Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.415
Richard B. Hovey
While progressing through my ongoing cancer treatments, in particular the reflection or re-reflections guided by Richard Kearney’s hermeneutic wager. I prefer a wager over the traditional cancer metaphors because it replaces the blatant harshness of a battle in a war. I am not saying in any way of form to be a passive observer during one’s cancer treatment journey, but to replace the winner-looser paradigm with carnage associated with war, shrapnel dismembered bodies unrecognizable to themselves and others. This does not mean that I am not standing up to and confronting cancer with vigor and intensity. The wager offers dignity during participation where all the “cards” are delt from both the cancer and the treatments with the integrity of the whole person who is living with cancer with their healthcare team and family play together as a community to successfully support the wager’s cause. The wager is respectful and addresses the risks involved and is fully c onscientious of outcomes as an unpredictable event. This wager is comprised of five reflections and/or conversations to engage in that I have adapted to learn about living with cancer and its treatments. The hermeneutic wager has five points of reflection: imagination, humility, commitment, discernment, and hospitality. These will be used to provide examples of how to offer insight into one’s experiences. Through these kinds of reflections on cancer, uncertainty can help us develop wings for the journey into the unknown uncertainty that often a diagnosis of cancer requires.
{"title":"Why the hermeneutic wager","authors":"Richard B. Hovey","doi":"10.26443/ijwpc.v11i1.415","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.415","url":null,"abstract":"While progressing through my ongoing cancer treatments, in particular the reflection or re-reflections guided by Richard Kearney’s hermeneutic wager. I prefer a wager over the traditional cancer metaphors because it replaces the blatant harshness of a battle in a war. I am not saying in any way of form to be a passive observer during one’s cancer treatment journey, but to replace the winner-looser paradigm with carnage associated with war, shrapnel dismembered bodies unrecognizable to themselves and others. This does not mean that I am not standing up to and confronting cancer with vigor and intensity. \u0000The wager offers dignity during participation where all the “cards” are delt from both the cancer and the treatments with the integrity of the whole person who is living with cancer with their healthcare team and family play together as a community to successfully support the wager’s cause. The wager is respectful and addresses the risks involved and is fully c onscientious of outcomes as an unpredictable event. This wager is comprised of five reflections and/or conversations to engage in that I have adapted to learn about living with cancer and its treatments. The hermeneutic wager has five points of reflection: imagination, humility, commitment, discernment, and hospitality. These will be used to provide examples of how to offer insight into one’s experiences. Through these kinds of reflections on cancer, uncertainty can help us develop wings for the journey into the unknown uncertainty that often a diagnosis of cancer requires.","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"74 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.412
R. Szwimer, Richard B. Hovey
Adolescents living with chronic pain (CP) are vulnerable to negative outcomes such as disability and impaired quality of life. They often miss opportunities for social engagement and suffer from anxiety and depression. Central to all accounts is a sense of interrupted life—phrases with negative connotations such as “couldn’t do” and “had to stop” are repeatedly used to express feelings of loss of control. To regain control over their situation, participants create within themselves a positive internal dialogue whereby they reconstruct the meaning of normalcy, practice acceptance, make downward social comparisons, and engage in daily positive affirmations. They also create a positive external environment, surrounding themselves with compassionate individuals as well as advocating for proper accommodations at school. While CP disrupts their personal and academic trajectories, the experience of living with pain has instilled in them the pursuit of significance. This pursuit is propelled by the imagery of a fulfilled life and seems to be particular to this age group. Ironically, some participants are grateful for their pain for granting them intuitive empathy for the suffering of others and the emotional credibility to help others.
