The International Journal of Whole Person Care
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The need for alternative solutions when caring for patients with language barriers
Get PDFBarriers to quality communication increase the risk for misunderstanding, negatively impact the thoroughness of health investigations, and can lead to delayed diagnoses and increased readmissions. In addition, language barriers disproportionately affect the most vulnerable populations; thus, a lack of appropriate interpretation services promotes health disparities and increases the vulnerability of the underserved minority populations. According to the Act Respecting Health Services and Social Services of Quebec, health organizations need to take into account the distinctive linguistic and sociocultural characteristics of each region and, “foster […] access to health services and social services through adapted means of communication for persons with functional limitations”.
A language barrier is a form of functional limitation that patients face when accessing healthcare services. Despite a clear policy, the current use of professional interpretation services is limited in our healthcare facilities, thus increasing obstacles in accessing healthcare services for patients with language barriers. It is thought that by identifying how language barriers present in our healthcare system and by highlighting the tools available to mitigate their consequences, healthcare workers, including medical students, may be better placed to serve the non-French and non-English speaking community.
A group of medical students from the Universities of Montreal and McGill who are part of MedComm researched the problematic, most specifically in Montreal, in the hopes of emphasizing the need for alternative solutions to the current state of affairs in regard to offering optimal care to patients with language barriers
From science to adapted patient education in retinal optical coherence tomography: How terminology influences diagnostic understanding
Get PDFOptical Coherence Tomography (OCT) in retinal imaging has evolved rapidly over the last twenty years. Along with these changes in technology, the nomenclature and relationships between healthcare professionals and patients have changed as well. How to translate the complex language of the field such that patients can understand it better is the focus of this paper
Brief online mindfulness training for medical students: a randomized control study
Get PDFBACKGROUNDMedical students experience high levels of stress during their training. Literature suggests that mindfulness can reduce stress and increase self-compassion levels in medical students. However, most mindfulness training programs are delivered face-to-face and require significant time commitments, which can be challenging for rurally-based students with heavy academic workloads and limited support networks.
PURPOSETo evaluate the feasibility and efficacy of a brief online Mindfulness training program for medical students based in rural areas, with regards to reducing stress, increasing self-compassion, mindfulness and study engagement.
METHODSThis is a non-registered randomised control trial. Participants included both urban and rural medical students from UWA, University of Notre Dame and the RCSWA from 2018-2020. Participants were randomised to the intervention group, an 8-week online mindfulness training program, or the control group. Using quantitative-qualitative mixed-methods approach, we measured the frequency, duration and quality of the participants mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion, mindfulness and study engagement levels. Further, the intervention group recorded a weekly reflective journal documenting their experience of the program.
RESULTS114 participants were recruited to the study. 61 were randomised to the intervention, and 53 to the control. Quantitative analysis of the frequency, duration and quality of mindfulness meditation practice and changes in stress, self-compassion, mindfulness and study engagement is currently being conducted. Preliminary qualitative results reveal that participants experienced increased self-awareness, more mindfulness of their day-to-day activities, improved emotional regulation and increased productivity, while also facing difficulties with making time for their mindfulness practice.
CONCLUSIONWe anticipate that this study will demonstrate that an online mindfulness training program tailored to reach rurally located medical students is feasible and effective in modifying their stress levels and psychological wellbeing.
Project Lotus: A really cool community-based initiative assisting women post-homelessness
Get PDFIn Canada, recent conservative estimates report upwards of 235,000 individuals are homeless on a given night. Of those experiencing precarious housing situations, women make up approximately 30% and are among the most vulnerable. Their residential insecurity has been further exacerbated with the community and social restrictions of the COVID-19 pandemic. Existing resources that assist women experiencing homelessness or housing insecurity are often stretched to the limit dealing with emergency and crisis housing situations, with less focus on post-shelter supports.
To address this issue, a community-based participatory research initiative ‘Project Lotus - Hope Together’ was established in Montreal. Grounded in the World Health Organization’s Commission on Social Determinants of Health Framework, the overarching goal of this research is to co-design a housing supports program for women leaving a shelter stay. We created a cross-sectorial Advisory Committee consisting of women with lived experiences of homelessness, service providers, community leaders, and researchers.
To date, we have conducted preliminary research (literature review, interviews with women with lived experience of homelessness, stakeholder meetings) to identity what has assisted women through this transition, and what barriers exist. We have also held virtual community consultation meetings to discuss preliminary findings of recommendations of key components that should be in a post-shelter support program for women.
