2024-03-29T10:54:44Z
https://ijwpc.mcgill.ca/oai
oai:ojs.iwpc.mcgill.ca:article/2
2017-09-27T18:40:35Z
IWPC:ES
driver
"140704 2014 eng "
2291-918X
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Humanizing clinical dentistry through a person-centred model
Apelian, Nareg
McGill University
Vergnes, Jean-Noel
CHU de Toulouse, Service d’Odontologie / UFR d’Odontologie de Toulouse
Bedos, Christophe
Division of Oral Health and Society, Faculty of Dentistry, McGill University
Ecole de Sante Publique, Universite de Montreal
The clinical approach in dentistry stems from a biomedical model of health that is anchored in positivism. This biomedical model was never explicitly developed or reflected on, but rather implicitly acquired as a product of historical circumstance. A reductionist understanding of health served dentistry well in the past, when health afflictions were mostly acute. Today, however, in the age of chronic illnesses, the current clinical approach is no longer adequate: patients and dentists are both dissatisfied, and there are problems with dental education and dental public health.
After a thorough review of the literature, highlighting the current state of the profession, we propose an alternative clinical model upon which updated approaches can be based. We call this model "Person-Centred Dentistry". Our proposed model is rooted on the notion of sharing of power between the dentist and the patient: a sharing of power in the relationship and epistemology. This leads to an expanded understanding of the person and the illness; a co-authoring of treatment plans; and interventions that focus not only on eliminating disease but also on patient needs.
McGill University Library & Archives
2014-08-19 16:00:30
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/2
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/5
2017-09-27T18:40:35Z
IWPC:TP
driver
"140702 2014 eng "
2291-918X
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Narrative and Palliative Care Team Identity Formation
Hess, Denise
Providence Little Company of Mary Medical Center-Torrance, California, USA
Palliative care is whole person care that attends to the physical, psychosocial, and spiritual needs of persons with a serious or life-limiting illness. This care is provided by a team of clinicians from several disciplines including physicians, nurses, social workers, and chaplains. The palliative care team functions as a dynamic system whose ability to provide quality care is dependent upon the ability of the team members to form and maintain an ongoing collaborative alliance. This alliance requires that team members maintain dual commitments to both the care receivers and to their fellow team members. Just as persons with illness express the human propensity toward meaning making in the face of suffering, so palliative care teams thrive when they are supported in reflective processes that enhance their ability to find meaning in their work. Creation of and attention to team narratives and their role in team identity formation can enhance team members’ flourishing by placing team identity in the context of a larger story. Narratives of rescuing and fixing foster a sense of control and expertise while narratives of containing and healing nurture attention to mindful presence and human-to-human encounter.
McGill University Library & Archives
2014-08-19 16:00:30
article
application/pdf
https://ijwpc.mcgill.ca/article/view/5
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/6
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
dc
Staying Present to Youth with an Unknown Future
Poitras, Susan
Canuck Place Children's Hospice, Vancouver, British Columbia, Canada
The intention of this workshop is to provide an opportunity to explore the various dimensions of clinical practice known to support and enhance coping in adolescents living with a life-threatening illness. The objectives are to: 1) Present recent research findings related to the future thinking activities of adolescents in pediatric palliative care; 2) Acknowledge that these findings stretch us as clinicians to “sit with” and \"create time for\" the youth’s exploration of future in the context of an anticipated shortened life; 3) Discuss several cases and provide experiential activities that can prepare the clinician in ‘being with’ and ‘staying present’ to youth who are exploring their future that remains unknown by virtue of the trajectory of illness.
The workshop will be broken down into three parts. In the first 30 minutes the findings from a doctoral study aimed at examining the future thinking of adolescents living with a progressive life-threatening neurodegenerative illness will be presented and discussed. Secondly, consideration will be given to how clinicians can mindfully prepare themselves for supporting adolescents and to consider aspects of the clinical self in our work with this population and finally, through both storytelling and the facilitation of active experiential activities, the presenters will share stories and ideas that have been integrated into existing practices.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/6
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/7
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Understanding Patient Perspectives of Self-Care in the Management of Chronic Disease
Burgess, Jean
University of New Brunswick
Clark, Roberta
University of New Brunswick
De'Bell, Kieth
St. Francis Xavier University
This workshop will provide participants with an understanding of how appreciative inquiry based methods can help us learn from patient experience, develop self-care plans and identify the roles of various support groups within those plans, and develop a framework for chronic disease management which is based on lessons learnt from patient experience.
Understanding patient experience with and perspectives on what supports on-going self care to manage chronic disease is critical to a whole person approach to chronic disease care. While the individual’s experience of chronic disease self-management may vary from individual to individual, our recent work demonstrates that appreciative enquiry is an effective tool for understanding the key support structures for effective management of self-care. This work also points to appreciative inquiry as an effective tool for patients and care-givers in developing approaches to individual self-care plans.
After a brief presentation of our recent findings, workshop participants will have an opportunity to use a modified appreciative inquiry approach to consider aspects of chronic disease care and particularly to discuss those factors that support chronic disease management. Appreciative Inquiry, as a positive form of narrative inquiry will elicit stories that make these supportive factors more concretely visible and comprehensible. Workshop participants will also be provided with a brief overview of thematic analysis as a way of identifying common themes in the appreciative inquiry data and developing a model of self-care support.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/7
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/8
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
dc
Transforming Challenging Patients into Interesting People - Creative Writing as Burnout Prevention for Health Professionals
Koppe, Hilton
North Coast GP Training, Lennox Head
And now for something completely different….. As health practitioners, we are involved in writing “stories” every day. The patient record is our interpretation of our patients’ stories (History) and a summary of our response to this (Examination and Management Plan).
This record does not allow for much creativity on the part of the writer, and is very limited in its ability to assist the health practitioner in making sense of what has gone on for them at a personal level. To assist in remedying this problem, this workshop will use creative writing as a tool to assist in burnout prevention.
The workshop will allow participants an opportunity to experience the use of stories and creative writing as a means of helping them to better manage some of the more challenging aspects of their working life, and to better make sense of what it means to be a health practitioner.
Practical writing exercises across a range of styles will assist participants in reflecting on the effect their clinical practice has on their lives with the goal of increasing their enjoyment of work, and of life in general. These simple writing exercises will magically transform challenging patients into interesting people. No previous writing experience is required. Most of all, it will be an opportunity for some light hearted fun with colleagues.
Learning Objectives: By the end of the workshop, participants will have had the opportunity to
1. Learn knew skills in creative writing
2. Reflect on what it means to be a health practitioner through the use of structured writing exercises
3. Develop skills in using reflective writing as a way of personal debriefing about experiences at work
4. Reignite previously lost passions for creativity
5. Marvel at the brilliance of their colleagues
6. Share some of their creative brilliance with colleagues, if they choose to.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/8
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/9
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
dc
Doing 'Technological' Time in a Pediatric Hemodialysis Unit
Zitzelsberger, Hilde
University of Ontario Institute of Technology
McKeever, Patricia
Chambon, Adrienne
Morgan, Kathryn
Spalding, Karen
Study objectives: For Canadian children living with end-stage renal disease, hemodialysis is a common intervention and usually received in a specialized ambulatory hospital-based unit. Although children spend up to 12 hours a week receiving hemodialysis, little is known about how they perceive and respond to hospital-based hemodialysis. The study’s purpose is to describe and interpret the children’s embodied situatedness in the temporal, spatial and technological regimes and relations of a pediatric hospital-based hemodialysis unit.
Methods: An ethnography was undertaken at a Canadian urban pediatric hospital. Time, space, and technology are viewed as significant interrelated aspects of the hemodialysis unit and the unit is conceived as nested in the broader contexts of the children’s everyday lives. The theoretical framework merges concepts of human embodiment and contemporary human geographical perspectives and philosophy of technology.
Results: The dominant theme emerging from the study findings is the notion of the children doing ‘technological’ time. The pervasiveness and reach of hemodialysis technologies upon the children profoundly textures their situations, shapes their perspectives, evaluations and expectations and impacts how they are seen by caregivers in the unit.
Conclusions: Crucial changes in practices are essential to envision ways to create with children an overall positive place that merges and balances technological care with child focused care. The inclusion of children’s views is critical because many settings typically occupied by children have been designed and designated by authoritative or professional adults as “places for children” (Rasmussen, 2004, p. 155) without children being involved. Exploration of the findings may contribute to the ways that healthcare providers, funders, administrators and policy-makers can facilitate the inclusion of children in the design and care provision of hemodialysis units as well as other high-tech hospital-based units.
References
Rasmussen, K. (2004). Places for children – children’s places. Childhood, 11(2), 155-173.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/9
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/11
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
dc
The Expectations of Low and High Risk Pregnant Women Who Seeking Obstetrical Care in a Highly Specialized Hospital
Behruzi, Roxana
McGill University
Hatem, Marie
Université de Montréal
Goulet, Lise
Université de Montréal
Fraser, William
Université de Montréal
Background: In the context of a highly specialized hospital, birth care might be is expected to be more medicalized and technocratic for both low and high risk pregnant women.
Objective: This study aimed to explore the expectation of low and high risk pregnant women who seeking an obstetrical care in a highly specialized hospital.
Methods: A single case study design was chosen for this study. The case under study was a tertiary and university affiliated hospital in Montreal, Canada. The data were collected through semi-structured interviews, field notes, participant observations and self-administered questionnaire. An inductive qualitative content analysis was used.
Results: As a whole 157 women were participated in the study. The analysis of data showed that both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, had the right to participate in the decision-making process and were surrounded by competent care providers and obstetric technology. The presence of an attentive care provider during labour who humanly cared for women and her family considered as essential component of birth care by women participant.
Conclusion: A birth care provider in a tertiary hospital setting should aim to meet both physiological and psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals, as well as the use of obstetric technology, could enhance the level of certainty and assurance in both high-risk and low risk women in a tertiary hospital.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/11
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/12
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Transforming the Intensive Care Culture Using the Palliative Approach
Guay, Diane
Université de Sherbrooke
Michaud, Cécile
Université de Sherbrooke
Mathieu, Luc
Université de Montréal
Pepin, Jacinthe
Université de Montréal
Introduction: Although the ultimate goal of the intensive care unit (ICU) is to save and prolong human life, the integration of palliative care approach in this fast-paced highly technologic environment is increasingly recognized as a means of restoring the global nature of care and enhances the integrity of the person. In this perspective, a recent study showed that three conditions promote the integration of palliative care in the ICU: sharing a common vision, a collaborative decision-making process and a proper environment.
Objective: In light of these findings, this study proposes to develop, implement and evaluate an intervention to integrate these previously identified conditions. The purpose of this communication is to present our approach and its main results.
Method: Based on the premise that research and action can coexist to improve practice, a qualitative inquiry of action research was chosen for this study. Valuing the consensual decision-making process, this research method provides an organizational structure allowing success and sustainability of this intervention.
Results: The intervention aims to improve the quality of interdisciplinary communication and consisted of two main components. The first propose to enhance the skills and leadership of nurses through interactive training and the second focused on the improvement of intra and inter disciplinary intervention plan.
Conclusions: The integration of the palliative care approach in the ICU is definitely an innovative strategy to transform the mission of the ICU caregivers and improve the care of the whole person.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/12
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/13
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
dc
Workshops in Healing for Senior Medical Students: A 5 Year Experience
Kearsley, John Henry
St. George Hospital, Sydney
University of NSW, Sydney
Lobb, Elizabeth
Calvary Healthcare Sydney
Cunningham Centre for Palliative Care, Darlinghurst
University of Notre Dame, Sydney
Objectives: To provide a 5-year (2008-2012) overview and appraisal of a novel course for senior undergraduate medical students (Workshops in Healing) at the University of New South Wales, Sydney, Australia within the context of a traditional 6-year curriculum. In these innovative workshops, 8-12 self-selected students per year participate over 6 hours in two sessions, several days apart. The sessions use artwork and other evocative images, poetry, music, statues and classic/contemporary literature to illustrate points of discussion relating to suffering, healing and the doctor-patient relationship.
Methods: A written open-ended reflection was requested from 48 students in the final year of their 6-year medical course within a few weeks of the second workshop. The study employed an emergent qualitative design. Open coding involved repeated reading of the sections of the student’s feedback and a line-by-line analysis of this data. Selective coding was then used to link data together and develop the themes.
Results: Students identified the following benefits from the workshops: 1) the opportunity to re-affirm their commitment to their chosen career path; 2) the value of listening to other students share their stories; 3) the importance of the timing of the Workshops to occur after exams; 4) the use of various mediums such as art, music and literature to present concepts of suffering and healing; and 5) the creation of a safe and confidential space.
Conclusions: Students reported that the workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of Medicine (healing) not covered in the traditional medical curriculum. For many students the workshops provided a broader understanding of the meaning of concepts such as suffering and healing, and helped them to rediscover a deeper meaning to Medicine, and their roles as healthcare professionals.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/13
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/14
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Challenging Conversations in Healthcare: Simulation-Based Interprofessional Learning
Rider, Elizabeth A.
Harvard Medical School;
Institute for Professionalism and Ethical Practice, Boston Children's Hospital http://www.ipepweb.org
Browning, David M
Department of Social Service, Massachusetts General Hospital Cancer Center;
Institute for Professionalism and Ethical Practice, Boston Children's Hospital
Bell, Sigall
Harvard Medical School;
Institute for Professionalism and Ethical Practice, Boston Children's Hospital
Lamiani, Giulia
Università degli Studi di Milano, Milan, Italy
Truog, Robert D
Harvard Medical School;
Division of Medical Ethics, Department of Global Health & Social Medicine, Harvard Medical School;
Institute for Professionalism and Ethical Practice, Boston Children's Hospital
Meyer, Elaine C
Harvard Medical School;
Institute for Professionalism and Ethical Practice, Boston Children's Hospital http://www.ipepweb.org
Introduction: Interprofessional education is central to the mission of the Institute for Professionalism and Ethical Practice, based at Boston Children's Hospital and affiliated with Harvard Medical School. The Institute’s Program to Enhance Relational and Communication Skills (PERCS) offers simulation-based interprofessional workshops designed to help trainees and practitioners engage in challenging healthcare conversations across situations such as critical care, primary care, parent presence during resuscitation, spiritual distress, adverse medical outcomes, informed consent, organ donation, and others.
Objective: To describe the pedagogy, recruitment statistics and sustained participant outcomes of the Program to Enhance Relational and Communication Skills (PERCS).
Methods: The pedagogical framework is based on creating safety for learning, emphasizing moral and relational aspects of care, suspending hierarchy to support interprofessional learning, honoring multiple perspectives, and valuing reflection and self-discovery. Programs bring together physicians, nurses, social workers, psychologists, chaplains and other healthcare professionals for a wide range of innovative educational offerings. Core learning occurs through live enactments of challenging conversations with professional actors portraying patients and family members, followed by guided debriefings that support individual and group reflection.
Results: Approximately 3000 local, national and international professionals have participated since the program’s inception in 2002. PERCS workshop participants have reported a greater sense of preparation, confidence, improved communication and relational skills, and decreased anxiety when holding challenging healthcare conversations immediately following training and up to 12 months later. Benefits of the training were not related to discipline, level of experience or previous educational opportunities.
Conclusions: Participants reported enhanced communication and relational skills. The program strives to develop relational competence in the healthcare world, including qualities of compassion, trust, and respect between clinicians and patients, and increased attention to interprofessional collaboration and knowledge sharing.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/14
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/15
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Caring for the Lived Experience: An Exercise in Teaching Whole Person Care
Ingram, Cory
Mayo Clinic
Common medical professions’ education for whole person care of seriously ill people and their family is often lacking. The balance of educational attention to the biology of disease often far outweighs similar attention to the lived experience of the illness and personal caring. In an attempt to test and teach the lived experience a written essay survey instrument has been created and administered to new palliative care staff and family medicine residents.
A summary of the participant’s responses to questions concerning ethical principles, dignity, health care desires, compassion, existential suffering, hope, grief, mindfulness, attunement, and end of life care will be shared in narrative fashion accompanied with teaching points used with participants. Third year family medicine residents’ reflections will be shared to reflect the impact of the teaching of whole person care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/15
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/16
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Person-Centered Care In Mental Health Education and Practice Through Arts-Informed Narrative Inquiry
Schwind, Jasna
Ryerson University
Lindsay, Gail
University of Ontario Institute of Technology
Coffey, Sue
University of Ontario Institute of Technology
Morrison, Debbie
Durham College, Oshawa
Mildon, Barb
Ontario Shores Centre for Mental Health Sciences
Objectives: We conceptualize person-centred care (PCC) as whole person care that is enacted through the relationship between caregivers and care-receivers. This understanding bridges education and practice, nursing students and nurses, and methodological approaches. The objective of our Associated Medical Services Phoenix Call to Caring funded research is to explore how students and nurses in mental health construct and enact person-centred care.
Methods: Our participants include students and nurses in mental health education and practice. We meet with them in integrated groups of nurses and students. Our research process engages participants in four arts-informed narrative inquiry sessions: stories of giving and receiving PCC, use of metaphors to access tacit knowing, collages and mandalas to explore embodied experience of PCC. Our research is multi-method through the addition of pre and post caring scales to document changes in participant attitudes and behaviours. A follow-up telephone call three months after the fourth session provides an evaluation of the significance of this exploration to PCC in their practice.
Results: Dimensions of enacting PCC are revealed including personal, regulatory, professional and institutional forces that shape students’ and nurses’ choice to be person-centred in their practice. Nurses and students increase self-awareness and critical thinking about the value and enactment of PCC in their practice, also shaping the healthcare environment. The significance of arts-informed narrative methods to illuminate knowledge construction is revealed.
Conclusions: PCC includes the practitioner and student as knowledge maker, in partnership with a patient and family. PCC involves choosing how to be in relationship as a whole person as well as conceptualizing patients as whole persons. PCC involves practitioner self-awareness and courage to advocate for personal integrity of patients and self-as-caregiver. Arts-informed narrative inquiry provides nurses (established and emergent) processes for continuing reflection and professional development.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/16
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/17
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Bringing Our Whole Person to Whole Person Care: Fostering Reflective Capacity with Interactive Reflective Writing in Health Professions Education
Armstrong, Grayson A
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Kofman, Aaron
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Sharpless, Joanna J
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Anthony, David
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Wald, Hedy S
Warren Alpert Medical School of Brown University, Providence, Rhode Island
Reflective learning and practice foster personal, professional, and interprofessional identity development within health professions education to encourage humanistic, competent patient care. Reflection on experience nurtures mindful presence and adaptive expertise/”practical wisdom,” enabling the health care professional to recognize and address patients’ and families’ emotional, psychosocial, cultural, and spiritual needs for optimizing whole person care (WPC). By heightening awareness of strengths, values, biases, and/or limitations, reflection also helps the provider bring more of his/her “whole person” to WPC, strengthening the provider-patient therapeutic relationship (reciprocity for healing). The use of reflective writing (RW) to augment reflective practice is well documented. RW in the small group setting fosters narrative competence (hearing/responding to a patient’s story, awareness of one’s own stories), self-assessment, moral sensitivity, empathy, emotional processing, and provider well-being. At Alpert Med, we have implemented an “interactive reflective writing” (IRW) paradigm of guided individualized feedback from interdisciplinary faculty to students’ RW in a Doctoring course and Family Medicine clerkship (with small group peer-based narrative sharing and collaborative feedback). Frameworks for enhancing educational value of feedback (BEGAN and REFLECT-reflective level evaluation rubric) were developed, incorporated into student and faculty guides, and applied in faculty development.