{"title":"Resilience in adolescent chronic pain: an exploration of coping mechanisms and personal growth","authors":"R. Szwimer, Richard B. Hovey","doi":"10.26443/ijwpc.v11i1.412","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.412","url":null,"abstract":"Adolescents living with chronic pain (CP) are vulnerable to negative outcomes such as disability and impaired quality of life. They often miss opportunities for social engagement and suffer from anxiety and depression. Central to all accounts is a sense of interrupted life—phrases with negative connotations such as “couldn’t do” and “had to stop” are repeatedly used to express feelings of loss of control. \u0000To regain control over their situation, participants create within themselves a positive internal dialogue whereby they reconstruct the meaning of normalcy, practice acceptance, make downward social comparisons, and engage in daily positive affirmations. They also create a positive external environment, surrounding themselves with compassionate individuals as well as advocating for proper accommodations at school. While CP disrupts their personal and academic trajectories, the experience of living with pain has instilled in them the pursuit of significance. \u0000This pursuit is propelled by the imagery of a fulfilled life and seems to be particular to this age group. Ironically, some participants are grateful for their pain for granting them intuitive empathy for the suffering of others and the emotional credibility to help others.","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"61 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.393
Niki Soilis, E. Kinsella, François Filion, Jason M. Harley, F. Bhanji, Fernanda Claudio, Laurence Roy, Vivetha Thambinathan, Nadja Benmohamed
Individuals experiencing homelessness encounter unique challenges in accessing and receiving care in our health systems[1,2,3,4] Preparing emerging health professionals to respond to their complex health needs will require innovative educational approaches that promote person-centered care, and stimulate critical reflection and action towards the personal, interpersonal and structural factors that shape health care delivery.[5,6,7] This presentation reports on preliminary findings of phase 1 of a critical qualitative case study of nursing student’s perceptions of learning about the experience of homelessness, through a virtual reality educational experience. The study design was informed by critical transformative learning theories and theories of embodiment. Twenty nursing students were engaged in a virtual reality experience of 12 minutes, followed by a 1:1 debrief interview. The debrief interview used an adapted version of the Promoting Excellence and Reflective Learning in Simulation (PEARLS) framework to elicit students’ reflections on the experience. The interviews were audio recorded and transcribed verbatim. Data analysis involved a process of reading all of the transcripts for a sense of the whole, mindmapping each of the transcripts, identifying themes that permeated the data set, and coding data in Quirkos software. Six preliminary themes include: a) seeing the person through story, b) destabilizing assumptions and questioning stereotypes, c) embodied emotional awareness, d) challenges to care, e) recognizing vulnerability of people experiencing homelessness, and f) quality of the immersive experience in learning. The findings contribute to our knowledge about virtual reality simulation as an innovative approach to fostering learning about homelessness in health professions education.
{"title":"Simulating a situation of homelessness: nursing students' perceptions of learning through virtual embodiment","authors":"Niki Soilis, E. Kinsella, François Filion, Jason M. Harley, F. Bhanji, Fernanda Claudio, Laurence Roy, Vivetha Thambinathan, Nadja Benmohamed","doi":"10.26443/ijwpc.v11i1.393","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.393","url":null,"abstract":"Individuals experiencing homelessness encounter unique challenges in accessing and receiving care in our health systems[1,2,3,4] Preparing emerging health professionals to respond to their complex health needs will require innovative educational approaches that promote person-centered care, and stimulate critical reflection and action towards the personal, interpersonal and structural factors that shape health care delivery.[5,6,7] \u0000This presentation reports on preliminary findings of phase 1 of a critical qualitative case study of nursing student’s perceptions of learning about the experience of homelessness, through a virtual reality educational experience. The study design was informed by critical transformative learning theories and theories of embodiment. Twenty nursing students were engaged in a virtual reality experience of 12 minutes, followed by a 1:1 debrief interview. The debrief interview used an adapted version of the Promoting Excellence and Reflective Learning in Simulation (PEARLS) framework to elicit students’ reflections on the experience. The interviews were audio recorded and transcribed verbatim. \u0000Data analysis involved a process of reading all of the transcripts for a sense of the whole, mindmapping each of the transcripts, identifying themes that permeated the data set, and coding data in Quirkos software. Six preliminary themes include: a) seeing the person through story, b) destabilizing assumptions and questioning stereotypes, c) embodied emotional awareness, d) challenges to care, e) recognizing vulnerability of people experiencing homelessness, and f) quality of the immersive experience in learning. \u0000The findings contribute to our knowledge about virtual reality simulation as an innovative approach to fostering learning about homelessness in health professions education. \u0000 ","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"60 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.394
