title: Impermanence and Sense of Coherence: Lessons Learned From the Adaptive Behaviors of Sri Lankan Buddhist Nuns With a Chronic Illness.
abstract: OBJECTIVE
  The purpose of this study was to explore the influence of traditional Buddhist spiritual beliefs and practices on coping with chronic illness.
  
  
  METHODS
  The study was a descriptive ethnography. Participant observation and semistructured interviews were used with 45 Sri Lankan Buddhist nuns with a chronic illness and 20 secondary informants. Cultural domains and taxonomies were explored to uncover themes pertaining to traditional Buddhist spirituality and experiences of chronic illness.
  
  
  RESULTS
  A repeating cultural theme, responsibility, was identified. Responsibility took four forms: to the Buddha, to the social circle, to self-liberation through meditation, and to finding security in old age. Nuns shaped spiritual practices (some with folk origins) to fulfill these responsibilities. Coping ranged from health-seeking to resigned acceptance.
  
  
  CONCLUSIONS
  Responsibilities and coping were situated in a context of Buddhist spiritual beliefs about impermanence. Findings were congruent with Antonovsky's model of salutogenesis, in particular, the construct of sense of coherence.
authors.affiliation: University of New Mexico, Albuquerque, NM, USA sunnywijesinghe@hotmail.com.
authors.forename: Sunny
authors.initials: S
authors.lastname: Wijesinghe
authors.affiliation: University of New Mexico, Albuquerque, NM, USA.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Parshall
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002016:Buddhism; D002908:Chronic Disease / Q000208:ethnology / Q000451:nursing / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D019122:Meditation; D008875:Middle Aged; D064866:Mindfulness; D012068:Religion and Medicine; D012941:Social Responsibility; D029181:Spirituality; D013188:Sri Lanka; D016746:Transcultural Nursing
keywords: Buddhist spiritual practice; chronic illness; coping; transcultural health