The International Journal of Whole Person Care
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Imagine the poss-ABILITIES! Therapeutic Recreation: An Integral Aspect of Whole-Person Health Care
No full textThe word recreation is really a very beautiful word. It is defined in the dictionary as “the process of giving new life to something, of refreshing something, of restoring something.” This something, of course, is the whole person. (Bruno Hans Geba)Background: The purpose of Therapeutic Recreation is to enable all individuals to improve quality of life, and achieve optimal health through meaningful experiences in recreation and leisure. We believe in the inherent capacities of individuals for wellness, personal growth, happiness and freedom, with or without absence of disease. Therapeutic Recreation is a profession which provides service to, and advocates for individuals with disabilities, illnesses, and other conditions in clinical, community and educational settings. We recognize that everyone has the right to have access to and experience the healing benefits from recreation and leisure opportunities. Therapeutic Recreation follows a systematic process of developing a therapeutic relationship, assessment, goal setting, program development, implementation through individual and group facilitation, documentation and evaluation. Programs are designed based on the strengths, interests and needs of the participants and promote improving wellness within the physical, emotional, spiritual, behavioural and social domains (according to the participant and their context) and to educate individuals about the skills and resources required to participate in recreation and leisure. We use evidence-based practice to create outcome-based interventions suitable to the participant’s abilities.Content: Presentation will be descriptive, drawing attention to the profession of Therapeutic Recreation and how it fits well with the whole person approach.Evidence: Current research indicates a significant number of positive health outcomes resulting from participation in Therapeutic Recreation programs such as: improved physical, cognitive, social and emotional functioning; leisure and life skill development to enhance functional independence; self worth, and quality of life of individuals and their families; adjustment to disability and/or illness and post-traumatic growth; reduced boredom, stress, anxiety, and agitation; reduced decline in physical, cognitive, and psychosocial functioning and as a result reduce the need for health care services; reduced secondary disability and associated higher health care costs.Conclusion: There is strong evidence that Therapeutic Recreation interventions are healing, support wholeness, and can have a major positive impact in the outcomes of people served. Thus, Therapeutic Recreation should be an integral part of any multi-disciplinary health care team that uses a whole-person care approach
Mindfulness-Based Medical Practice: Exploring the Link between Self-Compassion and Wellness
No full textObjectives: In light of the detrimental impact of burnout upon clinicians and their patients, the identification of means through which the well-being of health care professionals can be fostered and protected is timely and important. The present study explored outcomes associated with participation in Mindfulness-Based Medical Practice (MBMP), a program modeled after Mindfulness-Based Stress Reduction which included additional mindful communication exercises to foster the integration of mindfulness in various clinical settings.Methods: Physicians, nurses, psychologists, occupational therapists, and social workers enrolled in the 8-week MBMP program. Participants (N = 110) between the age of 24 and 82 years (M = 46.5, SD = 11.4: 73% women) completed self-report measures prior to and following the program; the Maslach Burnout Inventory, Perceived Stress Scale-10 and the Ryff Scales of Psychological Well-Being. Two process measures designed to capture mechanisms of change were administered: the Mindful Attention Awareness Scale, and the Neff Self-Compassion Scale.Results: Results from paired-sample t-tests indicated that health care professionals enrolled in MBMP can benefit from the program. Analyses demonstrated significant decreases upon measures of perceived stress [p= .000], emotional exhaustion [p= .000], depersonalization [p= .000], and an increase in personal accomplishment [p= .000] as well as mindfulness [p=.000], self-compassion [p= .000], and well-being [p= .000]. Hierarchical regression analyses indicated that change scores on perceived stress (Beta = -1.46, p LT 0.000) and self-compassion (Beta = 9.02, p LT 0.006) predicted changes in well-being in this sample. Additionally, participants rate perceived importance of having taken part in the course using a Likert-scale from 1-10 (M=8.5, SD = 1.51).Conclusions: This study suggests that for health care professionals enrolled in MBMP may experience a variety of benefits associated with participation in the program. Further, increases in self-compassion may hold particular implications for well-being in this population
Music Therapy in Whole Person Care at the End of Life