Anna Towers
Physician-administered euthanasia (Medical-Aid-in-Dying or MAiD) has been legally available in Canada since 2016, with ever-widening indications. Most palliative care physicians in Canada do not provide MAiD themselves but will refer to colleagues who provide this procedure. The author was involved in a qualitative research project on MAiD, looking at the views of Montreal-based palliative care physicians regarding their role. One interesting finding from that project is that our own individual personal views (i.e., what I would want for myself when I will inevitably face my own death) versus my professional views as a palliative care physician (i.e., the kind of end-of-life care that I am ready to provide, or what I think patients should receive) may radically differ. We teach our trainees (and the community beyond) that dying can have meaning up to the end of one’s natural life. Patients facing terminal illness commonly express a fear of becoming a burden to others. Yet we teach that this sentiment is often not well-founded, based on the expressed views of the patient’s loved ones. And yet dying can be difficult, even when patients receive the best available palliative care. Our professional view of what constitutes a dignified end-of-life and what patients and families (and I, eventually) will experience may be different. This presentation will spark reflection regarding this dichotomy. What feelings might this inner split provoke, when our professional and personal views conflict with each other? Am I being a dishonest physician? And yet…
{"title":"Facing our own dying: exploring conflicts between our individual professional stance and our own personal views on MAiD","authors":"Anna Towers","doi":"10.26443/ijwpc.v11i1.394","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.394","url":null,"abstract":"Physician-administered euthanasia (Medical-Aid-in-Dying or MAiD) has been legally available in Canada since 2016, with ever-widening indications. Most palliative care physicians in Canada do not provide MAiD themselves but will refer to colleagues who provide this procedure. The author was involved in a qualitative research project on MAiD, looking at the views of Montreal-based palliative care physicians regarding their role. One interesting finding from that project is that our own individual personal views (i.e., what I would want for myself when I will inevitably face my own death) versus my professional views as a palliative care physician (i.e., the kind of end-of-life care that I am ready to provide, or what I think patients should receive) may radically differ. \u0000We teach our trainees (and the community beyond) that dying can have meaning up to the end of one’s natural life. Patients facing terminal illness commonly express a fear of becoming a burden to others. Yet we teach that this sentiment is often not well-founded, based on the expressed views of the patient’s loved ones. And yet dying can be difficult, even when patients receive the best available palliative care. Our professional view of what constitutes a dignified end-of-life and what patients and families (and I, eventually) will experience may be different. \u0000This presentation will spark reflection regarding this dichotomy. What feelings might this inner split provoke, when our professional and personal views conflict with each other? Am I being a dishonest physician? And yet…","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"67 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.410
Yusuke Takamiya
A survey on the current status of undergraduate education on self-care was conducted in university medical schools and medical colleges in Japan. This survey was planned and conducted by the Professionalism Subcommittee of the Japan Society for Medical Education. Prior approval was given by the Ethics Committee of Showa University. Self-care education was defined as education to enhance the well-being (physical and mental health) of medical students. Of the 82 universities invited to participate, 65 universities responded to the survey, giving a response rate of 79.3%. Of these 65 universities, 32 universities (49.2%) indicated that they were implementing self-care education programs. Stress management, mindfulness, self-awareness, resilience, and improvement of self-affirmation were the most common topics, and many of the faculty in charge of the topics were psychiatrists, psychologists, and medical education faculty members. Although about half of the universities implemented self-care education programs, the educational content has not yet been standardized, suggesting the need for standardization of self-care education in the future. The survey was conducted in all medical year levels, and the results showed that self-care education is given to first- and second-year medical students. It was suggested that it is necessary to provide more education to upper-year medical students who undergo clinical practice and experience increased stress. The need for self-care education for medical students has become even more important since 2020 and onwards, partly because of the impact of the COVID-19 pandemic.
