Ó. Kristjansdottir, H. Zangi, C. Ruland, Jelena Mirkovic, K. Stange, Una Stenberg
Introduction: Healthcare providers play an essential but under-realized role in helping people with chronic illness become aware of and use their own personal strengths for self-management support. A digital application that encourages a focus on patients’ strengths could have a positive effect. Objective: To explore how rheumatology healthcare providers report: (1) helping patients mobilize their strengths and (2) the potential of a digital application to support this process. Methods: Focus groups and individual interviews were conducted with healthcare providers (n=16) with different professional backgrounds, recruited from a rheumatology specialist department providing in- and outpatient service. They were asked about their experience with helping patients use their strengths and for their feedback on an initial paper prototype of a digital application to encourage reflection and dialog on strengths. Thematic analysis was conducted. Results: Healthcare providers generally perceive helping patients to acknowledge and use their strengths as important and embedded in their work. Analyses identified 4 categories describing the subtle work of helping patients engage their strengths: Active Listening, The Importance of Contextualization, Promoting Learning and Not Without Challenges. Feedback on a potential digital application was summarized. Conclusion: The task of mobilizing strengths is seen by healthcare providers as part of their self-management support for patients with chronic illness. Based on their feedback on an initial prototype, a digital pre-consultation application might have the potential to support the process of helping patients build on their personal strengths.
{"title":"Helping patients mobilize their personal strengths within a rheumatology setting: A qualitative study with healthcare providers","authors":"Ó. Kristjansdottir, H. Zangi, C. Ruland, Jelena Mirkovic, K. Stange, Una Stenberg","doi":"10.5750/EJPCH.V7I2.1713","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1713","url":null,"abstract":"Introduction: Healthcare providers play an essential but under-realized role in helping people with chronic illness become aware of and use their own personal strengths for self-management support. A digital application that encourages a focus on patients’ strengths could have a positive effect. Objective: To explore how rheumatology healthcare providers report: (1) helping patients mobilize their strengths and (2) the potential of a digital application to support this process. Methods: Focus groups and individual interviews were conducted with healthcare providers (n=16) with different professional backgrounds, recruited from a rheumatology specialist department providing in- and outpatient service. They were asked about their experience with helping patients use their strengths and for their feedback on an initial paper prototype of a digital application to encourage reflection and dialog on strengths. Thematic analysis was conducted. Results: Healthcare providers generally perceive helping patients to acknowledge and use their strengths as important and embedded in their work. Analyses identified 4 categories describing the subtle work of helping patients engage their strengths: Active Listening, The Importance of Contextualization, Promoting Learning and Not Without Challenges. Feedback on a potential digital application was summarized. Conclusion: The task of mobilizing strengths is seen by healthcare providers as part of their self-management support for patients with chronic illness. Based on their feedback on an initial prototype, a digital pre-consultation application might have the potential to support the process of helping patients build on their personal strengths.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"29 1","pages":"367-376"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82907587","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}
Backgroung, aims and objectives: Endometriosis is a perplexing and chronic disease, with an unknown cause and no cure, affecting around 10-15% of women of reproductive age. Symptoms of the condition include severe menstrual cramps, pelvic pain before, during and after periods, nausea, fatigues, infertility, excessive bleeding and pain when moving bowels. Diagnosis can only be established via a laparoscopy and delays have been reported to occur from an individual patient level and a medical level. The study aimed to observe the impact that endometriosis has on women’s lives and contribute to the knowledge provided by the existing qualitative literature. Methods: The study adopted a qualitative approach and utilised secondary data in the form of videos published on YouTube. Six videos were chosen which were transcribed verbatim and data analysed using interpretative phenomenological analysis (IPA). The analysis conveyed three superordinate themes: making sense, effect on quality of life, and support. Results: The women reflected on the journey they endured which began by experiencing menstrual cramps and gradually worsened with the onset of additional symptoms. These symptoms had a negative impact on daily living and a reduction in their quality of life (QoL). Women revealed feeling isolated, which stemmed from the lack of support from medical professionals, friends and family. Despite many visits to doctors, the pathway to diagnosis was delayed. Symptoms were normalised by doctors, friends and family members, which reduced the legitimisation of the condition. Conclusion: Overall, there is a lack of sufficient knowledge, support and acceptance for women suffering with endometriosis. Suggestions for future research and practice include focusing on how to improve women’s quality of life, exploring effective self-management interventions, introducing educational interventions and developing person-centered models of care which could contribute to earlier diagnosis and less suffering.
