2024-03-29T11:32:06Z
https://ijwpc.mcgill.ca/oai
oai:ojs.iwpc.mcgill.ca:article/2
2017-09-27T18:40:35Z
IWPC:ES
driver
nmb a2200000Iu 4500
"140704 2014 eng "
2291-918X
10.26443/ijwpc.v1i2.2
doi
dc
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
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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/80
2017-09-27T18:40:35Z
IWPC:ES
driver
nmb a2200000Iu 4500
"140703 2014 eng "
2291-918X
10.26443/ijwpc.v1i2.80
doi
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
nmb a2200000Iu 4500
"140704 2014 eng "
2291-918X
10.26443/ijwpc.v1i2.82
doi
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
nmb a2200000Iu 4500
"140704 2014 eng "
2291-918X
10.26443/ijwpc.v1i2.83
doi
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/88
2017-09-27T18:40:35Z
IWPC:ES
driver
nmb a2200000Iu 4500
"150113 2015 eng "
2291-918X
10.26443/ijwpc.v2i1.88
doi
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/100
2017-09-27T18:40:36Z
IWPC:ES
driver
nmb a2200000Iu 4500
"151210 2015 eng "
2291-918X
10.26443/ijwpc.v3i1.100
doi
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/117
2017-09-27T18:40:36Z
IWPC:ES
driver
nmb a2200000Iu 4500
"160607 2016 eng "
2291-918X
10.26443/ijwpc.v3i2.117
doi
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/123
2017-09-27T18:40:37Z
IWPC:ES
driver
nmb a2200000Iu 4500
"170127 2017 eng "
2291-918X
10.26443/ijwpc.v4i1.123
doi
dc
Who experiences depressive symptoms following mindfulness-based stress reduction and why?
Dobkin, Patricia Lynn
McGill University http://mcgill.ca/wholepersoncare
Zhao, Qinyi
University Centre
Toronto Rehabilitation Institute
Monshat, Kaveh
Department of Psychiatry, University of Melbourne
Background: A small percentage of patients screen positive for depression following a mindfulness-based program. We identified patient characteristics associated with this outcome in order to understand this phenomenon.
Methods: Depressive symptoms, stress, mindfulness, coping with illness and sense of coherence were measured in 126 patients with various medical and psychological conditions pre- and post- Mindfulness-Based Stress Reduction (MBSR).
Results: Fewer patients (27% vs. 49%) screened positive for depression post-MBSR. Both pre- and post-MBSR patients who were depressive following MBSR scored lower on meaningfulness, comprehensibility, and manageability (sense of coherence), higher on emotional coping and lower on palliative and distraction coping. Smaller positive changes (e.g. stress) occurred in these patients as well. Viewing life as less meaningful pre-MBSR predicted more symptoms of depression post-MBSR.
Conclusions: Patients who suffered depressive symptoms following the program were unable to reappraise their lives in such a way as to become stress resilient.
McGill University Library & Archives
2017-01-27 10:29:50
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/123
The International Journal of Whole Person Care; Vol. 4 No. 1 (2017): Psychiatry in the 21st century – Orientations and Options
eng
Copyright (c) 2017 International Journal of Whole Person Care
oai:ojs.iwpc.mcgill.ca:article/238
2020-09-23T14:06:21Z
IWPC:ES
driver
nmb a2200000Iu 4500
"200715 2020 eng "
2291-918X
10.26443/ijwpc.v7i2.238
doi
dc
Presence and the paradox of time for palliative care clinicians: a phenomenological study
Vachon, Melanie
Département de psychologie
Université du Québec à Montréal
Maison Au Diapason
Goyette, Christine
Guité-Verret, Alexandra
Background: A presence of quality is recognized as a central competence for palliative care clinicians in their mission to accompany patients and families in their end-of-life journey. However, PC clinicians’ capacity for presence may be affected by the increasing emotional, professional and organizational demands of their working environment. Those demands may, in turn, affect quality of care and clinicians’ health. To our knowledge, no previous study has aimed at a better understanding of how PC clinicians view and experience presence in their day-to-day work, although this holds the potential of generating insights to help clinicians develop and cultivate a high-quality presence towards dying patients.
Methods: We conducted in-depth qualitative semi-structured interviews with 10 PC clinicians working on a specialized PC ward, later analyzed using Interpretative Phenomenological Analysis.
Results: Results account for three essential themes describing the experience of presence; connection to the self, to the other and to the meaning of care. Results also suggest that presence was lived and experienced within a very particular relation to time, which appeared to our participants as a significant challenge in achieving high-quality presence.
Conclusion: The stressful working environment in which PC clinicians daily evolve appeared as a threat to presence for our participants. Paradoxically, cultivating presence with mindfulness may be a promising tool to better cope with the competing demands of work and to foster clinicians’ resilience to stress.