{"title":"Survey on the current status of undergraduate education on self-care in university medical schools and medical colleges in Japan","authors":"Yusuke Takamiya","doi":"10.26443/ijwpc.v11i1.410","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.410","url":null,"abstract":"A survey on the current status of undergraduate education on self-care was conducted in university medical schools and medical colleges in Japan. This survey was planned and conducted by the Professionalism Subcommittee of the Japan Society for Medical Education. Prior approval was given by the Ethics Committee of Showa University. \u0000Self-care education was defined as education to enhance the well-being (physical and mental health) of medical students. Of the 82 universities invited to participate, 65 universities responded to the survey, giving a response rate of 79.3%. Of these 65 universities, 32 universities (49.2%) indicated that they were implementing self-care education programs. Stress management, mindfulness, self-awareness, resilience, and improvement of self-affirmation were the most common topics, and many of the faculty in charge of the topics were psychiatrists, psychologists, and medical education faculty members. Although about half of the universities implemented self-care education programs, the educational content has not yet been standardized, suggesting the need for standardization of self-care education in the future. \u0000The survey was conducted in all medical year levels, and the results showed that self-care education is given to first- and second-year medical students. It was suggested that it is necessary to provide more education to upper-year medical students who undergo clinical practice and experience increased stress. The need for self-care education for medical students has become even more important since 2020 and onwards, partly because of the impact of the COVID-19 pandemic.","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"47 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.395
Margie Sills-Maerov, Sofia Valanci
Empathy, or the ability to “feel” another person’s experience, evokes strong emotions and activates the neural pathways in the pain region of the brain. Compassion is empathy combined with purposeful action to relieve suffering and impacts the brain’s reward centres. What are the outward impacts of compassion? Compassion is human connection, reciprocity, feeling cared for and caring for another. It reduces stress and cortisol for the receiver and giver. It reduces suffering and impacts all areas of the Quadruple Aim. Yet nearly half of the population of America and 63% of providers believe that the health system is not compassionate.How do you build “compassion skills”? Being a compassionate clinician is not about knowledge, but the quality of communication and relational interactions. Many hold the belief that this ability is naturally acquired or inherent in medical practice, but this ability is technical, rooted in capabilities, intentional, and requires continuous practice and refinement. Healthcare practitioners are at a disadvantage: the rigours clinical learning and the perceived time pressures of practice take precedent, limiting the opportunity for refinement and practice of these interpersonal communication skills. Looking to bridge the gap on continuous professional development and learning from other sectors, the Royal College of Physicians and Surgeons of Canada has been considering approaches for practice improvement in compassion. To make compassion skills tangible, the presenters offered a “coaching skills” program for physicians. Early evidence is pointing towards the positive impacts of this type of communication skills training on the therapeutic alliance.
{"title":"The art and skills of compassion in practice","authors":"Margie Sills-Maerov, Sofia Valanci","doi":"10.26443/ijwpc.v11i1.395","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.395","url":null,"abstract":"Empathy, or the ability to “feel” another person’s experience, evokes strong emotions and activates the neural pathways in the pain region of the brain. Compassion is empathy combined with purposeful action to relieve suffering and impacts the brain’s reward centres. \u0000What are the outward impacts of compassion? Compassion is human connection, reciprocity, feeling cared for and caring for another. It reduces stress and cortisol for the receiver and giver. It reduces suffering and impacts all areas of the Quadruple Aim. Yet nearly half of the population of America and 63% of providers believe that the health system is not compassionate.How do you build “compassion skills”? Being a compassionate clinician is not about knowledge, but the quality of communication and relational interactions. Many hold the belief that this ability is naturally acquired or inherent in medical practice, but this ability is technical, rooted in capabilities, intentional, and requires continuous practice and refinement. Healthcare practitioners are at a disadvantage: the rigours clinical learning and the perceived time pressures of practice take precedent, limiting the opportunity for refinement and practice of these interpersonal communication skills. \u0000Looking to bridge the gap on continuous professional development and learning from other sectors, the Royal College of Physicians and Surgeons of Canada has been considering approaches for practice improvement in compassion. To make compassion skills tangible, the presenters offered a “coaching skills” program for physicians. Early evidence is pointing towards the positive impacts of this type of communication skills training on the therapeutic alliance.","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"58 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.425
Cory Ingram, Martha Siska
-
-
{"title":"Managing Estranged Relationships at the End of Life","authors":"Cory Ingram, Martha Siska","doi":"10.26443/ijwpc.v11i1.425","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.425","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"186 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140485904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Canadians’ health outcomes are inextricably tied to social inequities. While family medicine is aptly situated to provide care that addresses social factors through longitudinal knowledge of patients and their contexts, family physicians have come under increased pressure to do more for their patients with less time and resources due to financial and resource demands within primary care. Nursing scholar Ruth Malone has argued that remaining proximal, or close to patients, is a form of resistance to these demands. Using a critical narrative methodology, we conducted 36 interviews with 20 family physicians working with persons experiencing health needs related to social inequity in Ontario, Canada, whose stories expressed and expanded upon Malone’s proximity. Notions of proximity were invoked through descriptions of the role of family physicians in: i) generating physical proximity based on the patients’ needs for more time, space, and care; ii) developing narrative proximity through storytelling over time, both between colleagues and patient communities; and iii) engaging in moral proximity, or recognizing the vulnerabilities of their patients, by going “above and beyond” in their care and advocacy roles inspired by the needs of their patients. The findings add theoretical depth to proximity, extending this conceptualization into a new clinical context. These stories also complement current health services and health policy research that advocates for collaborative primary care approaches, as elements of these approaches are conducive to establishing proximity with patients who need care the most.