No full textWhole Person Care aims to be deeply present to the person in the patient; acknowledging the integration of physical, psychosocial and spiritual facets of human experience, and creating a space in which healing, or a greater sense of wholeness, may occur. Music offers a potent tool in this endeavor. With its inherent capacity to engage body, mind and spirit, music can stimulate or calm, transport us to other times and places, reach our innermost emotions, and connect us to ourselves, our loved ones and our spirituality. In palliative care, music therapy joins with whole person care to meet patients and their loved ones as fully as possible.Concepts central to whole person care will be presented and illustrated through the lens of clinical music therapy. For example, exploring how the skilful use of music addresses many dimensions of personhood will highlight Cassell’s concept of personhood. Demonstrating the ability of a significant melody to access and externalize personal meaning will integrate ideas from Frankl on meaning. Observing how relationship and creativity function as healing connections will draw from Mount, as will the idea of helping one move on a continuum from suffering to healing (Mount, Hutchinson, Kearney). The role of the health care professional as a ‘vulnerable-enough’ caregiver (Papadatou) or ‘wounded healer’ (Kearney) will also be touched upon. Throughout the presentation, poignant images, stories and video clips of patients engaging in music therapy at the end of life will serve to both enliven the didactic material and demonstrate how music therapy can create a space in which experiences of greater integrity may occur
Workshops in Healing for Senior Medical Students: A 5 Year Experience
No full textObjectives: To provide a 5-year (2008-2012) overview and appraisal of a novel course for senior undergraduate medical students (Workshops in Healing) at the University of New South Wales, Sydney, Australia within the context of a traditional 6-year curriculum. In these innovative workshops, 8-12 self-selected students per year participate over 6 hours in two sessions, several days apart. The sessions use artwork and other evocative images, poetry, music, statues and classic/contemporary literature to illustrate points of discussion relating to suffering, healing and the doctor-patient relationship. Methods: A written open-ended reflection was requested from 48 students in the final year of their 6-year medical course within a few weeks of the second workshop. The study employed an emergent qualitative design. Open coding involved repeated reading of the sections of the student’s feedback and a line-by-line analysis of this data. Selective coding was then used to link data together and develop the themes.Results: Students identified the following benefits from the workshops: 1) the opportunity to re-affirm their commitment to their chosen career path; 2) the value of listening to other students share their stories; 3) the importance of the timing of the Workshops to occur after exams; 4) the use of various mediums such as art, music and literature to present concepts of suffering and healing; and 5) the creation of a safe and confidential space.Conclusions: Students reported that the workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of Medicine (healing) not covered in the traditional medical curriculum. For many students the workshops provided a broader understanding of the meaning of concepts such as suffering and healing, and helped them to rediscover a deeper meaning to Medicine, and their roles as healthcare professionals
Patients’ Stories of Interprofessional Whole-Person Care
No full textObjectives: Interprofessional whole-person care has been depicted as being able to enhance patient health outcomes, increase health care provider satisfaction with care delivery, lower health care spending and decrease wait times for receiving care. Limited research has been conducted into exploring patients’ experiences of being recipients of this type of care. The objective of this oral presentation is to disseminate findings of a Master of Nursing study through patients’ stories of experience receiving care on aunit where inter professional care is practiced.Methods: Three participants underwent a two step data collection process: a one hour semi-structured interview and a 30 minute symbolic image artistic exercise, as adapted from Schwind’s Narrative Reflective Process. Participants were invited to describe how they experienced receivingcare from an interprofessional team and whether or not they believed whole-person care was delivered to them. Collected data are being analyzed using Clandinin and Connelly’s Narrative Inquiry approach of three dimensionalspace, temporality, sociality and place.Results: The emerging results suggest that participants express satisfaction with the care they received from the interprofessional team on their unit. Their stories indicate that strong interprofessional team-work can contribute to patient satisfaction in care received. For these teams to be successful, from the patients’ point of view, there needs to be: better communication between care providers, greater involvement of the patient in decision making, proper identification of who comprises the teams, andconsistency in team composition.Conclusion: By acknowledging experiences and feelings ofpatients who have received care from an interprofessional team, there is potential to increase sustainability of these teams. The data generated through this study can potentially help health care providers, who are members of interprofessional teams, to deliver more effective, comprehensive whole-personcare within health care institutions