INTERACTIVE WORKSHOP OBJECTIVES: 1) Participants will be familiarized with constructs of reflective learning/practice and IRW, 2) Participants will apply BEGAN and REFLECT to a student’s reflective essay as exemplar, 3) Participants will engage in interactive dialogue with medical student presenters on positive learning outcomes of IRW for WPC 4) Participants will consider and share merits, limitations, and possible utility of presented curricula/evaluative tools for their settings.
FORMAT/ACTIVITIES:
1. Didactic - Reflective Learning/Practice for WPC
2. Participants provide feedback to student’s RW
3. Discussion
4. Introduce BEGAN/REFLECT frameworks
5. Participants re-craft feedback with frameworks/Discuss
6. Student/faculty presenters share experiences of IRW pedagogy for fostering reflection and WPC
7. Wrap-up/Q and A.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/17
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/18
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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Group Art Therapy Program for Women Living with Breast Cancer
Laux, Katherine
Cedars CanSupport, Montréal
Lee, Virginia
McGill University Health Centre Cancer Care Mission
Meterissian, Sarkis
Cedars Breast Clinic, McGill University Health Centre
Gorman, Gwynneth
Cedars CanSupport, Montréal
Wexler, Sharon
Cedars CanSupport, Montréal
Background/Objective: A 9-week group art therapy program for women living with breast cancer is a new initiative to bring comprehensive cancer care to oncology patients and caregivers at our host institution, a major university health center. The development of this program was supported by a mixed-methods research study which explored the impact of art therapy on the psychosocial needs of women in treatment for breast cancer. Over 60 women were recruited for this study (control and intervention groups). The art therapy program offers tangible meaning-making opportunities through art-making in a therapeutic frame. Participants incorporated their artworks in group discussions and individual reflections of how they benefited from art-making.
Methods: Sources of data include the artwork and group discussions, an upcoming exhibit, narrative-based interviews, and quantitative questionnaires. The data will be analyzed qualitatively to elicit the major themes that the participants addressed in their art-making and group experiences, and in their narratives about their journey with cancer as a whole.
Results: The program’s 9 weekly topics will be presented and the qualitative results will be discussed. The topics include addressing a changing mind/body, processing challenging emotions / thoughts / relationships, highlighting one’s strengths and capabilities, building talismans and amulets (protection), and increasing one’s self-awareness of the realities of living with cancer. Some of the major themes from a preliminary data analysis include the development of one’s personal artistic language/symbolism; a place just for me; discovering and building connections; at a crossroads; and transformations.
Conclusion: This study highlights the importance and benefit of complementary therapies such as art therapy. We propose that creative arts therapies should be considered as an important contributor to the provision of whole person care in oncology clinics and wellness centres. The implications of group art therapy will be discussed in light of its feasibility in routine cancer care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/18
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/19
2017-09-27T18:40:32Z
IWPC:CON
"140117 2014 eng "
2291-918X
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When One is Sick and Two Need Help: Caring for the Caregiver
Law, Susan
St Mary's Hospital
McGill University
Objectives: To increase public and professional understanding of caregiving experiences of people who care for adults with chronic physical illness; to promote the use of caregivers’ lived experiences in the education of healthcare professionals.
Methods: Part 1: 40 qualitative audio/video recorded interviews were conducted with adult caregivers in a maximum variation sample from across Canada. Data collection and analysis is via rigorous qualitative research. 25 topics or themes are identified reflective of the participants’ concerns, meanings and priorities.
Results including video, audio or text clips, and evidence-informed resources are published on www.healthexperiences.ca. The methods are adopted from the award-winning website (www.healthtalkonline.org) from Oxford University, UK.
Part 2: collaboration with healthcare professionals, educational experts, researchers and caregivers to design educational modules to be piloted in University setting for healthcare professional education.Results: Caregivers described their experiences with the healthcare system as part of their role. They provide advice to health care professionals about issues such as access to information and services, attitude and behaviours, the impact of caregiving on their own well-being , and reflections on their role. Participants emphasize the importance of recognition for their role as part of the care team for patients with chronic physical illnesses. Some described the need for the healthcare system to consider caregivers as an important component in the ‘a circle of care’ around the patient. If caregivers suffer physical or mental illness, burn-out or lack of resources, the support system for the patient falls away. Educational modules featuring video and audio clips of caregivers’ stories are powerful educational tools in developing healthcare professional sensitivity to these issues in patient care.
Conclusion: The www.healthexperiences.ca / www.experiencessante.ca sites are unique in Canada in the field of patient experiences and healthcare communication. It is a great resource to educate health care professionals about the caregivers’ perspective on caring for adults with chronic physical illness.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/19
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/20
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Is the Whole Greater Than the Sum of Its Parts? Self-Rated Health and Transdisciplinarity
Picard, Martin
CMEM - Children’s Hospital of Philadelphia and UPenn
Juster, Robert-Paul
Department of Neurology and Neurosurgery, McGill University
Sabiston, Catherine M
Faculty of Kinesiology and Physical Education, University of Toronto
How individuals rate their general health – self-rated health, SRH – predicts future morbidity and mortality. Evidence shows that this prospective association hold true across age groups, patient populations and ethnicities, and is independent of existing illness or biomedical conditions. The reason why such subjective self-perception of one’s health (the whole) is a valid and powerful predictor of health outcomes, beyond traditional disease biomarkers and risk factors (the parts), has remained unclear. One possibility is that the experience of Health transcends the biological domain, and that psychological, social, behavioral and spiritual factors are integrated in unique ways among each individual/patient to shape “true” health. Each domain bears different relative importance for different individuals. Thus, self-rated health, by virtue that it arises from a completely non-leading and non-directed question, may capture an emergent holistic experience that best represents health, and which translates more directly than other focused assessments into healthspan and lifespan. By reviewing epidemiological, clinical and qualitative research findings about self-rated health, this presentation will adopt a transdisciplinary stance to explore new knowledge that can be derived from the study of self-rated health, as well as its limitations. We will also discuss a practical approach to “profile” self-rated health as a means to identify therapeutic windows and orient person-centered care. Integrating individuals’ self perceptions of health into healthcare practice should enhance patient satisfaction with care, strengthen the therapeutic alliance, and promote empowerment and sustainable care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/20
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/21
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Mind the Gaps
Kidd, Graeme
Howick House Surgery, Auckland, NZ
Eastern Bays Hospice, Auckland NZ
Totara Hospice, Auckland NZ
Objective: Reflection on 35 years in family medical practice - from home births to home deaths. My own wider understanding of "medical practise" through my personal growth.
THE GAPS
1) ISAAC NEWTON vs ALBERT EINSTEIN
Matter versus energy. Current medical practise is still largely perceived through a Newtonian mindset. In recent years the "repair shop" mentality has intensified as we find more sophisticated techniques for managing the ailing human body. We still practise in a reductive world where we believe that we can determine outcomes entirely by understanding the parts. Even a scant understanding of wave particle interactivity can help interpret a more holistic view of disease processes. Metastatic cancer is an enormous challenge and I believe outcomes are related to far more than the conventional invasive treatments.
2) LOUIS PASTEUR vs CLAUDE BERNARD
Germ theory versus milleu. The debate these two men initiated 170 years ago continues today - even though it is rumoured on his deathbed Louis was heard to say he thought Claude was right. We still practise medicine as if we are fighting an enemy and give scant regard to the milleu that we allow the "enemy" to inhabit. As the mystics and the scientists draw closer together through our quantum understanding, the milleu of our human system appears more complex and more connected to the world that we inhabit.
Although I practise conventional family medicine, I use metaphysics, metaphor and an interpretation of energy medicine to help patients understand their disease and enable them to use an holistic approach to intergrate both conventional and complimentary therapies. With increasing audit and protocol driven practise it seems that often humanity gets sidelined. HbA1c's become more important than the relationship the patient has with their disease.
Conclusion: The reintegration of humanity into the practise of medicine will help empower patients with insight that will not only enhance their quality of life but will also help save millions of dollars that currently is wasted within the victim / fix it model of medicine. I see the tide turning and this conference is evidence of a resurgence in a broader understanding of medicine through personhood.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/21
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/22
2017-09-27T18:40:32Z
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Creative Team Building with Staff Through Mandala Making
Goldman, Sondra
Donald Berman Maimonides Geriatric Centre
Objectives: Participants will learn how art therapists can achieve individual or group goals through the use of art materials and processes. They will also learn how organizational goals can be incorporated into relevant art making experiences. The presentation begins with a brief overview of art therapy and the history of mandala making in community building. We will then review the mandala-making staff workshops. The discussion will close with an exploration of how this process may be applied to other work environments.
Methods: These workshops were originally offered to our long-term care staff on eight different occasions during, "Planetree Month" in May of 2011, a month dedicated to staff self-care. The “Planetree Month” planning committee asked the art therapist to develop a team-building exercise that would be fun, creative and completed within 45 minutes. The committee also hoped that the workshop participants, who had little or no artistic experience or skill, would make a collective art work (within the time constraints,) that would be a source of pride for the participants and be good enough to be installed on the walls of the centre as a testament to the teamwork achieved.
Results: The goals of the workshop were accomplished through the careful design of this workshop. More than 200 staff members participated, embraced the process and completed eight mandalas which are now permanently displayed on the walls of Donald Berman Maimonides Geriatric Centre. Creativity can bring out the best in people, creating synergy and positive community growth.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/22
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/23
2017-09-27T18:40:32Z
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Whole Person Team Care
Komatsu, Glen
Providence TrinityCare Hospice, Torrance
Providence TrinityKids Care Hospice, Torrance
Hess, Denise
Providence Little Company of Mary Medical Center, Torrance
In the rapidly changing environment of 21st century healthcare, effective interdisciplinary team-based care is a key ingredient in providing whole person care across the continuum. Interdisciplinary teams face significant issues and challenges in providing whole person care given the boundaries that exist between various healthcare disciplines. Systemic institutional barriers and hierarchies commonly work against team communication, cooperation, and collaboration. These work environments contribute to work-related stress, staff turnover, inefficient, lower quality care, burnout, and compassion fatigue. Ultimately team environments that do not foster team member well-being are unlikely to find success in creating environments that foster whole person care. Given these realities, teams who hope to provide whole-person care need strategies for creating and sustaining a team environment of self-awareness, self-compassion, mindfulness and non-judgmental presence.
This session will present the outcomes of three innovative approaches to interdisciplinary care team flourishing through case study analysis of hospital-based palliative care teams, and adult/pediatric hospice teams. The first intervention illustrates a process for developing and implementing a team retreat experience. Combining elements of team building, experiential learning and discussion of assigned readings, palliative care and hospice teams exhibit increased team trust, respect and communication across discipline boundaries. The second intervention demonstrates positive meaning-making through the use of a “spiritual narrative.” Through sustained reflection on a guiding metaphor, “spiritual narratives” enhance team identity formation, function, and sustainability. The third intervention outlines a model for group mindfulness meditation. Through regular practice of mindfulness meditation as an integrated component of the work day, team members sought to increase their self-awareness, presence, attunement and compassion in clinical interactions. Attendees of this workshop will be inspired and equipped to with new ways to enrich interdisciplinary team flourishing while providing excellent whole person care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/23
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/24
2017-09-27T18:40:32Z
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Patients’ Stories of Interprofessional Whole-Person Care
Aksenchuk, Kateryna
Ryerson University, Toronto
University Health Network, Toronto
Schwind, Jasna K
Ryerson University, Toronto
Espin, Sherry
Ryerson University, Toronto
McCay, Beth
Ryerson University, Toronto
Gingras, Jacqui
Ryerson University, Toronto
Objectives: Interprofessional whole-person care has been depicted as being able to enhance patient health outcomes, increase health care provider satisfaction with care delivery, lower health care spending and decrease wait times for receiving care. Limited research has been conducted into exploring patients’ experiences of being recipients of this type of care. The objective of this oral presentation is to disseminate findings of a Master of Nursing study through patients’ stories of experience receiving care on aunit where inter professional care is practiced.
Methods: Three participants underwent a two step data collection process: a one hour semi-structured interview and a 30 minute symbolic image artistic exercise, as adapted from Schwind’s Narrative Reflective Process. Participants were invited to describe how they experienced receivingcare from an interprofessional team and whether or not they believed whole-person care was delivered to them. Collected data are being analyzed using Clandinin and Connelly’s Narrative Inquiry approach of three dimensionalspace, temporality, sociality and place.
Results: The emerging results suggest that participants express satisfaction with the care they received from the interprofessional team on their unit. Their stories indicate that strong interprofessional team-work can contribute to patient satisfaction in care received. For these teams to be successful, from the patients’ point of view, there needs to be: better communication between care providers, greater involvement of the patient in decision making, proper identification of who comprises the teams, andconsistency in team composition.
Conclusion: By acknowledging experiences and feelings ofpatients who have received care from an interprofessional team, there is potential to increase sustainability of these teams. The data generated through this study can potentially help health care providers, who are members of interprofessional teams, to deliver more effective, comprehensive whole-personcare within health care institutions.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/24
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/25
2017-09-27T18:40:32Z
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Restoring Core Values: An International Charter for Human Values in Healthcare
Rider, Elizabeth A.
Harvard Medical School
Boston, MA USA
Ho, Ming-Jung
National Taiwan University College of Medicine,
Taipei, Taiwan
Branch, Jr, William T
Emory University School of Medicine, Atlanta, GA USA
Slade, Diana
University of Technology Sydney, Sydney, New South Wales, Australia; and
Hong Kong Polytechnic University, Kowloon, Hong Kong
Kurtz, Suzanne
University of Calgary, Calgary, AB Canada; and
Washington State University, Pullman, WA USA
Pun Kwok Hung, Jack
Oxford University,
Oxford, UK; and
Hong Kong Polytechnic University, HK
Background: The human dimensions of healthcare are fundamental to the practice of compassionate, safe, and ethical relationship-centered care. Attending to the human dimensions improves patient and clinician satisfaction, outcomes and quality of care; however, these dimensions have not received the emphasis necessary to make them central to every healthcare encounter. We established an international collaborative effort to identify and promote the human dimensions of care.
Objectives: a) To describe work to date on the International Charter for Human Values in Healthcare; b) To discuss translation of the Charter’s universal values into education, research, and practice.
Methods: An international working group of expert educators, clinicians, linguists, and researchers identified initial values that should be present in every healthcare interaction. The working group and four additional groups -- National Academies of Practice (NAP) USA, International Conference on Communication in Healthcare, Interprofessional Patient-Centered Care Conference, American Academy on Communication in Healthcare Forum -- identified values for all healthcare interactions and prioritized top values. The NAP group also prioritized top values for interprofessional interactions. Additional data was gathered via a Delphi process and 2 focus groups of Harvard Macy Institute scholars and faculty.
Results: Through iterative content analyses and consensus, we identified 5 categories of core human values that should be present in every healthcare interaction: Capacity for Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare. Through further consensus and Delphi methodology, we identified values within each category.
Conclusions: The International Charter for Human Values in Healthcare [1] is a cooperative effort to restore core human values to healthcare around the world. Major healthcare and education partners have joined this international effort. We are working to develop methods to translate the Charter’s universal values into education (teaching, assessment, curricula), research and practice.
Reference
The International Charter for Human Values in Healthcare. http://charterforhealthcarevalues.org
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/25
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/26
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Enduring Witness - The Inner Journey of a Compassionate Doctor
Koppe, Hilton
North Coast GP Training, Lennox Head
“Enduring witness” is a 30 minute DVD produced in Australia. It traces the fictional relationship between a family practitioner (Geoff) and one of his female patients (Lisa) as she make the transition from adolescence to adulthood, through snippets from consultations about contraception, marriage, pregnancy and caring for her young children. Lisa then develops breast cancer, and we watch how Geoff manages breaking the news, assisting her with treatment, remission, relapse and palliative care. Issues relating to after care for Lisa’s family are covered at the end.
Some of Geoff’s “qualities” as a doctor (empathy, openness, patient-centredness) are the very same factors which put him at risk of burn out and compassion fatigue. The story is told primarily through the eyes of the doctor, and we gain access to some of his “hidden thoughts”.
The primary goal of the DVD is to promote discussion about preventing burnout and compassion fatigue which can occur from managing emotionally draining situations in clinical practice. There is further opportunity to explore issues such as breaking bad new, support for colleagues, boundary issues and surviving the ups and downs of working with people at the end of their lives.
The DVD will be shown at the start of the workshop. This will then be followed by a facilitated discussion between participants. Discussion will focus on both personal responses of participants to the DVD, and also on how as practitioners we can best deal with the emotional challenges that arise in clinical practice.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/26
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/27
2017-09-27T18:40:32Z
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Therapeutic Conversations with Seriously Ill People and Their Families
Ingram, Cory
Mayo Clinic
Wild, Ellen
Mayo Clinic Health System, Mankato
Seriously ill people and those they love encounter health care professionals regularly. Published studies, representing how seriously ill people prefer to be communicated with suggest they would like open, honest and thoughtful communication. Additionally, these studies emphasize that seriously ill people prefer to talk about their illness when they are ready. Medical professionals are often on the frontline of communication with these people. There is a paucity of education on communicating with seriously ill people in professional education spanning many health care professions.
Our workshop will empower participants in all capacities to better communicate with seriously ill people. We will teach not how to communicate information but rather how to have a therapeutic interaction that is consistent with what we know to be true about what seriously ill people value in their communication with their health care team.
We will use patient narratives both oral and video, role play and reflection to convey an easy to implement framework to therapeutic communication.
