The International Journal of Whole Person Care
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What Does it Mean to Live with Thalassemia? An Interpretative Phenomenological Inquiry
Get PDFLiving with Thalassemia, means that the body is unable to produce normal levels of hemoglobin to carry oxygen throughout the body. Without sufficient levels of hemoglobin (due to inefficiency of bone-marrow to produce normal red blood cells), one can experience signs and symptoms, such as severe anemia, chronic fatigue and other serious health concerns. My interest in this topic is because, I live with this condition, but, also interested in the lived experience of the Thalassemia community. My research is a phenomenological exploration through interpretation of research participants’ narratives. The overarching goal of the proposed research is to investigate the contribution to the medical personnel who may use the findings from the study to improve the clinical care from not only from patient centered, but also from a whole person care perspective. There are various clinical and psycho-social challenges such as, academics, career, and family / friend relationship issues. Families address the treatment issues of Thalassemia on a continuum Extreme Drive - No Drive to improve their lives. Thalassemia was seen as a “fatal condition,” today it is a “manageable condition,” therefore, we need to learn, how best to thrive to lead a healthy lifestyle? Through this research I am hoping to share my story and with others to inspire people living with Thalassemia, to go beyond managing towards thriving
Can Doctors Still Have a Voice in Healthcare?
Get PDFIn the fall of 2014 the Quebec Health Ministry announced plans for a broad restructuring of the entire Healthcare network, implemented shortly thereafter in 2015. The effect on institutions was dramatic and immediate. Local management was eradicated, concentrating and centralizing control of the entire system ultimately into the office of the Minister. With the abrupt reorganization of services came relocation of large numbers of personnel. Management at a distance became the norm. In many institutions, the commonly held view among physicians with regard to relations with management can be summarized as, “Suddenly there was no one to talk to.”Confusion and tension were prevalent and palpable. In this context, in attempt to have a voice, a group of physicians at one community hospital formed an independent organization. It developed into an influential body which continues to remain active. This workshop will use the experiences and reflections of physicians from that organization as a basis to explore questions such as: -Is there a difference between Health Services and Health Care? Do we care? -Does worker engagement matter in Healthcare delivery? Or are good systems and modern equipment all we really need? -Does sense of community matter within a healthcare institution? If so why?If it matters, is it just for the benefit of those working for the organization? Or is there a benefit for the users too? -What is the basis for sense of community? Where does it come from? Can it be destroyed? Can it be developed? -Is there an importance to the quality of relationships between people working within Healthcare? Do these relationships have impact on quality of care? -Should the perspective of those working in the system be incorporated input Management decision making? If so how? -What can physicians, nurses and other allied Healthcare professionals do in order to have a voice?
Dreamwork Principles and Approaches for Palliative Care
Get PDFRemembering and working with dreams can be of great benefit in life and especially in connection with death and palliative care not only for the dying, but also for friends and relatives, and even for the caregiver(s).Inevitably, dreams around the time of death of both the dying and their loved ones will be offering incredible opportunities for vital emotional release, insight into deep unresolved interpersonal patterns, and a source of communication between personality and spirit for acceptance of death itself.Dreams of the dying, friends, relatives, and caregivers alike also often act as a daily inner compass and source of wisdom for health and treatment.Caregivers may use dreamwork and related appraoches as powerful tools even with patients who are unable to communicate, not very lucid, or even in a coma.Research shows that anyone can learn to recall dreams and tap their wisdom for daily guidance, and social/emotional, mental, and even physical healing, including the dying, visitors, and caregivers alike. In this way, dreams can become the source of insight and transformation they are meant to be.The presentation will cover the science, philosophy, and real-world examples of practical applications of dreams, such as for healing and caregiving, and will touch upon concepts and methods for inducing, remembering and working with dreams that can provide opportunities for healing, greater fulfillment, enhanced treatment, and a personal soul connection around the time of death.
A Model for the Formation of the Person-centered Dental Care Provider
Get PDFDental education continues to emphasize scientific knowledge and technical skills, yet research reveals that what matters most to patients is how we communicate and relate to them. How do we teach trainees communication and relational skills and continue to cultivate these skills throughout clinical practice? A comprehensive model for the formation of the patient-centered dental provider is proposed and is represented by the metaphor of a tree. The model is the fruit of interviews with dental patients, observation of dental professionals, and review of literature on patient-centered care, patient satisfaction and malpractice trends. Six core relational skills include: Introduce, Solicit, Listen, Empathize, Explain, and Power of the patient (ISLEEP) and are represented by the branches of the tree. Discerning how to respond to a patient, how to apply the ISLEEP skills, moment by moment, requires being present with a kind intention, the definition of mindfulness. Mindfulness practices, represented by water, cultivate the roots of the tree which are the four aspects of mindfulness: Equanimity, Attentiveness, Self-awareness, and Empathy (E.A.S.E). Rooted in mindfulness, the dental care provider responds with intelligent and kind action, or whole person care, enriching both patient and provider
Defining the experience: How do you know you are practicing Whole Person Care?
