The International Journal of Whole Person Care
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How Do Junior Medical Students Learn about the Doctor Patient Relationship?
Get PDFJunior medical students have the capacity to engage well with patients at an early stage in their training. With careful coaching, students can also write moving and accurate accounts of their significant learning experiences. In this article, we introduce an innovative learning programme at Otago University in New Zealand, and present carefully chosen extracts from student essays. These extracts illustrate students’ early exposure to, and challenges in, the student-patient relationship, a precursor to their own professional relationships. Reflective writing helps students internalize foundational interpersonal concepts such as meaningful engagement, self-awareness, the role of other health professionals, and the need for self-care. This early orientation towards whole person care may be helpful grounding for future clinical practice
Making sense of a diagnosis of incurable cancer: The importance of communication
Get PDFPurpose: Patients diagnosed with incurable cancer may experience existential distressand difficulty in re-appraising their lives because of uncertainty about the future. Objectives: This study sought to understand how patients living with incurable cancer made sense of their diagnosis, how they prepared for the future and what support they wanted from their health professionals. Subjects: 27 patients were recruited from the oncology and palliative care service at three metropolitan hospitals. Methods: A qualitative research approach was used. Semi-structured face-to-face interviews were conducted. Interviews were audio-taped and transcribed verbatim. Data was analyzed using the constant-comparative method. Results: Participants did not express a need to make sense of their diagnosis nor always ascribe to a particular religious belief; rather, many relied on a personal spirituality or philosophy to bring meaning to their experience. Importance was placed on their doctor keeping up with technology, being honest, and being confident and positive. Conclusion: Participants in this study had incurable cancer but making sense of their current situation was not a conscious priority. For these patients, uncertainty was a positive, as certainty for them indicates death is approaching. What these interviews suggest, from the patient’s perspective, is that there is an implied contract between doctor and patient during this period which involves the doctor managing the flow of difficult information so that the patient can maintain normality for as long as possible. Understanding this helps to explain the difficulty of having advance care planning conversations within this setting, despite the many opportunities that a longer disease trajectory would seem to offer.
Carrying the healer’s baton
Get PDFThe story of a relatively brief interaction I had with a ward patient that taught me how little effort it can sometimes take to completely change a patient's experience of their hospital admission
Mindful medical practice and the therapeutic alliance
Get PDFThis review article focuses on how the therapeutic relationship is central to clinician-client/patient relationships in psychiatry as well as other medical and psychotherapeutic encounters. Crucial to this relationship is the alliance formed between the caregiver and the person who seeks their care. The threats to the therapeutic alliance in psychiatry are discussed as is the importance of facing them. How mindfulness enables clinicians to build such bonds and foster well-being in themselves and in those they treat is examined in the context of quantitative and qualitative studies
Family Medicine Quartet
Get PDFFamily medicine is a unique medical discipline centred on the patient and the doctor patient relationship. In this essay I use an arts based inquiry juxtaposing clinical narratives to illustrate the clinical philosophy of Ian McWhinney
Incorporation of spiritual care as a component of healthcare and medical education: comparison of Sub-Saharan African and Northern European viewpoints
No full textThis study addresses cultural differences regarding views on the place for spirituality within healthcare training and delivery. A questionnaire was devised using a 5-point ordinal scale, with additional free text comments assessed by thematic analysis, to compare the views of Ugandan healthcare staff and students with those of (1) visiting international colleagues at the same hospital; (2) medical faculty and students in United Kingdom. Ugandan healthcare personnel were more favourably disposed towards addressing spiritual issues, their incorporation within compulsory healthcare training, and were more willing to contribute themselves to delivery than their European counterparts. Those from a nursing background also attached a greater importance to spiritual health and provision of spiritual care than their medical colleagues. Although those from a medical background recognised that a patient’s religiosity and spirituality can affect their response to their diagnosis and prognosis, they were more reticent to become directly involved in provision of such care, preferring to delegate this to others with greater expertise. Thus, differences in background, culture and healthcare organisation are important, and indicate that the wide range of views expressed in the current literature, the majority of which has originated in North America, are not necessarily transferable between locations; assessment of these issues locally may be the best way to plan such training and incorporation of spiritual care into clinical practice