Session attendees will be able to
1. Understand foundational communication desires of seriously ill people and their families.
2. Describe a framework to approach difficult conversations with a therapeutic intention.
3. Implement practical approaches to enhance their communication with seriously ill patients and families they encounter daily.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/27
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/28
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Making Sense of Collaborative Practices: Practice as a Social and Scientific Phenomenon
Briggs, Marion
Northern Ontario Medical School, Sudbury, Ontario
Workshop Description (objectives, methods, results, conclusions): The concept of “practice” has received little attention in healthcare literature. This is an important oversight as practitioners tend to equate the dominant scientific discourse with practice. This covers over the social nature of individual and team-based practices. Social theorists argue that human nature is ‘helplessly’ social and interdependent. This failure to recognize the social construction of knowledge and knowing influences our ability to engage in collaborative practice and provide whole person care. We cannot see where “hidden practices” (the practice equivalent to 'hidden curriculum') influence what we can see and what remains hidden, what we can say and what we must keep silent about, or which actions are encouraged and which are constrained. We will explore the paradox of the co-existence of rational science and social constructionist views of knowledge and knowing and propose that practices are complex, responsive, processes of relating that are informed by, and in turn, challenge and further inform science. Using a mix of presentation, personal reflection, and case studies in small groups, this 90 minute workshop we will explore the social nature of practice, the theory/practice (science/experience) paradox, and consider how this “two-eyed” understanding could facilitate the provision of whole person care.
Specific Objectives: Participants will be able to:
1. Define collaborative practice
2. Elaborate and understand their own experience of collaborative practice
3. Differentiate between social and scientific paradigms and explain the differences and implications
4. Explain the concept and implications of the practices of particular communities and of first- and second-order breakdowns
5. Understand the nature of collaboration and distinguish it from included and related concepts of communication, coordination, cooperation, and co-location
6. Articulate personal definitions of and strategies for and identify personal commitments to collaborative practice related to whole person care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/28
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/29
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Who Am I? Exploring Our Professional Identities: A Workshop for Health Care Professionals
Sanderson, Christine
Calvary Health Care Syndey, Beverly Park, Sydney
Marr, Lisa
University of New Mexico Hospital, Albuquerque
Objectives:
1. Explore the history and meaning of each participant’s own professional identity
2. Reflect on how professional identity affects the ability to be present with the patient
3. Create a space to playfully explore benefits and burdens of the professional persona for caregivers and patients
4. Consider possible new ways of being present as professional caregivers which may be safe, authentic, and often joyful.
Background: Health care is highly professionalised. Health professionals are perceived as powerful and prestigious, with great responsibility for patients’ well-being. Social expectations of health professionals are extremely pervasive. Professionalisation involves learning and negotiating one’s role, and becoming comfortable in the professional persona. To offer whole person care requires the professional caregiver to be simply and authentically present with the patient. Yet the professional persona can be a barrier to presence, often using behaviours that are distancing, disease-focused, and impersonal. Over time, working as a professional can deeply affect our experience of ourselves.
Workshop process: This workshop offers an opportunity to explore the effects of professional identities on us as caregivers and as persons.Some topics that will be considered: How do we experience our professional identities? Benefits and burdens of the roles we have adopted? Do they sustain us or not? How do they help, and hinder, our ability to be present for patients? How do we want to proceed in future? Through interactive, creative exercises in a supportive environment, participants will investigate the professional identities they have crafted over time. Using meditation and writing exercises, participants will reflect on the self that offers whole person care to patients, and what is needed for this self to flourish. Participants will share insights and challenges to being present, as a professional, with patients.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/29
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/30
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The Health and Wellness of Future Physicians: Barriers to Change and Innovations in Undergraduate Medical Curricula
Wilson, Hamish
Dunedin School of Medicine, University of Otago, Dunedin
Objectives: 1) To build on existing theory about the health and wellbeing of medical students and physicians; 2) To explore barriers to educational and institutional change; 3) To identify current educational innovations that improve the resilience of students and future doctors.Methods: Current explanatory models and research findings have been augmented through interviews with key academics and educators in North America, Australia and UK, as well as through reviewing innovative curricular interventions related to health and wellness of students and physicians.Results: Medical students are at risk of anxiety, depression and burnout,(1) while doctors suffer a range of occupational health hazards that illustrate psychological vulnerability.(2) Many commentators have called for changes to undergraduate education to improve the general resilience of doctors.(3, 4) The long delay in addressing physician stress may relate to the tacit assumptions of biomedicine that act as guiding principles in clinical practice.(5) While helpful in increasing the efficacy of modern medicine, these assumptions act as barriers to more progressive curricula. A ‘whole person care’ paradigm of patients is becoming well theorised, but acknowledging the ‘whole person’ of the student and physician is still work-in-progress. Fortunately, recent initiatives in many countries illustrate substantial progress. Undergraduate programs now focus on self-awareness, interpersonal skills, work-life balance, whole person care, and career choice. Methods vary widely and include coaching on physical, mental, and emotional health. Mindfulness, mentoring and Balint groups are increasing. Reflective practice is a prominent feature in a revised approach to professionalism.Conclusions: There is increasing evidence that the self-care of physicians will impact on patient outcomes. (6, 7) We also have a moral responsibility as educators, faculty and senior clinicians to provide more humane learning and working environments for students and doctors. Innovative educational initiatives are finding ways to overcome significant historical and institutional barriers.References1. Jennings M. Medical student burnout: interdisciplinary exploration and analysis. J Med Humanities. 2009;30(4):253-69. 2. Linzer M, Gerrity M, Douglas JA, McMurray JE, Williams ES, Konrad TR. Physician stress: results from the physician worklife study. Stress Health. 2002;18(1):37-42. 3. Dunn L, Iglewicz A, Moutier C. A conceptual model of medical student well-being: promoting resilience and preventing burnout. Acad Psychiatry. 2008;32(1):44-53.4. Seritan A, Hunt J, Shy A, Rea M, Worley L. The state of medical student wellness: A call for culture change. Acad Psychiatry. 2012;36(1):7-10.5. McWhinney I. Changing models: The impact of Kuhn's theory on medicine. Fam Pract. 1984;1(1):3 -9.6. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294-300. 7. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. The Lancet. 2009;374(9702):1714-21.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/30
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/31
2017-09-27T18:40:32Z
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Compassion Training: The Missing Link in Healthcare Education?
Deleo, Kirsten
Spiritual Care Program, Berne, New York
Anderson, Angela
Hasbro Children's Hospital, Providence, Rhode Island
Brown University, Providence, Rhode Island
Cullerton-Sen, Crystal
Spiritual Care Program, Berne, New York
Compassion is an essential skill in whole person care. But, can it be cultivated through training?
Current research in neuroscience elucidates the mechanisms of empathy and compassion and provides a new framework for professional education. It suggests that clinical detachment is neither effective for ensuring good care, nor a realistic strategy to prevent burnout. Cultivating compassion on the other hand, increases non-judgmental awareness, builds resilience, and enables us to respond more effectively to others’ needs with greater empathy (Frickson, 2008, Klimecki, 2102, Lutz, 2004). Moreover, it is a skill we can learn (Wasner et al, 2005, Lutz 2009). Despite these findings, however, training in compassion is largely absent in current professional curricula.
Presenters will review current findings on compassion and its benefits, and demonstrate how we can train in it using examples from two unique compassion skills-training curricula: (1) a training for pediatric residents working in an inner-city hospital and (2) a certificate program in contemplative end-of-life care for hospice/palliative care workers.
These models are inspired by the contemplative tradition of Tibetan Buddhism, with its long-standing and effective methodologies for deepening the human capacity for compassion. This approach has formed the basis of many scientific studies on compassion and the emerging field of contemplative-based, secular training models (Lutz, 2009). Participants engage in contemplations on compassion as well as mindfulness and meditation. The aim is to support clinicians to generate self-compassion - the foundation for building resilience and extending compassionate care – thereby improving communication and the overall quality of care.
The workshop will introduce key principles, feature hands-on experience of selected methods, and include a discussion of the potential impact on the greater healthcare system.
A wider implementation of compassion training promises to be the missing link for building a fulfilling clinical practice and strengthening our capacity to provide effective whole-person care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/31
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/32
2017-09-27T18:40:33Z
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Sharing and Supporting the Hopes and Dreams of Students and Faculty in a Canadian BScN Program
Coffey, Sue
University of Ontario Institute of Technology, Oshawa
Zitzelsberger, Hilde
University of Ontario Institute of Technology, Oshawa
Cochrane, Marianne
Durham College, Oshawa, Ontario
Cummings, Katherine
Durham College, Oshawa, Ontario
Healthcare educators are in a unique position to support students’ personal and professional development. The UOIT-DC Nursing Program curriculum is founded on caring values that assert a commitment to the primacy of relationships. According to humanistic nursing, caring involves the interrelated concepts of ‘being’ and ‘doing’ in which both require an active presence and willingness to come to know another person (Paterson and Zderad, 1976). A deeply held tenet of nursing practice is the notion that when a nurse knows or understands a person, he or she will be better able to care for that person. We believe that this notion also pertains to student and faculty relationships in nursing education, ultimately leading to more effective and meaningful learning opportunities and experiences.
This poster will report on a qualitative study exploring undergraduate nursing students’ hopes and dreams when they begin their education and the ways these hopes and dreams may shift and evolve as they progress through the program. The intersections of students’ hopes and dreams for their education and faculty members’ hopes and dreams in teaching students will be presented. The impetus for the project arose from conversations among faculty members about the complex relational nature of nursing education and our hope to enhance relational awareness and practices through a deeper understanding of the aspirations and goals that students hold. Exploration of how the findings may contribute to deeper understandings of and responsiveness to students and the significance of nursing practice and education to them will be presented.
References
Paterson, J. G., and Zderad, L. T. (1976). Humanistic nursing. New York: John Wiley and Sons.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/32
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/33
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Electronic Health Record (EHR) Training in Undergraduate Medical Education: Theory-Informed Development of a Longitudinal Curriculum for Empowering Patient- and Relationship-Centered Care in the Computerized Setting
Sharpless, Joanna J
Warren Alpert Medical School of Brown University, Providence
George, Paul
Warren Alpert Medical School of Brown University, Providence
Reis, Shnuel P
Bar-Ilan University Faculty of Medicine in the Galilee, Safed, Israel
Warren Alpert Medical School of Brown University, Providence
Scott Taylor, Julie
Warren Alpert Medical School of Brown University, Providence
Wald, Hedy S
Warren Alpert Medical School of Brown University, Providence
Objectives: While electronic health record (EHR) use is becoming state-of-the-art, formal teaching of Health Care Information Technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT but formal pedagogy is sparse. Fundamental challenges include preserving and fostering effective health care provider-patient communication skills in the computerized setting to preserve patient and relationship-centered care and facilitate reciprocity within whole person care. Thus, curriculum innovation with overarching goal of empowering undergraduate medical students’ patient- and relationship-centered interviewing skills, information mastery, electronic documentation skills, and HCIT-supported patient education is needed.
Methods: The authors describe innovative, systematic curriculum development for EHR training within a series of clinical skills courses at their institution, informed by Kern et al.’s framework, narrative medicine, and reflective practice. Initially, a didactic and an observed standardized patient encounter were piloted in Year 3. Subsequent surveys of participating faculty both validated the session’s educational value and identified the need for additional practice opportunities.
Results: In addition to the existing presentation and individualized practice, second iteration revisions include reflective readings and exercises, relevant “introductory” skills presented in grid format, and opportunities for direct observation of and by mentor physicians in clinical settings. The behavior grid was then expanded to include “advanced” Year 4 skills, i.e. patient participation for chart building, patient education/information sharing, shared decision-making, and sending information to the interprofessional health care team.
Conclusions: Effective triangulation of physician-patient-computer may be optimized with medical education curriculum developing competencies of effective EHR use preserving patient-and relationship-centered care, reflection, and narrative medicine. Systematic, longitudinal monitoring of learners' skill development by faculty, standardized patient, self-assessment, and reflective writing will inform our innovative multi-faceted, longitudinal, transferable curriculum presented herein. Further research is needed on formal pedagogy for EHR use by learners.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/33
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/34
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Music Therapy in Whole Person Care at the End of Life
Salmon, Deborah
McGill University Health Centre
Whole Person Care aims to be deeply present to the person in the patient; acknowledging the integration of physical, psychosocial and spiritual facets of human experience, and creating a space in which healing, or a greater sense of wholeness, may occur. Music offers a potent tool in this endeavor. With its inherent capacity to engage body, mind and spirit, music can stimulate or calm, transport us to other times and places, reach our innermost emotions, and connect us to ourselves, our loved ones and our spirituality. In palliative care, music therapy joins with whole person care to meet patients and their loved ones as fully as possible.
Concepts central to whole person care will be presented and illustrated through the lens of clinical music therapy. For example, exploring how the skilful use of music addresses many dimensions of personhood will highlight Cassell’s concept of personhood. Demonstrating the ability of a significant melody to access and externalize personal meaning will integrate ideas from Frankl on meaning. Observing how relationship and creativity function as healing connections will draw from Mount, as will the idea of helping one move on a continuum from suffering to healing (Mount, Hutchinson, Kearney). The role of the health care professional as a ‘vulnerable-enough’ caregiver (Papadatou) or ‘wounded healer’ (Kearney) will also be touched upon. Throughout the presentation, poignant images, stories and video clips of patients engaging in music therapy at the end of life will serve to both enliven the didactic material and demonstrate how music therapy can create a space in which experiences of greater integrity may occur.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/34
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/35
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Using the Arts to Explore Whole Person Care
Silberberg, Peter
North Coast General Practice Training, Ballina, New South Wales
Koppe, Hilton
North Coast General Practice Training, Ballina, New South Wales
There has been an increase in the use of arts in Australian General Practice medical education in recent years. This workshop will aim to continue the Australian journey by exploring how the arts can teach about the whole person care. It will be facilitated by two medical educators experienced in these teaching techniques. Participants will be asked to contribute an example from the arts (film, writing, image, music etc) and be guided via skilled facilitation in how this could be used to explore whole person care. There will be discussion of how these pieces could be used in teaching and clinical practice. Potential benefits and pitfalls will be highlighted. At the conclusion, these resources will be collated for distribution and made freely available.
Learning objectives include: (i) how to use the arts in teaching whole person care, (ii) to discuss different methodologies and the pros and cons of each one (iii) to allow participants an opportunity to experiment and participate with different mediums (iv) to collate a list of different examples used from the workshop to distribute to the group.
Please note, if you attend this workshop you will need to bring a small contribution of art (film, writing, image, music etc) to share with the group. Electronic versions are welcome. It does not need to be original.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/35
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/36
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Facilitating Whole Person Care Using Video Reflexive Ethnography
Collier, Aileen
Flinders University, Adelaide, South Australia
Wyer, Mary
University Technology Sydney, Sydney, New South Wales
Carroll, Katherine
University Technology Sydney, Sydney, New South Wales
Hor, Suyin
University Technology Sydney, Sydney, New South Wales
Lenne, Brydan
University Technology Sydney, Sydney, New South Wales
Iedema, Rick
University Technology Sydney, Sydney, New South Wales
Aim: Explore the application and potential of video reflexive ethnography (VRE) to facilitate whole person care (WPC).
Objectives: Discuss the ethical issues associated with VRE; explore the foundations of the methodology; and discuss its potential to facilitate WPC.
Description: WPC requires a paradigm shift in how we see those we care for, how we see our co-workers and how we see ourselves. VRE involves videoing real-time everyday clinical practice and or patient and family accounts of care, and then involving participants to analyse the visual data that they feature in or have gathered themselves. Uniquely, video footage can challenge the taken for granted and attune people to dimensions of themselves and others that they might not otherwise have considered. This has the potential to open people up to alternative ways of thinking and perceiving, being and acting. It offers “transformative potential” towards WPC.
We draw from our diverse disciplinary perspectives to explore the potential of VRE as a tool to facilitate WPC. Using specific examples from five research studies, this workshop will demonstrate the use of VRE in a variety of health care contexts. The contexts of the studies we draw from include: end of life care; autism diagnostics; infection control, and intensive care.
The workshop proceeds in four parts. We first invite you, the participant, to engage in a video reflexive event, where you are expected to reflect on the socio-interactive conduct that you produce as a group in response to a specific task. We then describe the process of VRE, outline its pedagogic and theoretical foundations, and present some examples from our research. We then invite questions about the theoretical basis and practical approach of VRE. Finally, participants will be asked to project a version of reflexive video onto their 'home' area of research, and reason about potential outcomes.
1. Carroll, K., Iedema, R. and Kerridge, I. 2008, 'Reshaping ICU Ward Round Practices Using Video Reflexive Ethnography', Qualitative Health Research, vol. 18, no. 3, pp. 380-390.
2. Collier, A. 2012, 'Safe Healing Environments', in N. Godbold and M. Vaccarella (eds), Autonomous Responsible Alone: The Complexities of Patient Empowerment, Interdisciplinary Press, London, pp. 155-170.
3. Iedema, R. 2011, 'Creating Safety by Strengthening Clinicians' Capacity for Reflexivity ', British Medical Journal, vol. 20, pp. S83-S86.
4. Iedema, R. and Carroll, K. 2011, 'The 'clinalyst': Institutionalising reflexive space to realise safety and flexible systematisation in health care', Journal of Organisational Change Management vol. 4, no. 1, pp. 65-86.
5. Iedema, R., Long, D., Forsyth, D. and Lee, B.B. 2006, 'Visibilising Clinical Work: Video ethnography in the contemporary hospital', Health Sociology Review, vol. 15, pp. 156-168.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/36
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/37
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Exercise-Never Too Late: The Meaning of Exercise for Advanced Palliative Care Patients
Savage, Roslyn Joy
Calvary Health Care Sydney
Gibbons, Jill
Calvary Health Care Sydney, Glebe, New South Wales
Potter, Kathy
Calvary Health Care Sydney, Glebe, New South Wales
Objective: Increasing evidence supports the role of exercise for palliative care patients through maximizing physical function, improving fatigue and overall quality of life in the face of advancing disease. The objective of this study was to explore the meaning of exercise for these patients and their carers and to increase the understanding and value of exercise for this population.
Methods: An emergent qualitative study design was employed using semi structured interviews with patients attending a palliative care gym program and their carers. Thirteen patients and seven carers participated.Interviews were taped and transcribed verbatim and analyzed to identify common themes.
Results: Patients and carers identified improvement in strength, confidence and mood that enabled greater participation in life. Access to an open flexible program that allowed patients control of their exercise was important. Exercise contributed to promoting self identity and as a consequence provided a source of inner strength. Benefit was also felt from the shared positive experience in a safe environment. Carers used the session as a form of respite or opportunity for interaction.