{"title":"“Waves and waves of excruciating pain”: An interpretative phenomenological analysis of women living with endometriosis","authors":"S. Meral","doi":"10.5750/EJPCH.V7I2.1649","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1649","url":null,"abstract":"Backgroung, aims and objectives: Endometriosis is a perplexing and chronic disease, with an unknown cause and no cure, affecting around 10-15% of women of reproductive age. Symptoms of the condition include severe menstrual cramps, pelvic pain before, during and after periods, nausea, fatigues, infertility, excessive bleeding and pain when moving bowels. Diagnosis can only be established via a laparoscopy and delays have been reported to occur from an individual patient level and a medical level. The study aimed to observe the impact that endometriosis has on women’s lives and contribute to the knowledge provided by the existing qualitative literature. Methods: The study adopted a qualitative approach and utilised secondary data in the form of videos published on YouTube. Six videos were chosen which were transcribed verbatim and data analysed using interpretative phenomenological analysis (IPA). The analysis conveyed three superordinate themes: making sense, effect on quality of life, and support. Results: The women reflected on the journey they endured which began by experiencing menstrual cramps and gradually worsened with the onset of additional symptoms. These symptoms had a negative impact on daily living and a reduction in their quality of life (QoL). Women revealed feeling isolated, which stemmed from the lack of support from medical professionals, friends and family. Despite many visits to doctors, the pathway to diagnosis was delayed. Symptoms were normalised by doctors, friends and family members, which reduced the legitimisation of the condition. Conclusion: Overall, there is a lack of sufficient knowledge, support and acceptance for women suffering with endometriosis. Suggestions for future research and practice include focusing on how to improve women’s quality of life, exploring effective self-management interventions, introducing educational interventions and developing person-centered models of care which could contribute to earlier diagnosis and less suffering.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"4 1","pages":"265-295"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76763562","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}
A. H. Andersen, E. A. Hvidt, N. Hvidt, Z. Illés, G. Handberg, K. Roessler
Background: Facing a severe, chronic disease can be experienced as an existential crisis that may lead to a lower quality of life and even risk of suicide. Existential, spiritual and religious ways of meaning-making are in many cases positively related to health and can be important in times of crises. This project aims to study a gap in the current knowledge with a specific focus on patient-centeredness as an attention to the whole person. How do physicians experience their patients’ existential, spiritual and religious needs in relation to chronic disease? How do they address these needs and are patients satisfied with this communication? Methods / Design: Two chronic diseases with severe illness in common were chosen: Chronic Pain and Multiple Sclerosis. For each disease, an in-depth study of 12 patients and 4 physicians will precede the comparison of the cases resulting in 24 patient interviews and 8 physician interviews. Further, we will compare the existential, spiritual and religious needs of these 2 patient groups. Interpretative Phenomenological Analysis is applied as methodology and semi-structured interviews and observations are used as data generation methods. Discussion: Investigating and addressing existential, spiritual and religious meaning in life in exchange with patients may enhance quality of care and improve efficacy of and satisfaction with treatment. The results of this project will hopefully provide a substantial contribution to the knowledge about existential, spiritual and religious needs of patients living with a chronic disease. The knowledge may be used in clinical practice as well as for educational purposes.
