The International Journal of Whole Person Care
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Ontological exercises to overcome mismatch diseases’ obstacles to holistic health
Get PDFThe current urban environment inhabited by humans in North America reflects profound changes in its physical and social architecture that occurred more rapidly than the human biological capacity to adapt. This mismatch between self and environment can result in ailments and diseases that are physical (e.g. metabolic syndrome) and psychological (e.g. anxiety, depression). These mismatch ailments act insidiously, as their chronic/diffuse nature makes them go generally unnoticed. However, their effects are no less important on overall wellbeing and deserve attention from health professionals. The overarching hypothesis is that ontological exercises, i.e. practices that are aimed to foster a deeper understanding of the nature of being, promote holistic health to counterbalance the feeling of threat arising from the disconnect between post-modern society and the ancestral makeup of human beings. Numerous cultural practices have emphasized exercises aimed at operating transformative changes to increase wellbeing, empathy, compassion and pro-social behaviors. Ontological exercises from ancient Greeks, Buddhists and Native Americans will be explored in this context
Engaging heARTS: Developing an arts-based curriculum to enhance compassion and creativity in healthcare
Get PDFIn 2014-15 Hamilton Health Sciences (HHS), with supportive funding from the Ontario Arts Council, partnered with a local group of professional artists to develop a curriculum called Awakening Your Creative Power: a seminar series on creativity, compassion and play. In order to understand the feasibility and impact of this arts-based curriculum for healthcare personnel working within a hospital, HHS undertook a comprehensive program evaluation. Input from participants who attended the course was obtained in three ways: (1) weekly evaluation forms at the end of each session (2) a final evaluation that asked questions about the overall seminar series, and (3) a focus group discussion held 2 weeks after the seminar series ended. This paper reports on the outcomes of the evaluation and the evolution of the curriculum over the past 3 years, including its impacts on both participants and the arts partners. The evaluation data demonstrate that the course was successful in meeting its stated objectives which include: enhancing interpersonal skills, fostering self-reflection, deepening compassion, cultivating resilience, recognizing creative potential, applying intention and coping with daily stresses through the power of play. In addition, the course also: increased self-awareness, fostered a sense of community, emphasized the value of creativity for its own sake, empowered participants, provided participants with a sense of accomplishment and made participants feel valued by the institution. The paper concludes with some reflections on the potential of engaging arts professionals in health professional education.
De-fuzzification of reflection in the education of health professionals
Get PDFOur educational institutions are mandated to equip future physicians and other health care professionals with the scientific, craft, and inter-personal knowledge and skills to meet the demands of contemporary clinical practice. Clinicians must acquire advanced communication skills, develop the ability to manage complex situations, make appropriate use of medical knowledge and technology, and problem-solve through the exercise of refined judgment. The ability to reflect in and on situations of this nature is considered a necessary professional aptitude in order to ensure effective and compassionate whole person care. Notwithstanding the general acceptance of these premises, ‘reflection’ remains a fuzzy concept. It is a polysemous term that has proved difficult to define and has attracted to itself numerous false claims and unfulfilled promises. Excellence in reflective abilities is notoriously difficult to recognize in another individual and it may not be ‘teachable’. Furthermore, there have been recurring doubts as to the feasibility of meaningfully assessing reflection.We intend to explore these issues in this session. We will demonstrate how reflection can be role-modeled and inculcated. Instructional Methods This will be an interactive workshop. Learning Objectives By the end of the workshop, participants will be able to:• clarify the concept of reflection and understand its application to the education of health professionals• discuss a framework, including specific methods, for the structuring and deployment of an educational program aimed at promoting reflection
The head start program for women newly diagnosed with breast cancer
Get PDFWe present the beneficial impact that our Head Start Program for women newly diagnosed with breast cancer has on participants at the Ottawa Integrative Cancer Centre. While beginning a new world of conventional cancer treatments, our program provides support and guidance at a crucial time of flux in a woman’s life, and addresses the spiritual, physical and mental emotional health of women of all ages, from generation Y through to our elders, who are dealing with a cancer diagnosis.This 6 week program is comprised of workshops, support group sessions and experiential mind body techniques, and is led by a group of therapists skilled in cancer’s psychological and physiological effects.Our research outcome measures of the program to date will be touched upon
Reflective practice and the role of transformational learning in healthcare
Get PDFAmong possible adult learning theories, transformative learning emerged in the 1990’s with the aim to provide learners an educational experience consistent with the purpose of changing perspectives. Transformational learning theory provides the opportunity to learn, confront, engage and reflect on the possibility of learning through changes in perspective and to explore new meanings, roles, relationships and actions contained within it.Perspective transformation is, therefore, not only intended to create ownership of new knowledge, but its re-integration into new or re-configured ways of everyday living. The readiness to apply new knowledge is triggered by confronting an event, or mode of thought, that moves individuals from experiencing knowledge as a series of facts disconnected from their meaning and context into a relevant context, or one that has a different significance for the learner. New understanding requires that learners assess the meanings behind words, the coherence, truth and appropriateness of what is being communicated as well as the truthfulness, credibility and authenticity of the presenter. Unlike focusing only on instrumental learning in which logical problem solving and inquiry dominate, transformative learning entails the use of metaphor, analogies and reflective dialogue so that learners revise their interpretations of knowledge. In these ways transformative learning might help healthcare providers to change their frame of reference and perceptions to accommodate new and different ways of learning and engaging within a multidisciplinary clinical team.