McGill University Library & Archives
2020-07-15 00:00:00
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/238
The International Journal of Whole Person Care; Vol. 7 No. 2 (2020): Preparing Medical Students for the Real World of Patient Care
eng
Copyright (c) 2020 Melanie Vachon, Christine Goyette, Alexandra Guité-Verret
oai:ojs.iwpc.mcgill.ca:article/248
2020-09-01T15:02:32Z
IWPC:ES
driver
nmb a2200000Iu 4500
"200715 2020 eng "
2291-918X
10.26443/ijwpc.v7i2.248
doi
dc
Mindfulness in medical education: Students’ perceptions and four recommendations for implementation of a mindfulness intervention
Sanchez-Campos, Millaray
University of Ottawa
Faculty of Medicine http://orcid.org/0000-0002-6006-620X
Archibald PhD, Doug
Department of Family Medicine
University of Ottawa
MacLean, Heather
Department of Medicine
Faculty of Medicine
University of Ottawa
Koszycki, Diana
Professor Faculty of Education (Psychology) and Medicine (Psychiatry), University of Ottawa.
Gonsalves, Carol
Department of Medicine
Faculty of Medicine
University of Ottawa
Background: Faculties of Medicine around the globe have implemented mindfulness-based curricula to deal with medical student’s burnout, anxiety and depression. The purpose of this qualitative study is to assess students’ perception of a mandatory mindfulness intervention and their recommendations for further curricula development and implementation.
Methods: Third-year medical students participated in a mandatory three-hour mindfulness workshop embedded in their family medicine academic week. Eleven students consented to two interviews which explored their perceptions of mindfulness and the workshop in relation to their personal and professional wellbeing as well as their views for the implementation of a longitudinal mindfulness curriculum.
Results: Student and institutional benefits and barriers relating to the curriculum were identified. Student’s benefits included positive changes in stress, self-awareness and personally that also translated into self-reported better patient care. Students reported lack of time, forgetting to practice and lack of knowledge about mindfulness as barriers. Institutional pride for their support of student wellness and an overfilled curriculum, were the major institutional benefits and barriers respectively, to the expansion of this curriculum. Among developing an implementing a longitudinal mindfulness curriculum, we found four key features to consider: Firstly to engage the stakeholders; secondly, to incorporate the mindfulness intervention into the curriculum with both a mandatory and elective component; thirdly, to emphasize the clinical implications of the mindfulness intervention and fourthly, to have protected time for wellness interventions.
Conclusions: Introducing mindfulness into the undergraduate medical school curriculum through this workshop resulted in perceived personal, institutional and professional benefits. For faculties of medicine that want to implement a mindfulness intervention, we found four key components for implementing a mindfulness intervention in their institutions. Further research is needed to better quantify the benefits and to identify ways to manage barriers at both individual and institutional levels.
McGill University Library & Archives
2020-07-15 00:00:00
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/248
The International Journal of Whole Person Care; Vol. 7 No. 2 (2020): Preparing Medical Students for the Real World of Patient Care
eng
Copyright (c) 2020 Millaray Sanchez-Campos, Doug Archibald, Heather MacLean, Diana Koszycki, Carol Gonsalves
oai:ojs.iwpc.mcgill.ca:article/365
2024-01-29T17:12:50Z
IWPC:ES
driver
nmb a2200000Iu 4500
"240129 2024 eng "
2291-918X
10.26443/ijwpc.v11i1.365
doi
dc
A Medical Student Study of Rural Health Concerns, Community Determinants and Whole Person Care
Harper, Andrew
Curtin University Medical School https://orcid.org/0000-0002-1533-7365
Sanders, Kiera
Sir Charles Gairdner Hospital
Edwards, Kahla
St John of God Public and Private Hospital Midland
Billah, Tasfeen
Royal North Shore Hospital
Corbett, Tessa
Fiona Stanley Hospital
Irvine, Lucy
Bunbury Regional Hospital
Background: Following a short rural health placement in the second year of medical school five students opted, as an extra-curricular activity, to conduct an exploratory research project into the wellbeing and health concerns of rural residents in the Wheatbelt of Western Australia. The project was conducted in collaboration with the local shires. The aim was to document, analyse and understand the health concerns and experience of rural residents.
Methods: A phenomenological research approach was employed. Seventeen rural residents selected by the shires, and four key informants responded to open-ended interviews. Their narratives were subjected to a thematic analysis.
Results: The narratives described a wide range of health concerns relating to health services, mental illness, transportation, accommodation, marginalisation of the community, bureaucratisation of administration, community fragmentation and the desire for community partnerships. Frustration and inconvenience from community factors were associated with anxiety, depression, isolation, and loss of wellbeing.
Discussion: The respondents described a dysfunctional and under resourced local rural community. They defined numerous health concerns related to deficiencies in community cohesion and integration. They illustrated how whole person health involving prevention, acute and chronic treatment and aged care are all impacted by rural community circumstances. The narratives highlight the need for community development at the population level and for community context to be a principal focus in the clinical practice of whole person care in rural communities.
McGill University Library & Archives
2024-01-29 12:12:48
research-article
application/pdf
https://ijwpc.mcgill.ca/article/view/365
The International Journal of Whole Person Care; Vol. 11 No. 1 (2024)
eng
Copyright (c) 2023 Andrew Harper