Conclusions: Patients perceive exercise as important as it enables independence but it also provides significant psychosocial and spiritual support. Carers similarly identify the benefits beyond improved physical function. Exercise is a positive treatment regime that contributes to wholistic care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/37
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/38
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Exploring the Relational Aspects of Patient and Doctor Communication
Hovey, Richard
McGill University
Massfeller, Helen
University of Calgary
The alliance concept is an essential component of therapeutic relationships. Contrary to empirical evidence, its relevance is often not acknowledged in medical encounters. This circumstance invites the question, ‘‘How can the doctor and patient connect relationally with each other to improve the communication process and promote healing?’’ We propose that healing can be accomplished through dialog that emphasizes the collaborative nature of the partnership between the doctor and patient. The typical conversation in a medical encounter may be reduced to an information exchange and a medium for prescribing directives. This being-with approach can override patients’ involvement in the process. A positive doctor–patient relationship may be one of the most important, and most frequently overlooked, factors for predicting patient response to negative medical information. Receiving such news is potentially upsetting for the patient and may require the doctor to let go of the conversational medical agenda and adopt a being-for mode of relationship. We propose that this approach invites the doctor and patient to work together and negotiate how to manage the chronic illness eliciting patient-preferred treatment options. The authors propose the adoption of the being-for relationship as a way of enhancing the therapeutic potential of the doctor–patient relationship.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/38
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/39
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Creating Significant Life Rituals in Neuro-Palliative Care
McGeary, Lana Kim
McGill University Health Center
Ritual can be described as an act which helps make sense of life, “there is what many people recognize as a spiritual quality to life, which in suffering, confronts people with questions and possibilities that reach beyond the immediate dilemmas of physical insult.” (Cobb and Robshaw, 1998); in this vein, ritual serves as a vehicle to navigate the inherent moments of sorrow and suffering in our lives. Fred Bird describes ritual as something which allows for communication, representation, meaning making, validation and relationing. (Bird, 1995)
This presentation explores the ways in which creating accessible and significant contemporary rituals, within a hospital setting, may serve as a means to crystallize our deepest sensitivities for life, and living. It looks at some of the ways rituals can serve as a bridge to wholing and healing, within the patient, with family members and with health care professionals interacting with patient. Through examples from spiritual care counseling, within a multidisciplinary team setting, in neuro-palliative care, a path is set for some simple ways to ritually nurture quality of life issues, as part of a whole person care health protocol.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/39
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/40
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Promoting Resilience with the Mindfulness-Based Stress Reduction Program in Patients With Chronic Illness
Zhao, Qinyi
McGill Programs in Whole Person Care, McGill University
Bernardi, Nicolò
Department of Psychology, McGill University
Dobkin, Patricia
McGill Programs in Whole Person Care, McGill University
Objectives: Twenty-first century patients need to take a proactive stance with regard to their health in order to cope well with chronic illness. Mindfulness-Based Stress Reduction (MBSR) is an 8-week structured group program that encourages patients to take responsibility for their health and teaches them to cope with stressors inherent in living with illness.
Methods: Patients with chronic illnesses (e.g., breast cancer, chronic pain, multiple sclerosis) participated in the MBSR program from 2006-2012. They completed questionnaires pertaining to depression, medical symptoms, stress, coping, sense of coherence, and mindfulness pre- and post-MBSR. They filled out a follow-up questionnaire that asked them to rate the program and its components. A self-care index was created from 5 items.
Results: Of the 126 patients, 85.7% were woman, breast cancer was the most common illness (46.8%), and the average age was 52.3 (SD = 13.3). There were significant improvements on the following outcomes: depression, stress, and medical symptoms. With regard to process measures, there were significant increases in: mindfulness, sense of coherence (comprehensibility, manageability, and meaningfulness of life), as well as significant decreases in emotional coping. Patients rated the program with a mean of 8.94 (1 to 10 scale) for importance. They rank ordered the program components in terms of helpfulness with awareness of breath, the silent retreat day, and yoga practice as the highest of 10 items. There was a significant positive correlation between self-care index at the end of the course and its perceived importance. Moreover, self-care was positively and significantly correlated with post-MBSR mindfulness and viewing life as meaningful.
Conclusions: Patients who took the MBSR program reported mental and physical health benefits. Furthermore, being mindful enabled them to cope better, take care of themselves, and view life as more coherent such that they became more stress resilient.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/40
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/41
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Healing the Feelings and Feeling the Healing: Hypnotic Approaches in Cancer and Palliative Care
Néron, Sylvain
McGill University
Handel, Daniel
National Institutes of Health (NIH), Bethesda, Maryland
This workshop will focus on clinical demonstrations of hypnotic suggestion through metaphors for self-regulation improvements, pain relief, palliation of symptoms, and amelioration of hope in the face of advanced or progressive illness. These materials were designed (Néron and Handel, In Press) for health care professionals who use – or may decide to use – clinical hypnosis in their professional work with patients. The role of adjunctive hypnotic therapy in cancer care is to help manage distressing symptoms and to give the sufferer a sense of control via mind-body regulation. Physicians and health care professionals can integrate personalized hypnotic approaches in order to help patients regulate physiological functions, alleviate pain, enhance the release of tension, reframe hope, facilitate new levels of personal adjustments, and promote or restore healing spiritual experiences.
The workshop will include case-based, video clip demonstrations to cover the following topic areas: a) addressing patients’ misconceptions about hypnosis, b) establishing appropriate clinical goals, c) using hypnotic techniques in different medical settings, d) developing quick ways of reaching a hypnotic state, e) teaching self-hypnosis, f) preparing for medical procedures, g) reframing hope, and h) promoting healing spiritual experiences.
Objectives: Participants will be introduced to ways of: a) Integrating guided clinical hypnosis procedures at bedside and in several medical contexts. b) Empowering the sufferer by teaching him or her how to use self-hypnosis for symptom relief and for addressing their existential issues.
Reference
Néron, S., and Handel, D. Hypnotic Approaches in Cancer and Palliative Care. Quebec: Presses de l’Université du Québec, In Press.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/41
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/42
2017-09-27T18:40:33Z
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Self-Care and Self-Discipline through Qi Gong
Aung, Steven
University of Alberta, Edmonton, Alberta
Objectives: One of the most important aspects of Qi Gong practice is to understand self-care and self-discipline as a practitioner’s service both to themself and to others. Self-care and self-discipline is physical, mental, and spiritual. By understanding one’s responsibility in this way, practitioners are free to practice medicine as a relationship between themselves and patients, helping them to become a healer.
Methods: Traditional Chinese Medicine as a philosophy and practice will be introduced in the context of developing a successful Qi Gong practice. Basic Qi Gong techniques in posture, movement, breathing, phonation, and visualization will be demonstrated interactively. Increasing self-awareness will be emphasized, so that practitioners can use Qi Gong techniques to develop healing skills in their medical practice.
Results: Although it requires long-term commitment to receive many of the deeper rewards of a dedicated Qi Gong practice, many of the early benefits are possible with only a modest investment in performing proper Qi Gong techniques. Practitioners will learn to increase their mindfulness and concentration, and understand the value of self-care and self-discipline. Through short practice sessions, the utility of Qi Gong in improving healing will become evident to the novice and initiated alike.
Conclusions: Qi Gong is a series of ancient techniques from Traditional Chinese Medicine that promote self-care and self-discipline as a service to oneself and others. Qi Gong is a valuable method for taking care of oneself, and also allows practitioners to transfer its benefits to patients during the compassionate practice of medicine. It forms a foundation for whole person care by strengthening practitioners to provide healing to patients on the physical, mental, and spiritual levels.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/42
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/43
2017-09-27T18:40:33Z
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Reiki for Whole Person Care: Case Studies in Oncology Patients, a Preliminary Report
Gomez, Martha
Cedars CanSupport, Montréal
Gonzom, Maddalena
Cedars CanSupport, Montréal
Objective: Reiki has been introduced as part of the complementary therapy program for oncology patients in two major university hospitals to which our institution is affiliated, with the objective to provide whole person care. Reiki is a deep relaxation technique that promotes balance, healing and harmony in all aspects of the person – body, mind, emotions and spirit. A Reiki session is given using very light or no touch on a fully clothed individual, sitting or lying down. Reiki is best understood by actually experiencing a session.
The objective of this preliminary study is to document how Reiki can support and benefit oncology patients in facing the day-to-day challenges related to their illness.
Methodology: Weekly Reiki sessions lasting from 20 to 60 minutes have been conducted with adult patients. Inclusion criteria: any patient living with cancer: all stages, from pre-diagnosis to diagnosis, ongoing treatment (in and out-patients), post-treatment and palliative care. Data has been collected using a questionnaire and a symptom scale, before and after sessions, as applicable. Qualitative experiences from palliative care patients will also be obtained from staff and family caregivers.
Results: Preliminary results after each session indicate a significant reduction of anxiety and stress, in addition to improving regulation of pain, fatigue, emotional state, and digestive issues. Patients commonly express a feeling of serenity, calmness, and peace. Qualitative results will be presented.
Conclusion: Data collected so far suggests that Reiki as a complementary therapy, improves overall quality of life for patients. A more relaxed and less anxious patient facilitates the intervention of medical staff and lightens the efforts of caregivers and family. Closer communication between the medical and complementary therapies staff can manifestly enrich the whole person care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/43
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/44
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Whole Person Care at the Ottawa Integrative Cancer Centre
Seely, Dugald
Ottawa Integrative Cancer Centre
Weeks, Laura
Ottawa Integrative Cancer Centre
Flower, Gillian
Ottawa Integrative Cancer Centre
Young, Sarah
Ottawa Integrative Cancer Centre
Pitman, Anne
Ottawa Integrative Cancer Centre
Cordell, Raina
Ottawa Integrative Cancer Centre
Objectives: An interprofessional team of healthcare practitioners at the Ottawa Integrative Cancer Centre (OICC) provides individualized and whole person care in an effort to bridge the gap between conventional and complementary cancer care. The objective of this presentation is to describe the population receiving care at the OICC in terms of demographic and disease-related characteristics, in addition to their experience receiving care in terms of therapies received and preliminary outcomes.
Methods: All people receiving care at the OICC are invited to complete a registration package that documents demographic and disease-related characteristics in addition to baseline quality of life (EORTC-QLQ C30), cancer-related symptom (ESAS) and patient-identified concerns or problems (MYCaW). Every 3 months, a follow up assessment is completed for continuing patients.
Results: In the 18 months since opening, more than 600 unique people have received care at the OICC. Most commonly people consult a naturopathic doctor, often in combination with a general practitioner, nutritionist, acupuncturist, physiotherapist, or counselor. The majority of people seek care to manage cancer and treatment-related side effects, including pain, neuropathy, energy, and digestive concerns. Other people are seeking supportive interventions to their prescribed standard care, to control or cure their cancer, or to prevent a recurrence. Approximately one half of people self-identify as under distress for at least one common cancer-related symptom. Preliminary results will be presented regarding quality of life, cancer related symptoms and patient-identified concerns, stratified as possible by age, sex, cancer type, stage and types of treatment received.
Conclusions: The results presented here contribute to an understanding of who seeks integrative and whole person care as well as the growing body of literature regarding potential benefits. Results will be used to guide development of a clinical trial designed to assess the feasibility, safety, effectiveness, and cost-effectiveness of integrative, whole person cancer care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/44
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/45
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No Talent Required: Using Drama Therapy in Support Groups for Cancer Patients
Finestone, Jennifer
Cedars CanSupport, MUHC
Objectives: It is well known that a cancer diagnosis impacts a person’s mental, emotional and spiritual well-being as well as their body. Many patients and caregivers seek out support groups to bolster themselves in this challenging time. While talk and peer-based groups can provide validation and understanding, drama therapy can provide a beneficial approach for support groups.
Methods: Drama therapy is a gentle form of creative therapy between a trained therapist and one or more clients with a specific therapeutic intention. It uses action methods (such as role play, storytelling, improvisation, writing, and projective tools) to facilitate creativity, imagination, learning, insight and growth. Drama therapy provides a creative-expressive basis for support groups within a humanistic framework.
Results: Drama therapy-based support groups encompass the patient’s holistic experience and address all aspects of their cancer experience in order to provide meaning. In addition to validating participants’ perspectives, they help participants to come to terms with their experiences and emotions, to gain insight into their responses and to learn new ways of dealing with them. Drama therapy utilizes the concepts of distance, projection and witnessing to allow clients to explore challenging issues in a safe – and potentially playful – way. It is a flexible approach that can be adapted to the specific needs of participants and therefore is well equipped to serve a broad spectrum of issues and concerns in varying and supportive ways.
Conclusions: This poster will highlight some of the theory behind drama therapy-based support groups to show the advantages these groups entail. It will also showcase various creative interventions that have been used with cancer patients.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/45
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/46
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Narrative Reflective Process: A Means to Whole Person Research Cluster Formation
Schwind, Jasna
Ryerson University
McCay, Elizabeth
Ryerson University, Toronto
Lapum, Jennifer
Ryerson University, Toronto
Fredericks, Suzanne
Ryerson University, Toronto
Beanlands, Heather
Ryerson University, Toronto
Romaniuk, Daria
Ryerson University, Toronto
Edwards, Susanna
Ryerson University, Toronto
LeGrow, Karen
Ryerson University, Toronto
Objectives: As nursing faculty members of Health and Illness research cluster our focus is on promoting humanistic practices, such as person-centered care, for individuals and their families living with illness and its consequences. In keeping with this holistic focus we wanted to explore a non-traditional approach to building a productive professional collaboration.Methods: In the early stages of our research cluster formation, we chose to engage in Schwind’s Narrative Reflective Process (NRP), a creative self-expression activity that is informed by the Connelly and Clandinin’s Narrative Inquiry research approach. Creative activities included storytelling, metaphors and drawing. We began the process by working in pairs, telling stories of our research experiences, both positive and negative. We then drew images that metaphorically represented each of these. Following, we described our images to the cluster group, while considering common narrative threads. The process ended by the group envisioning our interpretation of our collaborative cluster work. Throughout the year, our cluster met on a regular basis working on our common interest of person-centred care. One year later, we recreated our images to see how the view of our collaborative cluster work had evolved. This time we chose to create one large image together.Results: We found that our creative experiential activities opened possibilities for trust and created a safe space for research cluster members to share their developing ideas. We felt that by sharing our personal experiences through drawings and metaphors allowed us to connect with one another as whole persons. It allowed us to recognize that we are more than just our professional roles.Conclusions: Through the creative self-expression of NRP we engaged the research cluster members as whole persons. As a result, the cohesion, trust and collaboration resulted in increased research creativity and productivity, which would not have been possible to create alone.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/46
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/47
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Whole Person Teaching Makes an Effective Baccalaureate Nursing Teacher: Student Voices Enlighten Us
Matthew-Maich, Nancy
Mohawk College, Hamilton
Martin, Lynn
McMaster University, Hamilton
Mines, Carrie
Mohawk College, Hamilton
Ackerman-Rainville, Rosemary
Mohawk College, Hamilton
Hammond, Cynthia
Mohawk College, Hamilton
Palma, Amy
McMaster University, Hamilton
Roche, Carmen
Mohawk College, Hamilton
Sheremet, Darlene
Mohawk College, Hamilton
Stone, Rose
Mohawk College, Hamilton
Objectives: The goals of this study were to understand: 1) what makes an effective teacher in each level of the baccalaureate nursing program, 2) what are the skills, attributes and strategies of an effective teacher in both theory and clinical courses, and 3) how does this impact student learning and the student experience in each level of the curriculum?
Methods: A qualitative description approach was used. All BScN students at two sites (1000 students) were emailed an invitation to participate in an online survey to identify what makes an effective teacher in the baccalaureate nursing program. Students were also invited to participate in focus groups to discuss what makes an effective teacher and the impact on their learning. It is anticipated that six focus groups of 10 to 12 students will be conducted. Survey and focus group data are analyzed using qualitative content analysis.
Findings: A preliminary finding emergent from the data is that students perceive whole person teaching, that is understanding the learner as a whole person, makes an effective teacher. This study has the potential for important impact on students and faculty in baccalaureate nursing programs. The results will be used to plan faculty development initiatives throughout all levels within relevant programs. Findings, conclusions and recommendations will be shared at the conference.
Conclusions: Will be available at the time of the conference. Faculty members are learning how to optimally facilitate learning in a new context that embraces a person-centered, problem based, self-directed and small group learning approach. Students are in the best position to articulate what makes an effective teacher in each year of the four year program. Students were eager and empowered to share their perceptions and faculty eager to learn from student voices to optimize student experiences and learning.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/47
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/48
2017-09-27T18:40:33Z
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Attitudinal Changes of Health Sciences Students Participating in an Interprofessional Education (IPE) Course Enriched with Complementary and Alternative Medicine (CAM) Education and CAM Fair – A Two Year Study
Kutt, Anastasia
University of Alberta, Edmonton
Vohra, Sunita
Objectives: Whole person care is ideally provided by a high functioning team, knowledgeable about all the therapies a patient has available to them (conventional or complementary), who coordinates efforts to efficiently meet all of a patient’s health care needs. Therefore, health sciences students at Canadian universities require team skills, and basic knowledge about complementary and alternative medicine (CAM). This project evaluates the attitudinal changes of health sciences students participating in a teaching intervention combining interprofessional education (IPE) and complementary and alternative medicine (CAM) education.
Methods: At our university, “IntD410 Interprofessional Health Team Development” is a mandatory 10-week, 30-hour IPE course for all undergraduate health sciences students including medicine, nursing, pharmacy, physical therapy, and occupational therapy. The CAM-stream was developed by adding: (i) several didactic lectures; (ii) large group learning provided by CAM providers (i.e. Qi Gong, Mindfulness Meditation); (iii) small group work solving discovery-style cases; and (iv) the CAM Fair, providing one-on-one interactions with CAM providers. The CAM-stream was offered in 2012 (N=71) and 2013(N=120). Quantitative data was collected via pre/post validated questionnaires testing student attitudes towards CAM, interprofessional learning, and collaboration. Qualitative feedback was collected via reflective assignments and course evaluations.
Results: Quantitative assessment revealed that the CAM-stream’s CAM beliefs increased, as did their recognition of the need for interprofessional learning. Qualitatively, initial reflections revealed that many students did not know what each other’s professions entailed, and they had misconceptions about CAM. Final reflections revealed the students felt more comfortable evaluating CAM practices, and recognized the value in collaboration. The CAM Fair was cited as the most impactful part of the curriculum.