{"title":"Conversation or non-versation? Physicians’ communication about existential, spiritual and religious needs with chronically ill patients - protocol for a qualitative study","authors":"A. H. Andersen, E. A. Hvidt, N. Hvidt, Z. Illés, G. Handberg, K. Roessler","doi":"10.5750/EJPCH.V7I2.1715","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1715","url":null,"abstract":"Background: Facing a severe, chronic disease can be experienced as an existential crisis that may lead to a lower quality of life and even risk of suicide. Existential, spiritual and religious ways of meaning-making are in many cases positively related to health and can be important in times of crises. This project aims to study a gap in the current knowledge with a specific focus on patient-centeredness as an attention to the whole person. How do physicians experience their patients’ existential, spiritual and religious needs in relation to chronic disease? How do they address these needs and are patients satisfied with this communication? Methods / Design: Two chronic diseases with severe illness in common were chosen: Chronic Pain and Multiple Sclerosis. For each disease, an in-depth study of 12 patients and 4 physicians will precede the comparison of the cases resulting in 24 patient interviews and 8 physician interviews. Further, we will compare the existential, spiritual and religious needs of these 2 patient groups. Interpretative Phenomenological Analysis is applied as methodology and semi-structured interviews and observations are used as data generation methods. Discussion: Investigating and addressing existential, spiritual and religious meaning in life in exchange with patients may enhance quality of care and improve efficacy of and satisfaction with treatment. The results of this project will hopefully provide a substantial contribution to the knowledge about existential, spiritual and religious needs of patients living with a chronic disease. The knowledge may be used in clinical practice as well as for educational purposes.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"21 1","pages":"377-385"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79925788","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}
Rationale, aims and objectives: Healthier patients require healthier staff and healthier institutions. As a member of the Health Promoting Hospitals (HPH) Network, we focused on the 4 th standard of HPH implementation (Promoting a Healthier Workplace) by developing a program of systematic medical check-ups for all employees. The objectives are: (1) to systematically evaluate hospital worker’s health and according to the results and (2) to improve and promote healthier workplace conditions. Method: Age- and gender-specific systematic medical check-ups for the hospital workers. Results: Out of 1340 workers (1018 medical), 834 (64.5%) expressed initial interest to participate and 658 (49.1%, proportionally medical and non-medical) finally completed the program. Arterial hypertension was the predominant existing medical condition (48.8%). At least one new condition (mainly dyslipidemia, 31.2%), was detected in 347 participants (52.7%). Among 18 (2.7%) participants with newly diagnosed tumors, 3 had malignancies (0.5%). In a multivariate analysis, the risk of detecting a new medical condition was lower in medical ( vs . non-medical) staff (RR=0.79, 95% CI 0.68-0.91) and in those with at least one known medical condition ( vs . none) (RR=0.86, 95% CI 0.74-0.99). Several actions followed: (a) new individual preventive (hypolipemic diet to 293 participants, 44.5%; tighter blood pressure control to 74 participants, 11.2%) and therapeutic (73 participants, 11.1%) measures were prescribed; (b) dietary educational material was disseminated; (c) hospital menus were changed in line with the detected major cardiovascular risk factors and (d) a standardized template for future check-ups was developed. Conclusion: This program has the potential to be introduced as a new indicator of the 4 th standard for heathier workplace promotion in a hospital setting.
