploie. Le savoir de la séduction est un parcours, savoir du corps et de l'esprit.

Hubert Aquin et la Gnose

Reprendre contact avec les réalités de l’âme, rouvrir la source où l’être rejaillit éternellement : tel est l’idéal occulte, inavouable, d’où procède la poétique d’Hubert Aquin. Depuis sa jeunesse, Aquin s’emploie clandestinement à défaire les mailles de la conscience et à rebrousser chemin vers les arrière-plans ténébreux du Moi, vers le Plérôme de la vie nue. Il manœuvre pour se mettre au service de l’intentionnalité impersonnelle inscrite au plus profond de sa psyché, pour devenir l’instrument du vouloir aveugle « qui opère en lui comme une force d’inertie ». Son œuvre ne s’accomplit pas dans le texte, mais à rebours du texte, voire à rebours du langage ; elle se déploie sur le terrain d’une confrontation enivrée avec le Négatif — avec la Parole sacrée issue de l’abîme. En d’autres termes, elle prend la forme d’une Gnose, c’est-à-dire d’un exercice de dé-subjectivation, de destruction de soi, consistant à réaliser la connaissance participative de l’empreinte imaginale scellée derrière les barreaux de la finitude. Essentiellement consacrée à l’analyse de la dimension gnostique de l’œuvre d’Hubert Aquin, cette thèse vise à montrer que la connaissance du hiéroglyphe mystérieux gravé au fond de l’âme n’est pas une sinécure. Il s’agit plutôt d’un opus contra naturam qui comporte bien des risques (en tout premier lieu celui d’une inflation psychique). Pourtant, ce travail est aussi, aux yeux de l’auteur, le seul véritablement digne d’être accompli, celui qui donne à l’homme le moyen de se soustraire à l’engloutissement de la mort et la possibilité de renaître. Comme l’écrit Aquin dans un texte de jeunesse, l’ouverture inconditionnelle au Négatif (la destruction de soi) est « une façon privilégiée d’expérimenter la vie et un préalable à toute entreprise artistique » ; elle correspond à « un mode supérieur de connaissance », à un savoir « impersonnel » qui offre immédiatement le salut.