Conclusions: IPE and CAM education are urgently needed in Canadian universities to overcome biases and misconceptions, to develop team skills, and to provide coordinated whole person care. They are effectively taught concurrently.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/48
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/49
2017-09-27T18:40:33Z
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Fostering Resilience over Multiple-losses for Nursing Staff in the Palliative Care Unit: Whole Person Approach – Part 1
Munesada, Minako
Tokyo Metropolitan Komagome Hospital
Kurihara, Yukie
Tokyo Metropolitan Komagome Hospital
Takahashi, Satoe
Tokyo Metropolitan Komagome Hospital
Tanaka, Keiko
Tokyo Metropolitan Komagome Hospital
Objectives: “Bereavement overload” due to multiple losses is one of the stressors for the nursing staff working at Palliative Care Unit (PCU), which may be especially tough to those with less exposure to such situation. A support program was developed for the nursing staff of newly-opened PCU (April 2011) in order to foster resilience and wellness despite multiple losses. We conducted a study to evaluate the effectiveness of the support program with “whole person approach” – consisting of 3 modules; 1) lecture on grief and bereavement (mind), 2) experiential workshop on body awareness and relaxation (body/spirit), and 3) group discussion (mind/spirit), for the increased sense of self-efficacy, awareness of their inner healing power, and fostering mutual understanding and support.
Methods: 20 nurses were randomly assigned to two groups for the action research project. Data included participant observation, individual and focus group interviews with one of the investigators. The support program package was offered from October to December 2012 (A) and from January to March 2013 (B) respectively, using wait-list control method. Self-efficacy scale was used at the base line, at the completion of package A, and at the completion of package B. Participants also answered brief survey after each module, followed by semi-structured interview.
Results: The self-efficacy score initially showed decline of both groups (intervention/control) , reflecting the “tough two months” with the highest number of the total deaths as well as deaths within 5 days post admission. However, intervention group showed more gradual decline comparing to the control group, plus higher elevation 3 months later, which may indicate some effect of the program.
Conclusions: The support program was positively received and contributed to the nursing staff’s increased sense of self-efficacy and resilience over “bereavement overload.” Continued program development is in progress based on the feedback.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/49
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/50
2017-09-27T18:40:33Z
IWPC:CON
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Fostering Resilience over Multiple Losses for Nursing Staff in the Palliative Care Unit: Whole Person Approach – Part 2
Kurihara, Yukie
Tokyo Metroplitan Komagome Hospital
Munesada, Minako
Tokyo Metroplitan Komagome Hospital,
Takahashi, Satoe
Tokyo Metroplitan Komagome Hospital,
Tanaka, Keiko
Tokyo Metroplitan Komagome Hospital,
Objectives: “Bereavement overload” due to multiple losses is one of the stressors for the nursing staff working at Palliative Care Unit (PCU), which may be especially tough to those with less exposure to it. A support program was developed for the nursing staff of newly-opened PCU (April 2011) in order to foster resilience and wellness despite multiple losses. We conducted a study to evaluate the effectiveness of the support program with “whole person approach” – consisting of 3 modules: 1) lecture on grief and bereavement (mind), 2) experiential workshop on body awareness and relaxation (body/spirit), and 3) group discussion (mind/spirit), for the increased sense of self-efficacy, awareness of their inner healing power, and fostering mutual understanding and support.
Methods: 20 nurses were randomly assigned to two groups for the action research project. Data included participant observation, individual and focus group interviews with one of the investigators. The support program package was offered from October to December 2012 (A) and from January to March 2013 (B) respectively, using wait-list control method. Self-efficacy scale was used at the base line, at the completion of package A, and at the completion of package B. Participants also answered brief survey after each module, followed by semi-structured interview.
Results: The participants’ overall responses were positive, with comments like “becoming more aware of my own grief process” (module 1), “was amazed by the power of awareness and simple touch” (module 2), “inspired by learning others’ perspectives on death and dying” (module 3). Shared learning and reflection as well as “learning something tangible” seem to be important components of the program.
Conclusions: The support program was positively received and contributed to the nursing staff’s increased sense of self-efficacy and resilience over “bereavement overload.” Continued program development is in progress based on the feedback.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/50
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/51
2017-09-27T18:40:33Z
IWPC:CON
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Using Popular Nursing Literature Critique to Help Nursing Students Explore Their Perceptions of Disability
Anyinam, Charles
George Brown College, Toronto
Coffey, Sue
University of Ontario Institute of Technology
Objectives: Disabled people have a history of disadvantage, discrimination, and disempowerment that continues to present day. Despite strong critique and activism by disabled people, popular understandings of disability as necessarily tragic, medically based, and individualistic requiring ‘fixing’ persist among health professionals. Recent research demonstrates that health professional students often harbour negative attitudes that may directly affect their relationships with and care provided to disabled clients (Sabin & Akyol, 2010; Scullion, 1999). Further, personal accounts and research evidence suggests that the relationship between healthcare providers and disabled people is often unsatisfactory (Sabin & Akyol, 2010; Seccombe, 2007; Scullion, 1999).
Methods: Nursing education has a responsibility to ensure that nursing practice with disabled people is enabling rather than disabling (Scullion, 1999a, 1999b, 2000; Sabin & Akyol, 2010). A key strategy is to imbed within curricula opportunities for students to engage in the processes of critical thinking towards and analysis of disability and the experiences of disabled people. This poster describes an approach to teaching-learning in which critique of ‘popular culture’ nursing literature is used to support student exploration of messaging about disability.
Results and Conclusions: The purpose and description of the assignment, authors’ experiences, and outcomes for both teachers and learners will be presented. Application beyond nursing to other health professions will be described.
References
Sabin, H. & Akyol, A. D. (2010). Evaluation of nursing and medical students' attitudes towards people with disabilities. Journal of Clinical Nursing, 19, 22712279.
Scullion, P. A. (1999). Conceptualizing disability in nursing: Some evidence from students and their teachers. Journal of Advanced Nursing, 29, 648657.
Scullion, P. A. (2000). Enabling disabled people: Responsibilities of nursing education. British Journal of Nursing, 9(15), 1010-1015.
Seccombe, J. A. (2007). Attitudes towards disability in an undergraduate nursing curriculum: A literature review. Nurse Education Today, 27, 459465.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/51
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/52
2017-09-27T18:40:33Z
IWPC:CON
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Healing as Recycling Energy from Negative to Positive
Aung, Steven
University of Alberta, Edmonton, Alberta
Objectives: For many practitioners and patients, the most critical aspect of medical practice is healing. Healing requires compassion in order to elevate clinical practices above the skills of a medical technician. At the same time, the act of healing is deeply involved. When practitioners heal, they must take care not to experience physical, mental, or spiritual fatigue or injury to themselves. By practicing healing as recycling energy from negative to positive, practitioners develop contemplative compassion. The more practitioners treat patients, the more they understand how to recycle and heal, and the better the practitioner they become.
Methods: Healing recycling involves practitioners engaging their own chakra system on the physical, mental, and spiritual levels. Negative energy is drawn from the patient and flows through the practitioner to their solar plexus, where it is converted to positive energy. The practitioner then returns the positive energy to the patient as a vital healing force. In order to avoid injury through this process, practitioners must purify and harmonize themselves through practice and discipline in body, mind, and spirit exercises.
Results: Traditional Chinese Medical philosophy will be introduced and used to examine the concepts of energy, healing, discipline, and holistic medicine. The various modalities of healing recycling will be demonstrated, including through the hand, the eye, the nose, and the third eye. By practicing healing recycling, practitioners will avoid becoming “wounded healers”, and improve their overall ability to heal.
Conclusions: Practitioners who can contemplate compassion in their medical practice become healers. Without compassion, there is no healing. Without healing, there is no medicine. Therefore, the practice of medicine needs a better understanding of how to recycle energy. At the same time, greater healing will translate into improved quality of life for patients.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/52
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/53
2017-09-27T18:40:33Z
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Healing at the End of Life: The Voice of the Patient
Ingram, Cory
Mayo Clinic
In palliative care we have the privilege to care for seriously ill people and their families. Some people value capturing their life story or illness journey on film. I have been fortunate to have been invited into the lives of many people close the end of life for a heartfelt conversation.
On an interactive iPad incorporated in the poster, the recorded narrative of patients and one bereft spouse the poster audience will experience the lived experience of people close to the end of life as they reflect on their lives. The narratives will demonstrate how each lived with a new found improved quality of life in the face of increasing symptoms, declining functioning and the approaching end of life; otherwise known as healing. Topics of healing and quality of life, patient-centered care, dignity, human development, spirituality and love will be the focus of their stories. The stories lay bare the very practical, emotional, existential, and personal experience central to our provision of whole person care through palliative care. The poster audience will experience a renewed sense of the impact of a dedicated approach to whole person care as experienced through those on the receiving end.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/53
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/54
2017-09-27T18:40:33Z
IWPC:CON
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'Flowers Will Bloom': Assessing Support for Survivors of Japan's 3/11 Disaster through the Charity Song
Ota, Ikuko
Hiroshima City University
Objective: NHK, Japan’s public broadcast network, produced a theme song in March 2012 to promote public support for survivors of the 3/11 disaster of 2011. The objective of this study is to evaluate how and to what extent this charity song Hana wa Saku (“Flowers Will Bloom”) has contributed to assisting survivors of the disaster.
Methods: First, the song’s characteristics are considered in two categories, (1) the way the original Japanese recording was conducted, and (2) the song itself. Then, the effects on the survivors are assessed through analyzing the actual ways the song was performed and their repercussions covered by the media.
Results:
(1) Along with the composer and the lyricist, all singers (thirty-six celebrities) of the original Japanese recording had strong personal links to the region affected by the disaster. In the video-clip performance, each singer relays a phrase of the song, holding a gerbera daisy instead of a baton. This performance has left a lasting impression of connectedness specifically between the survivors and the victims.
(2) According to lyricist IWAI Shunji, the song’s words represent “a message from those who lost their lives to the people they left behind.” Repeatedly listening to the fictional messages of their loved ones in heaven, through the voices of the living people trying to provide comfort, have particularly helped young survivors bounce back from their sufferings.
Conclusion: Responding to NHK’s call, more than 10,000 people have posted their amateur performances of the song on the official website by May 2013. All royalties and other proceeds of the song are being donated for recovery efforts for the affected region (28,907,109 yen as of March 2013). Findings demonstrate that, despite differences in its impact among survivors, this charity song can be an effective and accessible means to foster public support for the survivors.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/54
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/55
2017-09-27T18:40:34Z
IWPC:CON
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Impact d'une formation à la gestion du stress sur le vécu de la maladie dans l'insuffisance rénale chronique dans un hôpital universitaire français
Isnard Bagnis, Corinne
Pitié Salpetrière Hospital, Paris
Khaldi, Celine
Chaire de Recherche en Education Thérapeutique, Fondation UPMC, Paris
Introduction : Les patients vivant avec une maladie rénale chronique expriment une franche altération de leur qualité de vie. Parmi les éléments impactant ces résultats, le stress chronique lié à la maladie et ses traitements et la douleur sont des plaintes très prévalentes et insuffisamment prises en charge. Cette étude évalue l'impact de la participation de patients insuffisants rénaux chroniques à un programme de gestion du stress par la méditation de pleine conscience (développé aux USA il y a plus de 25 ans par J. Kabat Zinn).
Patients et Méthodes : L’enquête s’est concrétisée par la réalisation d’un dispositif « d’observation participante » par une sociologue au sein d’un programme MBSR (meditation-based-stress-reduction program) mis en place dans un service de néphrologie et la réalisation d’une enquête longitudinale : suivi des patients après la formation réalisés dans le cadre de « récits de vie ». Les résultats sont qualitatifs et portent sur la gestion du stress, la capacité à prendre soin de soi et à se mettre en posture de résilience.
Résultats : Les premiers résultats permettent de rendre compte d’une amélioration des compétences des patients dans la gestion du stress, dans leur capacité à prendre soin d’eux, à anticiper les difficultés liées à leurs pathologies et à développer des mécanismes de compensation. L’enquête permet aussi de rendre compte d’une amélioration dans le vécu des malades du système de soin et une vision plus positive de l’hôpital et du rapport avec les soignants.
Discussion et Conclusion : Les programmes d'education thérapeutique peuvent s'enrichir d'interventions pédagogiques orientées vers l'acquisition de compétences necessaires au maintien de soi en vie avec la maladie. L'amélioration de la gestion du stress par la méditation de pleine conscience pourrait être un moyen d'améliorer la qualité de vie des patients et en tous cas de diminuer le stress perçu.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/55
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/56
2017-09-27T18:40:34Z
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Exploring the Relationship Between Subjective Ratings of Mindfulness Practices and Outcomes in Patients Participating in an MBSR Program
Bernardi, Nicolò F.
McGill University, Montréal
Zhao, Qinyi
McGill University
Dobkin, Patricia L
McGill University
Objectives: The present study explored relationships between outcomes of the Mindfulness-Based Stress Reduction (MBSR) program and the importance attributed by patients to the mindfulness practices taught.
Methods: Patients with chronic illnesses (46.8% breast cancer; N=126) completed questionnaires pertaining to medical symptoms, stress, and mindfulness, pre- and post-MBSR. At program completion, each patient rated the importance of the mindfulness practices employed. Stepwise linear regression analyses were run to investigate associations between changes in outcome variables and subjective ratings of practice importance.
Results: Increases in mindfulness were associated with high ratings of importance for sitting meditation (p LT 0.02) and homework manual (p LT 0.02; Adjusted R2 = 0.10). Decreases in medical symptoms were associated with high ratings for the body scan (p LT 0.01) and small group exercises (p LT 0.01; Adjusted R2 = 0.13). High ratings for the body scan were moderately, albeit significantly, correlated with decreases in perceived stress (p LT 0.01, Adjusted R2 = 0.05). A cluster analysis performed on all 10 of the ratings of practice importance showed that greater importance was associated with better outcomes for all three dependent variables (p LT 0.01). A qualitative examination of patients’ answers to open-ended questions revealed that incorporating mindfulness practices in daily life was a central component of the lifestyle changes experienced during the course of the program.
Conclusions: Understanding the mechanisms underlying MBSR’s effectiveness is important as this program becomes recognized as an empirically-supported intervention. These results suggest that specific types of practice (concentration vs. the body scan) are related to distinct outcomes (dispositional mindfulness vs. medical symptoms, respectively). Overall, awareness of the importance of practicing is connected to actual program outcomes.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/56
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/57
2017-09-27T18:40:34Z
IWPC:CON
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Perceived Effects of a Somatic Psychopedagogy (SPP) Program in Nurse Training: An Exploratory Study
Lachance, Josée
Université de Sherbrooke
Paillé, Pierre
Université de Sherbrooke
Desbiens, Jean-François
Université de Sherbrooke
Xhignesse, Marianne
Université de Sherbrooke
Background: Developed in Europe in the 1980’s, somatic psychopedagogy (SPP) is a formative practice geared toward care giving and support. Characterized as a type of mind-body medicine, it examines how the use of the body and its movement allows for the development of one’s conscience, one’s sense of self and of others, which are all desirable qualities for professionals within the health care sector.
Purpose: To explore if and how SPP training followed by nurses modifies their perception of the quality of their self awareness, their presence in regard to others, as well as their relationship with respect to health and their professional practice.
Methods: Qualitative research based on two types of semi-structured interviews: comprehensive and elicitation. Exploratory interviews with three nurses trained (or in training) in SPP. The content of the interviews was first analyzed thematically then grouped by categories.
Findings: The three participants perceived a change in the quality of their presence with respect to themselves and to others as well as changes within the nature of their relationships with their patients, colleagues and healthcare team members. Content analysis of the interviews has allowed us to conclude that relationships with the health care team evolved into a better ability to give recognition and a better quality of interaction between members. Participants also reported an increased ability to express their opinions in both their personal and professional lives. A second level of analysis has allowed for the identification of differences between nurses just finishing their first year of training and those having completed the full four-year course.
Conclusion: Interesting transformations are reported at different levels confirming the relevance of a second phase of the project. The latter will permit to identify whether physicians trained in SPP experience changes similar to those of the nurses, and if so, whether they perceive these as having an impact on their practice.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/57
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/58
2017-09-27T18:40:34Z
IWPC:CON
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Primary Care and the Ethics of Integrating Genomic Medicine
Rahimzadeh, Vasiliki
McGill University
Objectives: To explore the practical barriers to, and implications of, incorporating genomic technologies in the primary care setting. In evaluating the primary care mission and anticipated role of genomic medicine in conversation with one another, I discuss the ways in which the primary care philosophy problematizes innovations afforded to clinical medicine through whole genome sequencing. I discuss these themes in relation to the evaluation frameworks that must precede full integration, specifically the Analytic validity, Clinical validity, Clinical Utility and Ethical, legal social considerations (ACCE) model. Finally, my analysis will consider the added ethical nuances for integrating genomic medicine in the wake of new standards for healthcare delivery in the U.S.
Methods: I review the literature concerning 1) models for evaluating the applicability of emerging genomic technologies in the primary care setting, namely the ACCE model proposed by the Center for Disease Control, and 2) anticipated changes to primary care delivery through proposed healthcare legislation.
Results: Three main facets of primary care delivery problematize full integration of genomic medicine in clinical practice. They include: primary care providers' propensity to maintain therapeutic relationships with patients over the lifecourse, acuity to community health patterns, and gaps in genetic/genomic-specific knowledge among practicing clinicians. Implementation of genomic medicine requires that technologies be adaptable to the heterogeneity of the primary care clinic, in both the diverse populations it serves and broad spectrum of resource availability.
Conclusions: The rapid pace at which genomic technology has fundamentally altered the direction of medical research scene is extraordinary to say the least. The potential benefits for incorporating these innovations depict a clinical landscape that predicts and prevents disease before it manifests, and cares for patients using treatments that are tailored to their own genetic person. The primary care arena presents unique challenges to the evaluation, diffusion and translation of genomic technologies. Yet the same aspects that present limitations also reinforce the reasons why the primary care setting is a critical forum in which to operationalize genomic medicine in practice. With so much dialogue generated around ushering in a new era of medicine, it is unclear whether this is celebrating the novelty of the genomic revolution, or the reinvigoration of a longstanding clinical tradition in patient-centered primary care.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/58
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/59
2017-09-27T18:40:34Z
IWPC:CON
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Doctor, You Can Be Less Error Prone Right Now
Meagher, John
Dalhousie University, Halifax
The Problem:
From moment to moment, while tending their patients, physicians can slip from: patience to impatience; genuine enquiry to assumptions; attention to the task-at-hand to inattention; certain doubt to doubtful certainty; and from doing what is inconvenient to doing what is convenient. In summary, one can slip from neo-cortex to archi-cortex (reptilian brain) emphasis. (The hazardous attitudes associated with aviation and medical mishaps are reptilian in character). This is expressed: to err is human, the reptilian part.
Objectives: Therefore, to improve decisions, one needs to reclaim the new-brain emphasis, the advocate for the patient’s interests.
Method: To be aware which emphasis one commands, ask oneself a few reptilian-revealing questions. Then counter the reptilian attitude by specific and or generic antidotes to be less error prone.