Intervening with persons experiencing mental illness and substance use: Patient perceptions of helpful care during psychiatric hospitalization
Get PDFBackground30 - 50% of people with mental illness also experience a substance use problem or concurrent disorder (CD). This dual diagnosis is associated with complex health and social problems, high suicide risk and poor longterm outcomes. Persons with CD have unique needs which present significant challenges for health providers during psychiatric hospitalization. While hospital personnel play a significant role in promoting health and well-being, what “helpful care” means to persons with CD during psychiatric hospitalization remains unexplored, and the health benefits unknown. Research QuestionWhat actual and/or potential interventions, attitudes, actions, and behaviours are perceived as “helpful” by persons with CD during psychiatric hospitalization?MethodsQualitative-descriptive design; individual, semi-structured audio-recorded interviews with 12 inpatient adults diagnosed with CD.ResultsParticipants reported both beneficial and harmful practices.Examples of helpful interventions occurred within 3 distinct areas: 1) building a therapeutic relationship; 2) engaging in health-promoting activities within a healing environment; 3) managing substance use in tandem with mental illness. ImplicationsFindings highlight the importance of relational interventions for persons with CD. This includes actions aimed at tailoring care to fit each individual while offering interpersonal approaches, attitudes and behaviours that are collaborative, caring and respectful. Helpful activities include assisting with daily care, advocating for time outside, offering teaching and learning sessions and facilitating discharge. There is an urgent call to prevent harmful practices and to understand and promote interventions consistent with whole person care for hospitalized clients with CD
Mindful Leadership in Interprofessional Teams
Get PDFLarge interprofessional teams are complex systems in which the expertise of the individual team members interact with the health situation and the external environment in the delivery of modern day health care. The need for coordinating leadership and the (dynamical) need for appropriate expertise to come to the fore involves a tension between the traditional role of the team leader as authority figure and the collaborative leadership preferred by individual team members in their field of expertise. Mindful leadership may provide the leader attributes that allow for and facilitate emergent team structures to meet system changes required in implementing patient and family-centred care. In this paper, we discuss the nature of these attributes and their implications for models of interprofessional teams
Personal narrative writing workshops for medical students and patients with HIV: narrative medicine in the post-HAART era
Get PDFSince the advent of highly active antiretroviral therapy(HAART) in the mid-1990's, HIV in the United States has become a chronic and largely controllable disease. Adherence to therapy is one of the most crucial aspects of HIV treatment and control due to the high risk of viral resistance. The main barriers to successful treatment are now psychosocial and structural, including social stigma and the high burden of disease in vulnerable communities. To improve clinical outcomes, physicians today must learn to engage with their patients on the level of their lived experiences, which include their social backgrounds and personal values and priorities. In 2016, supported by a Narrative Medicine Fellowship from Columbia University, we piloted a novel narrative medicine-based medical education intervention in which patients with HIV and medical students from the Keck School of Medicine of the University of Southern California wrote and shared personal narratives with each other. Nine medical students and five patients participated in one of two five-week long workshop series. Patients were recruited from the Maternal, Child, and Adolescent/Adult Clinic at Los Angeles County General.Mixed methods were used to evaluate the feasibility and effectiveness of the intervention. This included the development of a grounded theory of participants’ experiences of the workshop series. Participants articulated how the workshop series expanded their sense of agency, humanity, and empathy toward others, enabling them to explore new ideals for therapeutic physician-patient relationships. The results of the study, as well as the workshop series method and syllabus, will be presented.
Architecture’s creative contributions to healing: oncology patients in the Cedars Cancer Centre
Get PDFBACKGROUND: The present state of Evidence-Based Design (EBD), the dominant paradigm in healthcare architecture, arguably limits architecture’s creative contributions to healing. EBD is founded upon the principle of designing built environments based on research to optimize outcomes. However, EBD’s current heavy focus on measurable results may not sufficiently address the multidimensionality of patienthood. Using EBD, designers of Montreal’s new Cedars Cancer Centre endeavoured to create a patient-centered space that holistically addresses oncology patients’ needs. PURPOSE: Using ethnographic and architectural approaches, this study evaluates whether oncology patients’ lived experiences of the Cancer Centre correspond to designers’ original qualitative intentions for a supportive, healing environment. METHODS AND RESULTS: This paper presents results from thematic analysis of annotated architectural floor plans and transcribed interviews with sixteen Cancer Centre outpatients between January and May 2017. Themes are content-analyzed and organized according to original design aims: 1) improving patient-staff relations, 2) reducing patient stress and anxiety and 3) empowering patients. SIGNIFICANCE: Our oncology design study is the first of its kind to delve into patient backstories, intertwining them with in-depth analysis of the design process and final architectural product.Our findings promote an analytical discussion about EBD and highlight new insights about oncology design and cancer patients’ spatial needs. More broadly, we propose implications for the relationship between architecture and Whole Person Care (WPC), namely: 1) drawing out architectural lessons that increase empathy towards space’s impact on illness, thus deepening health professionals’ relationships with patients, and 2) conceptualizing application of WPC principles in healthcare design.
Mindful Dentist
Get PDFDental anxiety challenges patients and providers alike, creating barriers to care, increasing pain perception, and increasing the time and effort required to complete treatment. While patient-centered dentistry invites us to care for the person attached to the teeth, many dentists feel ill-equipped to handle the many emotions that arise during dental treatment. Mindfulness and the practices that cultivate it are invaluable to the provision of patient-centered care in four respects: 1) it provides balance to the dental professional during stressful times, 2) it cultivates the qualities of a patient-centered health care provider 3) it guides actions necessary to meet a patient’s needs, 4) it provides techniques that patients can themselves use to find balance during stressful times. All of these fruits of mindfulness practices are demonstrated in three true vignettes of fearful patients who were treated by the author. Video footage of the three stories is also provided