The International Journal of Whole Person Care
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Mindfulness and Compassion as Antidotes to Physician Addiction
Get PDFAddiction, broadly defined, is common in healthcare settings. A person can be addicted to substances, junk food, work, power, money, using mobile devices, and so on. The problem is generally ignored until dire consequences occur (e.g. a critical mistake is made, or the clinician acts in an unprofessional manner). Once identified, addicted physicians are usually referred to Physician Health Programs i.e. sent elsewhere to deal with their presumed personal issues. A Buddhist view of addiction differs from Western psychology and psychiatry in that it examines compulsive behaviours in the light of ‘common humanity.’ Craving is seen to be the cause of (all) suffering. Obsessions (about the desired object) occur in the mind; this then triggers compulsive acts. And thus, treatment includes examining how the mind works, how it influences behaviours, and how it can be used to heal suffering.
Implementation of an Iraqi women’s behavioral health support group: Lessons learned in a pre and post US election climate
Get PDFThe Colorado Refugee Wellness center is an integrated primary and behavioral health care provider for newly arrived refugees resettling in the City of Aurora, CO. In the Spring of 2016, behavioral health staff responded to a need identified by Iraqi Muslim women clients to come together to share experiences and get support in light of the rise in anti-Muslim and anti-refugee rhetoric, and so a therapy group for Iraqi women was created.Topics addressed in group included cultural considerations related to communication styles, generational hierarchy, respect of authority, religious values, physical health and building community as well as psychological issues of losses, cultural conflicts, fear and safety, and achieving health goals in the face of adversity. The Iraqi patient navigator served as an invaluable cultural broker in the recruitment and retention of clients, as well as provided cultural insight into conducting ongoing program evaluation to revise the goals and purpose of the group.In this presentation, we share clinical and cross-cultural experiences, as well as lessons learned on the creation, implementation, and adaption of an Iraqi women’s behavioral health support group in the political climate of the 2016 US election year and approaches to flexible program development and evaluation. We discuss the limitations of applicability of Western core group therapy interventions and recovery models based on the insights from the Iraqi women’s group. In particular, we focus on the crisis debrief session with group members on the day following the election via a process of reciprocal healing.
Strength based nursing: caring for the whole person
Get PDFStrengths-Based Nursing (SBN) is an integrated value-driven approach based on a philosophy of care to guide actions. It consists of eight values which guide nursing practice to promote care of the whole person and family. SBN promotes empowerment, collaborative partnership, innate health and healing, authentic relationships while focusing on enhancing and developing strengths to cope with challenges and minimize, contain or circumvent that which is not working.Our poster will illustrate the basics of SBN and how it can be utilized in the promotion of whole person care.Conclusion: SBN has enlarged our perspective, broadened our skilled-know how, and opened us to new ways of caring for persons and families dealing with cancer. It has also given us insights into our nursing practices and illustrates the importance these eight values have in supporting development of whole person care
Where did everybody go? Working with anxiety when cancer treatment ends
Get PDFAnticipating the end of cancer treatment, we think we will be nothing but relieved. In most cases, there is significant relief, but also significant fear. To add to the difficulty, when cancer treatment finishes, so do most supportive programs. People expect us to be “back to normal” now that we “have our life back”, even though our perspective on life may well have changed during the process of cancer treatment. Ultimately, we can feel quite alone, worried about the cancer coming back and not being sure how to live this new reality.This workshop invites practicing psychosocial clinicians and allied health professionals to learn to integrate a host of effective holistic techniques to patients and caregivers at this uniquely stressful time. In this experiential workshop learn body-centered tools to soften the fear of recurrence, re-balance the nervous system and help people both settle and thrive into this “new normal” life
A patient expectation and satisfaction survey with regards to exercise prescription from their osteopathic manual practitioner
Get PDFBackground: Patient satisfaction is virtually synonymous with health status. There exists little empirical data which examine osteopathic patient expectation and satisfaction with respects to self-care and home exercise interventions. Objective: To examine patient expectation and satisfaction in Ontario with regards to receiving exercise prescription from their Osteopathic Manual Practitioner (OMP) for management and prevention of their chief complaint. Design: A cross-sectional patient expectation and satisfaction survey. Methods: 75 surveys were delivered to 10 osteopathic clinics in the Greater Toronto Area. 45 of those surveys were completed and returned. Microsoft Excel 2010 was used to analyze the descriptive data and GraphPad Prism 6 was used for inferential analysis. Content analysis was used for all free text responses. Results: A high majority of osteopathic patients are satisfied with their treatments (97.8%). The Fisher’s Exact test revealed no significant difference in satisfaction between patients who expected exercise and received it and those who expected exercise but did not receive it (p= 0.14). A significant minority (43.2%) would like to be provided with more home care exercise advice. Other areas of improvement are: follow-up, referral base,take- home tools, and in-office exercise equipment. Conclusions: This study examined patient expectation and satisfaction in Ontario with regards to receiving exercise prescription from their OMP. The results showed that, overall, patients are satisfied with their osteopathic treatments. Patients expected exercise advice from their OMP, and generally, received it. As satisfaction and health outcome are synergistic however, there are several areas in need of improvement.
