The International Journal of Whole Person Care
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Understanding Patient Perspectives of Self-Care in the Management of Chronic Disease
No full textThis workshop will provide participants with an understanding of how appreciative inquiry based methods can help us learn from patient experience, develop self-care plans and identify the roles of various support groups within those plans, and develop a framework for chronic disease management which is based on lessons learnt from patient experience.Understanding patient experience with and perspectives on what supports on-going self care to manage chronic disease is critical to a whole person approach to chronic disease care. While the individual’s experience of chronic disease self-management may vary from individual to individual, our recent work demonstrates that appreciative enquiry is an effective tool for understanding the key support structures for effective management of self-care. This work also points to appreciative inquiry as an effective tool for patients and care-givers in developing approaches to individual self-care plans.After a brief presentation of our recent findings, workshop participants will have an opportunity to use a modified appreciative inquiry approach to consider aspects of chronic disease care and particularly to discuss those factors that support chronic disease management. Appreciative Inquiry, as a positive form of narrative inquiry will elicit stories that make these supportive factors more concretely visible and comprehensible. Workshop participants will also be provided with a brief overview of thematic analysis as a way of identifying common themes in the appreciative inquiry data and developing a model of self-care support
Whole Person Teaching Makes an Effective Baccalaureate Nursing Teacher: Student Voices Enlighten Us
No full textObjectives: The goals of this study were to understand: 1) what makes an effective teacher in each level of the baccalaureate nursing program, 2) what are the skills, attributes and strategies of an effective teacher in both theory and clinical courses, and 3) how does this impact student learning and the student experience in each level of the curriculum?Methods: A qualitative description approach was used. All BScN students at two sites (1000 students) were emailed an invitation to participate in an online survey to identify what makes an effective teacher in the baccalaureate nursing program. Students were also invited to participate in focus groups to discuss what makes an effective teacher and the impact on their learning. It is anticipated that six focus groups of 10 to 12 students will be conducted. Survey and focus group data are analyzed using qualitative content analysis.Findings: A preliminary finding emergent from the data is that students perceive whole person teaching, that is understanding the learner as a whole person, makes an effective teacher. This study has the potential for important impact on students and faculty in baccalaureate nursing programs. The results will be used to plan faculty development initiatives throughout all levels within relevant programs. Findings, conclusions and recommendations will be shared at the conference.Conclusions: Will be available at the time of the conference. Faculty members are learning how to optimally facilitate learning in a new context that embraces a person-centered, problem based, self-directed and small group learning approach. Students are in the best position to articulate what makes an effective teacher in each year of the four year program. Students were eager and empowered to share their perceptions and faculty eager to learn from student voices to optimize student experiences and learning
Promoting Resilience with the Mindfulness-Based Stress Reduction Program in Patients With Chronic Illness
No full textObjectives: Twenty-first century patients need to take a proactive stance with regard to their health in order to cope well with chronic illness. Mindfulness-Based Stress Reduction (MBSR) is an 8-week structured group program that encourages patients to take responsibility for their health and teaches them to cope with stressors inherent in living with illness.Methods: Patients with chronic illnesses (e.g., breast cancer, chronic pain, multiple sclerosis) participated in the MBSR program from 2006-2012. They completed questionnaires pertaining to depression, medical symptoms, stress, coping, sense of coherence, and mindfulness pre- and post-MBSR. They filled out a follow-up questionnaire that asked them to rate the program and its components. A self-care index was created from 5 items.Results: Of the 126 patients, 85.7% were woman, breast cancer was the most common illness (46.8%), and the average age was 52.3 (SD = 13.3). There were significant improvements on the following outcomes: depression, stress, and medical symptoms. With regard to process measures, there were significant increases in: mindfulness, sense of coherence (comprehensibility, manageability, and meaningfulness of life), as well as significant decreases in emotional coping. Patients rated the program with a mean of 8.94 (1 to 10 scale) for importance. They rank ordered the program components in terms of helpfulness with awareness of breath, the silent retreat day, and yoga practice as the highest of 10 items. There was a significant positive correlation between self-care index at the end of the course and its perceived importance. Moreover, self-care was positively and significantly correlated with post-MBSR mindfulness and viewing life as meaningful.Conclusions: Patients who took the MBSR program reported mental and physical health benefits. Furthermore, being mindful enabled them to cope better, take care of themselves, and view life as more coherent such that they became more stress resilient