{"title":"“I get to know them as a whole person”: family physician stories of proximity to patients experiencing social inequity","authors":"Monica Molinaro, Katrina Shen, Gina Agarwal, Gabrielle Inglis, Meredith Vanstone","doi":"10.26443/ijwpc.v11i1.402","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.402","url":null,"abstract":"Canadians’ health outcomes are inextricably tied to social inequities. While family medicine is aptly situated to provide care that addresses social factors through longitudinal knowledge of patients and their contexts, family physicians have come under increased pressure to do more for their patients with less time and resources due to financial and resource demands within primary care. \u0000Nursing scholar Ruth Malone has argued that remaining proximal, or close to patients, is a form of resistance to these demands. Using a critical narrative methodology, we conducted 36 interviews with 20 family physicians working with persons experiencing health needs related to social inequity in Ontario, Canada, whose stories expressed and expanded upon Malone’s proximity. Notions of proximity were invoked through descriptions of the role of family physicians in: i) generating physical proximity based on the patients’ needs for more time, space, and care; ii) developing narrative proximity through storytelling over time, both between colleagues and patient communities; and iii) engaging in moral proximity, or recognizing the vulnerabilities of their patients, by going “above and beyond” in their care and advocacy roles inspired by the needs of their patients. \u0000The findings add theoretical depth to proximity, extending this conceptualization into a new clinical context. These stories also complement current health services and health policy research that advocates for collaborative primary care approaches, as elements of these approaches are conducive to establishing proximity with patients who need care the most.","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"39 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Medical Student Study of Rural Health Concerns, Community Determinants and Whole Person Care","authors":"Andrew Harper, Kiera Sanders, Kahla Edwards, Tasfeen Billah, Tessa Corbett, Lucy Irvine","doi":"10.26443/ijwpc.v11i1.365","DOIUrl":"https://doi.org/10.26443/ijwpc.v11i1.365","url":null,"abstract":"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.\u0000Methods: 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.\u0000Results: 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.\u0000Discussion: 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. ","PeriodicalId":348245,"journal":{"name":"The International Journal of Whole Person Care","volume":"56 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.26443/ijwpc.v11i1.405
Adrian Goin, Danielle Fox, David Hornstein
The intensive care unit (ICU) provides specialized care to critically ill patients. Given the traumatic nature of critical illness and its treatments, up to 75% of family members of ICU decedents and survivors experience long-term psychological consequences, termed post-intensive care syndrome family (PICS-F). Anxiety, PTSD, and depression are common manifestations that significantly impact families’ quality of life and the recovery of those dependent on their caregiving. Although PICS-F can be mitigated by engagement with ICU staff, critical care workers are at risk of burnout and requesting closer liaisons with families is unfeasible. Bridging visitors and the ICU health care team would ensure that family members never feel like “the elephant in the room”.The ICU Bridge Program (ICUBP) is a unique volunteering and shadowing initiative designed and run by university students. Bridge Program volunteers are assigned to hospital ICUs in Montreal to be the first point of contact for visitors. This program addresses PICS-F by humanizing the ICU experience through compassionate human contact, continuous support, and an open line of communication. The diverse applicants are carefully selected and trained to maximize soft skills, such as emotional intelligence and active listening, which ensures that families feel welcome and understood in this tense environment. Furthermore, the ICUBP’s self-sufficient structure off-loads administrative responsibilities from resource-constrained hospitals and makes its implementation feasible and cost-efficient. By continuously monitoring its effect on patients, families, and staff, the ICUBP aims to improve and expand its contribution to whole-person care in the ICU.
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