Conclusion: Doctors should realize that there is also another patient one is tending: the patient called oneself, whose symptoms are haste, egoism and apathy and whose diagnosis is the reptilian brain. While this lesion is inoperable and the prognosis is guarded, yet amid the uncertainty and demands of our medical tending, one can toggle back to patience and doing the inconvenient to reach after fact and reason.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/59
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/60
2017-09-27T18:40:34Z
IWPC:CON
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Mindfulness-Based Medical Practice: Exploring the Link between Self-Compassion and Wellness
Irving, Julie Anne
Centre for Addiction and Mental Health, Toronto
Dobkin, Patricia L
McGill University
Park-Saltzman, Jeeseon
McGill University
Fitzpatrick, Marilyn R.
McGill University
Hutchinson, Tom A
McGill University
Objectives: In light of the detrimental impact of burnout upon clinicians and their patients, the identification of means through which the well-being of health care professionals can be fostered and protected is timely and important. The present study explored outcomes associated with participation in Mindfulness-Based Medical Practice (MBMP), a program modeled after Mindfulness-Based Stress Reduction which included additional mindful communication exercises to foster the integration of mindfulness in various clinical settings.
Methods: Physicians, nurses, psychologists, occupational therapists, and social workers enrolled in the 8-week MBMP program. Participants (N = 110) between the age of 24 and 82 years (M = 46.5, SD = 11.4: 73% women) completed self-report measures prior to and following the program; the Maslach Burnout Inventory, Perceived Stress Scale-10 and the Ryff Scales of Psychological Well-Being. Two process measures designed to capture mechanisms of change were administered: the Mindful Attention Awareness Scale, and the Neff Self-Compassion Scale.
Results: Results from paired-sample t-tests indicated that health care professionals enrolled in MBMP can benefit from the program. Analyses demonstrated significant decreases upon measures of perceived stress [p= .000], emotional exhaustion [p= .000], depersonalization [p= .000], and an increase in personal accomplishment [p= .000] as well as mindfulness [p=.000], self-compassion [p= .000], and well-being [p= .000]. Hierarchical regression analyses indicated that change scores on perceived stress (Beta = -1.46, p LT 0.000) and self-compassion (Beta = 9.02, p LT 0.006) predicted changes in well-being in this sample. Additionally, participants rate perceived importance of having taken part in the course using a Likert-scale from 1-10 (M=8.5, SD = 1.51).
Conclusions: This study suggests that for health care professionals enrolled in MBMP may experience a variety of benefits associated with participation in the program. Further, increases in self-compassion may hold particular implications for well-being in this population.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/60
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/61
2017-09-27T18:40:34Z
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Clinical and Personal Value of Narrative Medicine Writing Workshops for Physicians and Practitioners
Janisse, Tom
The Permanente Journal http://www.thepermanentejournal.org
Objectives: We write to tell our stories of patient encounters and come to understand them. A story discovers meaning in medicine. The objective is to write and tell stories of clinical encounters to develop self-awareness, patient perspectives and to demonstrate caring behaviors.
Methods: One session takes 60 minutes (full exercise in poster). Longer sessions have multiple writing opportunities, longer small-table conversations, and a primer on developing character and setting in writing.
Results: Over 8 years, in two conferences and 24 workshops (in 13 cities), 951 participants rated the sessions overall as 4.75 of 5, and 75% would use narrative in their practice. Also, 144 participants attended 20 writing groups. Selected Participant Comments:“Reminds me why we became doctors.”“Taking time to remember that each patient has an unfolding story is life affirming, however I found it startling to consider the doctor as part of the story.”“The training/sharing I had today will change how I view each patient interaction.”“Opened my eyes to how important my stories can be, and a new creative outlet.”“I know the people around my table better in two hours than I know the colleagues I work with everyday.”“I see this as a wellness mechanism! I am unlikely to meditate or go out for lunch during my busy day, but see myself able to close my office door and take 10 minutes to reflect upon a patient interaction in an attempt to find comfort or meaning there.”
Conclusions: Offering a forum for physicians and practitioners to recall, write and share meaningful clinical moments has professional and personal value, as evidenced by the ratings and comments. Publishing the copyedited writings (with permission) in a medical journal, booklets, or a medical lit-art e-journal heightens the value, and allows others to share the experiences.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/61
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/62
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A Role for Cancer Nurses: Responding to Distress in Cancer Patients
Fitch, Margaret
Sunnybrook Health Sciences Centre, Toronto
McLeod, Deborah
QEII Health Sciences Centre, Halifax
Howell, Doris
University Health Network, Toronto
Green, Esther
Cancer Care Ontario, Toronto
Background: Although all patients experience distress, between 35-45% experience clinically significant levels of distress such as anxiety, depression and adjustment difficulties. Early identification of distress and the provision of relevant interventions is a standard of quality cancer care. Nurses have a critically important role in identifying individuals with distress and providing interventions to manage distress.
Objectives: Our objectives are to define the role of cancer nurses in responding to emotional distress experienced by cancer patients and to document the best practices for implementing a program of screening for distress in ambulatory settings.
Methods: A programmatic approach to screening for distress (6th vital sign) has been implemented in several cancer facilities across Canada. The program includes protocols for screening, algorithms for assessment, and guidelines for evidenced based interventions. Introduction of the programs have included relevant education of nurses and close attention to uptake and utilization of practice guidelines. Implementation has been mounted within the context of continuous quality improvement and the use of rapid cycle evaluation.
Results: Evaluation of successful program implementation has shown increased patient satisfaction with care. Patient concerns provide the focus for opening conversations with individuals and the basis for planning person-centered approaches to care. Patient concerns are identified through the screening maneuver beyond those related to tumor and side effect management. Nurses are in an excellent position to respond to scores on a standardized distress screening tool as part of their patient assessments. The assessments provide a foundation for individualized or tailored interventions.
Conclusions: Using a concrete programmatic approach, including screening, focused evidence-based assessment and interventions, offers benefits in achieving person-centered care for cancer patients. In busy clinical settings, an intentional effort is needed to implement a programmatic approach to screening followed by appropriate assessment and intervention.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/62
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/63
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Reasons for Returning to the Emergency Department: Perspectives of Patients and the Liaison Nurse Clinician
Vat, Molywan
McGill University Ingram School of Nursing
Common, Carol
McGill University Health Center
Laizner, Andrea
McGill University Ingram School of Nursing
Maheu, Christine
McGill University Ingram School of Nursing
Objectives: The authors wanted to understand the reasons why patients discharged from internal medicine units return to the emergency department within a short term period. The purpose of the study was to explore patients’ perspective of their reasons for returning to the emergency department within fourteen days post-discharge from an internal medicine unit, and to examine how these reasons relate to those determined by the liaison nurse clinician prior to discharge.
Methods: A qualitative descriptive design was selected to develop the study and individual face-to-face semi-structured interviews were conducted with participants. A convenience sample of eight participants was recruited from a major teaching hospital in Montreal, Canada. The study triangulated three different data sources, which were the patient’s perspective through the interview and the liaison nurse clinician’s perspective through the use of two evaluation tools, which were the Bounceback Probability Legend and the LACE Index Scoring Tool.
Results: The participants attributed their return to the emergency department due to 1) being discharged too soon, 2) feeling weak at discharge, 3) having limited discharge instructions prior to discharge, and 4) having limited resources available to rely on for help once home. It was also noticed that participants went through a decision-making process for choosing to return to the emergency department. Additionally, the liaison nurse clinician’s evaluation tools identified different reasons from those the participants had attributed to their return to the emergency department.
Conclusions: The findings suggest that health care professionals must evaluate and assess patients on several components upon their discharge, such as the understanding of their illness, primary concerns, and readiness prior to discharge. The study provides further data in supporting the need of patient’s involvement in the process of discharge planning.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/63
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/64
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The Role of a Psychiatrist (Rehabilitation Physician) in the Palliative Care Team
Miyata, Chieko
Keio University School of Medicine, Tokyo
Tetsuya, Tsuji
Keio University School of Medicine
Hashiguchi, Saori
Keio University School of Medicine
Liu, Meigen
Keio University School of Medicine
Objective: Although palliative care consultation teams (PCTs) have become an integral part of all regional cancer care hospitals, cancer rehabilitation is still in the developing stage in Japan. At our hospital, a physiatrist, or a rehabilitation physician, joined the PCT as a member, and we have been achieving good results. The purpose of this study is to clarify the role of a physiatrist as a member of the PCT by investigating the current status of the PCT at our hospital.Method: We retrospectively analyzed the records of 144 patients receiving rehabilitation out of 345 patients who had started receiving PCT services from April 2012 to March 2013 at Keio University Hospital.
Results: Among the 144 patients, 67 patients (46.5%) had already received rehabilitation before starting PCT services, and the remaining 77 patients (53.5%) started receiving rehabilitation based on the recommendation by the physiatrist. In the later group, Dietz Cancer Stage Classifications were: preventative, 6.5%; restorative, 40.0%; supportive, 45.5%; and palliative, 9.1%. ECOG-PS were: PS0, 0.0%; PS1, 23.4%; PS2, 29.9%; PS3, 28.6%; and PS4, 18.2%. The main purposes of rehabilitation were: 1) fracture prevention and pain relief of limbs with bone lesions, 2) social support (e.g. measures for the reduction of nursing requirement, assistance in finding social aids, counseling for family members), 3) psychological support, 4) treatment of lymphedema, 5) management of breathlessness, 6) and approaches to swallowing deficits.
Conclusions: Half of the cancer patients started rehabilitation after the intervention by the PCT. Many patients receiving PCT services also needed rehabilitation services and the physiatrist had an important role of evaluating the rehabilitation needs. Physiatrists can act as important members of PCTs to maximize QOL while addressing the physical, psychological, social and spiritual needs of both patients and their families.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/64
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/65
2017-09-27T18:40:34Z
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CLEAR: Whole Person Care Model for the Health Sciences Professions
Gober, Carla
Loma Linda University Health, Loma Linda, California
McMillan, Kathy
Loma Linda University Health, Loma Linda, California
Whole-person care has been important throughout the 150-year history of Loma Linda University and Hospital system (now Loma Linda University Health - LLUH). Since the 1950s, the motto is, “To make man whole.” However, up to 2011 there was no corporate-wide understanding of whole-person care, or a model to guide teaching and practice. Connected to this has been the question of whether spiritual care and whole person care were similar categories of understanding.
Objective / Methods: In 2011 a group of nine researchers and clinicians designed a research/development project for the purpose of developing a whole-person care model to guide all teaching and practice at LLUH. A consultation group of approximately 300 researchers, clinicians, students and staff of LLUH were invited to give feedback during the course of the project through online avenues and group forums. This larger group was open to all interested people throughout LLUH. The research / development group considered all comments, critiques and suggestions made by the larger consultation group, with all work public to both groups.
Results / Conclusions: From the process emerged the first draft of a whole-person care model in March of 2012, with the following qualities: measureable, memorable, practical, flexible, and teachable. After several pilot tests, the model was adopted by LLUH as the model to guide all teaching and practice at LLUH. Since that time, the model has been integrated into the orientation of new employees (clinical and university), the teaching practices of three schools (medicine, nursing, and religion) and is being integrated into the remaining four schools by 2014. It is also guiding the development of the online wellness website for the corporation. Finally, it is used to guide two new developments for the School of Medicine: 1) a Narrative Project designed for the first year School of Medicine students, and 2) the Integrative Whole-Person Care Simulation Labs developed for second year School of Medicine students.
The poster presentation will describe the whole-person care model itself, the research/development process behind it, and give examples of how it has transformed teaching and practice in the university and clinical/hospital arenas.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/65
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/66
2017-09-27T18:40:34Z
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Watch Over Me©: Therapeutic Conversations in Advanced Dementia
Ingram, Cory
Mayo Clinic
“Watch over me” is a framework and strategies that clinicians can use in providing practical support and counseling to patients with dementia and their families. This framework is intended to address the needs and experiences of simultaneous trajectories of illness experienced by people with dementia and their family caregivers. These experiences can be described through the stages of dementia for the person with the disease and corresponding stages in the family’s journey. Each individual’s and family’s experiences are unique, yet these intentionally simplified schemas provide a context through which to address predictable problems and decisions regarding matters of physical health, living situation and caregiver needs and well being.
Watch Over Me builds on trust between each patient and his or her caregivers, including the person’s chosen proxy decision-makers. It also builds on and fosters trust between a patient and family and the patient’s doctor. Watch Over Me brings the trusting, covenantal values within loving relationships into the processes of planning and caring. This approach complements and balances the contractual values that are protective or defensive and are embedded in medical ethics and advance directives.
Communication with patients and families living with dementia is sometimes difficult and may be uncomfortable for physicians and other professional health care providers, yet it is always valued by patients and families and very often helpful in clarifying people’s perspective and priorities, thereby informing current plans of care. This presentation will offer practical therapeutic communication strategies to facilitate advance care planning conversations with patients and families as a person with dementia progresses to advanced
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/66
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/67
2017-09-27T18:40:34Z
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Achieving Person-centered Care: The Need for Multiple Strategies
Fitch, Margaret
Sunnybrook Health Sciences Centre, Toronto
Nicoll, Irene
Canadian Partnership Against Cancer, Toronto
Bennie, Fay
Background: Evidence from patient satisfaction surveys, needs assessments, and stakeholder forums provide a clear picture that cancer patients are not receiving the full range of supportive care services that could be of benefit to them. The cancer system needs to undergo a shift toward person-centered care. Such a cultural shift requires concerted effort and multiple strategies to be successful.Objective: The purpose of the Cancer Journey Action Group of the Canadian Partnership Against Cancer is to provide leadership to achieve person-centered care in the Canadian cancer care system.Methods: The Cancer Journey Action Group has developed and implemented several initiatives to demonstrate how person-centered care can be achieved. The initiatives include programs in screening for distress (6th vital sign), patient navigation, on-line support groups, survivorship care plans projects, cancer transition education, and palliative care/end-of-life education. Tools to support this work have been designed including evidence-based practice guidelines, algorithms, and on-line education modules. Evaluation has focused on program uptake, educational effectiveness, inter-professional teamwork and patient satisfaction.Results: All initiatives have been evaluated by patients/survivors as helpful. Issues of importance to patients/survivors are the focus of conversations with, and assessments by, health care professionals. Critical success factors across the respective programs for achieving person-centered care include clarity of a shared vision, leadership, persistent and concerted effort, and consistent messaging in communications.Conclusions: Demonstration projects undertaken for each topic area have provided an excellent opportunity to learn about best practices to implement the respective approaches. Guiding principles for implementation and relevant tools/resources have been developed as a result. Although progress toward person-centered care is evident, intentional and concerted efforts are necessary to sustain momentum of these efforts in routine clinical practice.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/67
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
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oai:ojs.iwpc.mcgill.ca:article/69
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The International Centre for Communication in Healthcare: Creating Safer and More Compassionate Healthcare Systems around the World
Slade, Diana
Hong Kong Polytechnic University, Kowloon
University of Technology Sydney, Sydney, New South Wales
Matthiessen, Christian M.I.M.
Hong Kong Polytechnic University, Kowloon
Rider, Elizabeth A.
Harvard Medical School, Boston, Massachusetts
Pun Kwok Hung, Jack
Hong Kong Polytechnic University, Kowloon
Background: The role of communication in healthcare receives increasing attention, yet little research exists that brings together perspectives from interprofessional healthcare researchers and practitioners with linguists and communication specialists. The International Centre for Communication in Healthcare[1] is a response to increasing recognition of the central role of communication and relationships in the delivery of safe, effective and compassionate healthcare.
Objective: To develop a worldwide, multidisciplinary collaborative of internationally recognized healthcare professionals and communication experts working together to translate research into education and practice to improve patient safety, communication and relationships in healthcare.
Methods: The International Collaborative for Communication in Healthcare (a precursor to the Centre) began in 2010, and was founded at Hong Kong Polytechnic University (PolyU) in March 2011. We initiated research collaborations and presented colloquia, workshops and papers at international conferences.
Results: The Centre, co-convened by PolyU and University of Technology, Sydney, was formally launched at PolyU in June 2013 with over 50 members from over 10 countries. The Centre is developing a strategic research agenda for communication in healthcare to improve the quality and safety of patient care, and to mobilize knowledge and expertise gained from research to guide teaching and implementation of communication skills and compassionate care in healthcare education and practice. In an early initiative in 2011, we created the International Charter for Human Values in Healthcare[2], a collaborative effort involving people, organizations and institutions around the world working together to restore core human values to healthcare. The values of the International Charter inform the Centre’s research, education and practice initiatives.
Conclusions: Effective communication is increasingly recognized as integral to safe, effective, and compassionate healthcare. The International Centre for Communication in Healthcare brings together interdisciplinary researchers, educators and practitioners from diverse disciplines to explore and improve communication and relationships in healthcare settings around the world.
References
1. The International Centre for Communication in Healthcare. Hong Kong Polytechnic University and University of Technology, Sydney. http://icchweb.org
2. The International Charter for Human Values in Healthcare. December 2, 2012. http://charterforhealthcarevalues.org
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/69
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/70
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Proposed Consensus-Based Canadian Integrative Oncology Research Priorities
Weeks, Laura
Ottawa Integrative Cancer Centre
Seely, Dugald
Ottawa Integrative Cancer Centre
Balneaves, Lynda
University of British Columbia, Vancouver
Boon, Heather
University of Toronto
Leis, Anne
University of Saskatchewan, Saskatoon
Oneschuk, Doreen
University of Alberta, Edmonton
Sagar, Stephen
McMaster University, Hamilton
Verhoef, Marja
University of Calgary
Objectives: An increasing number of integrative oncology programs are being established across Canada that offer a combination of complementary and conventional medical treatments in a shift towards whole-person cancer care. It was our objective to identify consensus-based research priorities within a coherent research agenda to guide Canadian integrative oncology practice and policy moving forward.
Methods: Members of the Integrative Canadian Oncology Research Initiative and the Ottawa Integrative Cancer Centre organized a 2-day consensus workshop, which was preceded by a Delphi survey and stakeholder interviews.
Results: Eighty-one participants took part in Round 1 of the Delphi survey, 52 in Round 2 (66.2%) and 45 (86.5%) in Round 3. Nineteen invited stakeholders participated in the 2-day workshop held in Ottawa, Canada. Five inter-related priority research areas emerged as a foundation for a Canadian research agenda: Effectiveness; Safety; Resource and Health Services Utilization; Knowledge Translation; and Developing Integrative Oncology Models. Research is needed within each priority area from a range of different perspectives (e.g., patient, practitioner, health system) and that reflects a continuum of integration from the addition of a single complementary intervention within conventional cancer care to systemic change. Participants brainstormed strategic directions to implement the developing research agenda and identified related opportunities within Canada. A voting process helped to identify working groups to pursue strategic directions within the interest and expertise of meeting participants.