理由、目的和目标:更健康的病人需要更健康的工作人员和更健康的机构。作为健康促进医院(HPH)网络的成员，我们通过为所有员工制定系统的医疗检查计划，专注于HPH实施的第四个标准(促进更健康的工作场所)。目标是:(1)根据结果系统地评估医院工作人员的健康状况;(2)改善和促进更健康的工作场所条件。方法:对医院职工进行按年龄和性别进行系统体检。结果:在1340名工人中(1018名医疗人员)，834人(64.5%)表示有兴趣参与，658人(49.1%，按比例为医疗和非医疗人员)最终完成了该计划。动脉高血压是主要的医疗状况(48.8%)。在347名参与者(52.7%)中检测到至少一种新疾病(主要是血脂异常，31.2%)。在18例(2.7%)新诊断肿瘤的参与者中，3例为恶性肿瘤(0.5%)。在一项多变量分析中，发现一种新的医疗状况的风险较低。非医务人员(RR=0.79, 95% CI 0.68-0.91)和至少有一种已知医疗状况的人员(vs。无)(RR=0.86, 95% CI 0.74-0.99)。随后采取了几项行动:(a) 293名参与者(44.5%)采用新的个人预防(低血脂饮食);对74名参与者(11.2%)采取更严格的血压控制措施，对73名参与者(11.1%)采取治疗性措施;(b)分发了饮食教育材料;(c)根据检测到的主要心血管风险因素改变了医院菜单;(d)为今后的检查制定了标准化模板。结论:该方案有可能作为促进医院工作场所健康的第4项标准的新指标引入。
{"title":"Healthier workplace promotion: medical check-ups for hospital workers","authors":"I. Mikačić, Maja Pipić, Sanja Ljubičić, P. Pekić","doi":"10.5750/EJPCH.V7I2.1638","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1638","url":null,"abstract":"Rationale, aims and objectives: Healthier patients require healthier staff and healthier institutions. As a member of the Health Promoting Hospitals (HPH) Network, we focused on the 4 th standard of HPH implementation (Promoting a Healthier Workplace) by developing a program of systematic medical check-ups for all employees. The objectives are: (1) to systematically evaluate hospital worker’s health and according to the results and (2) to improve and promote healthier workplace conditions. Method: Age- and gender-specific systematic medical check-ups for the hospital workers. Results: Out of 1340 workers (1018 medical), 834 (64.5%) expressed initial interest to participate and 658 (49.1%, proportionally medical and non-medical) finally completed the program. Arterial hypertension was the predominant existing medical condition (48.8%). At least one new condition (mainly dyslipidemia, 31.2%), was detected in 347 participants (52.7%). Among 18 (2.7%) participants with newly diagnosed tumors, 3 had malignancies (0.5%). In a multivariate analysis, the risk of detecting a new medical condition was lower in medical ( vs . non-medical) staff (RR=0.79, 95% CI 0.68-0.91) and in those with at least one known medical condition ( vs . none) (RR=0.86, 95% CI 0.74-0.99). Several actions followed: (a) new individual preventive (hypolipemic diet to 293 participants, 44.5%; tighter blood pressure control to 74 participants, 11.2%) and therapeutic (73 participants, 11.1%) measures were prescribed; (b) dietary educational material was disseminated; (c) hospital menus were changed in line with the detected major cardiovascular risk factors and (d) a standardized template for future check-ups was developed. Conclusion: This program has the potential to be introduced as a new indicator of the 4 th standard for heathier workplace promotion in a hospital setting.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"1 1","pages":"238-242"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88891233","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, aims and objectives: Many patients have a desire to have more influence on their course of treatment. The Danish Healthcare System is under development with a focus on patient involvement. Self-administration is a very important part of the whole concept of patient involvement. This pilot study aimed to investigate Danish patients’ attitudes towards and experience of the concept of self-administration during hospitalisation Method: A qualitative design with semi-structured, one-to-one interviews was used. Data were collected by one author (TEM) from March 2018 to April 2018. Included patients were all part of the intervention group from a randomised controlled trial. These patients were self-administrating their own medicine during hospitalisation. Results: In total, 8 patients agreed to be interviewed. One patient withdrew his consent during the interview, resulting in 7 interviews for analysis. No patients declined to participate. Interviews were, on average, 22 minutes in duration. From the analysed data, 3 major themes emerged: “Self-management = self-administration?”, “Ready, set, self-administration” and “Once self-administration, always self-administration?” Conclusion: This pilot study indicates that the patients have a very positive attitude towards and experience of self-administration during hospitalisation, as self-administration allowed them to regain control of their medicine and gave them a sense of independence and safety. All patients would prefer to be self-administering their own medicine rather than handing over the responsibility to the nurse in a future hospitalisation, due to the positive experience it has given them. Future studies are needed to confirm these findings.