Person-Centered Care: Perspectives of free dental clinic users in Montréal, Canada
Get PDFThere has been a relatively slow incorporation of person-centered care into dental care. Despite the efforts to sustain this approach in dental health care delivery, the perspectives of patients have yet to be considered, especially those using free dental clinics. Our objectives were: (1) to describe the perspectives of adults unable to access private dental clinics when using free dental clinics, (2) to document their suggestions for improvements to dental care. This qualitative descriptive study included 13 adults using a free dental clinic. To select participants, we adopted a maximum variation sampling strategy regarding age, sex, marital status, education level and employment status. We used in-depth, semi-structured interviews to collect data and thematic content analysis to analyze the verbatim transcripts. Participants were generally satisfied with the dental care they received in private and free dental clinics. However, they did not appreciate the long wait times at free clinics, and were bothered by the cost at private clinics. They emphasized a desire for quality time with the dentist allowing for more informed and shared decisions about their care, regardless of the clinic they visited. Participants want to feel cared for through a trustworthy relationship with the clinician, and suggested incorporating a walk-in concept into free clinics to address access to care. Adults using free dental clinics have various experiences with private and public dentistry, but they all need clinicians who adopt a comprehensive approach when providing information. This could improve patients’experiences through a more person-centered approach to dental care
Introducing graphic medicine: care and comics
Get PDFSince around 2000, there has been a growing body of work which tells medical stories using the form of comics. This genre has come to be called “Graphic Medicine” and has been organized and supported with annual (since 2007) global “Comics & Medicine” conferences and a publication series at The Pennsylvania State University Press. The seminal "Graphic Medicine Manifesto" was published by that press in 2015. In my presentation I would like to begin with a survey of the genre’s history and to transmit a sense of its scope. Graphic Medicine publications are composed and illustrated by physicians, nurse practitioners, patients, patients’ family members and other creator/observers. Sometimes they are testimonies of actual cases and other times they are imagined and constructed. The perspectives offered and illustrative styles are wildly variable. The scope of vision might be broad and sociologically dense, displaying the patient’s lifeworld or only show the experience of an isolated figure. I believe that Graphic Medicine can make claims to offer a unique instrument of mediation. As such, it can be used to facilitate the relation between doctors, students, patients and families. Comics can illustrate the imaginative and symbolic representations of figures and their dynamic relationships.Furthermore, I propose that its features are sympathetic to and supportive of the goals and methods of Whole Person Care. Graphic Medicine is holistic as it presents a contextualizing situation, while subjective draughtsmanship enhances the affective dimension. And they are also anxiety reducing - for after all, they are still comics
Mindful congruence, four noble truths and healing relationships
Get PDFAmidst the commotion of constant changes in health care systems, budget cuts, burnout and compassion fatigue there are resilient clinicians who relieve suffering and promote healing in those who seek their care. This workshop will focus on how doctors, nurses, and allied health care professionals serve in this way while maintaining equanimity and sense of meaning in their work and personal lives.This 90-minute experiential-based workshop will be divided into three parts.First, Mindful Clinical Practice will be described using narratives from different health care professionals in various settings. Mindful Congruence will be defined, along with Satir’s four other communication stances.Second, how the Four Noble Truths stemming from Buddhist philosophy inform clinical practice will be discussed with an emphasis on the Eightfold Path to end suffering. Third, a model of Healing Relationships (Scott et al, 2008; 2009) will be used to help participants identify underlying processes contributing to the relational outcomes: hope, trust, and being known. An Appreciative Inquiry exercise will be used to enrich participants’ understanding of their own experiences of being healers in clinical encounters.If and how medicine may be a spiritual practice will be examined.At the end of the workshop participants will be able to: 1. Define Mindful Congruence.2. Understand how the Four Noble Truths from Buddhist philosophy inform clinical practice.3. See how meditation practice contributes to clinicians’ mindfulness and emotional regulation.4. Discern the competencies and processes underlying healing
Narrative Medicine, Healing and Salutogenesis: Contrasting meta-narratives
Get PDFWhile narrative medicine “fortifies clinical practice with the narrative competence to recognize, absorb, metabolize, interpret, and be moved by stories of illness”, (www.narrativemedicine.org), the role of healing in clinical narratives has yet to be considered. Salutogenesis, defined by the late Anton Antonovsky, is the ‘creation of health and the fostering of healing’ where healing does not simply address reversal of disease but emphasizes health-promoting experiences and behaviors as distinct and differentiated from the illness perspective. This contrast between illness and healing offers an opportunity to consider a deeper meta-narrative (identity stories that confer legitimacy on what we do) – that can significantly broaden and likely add to the impact of narrative medicine. In this 45-minute workshop, Drs. Kreisberg and Huffaker will guide participants through two narrative exercises – the first, an illness narrative, and second, a healing narrative. By introducing Antonovsky’s perspective on healing, participants will gain an awareness of a deep and widespread meta-narrative comparison that has yet to be articulated in narrative medicine. In contrasting these meta-narratives, it is suggested that work has yet to be done to fully explore the potential for healing narratives in narrative medicine. They can afford the exploration of stories far beyond the bio-medical illness paradigm and introduce the likelihood that including both illness and healing stories offers an enriched potential for narrative elements of whole person care