Conclusion: The identified research priorities reflect the needs and perspectives of a spectrum of integrative oncology stakeholders. Ongoing stakeholder consultation, including engagement from new stakeholders, is needed to ensure appropriate uptake and implementation of the Canadian research agenda.
McGill University Library & Archives
2014-02-28 00:00:00
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https://ijwpc.mcgill.ca/article/view/70
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/71
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Person-Centred Dentistry: When Do We Start?
Apelian, Nareg
McGill University
Vergnes, Jean-Noel
McGill University
Bedos, Christophe
McGill University
Objectives: Although most health professions have adopted person-centred approaches in the last decades, dental professionals still rely on traditional paternalistic models. The objective of this research was to develop a model of person-centred care in dental practice.
Methods: Adopting an action-research approach, we started our process by adapting Stewart and colleagues' model of person-centred care to the field of dentistry. We then implemented and tested the new clinical approach in a private dental office of Montreal, Canada. During several months, an academic researcher observed the clinical activities of a dental practitioner, who was also the first researcher. At the end of each appointment, the observer and the practitioner shared their observations about the encounter and evaluated the clinical approach. Both suggested improvements to the model and implemented solutions to the next patients. After 39 rounds of observation-evaluation-improvement, a form of saturation was reached in the development of the clinical approach.
Results: The clinical encounter goes through four different stages. The first stage is how the relationship is built through an open dialogue on illness, fears and expectations. The second stage consists in gathering clinical information through examination, tests and questioning. The third stage is a disease-centered presentation of the results of the examination. The final stage is the development of a treatment plan after establishing a common ground through frank discussions and shared decision making. From this approach, a model emerged consisting in a stage of understanding, followed by planning, intervention, then back to understanding. This cycle takes place within the context of a patient-dentist relationship with mutual trust. This relationship, central to the encounter, acknowledges the whole-person dimension and psychosocial context of each party.
Conclusions: We hope this model will inspire other professionals and teaching institutions to develop their own approaches by using it as a theoretical framework.
McGill University Library & Archives
2014-02-28 00:00:00
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https://ijwpc.mcgill.ca/article/view/71
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/72
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The Caregiver’s Wandering: The Quest for Identity Integration in the Workplace Using Reflection, Talking Circles, and Creative Expression
Annoual, Pascale
Arts, Racines and Therapies, St-Laurent
These workshops are inspired by the observations of the author in the field of mental health services delivery. The way the caregiver’s role is interpreted is different between the caregiver and the management team - the clinician cannot imagine her professional commitment without considering personal values and motivations, whereas the employer considers personal motivations an impairment to professional effectiveness. This may explain the high rate of burnout for the practitioners working in already stressful conditions in healthcare. Could the reconciliation of personal and professional dimensions prevent this disavowal of human capital? Holistic art therapy proposes to integrate the divide, to repair the rupture often experienced by the caregiver in clinical practice. Furthermore the ethnopsychiatry approach helps to reintegrate bio-psychosocial and spiritual narratives to rebalance the power struggles of workplace which may undermine the professional’s performance and fundamental raison d’être. The caregiver can become whole, balancing interpersonal, interdisciplinary and intercultural dimensions in healthcare practices.
McGill University Library & Archives
2014-02-28 00:00:00
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https://ijwpc.mcgill.ca/article/view/72
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/73
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The Information Senses of Whole Person Care: A PatientsLikeMe.com Case Study
Douglas Ferguson, Robert
McGill University
Objectives: Whole Person Care (WPC) situates the act of curing within a larger framework of healing, in which meeting psychological and social needs of patients during times of illness are also considered integral to patient outcomes and wellbeing. That is, WPC entails greater attention to how information behaviors can balance competing biological, psychological, and social dimensions of patient care within the therapeutic relationship (Hutchinson, 2011; Kaslow et al., 2007; Donadio, 2005, Mount, 2003). But what role does documentation play in patient-provider communication and meeting the biopsychosocial needs of patients via WPC? This poster visually represents a content analysis of data collected from PatientsLikeMe.com using Marchionini’s (2010) Information Sense Framework to reflect upon the role of personal health information management in WPC.
Methods: Over an 8-month period starting in September 2010, the researcher engaged in participant-observation within PLM’s Mood Disorder Community, a social networking site and research platform for patients. Grounded Theory (Charmez, 2006; Strauss and Corbin, 1987) was used to analyze site members’ virtual interactions and evaluate the subjective impact of maintaining and sharing a public personal health record (PHR) with off-website care providers.
Results: Observations confirm Information Senses is viable for interpreting the WPC functions of PHR. Site members described online PHR as effective self-management tools, by helping patients visualize, track, and understand changes in their health between visits; and enhancing the subjective quality of provider-patient relationships and communication during visits.
Conclusions: Maximizing potential benefits entails reconceptualization of medical documentation beyond diagnostic, care-coordination, and audit functions for care providers exclusively. PHR also serve communicative and reminding functions that are underexploited. Leveraging documentation to enhance the quality of communication and trust between patients and care providers, through patient-accessibility health records for example, offers a viable route towards the realization of WPC and meeting biopsychosocial needs efficiently.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/73
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/74
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Dying with Dignity in Québec: Palliative Care, Moral Expertise, and the Debate on Euthanasia
Hutchinson, Nora
On March 22, 2012, the Select Committee on Dying with Dignity of the National Assembly of Québec released its final report recommending the adoption of “medical aid in dying” in the province of Québec, Canada. The majority of palliative care physicians, professed experts in end of life care, rejected the committee’s conclusion. And yet, the recommendation of the committee, in framing euthanasia as “medical aid in dying,” placed the practice squarely within the realm of their putative expertise.
The objective of this project is to examine the role of palliative care physicians in the Dying with Dignity debate in Québec and to answer the following question: why were palliative care practitioners unable to influence the outcome of the debate?
My methods include a detailed analysis of the committee proceedings of the Select Committee on Dying with Dignity and a review of the sociological literature on committees and on expertise, the philosophical literature on euthanasia, and the historical literature on palliative care.
I draw broad conclusion about: (i) committees, and the way in which committee formation and format prioritize certain societal values; (ii) medical expertise, and the devaluation of certain forms of knowledge in the evidence-based medicine framework; (iii) moral expertise, and its presumed absence in Western democratic society.
McGill University Library & Archives
2014-02-28 00:00:00
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https://ijwpc.mcgill.ca/article/view/74
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/75
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Spirituality in Medicine
Aung, Steven
University of Alberta, Edmonton, Alberta
Objectives: Spirituality is a vital component of whole person care; healing always involves body, mind, and spirit. We can anticipate the resolution of health problems holistically by providing correct physical, mental, and spiritual alignment to our dear patients. Alignment is accomplished both through the patients’ awareness of relaxation and self-care, and the harmonization and purification of the healing energy of the practitioner. Therefore, the patient and practitioner engage upon a healing journey through spiritual connection that vitalizes the process of medicine.
Methods: Traditional Chinese Medicine has employed a physical, mental, and spiritual approach for thousands of years. Enhancing spirituality in medicine involved strengthening exercises of the body, mind, and spirit. Patients are encouraged to increase their awareness of themselves on each level. Practitioners should learn to cultivate positive healing energy that will enhance their medical practice. Qi Gong posture, breathing, phonation, and visualization exercises will be demonstrated to introduce Traditional Chinese Medical philosophy and practice.
Results: Session participants will receive a general orientation to Traditional Chinese Medicine and learn specific skills in Qi Gong. Patients will learn greater attention to physical, mental, and spiritual alignment. Practitioners will learn to engage themselves for whole person healing, by understanding the relationship between patient and the practitioner.
Conclusions: Spirituality is vitally important in medicine to enhance the quality of both its preventive and healing aspects. Treatment is a two way relationship. Practitioners must treat patients with good intentions. Patients must prepare for a healing process that engages them on the physical, mental, and spiritual levels. Practitioners and patients, therefore, must work hand in hand, heart to heart, towards the goal of health and well-being.
McGill University Library & Archives
2014-02-28 00:00:00
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https://ijwpc.mcgill.ca/article/view/75
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
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oai:ojs.iwpc.mcgill.ca:article/76
2017-09-27T18:40:35Z
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Faut-il parler de l'âme? Réflexions à propos de 2 patients.
Kopferschmitt-Kubler, M-Christine
Service de Pneumologie HUS, Strasbourg
Fraisse, Philippe
Service de Pneumologie HUS, Strasbourg
Kocher, Annick
Aumônerie HUS, Strasbourg
Muller, Alexa
Service de Pneumologie HUS, Strasbourg
Graffi, Jonathan
Service de Pneumologie HUS, Strasbourg
Ledogar, Denis
Aumônerie HUS, Strasbourg
Quoix, Elisabeth
Service de Pneumologie HUS, Strasbourg
Deux patients souffrant d’un cancer broncho-pulmonaire métastatique ont évoqué l’âme.
Patient 1 : il ne signale aucune inquiétude face à la mort « je suis au clair avec ma spiritualité ». Il croit en une vie après la mort, avec lumière et amour, dans la paix de Dieu. De retour à domicile, il écrit par mail avant son décès : « je crois avoir trouvé une approche pour parler de la spiritualité. Référez-vous aux temps anciens et aux médecines orientales ou africaines, quand les médecins étaient aussi des médecins de l’âme »
Patient 2 : une forte angoisse a cessé brutalement « Docteur, j’ai découvert que j’avais une âme et qu’elle est belle ». Cette découverte est liée à la discussion avec un chaman, accompagnant sa famille. Ce patient a évoqué un grandissement de son âme, et son immortalité.
Des étudiants hospitaliers (EH, 26/31) ont participé à une étude par questionnaire sur la perception face à la fin de vie. Pour 21 EH (81%) l’âme existe. Leurs définitions parlent de souffle, présence, croyance, entité abstraite, invisible, ce qui donne la vie, ce qui reste après la mort, Divine ou moléculaire. Parmi eux, 10 pensent que l’âme est immortelle, 2 non, 7 doutent et 2 ne savent pas. La croyance la plus fréquente est l’existence de l’âme (81%), suivie de l’existence de Dieu/Puissance supérieure (62%), puis d’une forme de vie après la mort (54%).
Conclusion : Un patient évoque l’âme et son immortalité. L’autre souhaite un médecin de l’âme. Même si notre civilisation ne parle plus de l’âme, l’existence de l’âme est une croyance forte chez les étudiants hospitaliers. Face à une souffrance spirituelle, faut-il aborder la question de l’âme et en parler? En médecine globale, faut-il redonner, à côté du corps, une place à l’âme ?
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/76
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/77
2017-09-27T18:40:35Z
IWPC:CON
"140120 2014 eng "
2291-918X
dc
Integral Medicine: Treating the Whole—Patient, Provider, Healthcare System
Petrie, David
Dalhouse University, Halifax
Kreisberg, Joel
Integral Health and Medicine Center, Berkeley, California
Huffaker, Gary
Kaiser Permanente, Riverside, California
Baron Short, Edward
Medical University of South Carolina, Charleston, South Carolina
Jarrín, Olga
University of Pennsylvania, Philadelphia
Purpose: Integral Medicine is an approach to health, disease and healing that invites multiple perspectives and modes of inquiry to synergistically support healing for patients, providers and health care systems.
Approach: Integral Theory is a framework for organizing information that considers four perspectives essential to view the whole patient simultaneously – any or all of which may illuminate health or illness in a patient, population or system: “Interior-Individual” (mind, psycho-spiritual development, etc.), “Exterior-Individual” (molecules, cells, organs, bodies, etc.), “Interior-Collective” (cultural, ethical practices or norms, etc.), and “Exterior-Collective” (socioeconomic, environmental system, etc.).
Major Points: In practice, the application of Integral Theory to patient care can lead to four quadrant diagnosis and therapy for everything from status asthmaticus to chronic fatigue syndrome. When applied to the personal and professional development of providers an Integral Theory framework may improve critical thinking, ethical reasoning, mindfulness and empathy. At the healthcare system design level, patients have better outcomes when cared for by organizations ranked as having better work environments (where nurses report low rates of burnout, adequate time with patients, good relationships with colleagues, and opportunities for advanced training and continuing education).
Conclusions: Treating the whole person becomes more than simply including body, mind and spirit. The whole person includes multiple epistemological ways of knowing. Building on Integrative, Alternative, Complementary, Evidence-based Medicine, and Values-based care, Integral Medicine offers a methodology for integrating the “best” of each of these medical methodologies. Integral Theory, in this respect, can act as a meta-theory weaving together many of the converging concepts emerging in the service of whole patient care. Integral methodology also provides a common map/language for knowledge integration/translation and a shared inter-professional approach to whole patient care at the patient, population and health system levels.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/77
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/78
2017-09-27T18:40:35Z
IWPC:CON
"140120 2014 eng "
2291-918X
dc
Imagine the poss-ABILITIES! Therapeutic Recreation: An Integral Aspect of Whole-Person Health Care
Botner, Erica
Concordia University; Recreotherapy Montréal
The word recreation is really a very beautiful word. It is defined in the dictionary as “the process of giving new life to something, of refreshing something, of restoring something.” This something, of course, is the whole person. (Bruno Hans Geba)
Background: The purpose of Therapeutic Recreation is to enable all individuals to improve quality of life, and achieve optimal health through meaningful experiences in recreation and leisure. We believe in the inherent capacities of individuals for wellness, personal growth, happiness and freedom, with or without absence of disease. Therapeutic Recreation is a profession which provides service to, and advocates for individuals with disabilities, illnesses, and other conditions in clinical, community and educational settings. We recognize that everyone has the right to have access to and experience the healing benefits from recreation and leisure opportunities. Therapeutic Recreation follows a systematic process of developing a therapeutic relationship, assessment, goal setting, program development, implementation through individual and group facilitation, documentation and evaluation. Programs are designed based on the strengths, interests and needs of the participants and promote improving wellness within the physical, emotional, spiritual, behavioural and social domains (according to the participant and their context) and to educate individuals about the skills and resources required to participate in recreation and leisure. We use evidence-based practice to create outcome-based interventions suitable to the participant’s abilities.
Content: Presentation will be descriptive, drawing attention to the profession of Therapeutic Recreation and how it fits well with the whole person approach.
Evidence: Current research indicates a significant number of positive health outcomes resulting from participation in Therapeutic Recreation programs such as: improved physical, cognitive, social and emotional functioning; leisure and life skill development to enhance functional independence; self worth, and quality of life of individuals and their families; adjustment to disability and/or illness and post-traumatic growth; reduced boredom, stress, anxiety, and agitation; reduced decline in physical, cognitive, and psychosocial functioning and as a result reduce the need for health care services; reduced secondary disability and associated higher health care costs.
Conclusion: There is strong evidence that Therapeutic Recreation interventions are healing, support wholeness, and can have a major positive impact in the outcomes of people served. Thus, Therapeutic Recreation should be an integral part of any multi-disciplinary health care team that uses a whole-person care approach.
McGill University Library & Archives
2014-02-28 00:00:00
article
https://ijwpc.mcgill.ca/article/view/78
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/79
2017-09-27T18:40:35Z
IWPC:EDTL
driver
"140213 2014 eng "
2291-918X
dc
Healing, Whole Person Care and Inclusive Medicine
Jordan, Steven
McGill University
Dobkin, Patricia
McGill University
McGill University Library & Archives
2014-02-28 00:00:00
editorial
text/html
https://ijwpc.mcgill.ca/article/view/79
The International Journal of Whole Person Care; Vol. 1 No. 1 (2014): Congress October 2013
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/80
2017-09-27T18:40:35Z
IWPC:ES
driver
"140703 2014 eng "
2291-918X
dc
Whole Person Care: Where clinical excellence and patient service meet
Kearsley, John H.
University of New South Wales, Sydney
St. George Hospital, Kogarah
-
McGill University Library & Archives
2014-08-19 16:00:30
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/80
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/82
2017-09-27T18:40:35Z
IWPC:ES
driver
"140704 2014 eng "
2291-918X
dc
'BUT WHAT AM I GOING TO SAY?" Some advice to medical students about dealing with feelings of inadequacy
Kearsley, John H.
University of New South Wales, Sydney
St. George Hospital, Kogarah
Cassell, Eric J
Emeritus Professor of Public Health, Weill Medical College of Cornell University, Adjunct Professor of Medicine, Faculty of Medicine, McGill University, Attending Physician, New York Presbyterian Hospital, New York USA
Nil abstract
McGill University Library & Archives
2014-08-19 16:00:30
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/82
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/83
2017-09-27T18:40:35Z
IWPC:ES
driver
"140704 2014 eng "
2291-918X
dc
Stories at Work: Writing to Learn, Care, and Collaborate in Radiation Therapy
Whyte, Sarah
University of Waterloo
Damelin, Ariella
Peacock, Marnie
Sunnybrook Health Sciences Centre
Williams, Gail
Sunnybrook Health Sciences Centre
Osmar, Kari
Sunnybrook Health Sciences Centre
Narrative writing has shown potential to foster skilled, compassionate care among health professionals. We describe the process and effects of a project that introduced experiential narrative writing to professionals and students at a large Canadian cancer centre. Four 90-minute introductory workshops in experiential narrative writing were offered to radiation therapy students (9), radiation therapists (28), and oncology nurses (1). These workshops were followed by an in-depth narrative writing course consisting of four 60-minute sessions. The course was offered twice with a total of 11 participants (all radiation therapists). Participants were prompted to write about their experiences, share their writing, and respond to each other’s writing. Writing was not focused on professional experiences. All sessions were led by an experienced facilitator and researcher. In order to describe the process and effects of these courses, we used a combination of observations, reflective writing, ongoing dialogue with participants, and follow-up interviews (8 radiation therapists and 3 students). We describe five “active elements” of the narrative writing sessions: stories at (but not about) work, challenge, trust, quality of engagement, and continuity. We then discuss perceived effects of the narrative writing sessions, which we have termed pleasure, perspective, community, presence, craft, and collective artwork. These findings suggest potential for narrative writing to support the work, well-being, and community of health professionals in radiation therapy.
McGill University Library & Archives
2014-08-19 16:00:30
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/83
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/84
2017-09-27T18:40:35Z
IWPC:COMM
driver
"140707 2014 eng "
2291-918X
dc
Galen and Wellbeing: Whole Person Care
Marsden, Debbie
University of Exeter Medical School
Wilkins, John
University of Exeter
Gill, Christopher
University of Exeter
Dieppe, Paul
University of Exeter
n/a - commentary
McGill University Library & Archives
2014-08-19 16:00:30
article-commentary
application/pdf
https://ijwpc.mcgill.ca/article/view/84
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/85
2017-09-27T18:40:35Z
IWPC:EDTL
driver
"140702 2014 eng "
2291-918X
dc
See It, Do It, Teach it – or Be It?