When One is Sick and Two Need Help: Caring for the Caregiver
No full textObjectives: To increase public and professional understanding of caregiving experiences of people who care for adults with chronic physical illness; to promote the use of caregivers’ lived experiences in the education of healthcare professionals.Methods: Part 1: 40 qualitative audio/video recorded interviews were conducted with adult caregivers in a maximum variation sample from across Canada. Data collection and analysis is via rigorous qualitative research. 25 topics or themes are identified reflective of the participants’ concerns, meanings and priorities.Results including video, audio or text clips, and evidence-informed resources are published on www.healthexperiences.ca. The methods are adopted from the award-winning website (www.healthtalkonline.org) from Oxford University, UK.Part 2: collaboration with healthcare professionals, educational experts, researchers and caregivers to design educational modules to be piloted in University setting for healthcare professional education.Results: Caregivers described their experiences with the healthcare system as part of their role. They provide advice to health care professionals about issues such as access to information and services, attitude and behaviours, the impact of caregiving on their own well-being , and reflections on their role. Participants emphasize the importance of recognition for their role as part of the care team for patients with chronic physical illnesses. Some described the need for the healthcare system to consider caregivers as an important component in the ‘a circle of care’ around the patient. If caregivers suffer physical or mental illness, burn-out or lack of resources, the support system for the patient falls away. Educational modules featuring video and audio clips of caregivers’ stories are powerful educational tools in developing healthcare professional sensitivity to these issues in patient care.Conclusion: The www.healthexperiences.ca / www.experiencessante.ca sites are unique in Canada in the field of patient experiences and healthcare communication. It is a great resource to educate health care professionals about the caregivers’ perspective on caring for adults with chronic physical illness
Humanizing clinical dentistry through a person-centred model
Get PDFoai:ojs.iwpc.mcgill.ca:article/2The clinical approach in dentistry stems from a biomedical model of health that is anchored in positivism. This biomedical model was never explicitly developed or reflected on, but rather implicitly acquired as a product of historical circumstance. A reductionist understanding of health served dentistry well in the past, when health afflictions were mostly acute. Today, however, in the age of chronic illnesses, the current clinical approach is no longer adequate: patients and dentists are both dissatisfied, and there are problems with dental education and dental public health. After a thorough review of the literature, highlighting the current state of the profession, we propose an alternative clinical model upon which updated approaches can be based. We call this model "Person-Centred Dentistry". Our proposed model is rooted on the notion of sharing of power between the dentist and the patient: a sharing of power in the relationship and epistemology. This leads to an expanded understanding of the person and the illness; a co-authoring of treatment plans; and interventions that focus not only on eliminating disease but also on patient needs.
Dying with Dignity in Québec: Palliative Care, Moral Expertise, and the Debate on Euthanasia
No full textOn March 22, 2012, the Select Committee on Dying with Dignity of the National Assembly of Québec released its final report recommending the adoption of “medical aid in dying” in the province of Québec, Canada. The majority of palliative care physicians, professed experts in end of life care, rejected the committee’s conclusion. And yet, the recommendation of the committee, in framing euthanasia as “medical aid in dying,” placed the practice squarely within the realm of their putative expertise.The objective of this project is to examine the role of palliative care physicians in the Dying with Dignity debate in Québec and to answer the following question: why were palliative care practitioners unable to influence the outcome of the debate?My methods include a detailed analysis of the committee proceedings of the Select Committee on Dying with Dignity and a review of the sociological literature on committees and on expertise, the philosophical literature on euthanasia, and the historical literature on palliative care.I draw broad conclusion about: (i) committees, and the way in which committee formation and format prioritize certain societal values; (ii) medical expertise, and the devaluation of certain forms of knowledge in the evidence-based medicine framework; (iii) moral expertise, and its presumed absence in Western democratic society
Fostering Resilience over Multiple-losses for Nursing Staff in the Palliative Care Unit: Whole Person Approach – Part 1