Get PDFIntroduction: Whole Person Care (WPC) is a growing movement in health care recognized as an important tool for both practitioners and patient outcomes. What remains unclear is what WPC looks like in practice and how providers know they are practicing it successfully. Methods: Researchers conducted in-depth interviews with 30 healthcare providers during the WPC congress in 2017. An iterative qualitative process was used to code and analyze the data using qualitative research software.The primary research question explored how practitioners know that they are practicing WPC. Results: Our analysis revealed that the practice of WPC is an individual experiential process appreciated through self-awareness and connection. Most practitioners reported the importance of i) their ability to be present in an interaction and to acknowledge their own emotions, ii) the relationship between practitioner and patient, characterized by a feeling of trust and of mutual impact, and iii) relying on external cues, such as explicit patient feedback and body language. In this workshop, attendees will be prompted to reflect on their experiences of providing WPC through individual and group exercises. Attendees will be invited to reflect on the above results and discuss emerging themes. This participatory research model creates an interactive space for workshop attendees to build on our data and guide further analysis. Conclusion: Cues to whether you are practicing WPC rely on practitioner self-awareness and perceptions of how interactions transpire. This workshop offers an opportunity to create an experiential map of the elements contributing to the growing practice of WPC.
The Rural Clinical School of Western Australia Mindfulness Project
Get PDFBackground: Medical students experience high levels of stress during their training. Literature suggests that mindfulness can reduce stress and increase self-compassion levels in medical students. Most mindfulness training programs are delivered face-to-face and require significant time commitments, which can be difficult to achieve for rurally-based students with heavy academic workloads.Aim: We sought to determine the feasibility and effectiveness of a mindfulness training program delivered online to medical students at a Rural Clinical School.Methods: An 8-week online training program was delivered to third year medical students at the Rural Clinical School of Western Australia in 2016.Using quantitative-qualitative mixed-methods approach, we measured the frequency and duration of the participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.Results: 47 students were recruited to the study. 50% of participants were practising at least weekly by the end of the 8-week program, and 32% of responding students reported practising at least weekly 6 months following the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 6 month follow up. Participants reported qualitative insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice
Mindfulness-Based Reduction Stress Reduction for Patients with Rheumatoid Arthritis and Depressive Symptoms: a Pilot Trial
Get PDFBackground : Despite their efficacy at controlling joint inflammation, current treatments of rheumatoid arthritis (RA) leave up to 40% of patients into non-remission. Non-remission, frequently due to persistently negative self-reported impact of RA, was found to be associated with significant persistent depressive symptoms 6-7 months after initiation of arthritis treatment. Mindfulness-Based Stress Reduction (MBSR) is proposed to improve depressive symptoms and RA-related clinical outcomes. To pave the way for an eventual randomized controlled trial, a feasibility and acceptability study of MBSR has been realized. Methods: A standardized 8-week MBSR program was offered to groups of patients with controlled inflammatory disease but high levels of depressive symptoms.Qualitative interviews based on a theoretical framework of acceptability were conducted. Change in depressive symptoms (CES-D tool), fatigue and pain (SF-36), anxiety (GAD-7), pain, disease activity (PtVAS and SDAI scores) was measured over a 6-month period. Results: 27 patients have been recruited (3 distinct MBSR groups). Factors leading to a higher rate of success in recruitment were identified. Despite the small sample, the intervention was found to have a clear impact on depressive symptoms (p=0.004), anxiety (p=0.005), and social functioning (from the SF-36; p=0.04). Patients reported that MBSR gave them the opportunity to control their reactions in face of stressful situations.Perceptions were almost uniformly positive towards MBSR, and most appear to have integrated some part of the intervention in their daily life. Conclusions: Although recruitment was challenging, a MBSR trial on depressed patients with controlled inflammatory disease was found acceptable and feasible within this population. Preliminary clinical results showed positive impacts of such intervention.
A Patient's Journey in Curating Her Medical Team for Whole Person Care
Get PDFTwenty-nine years ago I was born with Short Bowel Syndrome, which required me, from birth, to depend on feedings through a gastrostomy tube and central line. To this day I require IV nutrition daily. I am not yet thirty years old, and I have had 65 surgeries, including a small intestine organ transplant, and bilateral hip replacements. I understand how the medical system works—and where it fails. I now have an incomparable level of knowledge and first-hand experience with our healthcare system that I hope to use to enlighten and educate.My care for the last three decades has not been whole-body. Instead, it has been fragmented highly subspecialized care, leaving me doing well in the short term, but with no cohesive long-term plan. I had discussions with my current medical care providers, I left teams that were inadequate, I inquired opinions of new doctors from around the country and curated my own team of professionals from 3 states in order to LIVE not survive in a hospital. The result: Whole person care with me as the driver and coordinator.I will impart pieces of my experience to understand what it takes to create the “pit crew,” the healthcare system was not providing me, and how you as a medical provider can be the best advocate for your patient on their “pit crew.” Hear real examples of patient-provider interactions, the vital importance of shared decision making, and the details behind true compassion that inspire whole person care