This presentation outlines the current findings and highlights the importance of participatory research. Implementing whole person care in the area of women’s homelessness requires both a comprehensive and individualized approach to help women and children secure home, health, and a sustainable future
When routine screening is not routine : Preparing patients for the unexpected
Get PDFIn our current environment of value based care and payment models, greater emphasis is placed on completing evidence based, routine screening tests for patients. While there is clear preventive health benefit, population based initiatives may overlook opportunities to prepare individual patients for possible abnormal results. Efforts to manage expectations, address health literacy gaps and ensure emotional support may help limit unnecessary distress and suffering during the screening process
The lived experiences of teenage girls with scoliosis and the effect of a peer support group, Curvy Girls
No full textCONTEXT: Scoliosis is an abnormal lateral curvature of the spinal column and affects approximately 1% to 3% of adolescents. The relationship between pain and idiopathic scoliosis has not been well documented and remains unclear in the literature. Curvy Girls is an international peer-run support group that aims to reduce scoliosis's emotional impact through education, mutual support, and self-empowerment.
OBJECTIVES: This study endeavors (1) to gain insight into the lived experience of teenage girls living with scoliosis and (2) to understand how the peer support group, Curvy Girls, has impacted their lives.
APPROACH: We interviewed sixteen members of Curvy Girls living with scoliosis. The interviews were transcribed verbatim, and then interpreted using applied philosophical hermeneutics.
FINDINGS:I. Personal Lens: The narratives of living with undiagnosed pain revealed confusion, solitude, and loneliness. The impact of labeling the pain (i.e., an official diagnosis) led to relief in some cases or irritation in some other cases.
II. Healthcare Lens: The stories of negative healthcare experiences and their impact on teenage girls are uncovered. The teenage girls wanted to be included in treatment decisions that may endorse autonomy and independence during adolescence.
III. Peer support Lens: Curvy Girls provides a safe environment for these adolescent girls to engage. The power of sharing and communicating helps Curvy Girls members cope and feel a sense of belonging.
SIGNIFICANCE: An insight into these teenage girls’ lived experiences allows for a better understanding of living with scoliosis and how a peer support group can help with this journey. 
Looking into the kaleidoscope of activism: the engagement of care ethics and global bioethics for a refined health security
Get PDFDuring public health crises, the United States utilizes a statist approach for securing its population’s health, which places state structures at the center of a (mainly economic) health security. The fairness of this approach relies on a distribution of resources to “trickle down” from institutions to individuals. Yet, “fairness,” in this regard, is determined a priori, that is, without reference to specific individuals who are receiving resources of health. This ignores contextual needs that arise from the disproportionate damage that epidemics and pandemics have on vulnerable populations. A statist approach can make a more equitable impact on global society if it integrates care ethics into its distributive justice.
In this paper, I demonstrate how an ethic of care can substantiate health security. First, I show how an ethic of care can be engaged anywhere embodiment is recognizable—not just in the one-on-one setting of the clinical encounter—but in the (inter)national contexts through which public health crises have a full effect on. Second, I provide a methodology for state institutions to recognize the social embodiment necessary to engage an ethic of care in these contexts, specifically engaging the social embodiment that manifests through the social activism of vulnerable populations during public health crises. Third, I demonstrate how the social embodiment that activism lives through forces an encounter with state institutions, mimicking in this manner a clinical encounter on a macrocosmic scale. Finally, I assign an ethic of care to this encounter, meshing caring values to the criteria of distribution
Healthcare highways in your community
Get PDFThis abstract serves to introduce a 10 minute video in which I will discuss issues pertaining to the structure of the healthcare system in Quebec. At the same time I will review the concept of community within and around that system. The relationship and interplay between the two will be explored in the hope that the viewer might find resonance and meaning, and perhaps a springboard to further reflection and conversation. Many perceive a need for change in both the organizational systems as well as in the existing cultures within healthcare institutions, both in and outside of Quebec. Yet we often feel powerless to act. I will touch upon ideas on how we can make a difference using our individual influence to bring about the changes we seek.
The concepts under discussion are abstract. In the hope of creating a greater degree of tangibility, I will offer a metaphor – namely the long-term detrimental effects brought about by the disruption, and in many cases destruction, of vibrant North American communities, caused by the building of highways straight through their hearts. I will suggest that though there may have been benefits to the society as a whole arising from the building of those highways, the adverse effects extended well beyond the individual communities involved. With this metaphor in mind, I will present the argument that the current structure of healthcare in Quebec, brought into effect in 2015, has resulted in over-bureaucratization and “decommunitization”, with a consequent diminution in the presence and role of culture, ultimately representing a loss for the community at large. Unintended deleterious societal effects arising from social system restructuring, are a phenomenon not unique to healthcare, nor to Quebec. It may take years for these consequences to become manifest, by which time they may prove difficult to reverse
Queering whole person care in a pandemic
Get PDFHow can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to?
In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat.
The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic.
A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat.
The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices