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
McGill University Library & Archives
2014-08-19 16:00:30
editorial
application/pdf
https://ijwpc.mcgill.ca/article/view/85
The International Journal of Whole Person Care; Vol. 1 No. 2 (2014): SEE IT, DO IT, TEACH IT – OR BE IT?
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/88
2017-09-27T18:40:35Z
IWPC:ES
driver
"150113 2015 eng "
2291-918X
dc
Making sense of a diagnosis of incurable cancer: The importance of communication
Lobb, Elizabeth Anne
Calvary Health Care Kogarah, Cunningham Centre for Palliative Care,
School of Medicine, the University of Notre Dame, Sydney
Lacey, Judith
Calvary Health Care Kogarah,
Southern Oncology Specialists,
St George Private Hospital
Liauw, Winston S
Cancer Care Centre St. George Hospital
Faculty of Medicine, University of New South Wales
White, Lesley E
Calvary Health Care Kogarah
Hosie, Annmarie
Calvary Health Care Kogarah,
School of Nursing, the University of Notre Dame, Sydney
Kearsley, John H
Cancer Care Centre St., George Hospital
Faculty of Medicine, University of New South Wales
Purpose: Patients diagnosed with incurable cancer may experience existential distress
and difficulty in re-appraising their lives because of uncertainty about the future.
Objectives: This study sought to understand how patients living with incurable cancer made sense of their diagnosis, how they prepared for the future and what support they wanted from their health professionals.
Subjects: 27 patients were recruited from the oncology and palliative care service at three metropolitan hospitals.
Methods: A qualitative research approach was used. Semi-structured face-to-face interviews were conducted. Interviews were audio-taped and transcribed verbatim. Data was analyzed using the constant-comparative method.
Results: Participants did not express a need to make sense of their diagnosis nor always ascribe to a particular religious belief; rather, many relied on a personal spirituality or philosophy to bring meaning to their experience. Importance was placed on their doctor keeping up with technology, being honest, and being confident and positive.
Conclusion: Participants in this study had incurable cancer but making sense of their current situation was not a conscious priority. For these patients, uncertainty was a positive, as certainty for them indicates death is approaching. What these interviews suggest, from the patient’s perspective, is that there is an implied contract between doctor and patient during this period which involves the doctor managing the flow of difficult information so that the patient can maintain normality for as long as possible. Understanding this helps to explain the difficulty of having advance care planning conversations within this setting, despite the many opportunities that a longer disease trajectory would seem to offer.
McGill University Library & Archives
2015-01-29 14:17:23
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/88
The International Journal of Whole Person Care; Vol. 2 No. 1 (2015): Tending to Mortals
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/89
2017-09-27T18:40:35Z
IWPC:TP
driver
"150112 2015 eng "
2291-918X
dc
Transformative Learning as the Basis for Teaching Healing
Kearsley, John H.
University of New South Wales, Sydney
St. George Hospital, Kogarah
The author describes the nature of transformative education, and highlights the potential importance of its implementation in creating physician-healers and propagating whole person care. The author proposes that teaching courses in healing are integral to the professional identity formation of “doctors as healers”.
The teaching of Healing in workshop format for medical students is used as a template to suggest innovative teaching models (after Mezirow, Boyd and Myers, Daloz and Dirkx) which may be used to engender personal transformation in doctors and medical students, many of whom are trained as applied scientists in health.
McGill University Library & Archives
2015-01-29 14:17:23
article
application/pdf
https://ijwpc.mcgill.ca/article/view/89
The International Journal of Whole Person Care; Vol. 2 No. 1 (2015): Tending to Mortals
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/90
2017-09-27T18:40:35Z
IWPC:CART
driver
"150115 2015 eng "
2291-918X
dc
Being Human in Medicine: Beyond Hierarchy
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
Bagnis, Corinne I
Groupe Hospitalier Pitié‐Salpêtrière et Chaire de Recherche en Éducation Thérapeutique du Patient de la
Fondation, Université Pierre et Marie Curie, Paris
Spodenkiewicz, Michel
Groupe Hospitalier Pitié‐Salpêtrière, Service de Psychiatrie de l’Enfant et de l’Adolescent, Unité Inserm U669
et Institut de Systèmes Intelligents et Robotique, Université Pierre et Marie Curie, Paris
None
McGill University Library & Archives
2015-01-29 14:17:23
discussion
application/pdf
https://ijwpc.mcgill.ca/article/view/90
The International Journal of Whole Person Care; Vol. 2 No. 1 (2015): Tending to Mortals
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/91
2017-09-27T18:40:36Z
IWPC:EDTL
driver
"150112 2015 eng "
2291-918X
dc
Tending to Mortals
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
McGill University Library & Archives
2015-01-29 14:17:23
editorial
application/pdf
https://ijwpc.mcgill.ca/article/view/91
The International Journal of Whole Person Care; Vol. 2 No. 1 (2015): Tending to Mortals
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/93
2017-09-27T18:40:36Z
IWPC:COMM
driver
"150128 2015 eng "
2291-918X
dc
Are You a Human Being or a Human Doing? The Role for Mindfulness in Our Lives
Gonsalves, Carol
The Ottawa Hosptial, Ottawa Blood Disease Centre, 501 Smyth Road Ottawa ON
None
McGill University Library & Archives
2015-01-29 14:17:23
article-commentary
application/pdf
https://ijwpc.mcgill.ca/article/view/93
The International Journal of Whole Person Care; Vol. 2 No. 1 (2015): Tending to Mortals
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/96
2017-09-27T18:40:36Z
IWPC:TP
driver
"150605 2015 eng "
2291-918X
dc
On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education
Rahimzadeh, Vasiliki Nataly
McGill University
Lessard, David
McGill University
Nugus, Peter
McGill University
Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.
Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.
Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.
Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.
McGill University Library & Archives
2015-06-09 16:20:01
article
application/pdf
https://ijwpc.mcgill.ca/article/view/96
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/97
2017-09-27T18:40:36Z
IWPC:CSN
driver
"150526 2015 eng "
2291-918X
dc
How Do Junior Medical Students Learn about the Doctor Patient Relationship?
Wilson, Hamish
Faculty of Medicine, University of Otago, Dunedin
Chambers, Stuart
Faculty of Medicine, University of Otago, Dunedin
Junior medical students have the capacity to engage well with patients at an early stage in their training. With careful coaching, students can also write moving and accurate accounts of their significant learning experiences. In this article, we introduce an innovative learning programme at Otago University in New Zealand, and present carefully chosen extracts from student essays. These extracts illustrate students’ early exposure to, and challenges in, the student-patient relationship, a precursor to their own professional relationships. Reflective writing helps students internalize foundational interpersonal concepts such as meaningful engagement, self-awareness, the role of other health professionals, and the need for self-care. This early orientation towards whole person care may be helpful grounding for future clinical practice.
McGill University Library & Archives
2015-06-09 16:20:01
case-report
application/pdf
https://ijwpc.mcgill.ca/article/view/97
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/98
2017-09-27T18:40:36Z
IWPC:COMM
driver
"150514 2015 eng "
2291-918X
dc
Looking Beyond the Façade: A Whole Person Perspective of Suicidal Ideation
Lapum, Jennifer L
Ryerson University
n/a for commentaries
McGill University Library & Archives
2015-06-09 16:20:01
article-commentary
application/pdf
https://ijwpc.mcgill.ca/article/view/98
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/99
2017-09-27T18:40:36Z
IWPC:COMM
driver
"150526 2015 eng "
2291-918X
dc
Finding My Voice in Residency: Reflections on Integrative Family Medicine
Minichiello, Vincent Joseph
University of Wisconsin, Madison Family Medicine Residency Program
The author discusses how self awareness and healing play a key role within the evolving field of integrative family medicine.
McGill University Library & Archives
2015-06-09 16:20:01
article-commentary
application/pdf
https://ijwpc.mcgill.ca/article/view/99
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/100
2017-09-27T18:40:36Z
IWPC:ES
driver
"151210 2015 eng "
2291-918X
dc
Incorporation of spiritual care as a component of healthcare and medical education: comparison of Sub-Saharan African and Northern European viewpoints
Bell, David
Centre for Medical Education
The Queen's University of Belfast
Atkinson, Timothy
UK National Health Service
Agnew, Christopher Philip
UK National Health Service
Harbinson, Mark Thomas
Centre for Medical Education
The Queen's University of Belfast
This study addresses cultural differences regarding views on the place for spirituality within healthcare training and delivery. A questionnaire was devised using a 5-point ordinal scale, with additional free text comments assessed by thematic analysis, to compare the views of Ugandan healthcare staff and students with those of (1) visiting international colleagues at the same hospital; (2) medical faculty and students in United Kingdom. Ugandan healthcare personnel were more favourably disposed towards addressing spiritual issues, their incorporation within compulsory healthcare training, and were more willing to contribute themselves to delivery than their European counterparts. Those from a nursing background also attached a greater importance to spiritual health and provision of spiritual care than their medical colleagues. Although those from a medical background recognised that a patient’s religiosity and spirituality can affect their response to their diagnosis and prognosis, they were more reticent to become directly involved in provision of such care, preferring to delegate this to others with greater expertise. Thus, differences in background, culture and healthcare organisation are important, and indicate that the wide range of views expressed in the current literature, the majority of which has originated in North America, are not necessarily transferable between locations; assessment of these issues locally may be the best way to plan such training and incorporation of spiritual care into clinical practice.
McGill University Library & Archives
2016-01-06 13:57:16
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/100
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/103
2017-09-27T18:40:36Z
IWPC:CSN
driver
"150601 2015 eng "
2291-918X
dc
Family Medicine Quartet
Rappaport, Maureen Estelle
McGill university
St Mary's hospital
Family medicine is a unique medical discipline centred on the patient and the doctor patient relationship. In this essay I use an arts based inquiry juxtaposing clinical narratives to illustrate the clinical philosophy of Ian McWhinney.
McGill University Library & Archives
2015-06-09 16:20:01
case-report
application/pdf
https://ijwpc.mcgill.ca/article/view/103
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/104
2017-09-27T18:40:36Z
IWPC:EDTL
driver
"150514 2015 eng "
2291-918X
dc
Dizygotic Twins – WHOLE PERSON CARE AND FAMILY MEDICINE – Similar but Not Identical
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
McGill University Library & Archives
2015-06-09 16:20:01
editorial
application/pdf
https://ijwpc.mcgill.ca/article/view/104
The International Journal of Whole Person Care; Vol. 2 No. 2 (2015): WHOLE PERSON CARE AND FAMILY MEDICINE
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/106
2017-09-27T18:40:36Z
IWPC:TP
driver
"151210 2015 eng "
2291-918X
dc
Mindful medical practice and the therapeutic alliance
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
Lucena, Ricardo J. M.
Psychiatrist and Associate Professor
Department of Internal Medicine
Centre of Medical Sciences
Universidade Federal da Paraiba
João Pessoa-PB
This review article focuses on how the therapeutic relationship is central to clinician-client/patient relationships in psychiatry as well as other medical and psychotherapeutic encounters. Crucial to this relationship is the alliance formed between the caregiver and the person who seeks their care. The threats to the therapeutic alliance in psychiatry are discussed as is the importance of facing them. How mindfulness enables clinicians to build such bonds and foster well-being in themselves and in those they treat is examined in the context of quantitative and qualitative studies.
McGill University Library & Archives
2016-01-06 13:57:16
article
application/pdf
https://ijwpc.mcgill.ca/article/view/106
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/107
2017-09-27T18:40:36Z
IWPC:COMM
driver
"151210 2015 eng "
2291-918X
dc
Self-care following patient deaths: un-conceal grief and embrace vulnerability
Lapum, Jennifer L
Ryerson University
n/a
McGill University Library & Archives
2016-01-06 13:57:16
article-commentary
application/pdf
https://ijwpc.mcgill.ca/article/view/107
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/108
2017-09-27T18:40:36Z
IWPC:CSN
driver
"151210 2015 eng "
2291-918X
dc
Carrying the healer’s baton
Briedis, Jonas
McGill University
The story of a relatively brief interaction I had with a ward patient that taught me how little effort it can sometimes take to completely change a patient's experience of their hospital admission.
McGill University Library & Archives
2016-01-06 13:57:16
case-report
application/pdf
https://ijwpc.mcgill.ca/article/view/108
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/109
2017-09-27T18:40:36Z
IWPC:EDTL
driver
"151210 2015 eng "
2291-918X
dc
Whole Person Care: More Than Just A New Name
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
McGill University Library & Archives
2016-01-06 13:57:16
editorial
application/pdf
https://ijwpc.mcgill.ca/article/view/109
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/110
2017-09-27T18:40:36Z
IWPC:TP
driver
"151210 2015 eng "
2291-918X
dc
Pilgrims together: leveraging community partnerships to enhance workplace resilience
Frolic, Andrea Nadine
Hamilton Health Sciences
Many of today’s healthcare personnel find themselves in a double-bind. The question is: How to remain connected, caring and compassionate with patients, while mitigating the impact of chronic workplace stress? Mindfulness is emerging as a means for addressing this dilemma as it has the potential to both reduce workplace stress and boost employee resilience, while enhancing the patient experience. This article describes the development of a unique collaboration between local hospitals, primary care teams and a university, aimed at bringing mindfulness to life in healthcare. This is a conventional story of program development and evaluation, as well as an unconventional story of personal discovery, community-building, and organizational transformation. Each section of the paper highlights a critical success factor that we have uncovered in our journey, and poses a series of questions for contemplation. This paper aims to fill a gap in the literature by describing the key ingredients for developing and sustaining a community-wide collaboration aimed at integrating mindfulness into the healthcare system.
McGill University Library & Archives
2016-01-06 13:57:16
article
application/pdf
https://ijwpc.mcgill.ca/article/view/110
The International Journal of Whole Person Care; Vol. 3 No. 1 (2016): Whole Person Care: More Than Just A New Name
eng
Copyright (c)
oai:ojs.iwpc.mcgill.ca:article/111
2017-09-27T18:40:36Z
IWPC:CSN
driver
"160607 2016 eng "
2291-918X
dc
On Africa, children, and the mutual dimension of healing
Chadi, Nicholas
Hospital for Sick Children
Toronto, ON, Canada
None
McGill University Library & Archives
2016-06-07 15:54:55
case-report
application/pdf
https://ijwpc.mcgill.ca/article/view/111
The International Journal of Whole Person Care; Vol. 3 No. 2 (2016): Healing in Western Medicine
eng
Copyright (c) 2016
oai:ojs.iwpc.mcgill.ca:article/112
2017-09-27T18:40:36Z
IWPC:CART
driver
"160607 2016 eng "
2291-918X
dc
Uncovering freedom: a story of empowerment
Minichiello, Vincent Joseph
University of Wisconsin, Madison Family Medicine Residency Program
This article tells the story of a woman suffering from food anxiety and unintentional weight loss and how shifting to an empowerment-based model of care led her onto a path of health and healing.
McGill University Library & Archives
2016-06-07 15:54:55
discussion
application/pdf
https://ijwpc.mcgill.ca/article/view/112
The International Journal of Whole Person Care; Vol. 3 No. 2 (2016): Healing in Western Medicine
eng
Copyright (c) 2016
oai:ojs.iwpc.mcgill.ca:article/117
2017-09-27T18:40:36Z
IWPC:ES
driver
"160607 2016 eng "
2291-918X
dc
Psychophysiology of slow breathing exercises using heart rate variability measurements for stress reduction
Simbulan, Dante Jr. Guanlao
Department of Physiology
College of Medicine
DE LA SALLE HEALTH SCIENCES INSTITUTE (DLSHSI)
DASMARINAS, CAVITE 4114 PHILIPPINES
MIND-BODY STUDIES SECTION,
CENTER FOR COMPLEMENTARY AND INTEGRATIVE MEDICINE (CIM),
RESEARCH SERVICES, DLSHSI
DASMARINAS, CAVITE 4114 PHILIPPINES
Slow breathing exercises, associated with meditation and other eastern style modalities like tai chi and hatha yoga, are now increasingly employed in mainstream medicine to reduce stress, attenuate moderate hypertension, and alleviate symptoms of lifestyle-related illnesses. The clinical literature on slow breathing exercises includes studies employing various physiological measurements, including heart rate variability (HRV), galvanic skin response, and changes in skin temperature. HRV has been increasingly used to measure the activity of the autonomic nervous system in various human studies employing healthy and chronically ill subjects.
1. Objective: To understand the effects of slow breathing exercises on heart rate variability as a complementary intervention for stress reduction.
2. Method: Four subjects, through repetitive trials, were instructed to slow down their breathing following a metronome at 10 breaths per minute or 6 breaths per minute or spontaneously relax to slow down their respiratory rate. The ECG, heart rate, and respiratory rate were recorded using a Powerlab set-up (ADI).
3. Key Results: Results showed an increase in amplitude of heart rate variability during these slow breathing exercises, either through the metronome-guided or spontaneous slow-breathing exercises, especially around a breathing frequency of 6 breaths per minute. The increased amplitude of heart rate variability can be seen as a positive sign, a marker for sympathovagal balance.
4. Conclusion: HRV measurements have shown that slow breathing exercises can increase heart rate variability. Future protocols for clinical trials are being projected using the HRV technique and other physiological measurements for studying effects of yoga-based complementary interventions for stress reduction.
McGill University Library & Archives
2016-06-07 15:54:55
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/117
The International Journal of Whole Person Care; Vol. 3 No. 2 (2016): Healing in Western Medicine
eng
Copyright (c) 2016 International Journal of Whole Person Care
oai:ojs.iwpc.mcgill.ca:article/118
2017-09-27T18:40:37Z
IWPC:CSN
driver
"160607 2016 eng "
2291-918X
dc
Touching the compassionate heart: the ground of healing
Monshat, Kaveh
I am a psychiatrist, psychotherapist, secular mindfulness teacher and former university lecturer. Having conducted research in fields varying from laboratory molecular medicine to clinical applications of mindfulness, I took a two year sabbatical to focus on an inner search and healing. It was spent mostly spent in Plum Village: a Buddhist monastery in France in the tradition of Thich Nhat Hanh. I have recently returned to clinical work.
I found that it was not until I took a compassionate view of myself that I truly began to heal; and that following my heart was the only way I could negotiate the uncertainties of the path.
McGill University Library & Archives
2016-06-07 15:54:55
case-report
application/pdf
https://ijwpc.mcgill.ca/article/view/118
The International Journal of Whole Person Care; Vol. 3 No. 2 (2016): Healing in Western Medicine
eng
Copyright (c) 2016 International Journal of Whole Person Care
3978a96b9c014b525f63ddc9828c244f