Nursing ETDs

Publication Date



This study focused on the role of Buddhist spiritual practice in the lives and health of Sri Lankan Buddhist nuns with a chronic illness. The concept of spirituality has emerged recurrently in research as a means to cope with chronic illness. The question as to whether Buddhism, as observed in traditionally Buddhist countries, influences coping in chronic illness, has received little attention. Buddhism covers several sects and even within the same sect practices vary depending on each socio-cultural environment. Any attempt to study Buddhism's role in chronic illness requires isolating not only a sect, but also a country in which it is practiced. A focus on Sri Lankan Buddhism is important because it is generally believed that the oldest form of Theravada Buddhism remains preserved in Sri Lanka. The choice of the Buddhist nun serves the pragmatic purpose of allowing a female researcher access to conduct interviews in privacy. In order to ground the findings in the data, this descriptive ethnography followed the iterative, and recursive linguistic approach of Spradley (1979, 1980). The 45 primary participants, Sri Lankan Buddhist nuns with a chronic illness were selected through a snow-ball sampling strategy. Twenty secondary informants were identified to shed light on the topic from health-care, lay-Buddhist, and Buddhist-scholar perspective. Participant observation and semistructured interviews were used to explore cultural domains, to clarify each domain with taxonomies, and finally to uncover cultural themes. The repeating cultural theme was identified as responsibility, which took four forms: responsibility to the Buddha, to others (social circle), to self-liberate oneself through meditation, and to find security in old age. Nuns shaped their Buddhist spiritual practices to suit their sense of these responsibilities. The role of spiritual practice in their health was mediated by the strength of their resolve to fulfill their responsibility and resources, against a backdrop of the Buddhist phenomenon of impermanence. Their coping styles ranged from health-seeking to resigned acceptance. Incorporating the viewpoints of primary and secondary informants indicated these behaviors resembled constructs of the theory of Salutogenesis (Antonovsky 1979). Implications for nursing research, education, practice, and policy are discussed.

Degree Name


Level of Degree


Department Name

College of Nursing

First Committee Member (Chair)

Jennifer, Averill

Second Committee Member

Judy, Liesveld

Third Committee Member

Piyadasa, Kodituwakk


Buddhist spiritual practice, Coping, Chronic Illness, Buddhist nuns, Sri Lanka



Document Type