{"title":"Patients’ perspective on self-administration during hospitalisation - a qualitative pilot study","authors":"Trine Engholm Mahler, C. A. Sørensen, T. Graabæk","doi":"10.5750/EJPCH.V7I2.1688","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1688","url":null,"abstract":"Background, aims and objectives: Many patients have a desire to have more influence on their course of treatment. The Danish Healthcare System is under development with a focus on patient involvement. Self-administration is a very important part of the whole concept of patient involvement. This pilot study aimed to investigate Danish patients’ attitudes towards and experience of the concept of self-administration during hospitalisation Method: A qualitative design with semi-structured, one-to-one interviews was used. Data were collected by one author (TEM) from March 2018 to April 2018. Included patients were all part of the intervention group from a randomised controlled trial. These patients were self-administrating their own medicine during hospitalisation. Results: In total, 8 patients agreed to be interviewed. One patient withdrew his consent during the interview, resulting in 7 interviews for analysis. No patients declined to participate. Interviews were, on average, 22 minutes in duration. From the analysed data, 3 major themes emerged: “Self-management = self-administration?”, “Ready, set, self-administration” and “Once self-administration, always self-administration?” Conclusion: This pilot study indicates that the patients have a very positive attitude towards and experience of self-administration during hospitalisation, as self-administration allowed them to regain control of their medicine and gave them a sense of independence and safety. All patients would prefer to be self-administering their own medicine rather than handing over the responsibility to the nurse in a future hospitalisation, due to the positive experience it has given them. Future studies are needed to confirm these findings.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"90 1","pages":"358-366"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82365532","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 aims and objectives: Studies show an inequality in the support and outcomes for patients with life-limiting illness and social vulnerabilities. To understand the nature of this inequality and improve the healthcare of these patients, an understanding of their lived experience is necessary. The aim of this study was to explore the lived experiences of life-limiting illness in socially vulnerable patients. Methods : This study is based on qualitative interviews of 8 patients in palliative care with life-limiting cancer and one or more social vulnerabilities. The interviews were conducted from January 2018 to March 2018 in accordance with Kvale and Brinkmann’s semi-structured life-world interview and afterwards read, analysed and interpreted through a phenomenological-hermeneutic design in accordance with Ricoeur’s theory of interpretation. Results : From the analysis and interpretation of the patients’s experiences, 3 themes arose: (1) Finding comfort in social relations , (2) Being limited in the everyday life and (3) Meeting a system of boxes . Conclusion : On the basis of the themes, it is concluded that socially vulnerable patients have little to no social network and need support from social relations. It can also be concluded that socially vulnerable patients struggle with physical changes in their daily living and are in need of help to maintain their everyday life with illness. Furthermore, these patients feel marginalized in a healthcare system when they do not fit within the margins of a patient’s role.
{"title":"Vulnerable persons in a vulnerable position: exploring cancer patients’ lived experiences of life-limiting illness","authors":"I. Pedersen, R. Birkelund","doi":"10.5750/EJPCH.V7I2.1724","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1724","url":null,"abstract":"Background aims and objectives: Studies show an inequality in the support and outcomes for patients with life-limiting illness and social vulnerabilities. To understand the nature of this inequality and improve the healthcare of these patients, an understanding of their lived experience is necessary. The aim of this study was to explore the lived experiences of life-limiting illness in socially vulnerable patients. Methods : This study is based on qualitative interviews of 8 patients in palliative care with life-limiting cancer and one or more social vulnerabilities. The interviews were conducted from January 2018 to March 2018 in accordance with Kvale and Brinkmann’s semi-structured life-world interview and afterwards read, analysed and interpreted through a phenomenological-hermeneutic design in accordance with Ricoeur’s theory of interpretation. Results : From the analysis and interpretation of the patients’s experiences, 3 themes arose: (1) Finding comfort in social relations , (2) Being limited in the everyday life and (3) Meeting a system of boxes . Conclusion : On the basis of the themes, it is concluded that socially vulnerable patients have little to no social network and need support from social relations. It can also be concluded that socially vulnerable patients struggle with physical changes in their daily living and are in need of help to maintain their everyday life with illness. Furthermore, these patients feel marginalized in a healthcare system when they do not fit within the margins of a patient’s role.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"23 1","pages":"395-402"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74636909","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}
‘Person-centred care’ and ‘empathy’ are receiving an increasing amount of attention in the healthcare literature. These two concepts are related; however, their relationship has hitherto not been rigorously explored. In this paper we review the differences and commonalities between common definitions of the two concepts. We found that therapeutic empathy requires both interpersonal understanding (achieved via one of several potential means) as well as caring action. We also found that person-centred care could be defined as follows: Person-centred care is therapeutic empathy (interpersonal understanding and caring action) together with continuity, coordination, teamwork, access and empowerment. Conceived this way, therapeutic empathy is included within person-centred care, but not vice-versa . There are three important consequences of our analysis. First, empathy training can provide one of the means by which (part of) person-centred care can be achieved. Second, researchers and practitioners can use our analysis of empathy and person-centred care to collaborate in approaches to both research and training. Third, philosophers, who sometimes take empathy to be a foundational concept in interpersonal understanding, can use our findings to inform their work. Finally, we hope to have provided more clarity not just on the relationship between empathy and person-centred care, but also on the nature of those two individual concepts.
{"title":"The friendly relationship between therapeutic empathy and person-centered care","authors":"Doug I Hardman, J. Howick","doi":"10.5750/EJPCH.V7I2.1689","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1689","url":null,"abstract":"‘Person-centred care’ and ‘empathy’ are receiving an increasing amount of attention in the healthcare literature. These two concepts are related; however, their relationship has hitherto not been rigorously explored. In this paper we review the differences and commonalities between common definitions of the two concepts. We found that therapeutic empathy requires both interpersonal understanding (achieved via one of several potential means) as well as caring action. We also found that person-centred care could be defined as follows: Person-centred care is therapeutic empathy (interpersonal understanding and caring action) together with continuity, coordination, teamwork, access and empowerment. Conceived this way, therapeutic empathy is included within person-centred care, but not vice-versa . There are three important consequences of our analysis. First, empathy training can provide one of the means by which (part of) person-centred care can be achieved. Second, researchers and practitioners can use our analysis of empathy and person-centred care to collaborate in approaches to both research and training. Third, philosophers, who sometimes take empathy to be a foundational concept in interpersonal understanding, can use our findings to inform their work. Finally, we hope to have provided more clarity not just on the relationship between empathy and person-centred care, but also on the nature of those two individual concepts.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"34 1","pages":"351-357"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90334788","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}
Marie Broholm-Jørgensen, Nina Kamstrup-Larsen, A. D. Guassora, S. Reventlow, S. Dalton, T. Tjørnhøj‐Thomsen
Background, aims and objectives: In general practice, obtaining patients’ perspectives and finding common ground with patients has for many years been a core value. Negotiation is often associated with agenda setting as well as shared decision-making (SDM) and finding common ground between two parties. This study aims to connect the social meeting between general practitioner (GP) and patient with the organisational, physical and temporal contexts of general practice, to account for the possibilities of negotiation. Methods: We employed a qualitative study design which combined observations of clinical encounters and semi-structured interviews of GPs as well as of patients. The empirical material was collected in relation to the intervention project Check-In . The intervention examined the effectiveness of an invitation of patients with no formal education beyond the mandatory 7-9 years of schooling to a pre-scheduled preventive health check at his or her GP. Results: Overall, the findings in this study reveal how the wider context influences the degree to which time is spent on negotiation and finding common ground in the clinical encounter. Conclusion: This study shows that negotiation is sensitive to both the contexts of patients’ everyday lives as well as the contexts of the clinical encounter. In this way, finding common ground between GP and patients varies in different social contexts as the temporal conditions of the wider contexts influences and are influenced by negotiations between GPs and patients.