No full textObjectives: “Bereavement overload” due to multiple losses is one of the stressors for the nursing staff working at Palliative Care Unit (PCU), which may be especially tough to those with less exposure to such situation. A support program was developed for the nursing staff of newly-opened PCU (April 2011) in order to foster resilience and wellness despite multiple losses. We conducted a study to evaluate the effectiveness of the support program with “whole person approach” – consisting of 3 modules; 1) lecture on grief and bereavement (mind), 2) experiential workshop on body awareness and relaxation (body/spirit), and 3) group discussion (mind/spirit), for the increased sense of self-efficacy, awareness of their inner healing power, and fostering mutual understanding and support.Methods: 20 nurses were randomly assigned to two groups for the action research project. Data included participant observation, individual and focus group interviews with one of the investigators. The support program package was offered from October to December 2012 (A) and from January to March 2013 (B) respectively, using wait-list control method. Self-efficacy scale was used at the base line, at the completion of package A, and at the completion of package B. Participants also answered brief survey after each module, followed by semi-structured interview.Results: The self-efficacy score initially showed decline of both groups (intervention/control) , reflecting the “tough two months” with the highest number of the total deaths as well as deaths within 5 days post admission. However, intervention group showed more gradual decline comparing to the control group, plus higher elevation 3 months later, which may indicate some effect of the program.Conclusions: The support program was positively received and contributed to the nursing staff’s increased sense of self-efficacy and resilience over “bereavement overload.” Continued program development is in progress based on the feedback
CLEAR: Whole Person Care Model for the Health Sciences Professions
No full textWhole-person care has been important throughout the 150-year history of Loma Linda University and Hospital system (now Loma Linda University Health - LLUH). Since the 1950s, the motto is, “To make man whole.” However, up to 2011 there was no corporate-wide understanding of whole-person care, or a model to guide teaching and practice. Connected to this has been the question of whether spiritual care and whole person care were similar categories of understanding.Objective / Methods: In 2011 a group of nine researchers and clinicians designed a research/development project for the purpose of developing a whole-person care model to guide all teaching and practice at LLUH. A consultation group of approximately 300 researchers, clinicians, students and staff of LLUH were invited to give feedback during the course of the project through online avenues and group forums. This larger group was open to all interested people throughout LLUH. The research / development group considered all comments, critiques and suggestions made by the larger consultation group, with all work public to both groups.Results / Conclusions: From the process emerged the first draft of a whole-person care model in March of 2012, with the following qualities: measureable, memorable, practical, flexible, and teachable. After several pilot tests, the model was adopted by LLUH as the model to guide all teaching and practice at LLUH. Since that time, the model has been integrated into the orientation of new employees (clinical and university), the teaching practices of three schools (medicine, nursing, and religion) and is being integrated into the remaining four schools by 2014. It is also guiding the development of the online wellness website for the corporation. Finally, it is used to guide two new developments for the School of Medicine: 1) a Narrative Project designed for the first year School of Medicine students, and 2) the Integrative Whole-Person Care Simulation Labs developed for second year School of Medicine students.The poster presentation will describe the whole-person care model itself, the research/development process behind it, and give examples of how it has transformed teaching and practice in the university and clinical/hospital arenas
Spirituality in Medicine
No full textObjectives: Spirituality is a vital component of whole person care; healing always involves body, mind, and spirit. We can anticipate the resolution of health problems holistically by providing correct physical, mental, and spiritual alignment to our dear patients. Alignment is accomplished both through the patients’ awareness of relaxation and self-care, and the harmonization and purification of the healing energy of the practitioner. Therefore, the patient and practitioner engage upon a healing journey through spiritual connection that vitalizes the process of medicine.Methods: Traditional Chinese Medicine has employed a physical, mental, and spiritual approach for thousands of years. Enhancing spirituality in medicine involved strengthening exercises of the body, mind, and spirit. Patients are encouraged to increase their awareness of themselves on each level. Practitioners should learn to cultivate positive healing energy that will enhance their medical practice. Qi Gong posture, breathing, phonation, and visualization exercises will be demonstrated to introduce Traditional Chinese Medical philosophy and practice.Results: Session participants will receive a general orientation to Traditional Chinese Medicine and learn specific skills in Qi Gong. Patients will learn greater attention to physical, mental, and spiritual alignment. Practitioners will learn to engage themselves for whole person healing, by understanding the relationship between patient and the practitioner.Conclusions: Spirituality is vitally important in medicine to enhance the quality of both its preventive and healing aspects. Treatment is a two way relationship. Practitioners must treat patients with good intentions. Patients must prepare for a healing process that engages them on the physical, mental, and spiritual levels. Practitioners and patients, therefore, must work hand in hand, heart to heart, towards the goal of health and well-being
