The wonder of meaning : a phenomenological understanding of spiritual distress

The purpose of this study was to describe the phenomenon of spiritual distress as it is experienced by adults in the general population. This study focused on the key aspect of spiritual distress-concern about the meaning of life, death, and/or beliefs. Using phenomenological interview procedures, ten participants were asked to describe experiences of being concerned about the meaning of life, death, and/or their beliefs. All participants considered their beliefs to be very important, evaluated their health as good, and named a religious affiliation with which they identified. A hermeneutical approach was used for data analysis. Data were analyzed within the dialogic process of a phenomenological research group in addition to the researcher's individual work. The thematic structure derived from the data describes the experiential themes of spiritual distress and their inter-relationships. Participant narratives were grounded in the context of time. The thematic structure of the experience of spiritual distress was biphasic. The metaphor of the Web of Life, taken from the words of one participant, was used to describe both phases. Phase one was termed Breaking the Web, and occurred when an event broke the continuity of life. The three major themes and subthemes of this phase were: (1) Falling Apart (Pain, Instability), (2) Wondering (Questioning), and (3) Something Beyond (Feeling, Presence, Mystery). The second phase, during which participants found meaning in their experiences, was termed Rebuilding the Web. The four major themes and subthemes of this phase were: (1) Stability (Strength, Security), (2) Change and Growth (Self, Beliefs), (3) Wondering (No Answers, Accepting Limits to Knowing), and (4) Something Beyond, Findings were discussed in relation to nursing practice, education, and research. Implications of this research for the nursing diagnosis Spiritual Distress were addressed and suggestions were made for future research on spiritual distress.