{"title":"Negotiation, temporality and context - a qualitative study of the clinical encounter","authors":"Marie Broholm-Jørgensen, Nina Kamstrup-Larsen, A. D. Guassora, S. Reventlow, S. Dalton, T. Tjørnhøj‐Thomsen","doi":"10.5750/EJPCH.V7I2.1680","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1680","url":null,"abstract":"Background, aims and objectives: In general practice, obtaining patients’ perspectives and finding common ground with patients has for many years been a core value. Negotiation is often associated with agenda setting as well as shared decision-making (SDM) and finding common ground between two parties. This study aims to connect the social meeting between general practitioner (GP) and patient with the organisational, physical and temporal contexts of general practice, to account for the possibilities of negotiation. Methods: We employed a qualitative study design which combined observations of clinical encounters and semi-structured interviews of GPs as well as of patients. The empirical material was collected in relation to the intervention project Check-In . The intervention examined the effectiveness of an invitation of patients with no formal education beyond the mandatory 7-9 years of schooling to a pre-scheduled preventive health check at his or her GP. Results: Overall, the findings in this study reveal how the wider context influences the degree to which time is spent on negotiation and finding common ground in the clinical encounter. Conclusion: This study shows that negotiation is sensitive to both the contexts of patients’ everyday lives as well as the contexts of the clinical encounter. In this way, finding common ground between GP and patients varies in different social contexts as the temporal conditions of the wider contexts influences and are influenced by negotiations between GPs and patients.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"1 1","pages":"334-343"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88774651","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: The evolving landscape of new technologies offering minimally invasive options for the treatment of benign pelvic diseases present with varying effectiveness and safety profiles. This raises questions regarding how patients make treatment decisions. Patients may perceive risk or benefits of a device/treatment differently than physicians or regulators responsible for determining whether a new device can be marketed. Methods: We reviewed publications in PubMed investigating patients’ perceptions of surgical treatments for benign pelvic pathology, including perceived benefits and risks. In addition, we explored the social and cultural factors influencing these perceptions and treatment decisions. Results: We included 16 studies in our literature review. Factors which were identified to influence women’s perceptions include: symptom relief; surgical complications and recovery times; impact on periods; child-bearing capacity; femininity; sexual desire and sexual dysfunction; cosmetic effects; emotional effects and risk of cancer. Our review revealed some heterogeneity in patients’ perspectives on factors (including benefits and risks) associated with surgical treatments for benign pelvic pathology. Women’s intrinsic factors including age, race, sexuality and child-bearing status may influence how they perceive the potential effects of their surgical options and influence their treatment decision. Conclusions: It is important to understand the trade-offs patients make as they consider competing surgical treatment options. Patient preference information from future patient studies could quantify patient perspective thereby providing additional information to patients, clinicians, current and prospective device developers. In addition, it may be used by regulators in their evaluation of surgical devices for the treatment of benign pelvic disease.
{"title":"Women’s perceptions of hysterectomy and alternative surgical treatments for benign pelvic pathologies: A Literature Review","authors":"Olufemi Babalola, Jason Roberts, V. Price","doi":"10.5750/EJPCH.V7I2.1650","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1650","url":null,"abstract":"Background: The evolving landscape of new technologies offering minimally invasive options for the treatment of benign pelvic diseases present with varying effectiveness and safety profiles. This raises questions regarding how patients make treatment decisions. Patients may perceive risk or benefits of a device/treatment differently than physicians or regulators responsible for determining whether a new device can be marketed. Methods: We reviewed publications in PubMed investigating patients’ perceptions of surgical treatments for benign pelvic pathology, including perceived benefits and risks. In addition, we explored the social and cultural factors influencing these perceptions and treatment decisions. Results: We included 16 studies in our literature review. Factors which were identified to influence women’s perceptions include: symptom relief; surgical complications and recovery times; impact on periods; child-bearing capacity; femininity; sexual desire and sexual dysfunction; cosmetic effects; emotional effects and risk of cancer. Our review revealed some heterogeneity in patients’ perspectives on factors (including benefits and risks) associated with surgical treatments for benign pelvic pathology. Women’s intrinsic factors including age, race, sexuality and child-bearing status may influence how they perceive the potential effects of their surgical options and influence their treatment decision. Conclusions: It is important to understand the trade-offs patients make as they consider competing surgical treatment options. Patient preference information from future patient studies could quantify patient perspective thereby providing additional information to patients, clinicians, current and prospective device developers. In addition, it may be used by regulators in their evaluation of surgical devices for the treatment of benign pelvic disease.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"48 1","pages":"296-306"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83410244","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}
K. Müller, C. Gimpel, S. König, N. Kotschy-Lang, P. Wagner
Introduction: An active lifestyle represents a challenge for patients with chronic respiratory diseases because of pathophysiological alterations which lead to reduced physical activity (PA). Patients fall into a downward spiral of deconditioning with increased symptoms and reduced PA. Various studies suggest that a higher PA level in these subjects increases quality of life and reduces risk of hospital admissions and mortality, so that the long-term maintenance of PA in these patients is an important aim in disease management. As ordinary fitness training during inpatient rehabilitation seems to be insufficient, behavior changes promise long-term success. Methods and analysis: The objective of this longitudinal analysis is to investigate various physiological and psychological determinants of PA in patients with occupational respiratory diseases. The randomized controlled trial will examine the effects of a behavioral exercise intervention during inpatient pulmonary rehabilitation (PR) on the basis of objective (by ActigraphGT3x+®) and subjective physical activity measured 4 weeks before the start of the rehabilitation and 2, 6 and 12 months after rehabilitation. In addition, psychological determinants such as anxiety, depression and self-efficacy, will be investigated. Participants were randomized in an intervention group (IG) and control group (CG). The IG participated in a behavioral exercise intervention of 9 sessions, in addition to the regular PR. The CG received standard PR over 4 weeks. The behavioral exercise intervention is based on a theoretical framework of various behavior change models in order to maintain or increase PA with the help of volitional and motivational strategies including knowledge transfer, goal setting, action planning and barrier management. Every session consists of theoretical and practical elements to enable participants to pursue an active lifestyle. Conclusion: The purpose of the current study (a randomized controlled trial) is to examine the effectiveness of a behavioral exercise intervention during an inpatient rehabilitation of patients with occupational respiratory diseases on several outcomes, for example, physical activity and mental health. Thus, the results will contribute to optimize a sustainable disease management.
{"title":"Changes and interactions of physical activity in patients with occupational respiratory diseases after a behavioral exercise intervention: A study protocol","authors":"K. Müller, C. Gimpel, S. König, N. Kotschy-Lang, P. Wagner","doi":"10.5750/EJPCH.V7I2.1641","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1641","url":null,"abstract":"Introduction: An active lifestyle represents a challenge for patients with chronic respiratory diseases because of pathophysiological alterations which lead to reduced physical activity (PA). Patients fall into a downward spiral of deconditioning with increased symptoms and reduced PA. Various studies suggest that a higher PA level in these subjects increases quality of life and reduces risk of hospital admissions and mortality, so that the long-term maintenance of PA in these patients is an important aim in disease management. As ordinary fitness training during inpatient rehabilitation seems to be insufficient, behavior changes promise long-term success. Methods and analysis: The objective of this longitudinal analysis is to investigate various physiological and psychological determinants of PA in patients with occupational respiratory diseases. The randomized controlled trial will examine the effects of a behavioral exercise intervention during inpatient pulmonary rehabilitation (PR) on the basis of objective (by ActigraphGT3x+®) and subjective physical activity measured 4 weeks before the start of the rehabilitation and 2, 6 and 12 months after rehabilitation. In addition, psychological determinants such as anxiety, depression and self-efficacy, will be investigated. Participants were randomized in an intervention group (IG) and control group (CG). The IG participated in a behavioral exercise intervention of 9 sessions, in addition to the regular PR. The CG received standard PR over 4 weeks. The behavioral exercise intervention is based on a theoretical framework of various behavior change models in order to maintain or increase PA with the help of volitional and motivational strategies including knowledge transfer, goal setting, action planning and barrier management. Every session consists of theoretical and practical elements to enable participants to pursue an active lifestyle. Conclusion: The purpose of the current study (a randomized controlled trial) is to examine the effectiveness of a behavioral exercise intervention during an inpatient rehabilitation of patients with occupational respiratory diseases on several outcomes, for example, physical activity and mental health. Thus, the results will contribute to optimize a sustainable disease management.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"28 1","pages":"254-264"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79531480","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}
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