Healing as Recycling Energy from Negative to Positive
No full textObjectives: For many practitioners and patients, the most critical aspect of medical practice is healing. Healing requires compassion in order to elevate clinical practices above the skills of a medical technician. At the same time, the act of healing is deeply involved. When practitioners heal, they must take care not to experience physical, mental, or spiritual fatigue or injury to themselves. By practicing healing as recycling energy from negative to positive, practitioners develop contemplative compassion. The more practitioners treat patients, the more they understand how to recycle and heal, and the better the practitioner they become.Methods: Healing recycling involves practitioners engaging their own chakra system on the physical, mental, and spiritual levels. Negative energy is drawn from the patient and flows through the practitioner to their solar plexus, where it is converted to positive energy. The practitioner then returns the positive energy to the patient as a vital healing force. In order to avoid injury through this process, practitioners must purify and harmonize themselves through practice and discipline in body, mind, and spirit exercises.Results: Traditional Chinese Medical philosophy will be introduced and used to examine the concepts of energy, healing, discipline, and holistic medicine. The various modalities of healing recycling will be demonstrated, including through the hand, the eye, the nose, and the third eye. By practicing healing recycling, practitioners will avoid becoming “wounded healers”, and improve their overall ability to heal.Conclusions: Practitioners who can contemplate compassion in their medical practice become healers. Without compassion, there is no healing. Without healing, there is no medicine. Therefore, the practice of medicine needs a better understanding of how to recycle energy. At the same time, greater healing will translate into improved quality of life for patients
Creative Team Building with Staff Through Mandala Making
No full textObjectives: Participants will learn how art therapists can achieve individual or group goals through the use of art materials and processes. They will also learn how organizational goals can be incorporated into relevant art making experiences. The presentation begins with a brief overview of art therapy and the history of mandala making in community building. We will then review the mandala-making staff workshops. The discussion will close with an exploration of how this process may be applied to other work environments.Methods: These workshops were originally offered to our long-term care staff on eight different occasions during, "Planetree Month" in May of 2011, a month dedicated to staff self-care. The “Planetree Month” planning committee asked the art therapist to develop a team-building exercise that would be fun, creative and completed within 45 minutes. The committee also hoped that the workshop participants, who had little or no artistic experience or skill, would make a collective art work (within the time constraints,) that would be a source of pride for the participants and be good enough to be installed on the walls of the centre as a testament to the teamwork achieved.Results: The goals of the workshop were accomplished through the careful design of this workshop. More than 200 staff members participated, embraced the process and completed eight mandalas which are now permanently displayed on the walls of Donald Berman Maimonides Geriatric Centre. Creativity can bring out the best in people, creating synergy and positive community growth
Primary Care and the Ethics of Integrating Genomic Medicine
No full textObjectives: To explore the practical barriers to, and implications of, incorporating genomic technologies in the primary care setting. In evaluating the primary care mission and anticipated role of genomic medicine in conversation with one another, I discuss the ways in which the primary care philosophy problematizes innovations afforded to clinical medicine through whole genome sequencing. I discuss these themes in relation to the evaluation frameworks that must precede full integration, specifically the Analytic validity, Clinical validity, Clinical Utility and Ethical, legal social considerations (ACCE) model. Finally, my analysis will consider the added ethical nuances for integrating genomic medicine in the wake of new standards for healthcare delivery in the U.S.Methods: I review the literature concerning 1) models for evaluating the applicability of emerging genomic technologies in the primary care setting, namely the ACCE model proposed by the Center for Disease Control, and 2) anticipated changes to primary care delivery through proposed healthcare legislation.Results: Three main facets of primary care delivery problematize full integration of genomic medicine in clinical practice. They include: primary care providers' propensity to maintain therapeutic relationships with patients over the lifecourse, acuity to community health patterns, and gaps in genetic/genomic-specific knowledge among practicing clinicians. Implementation of genomic medicine requires that technologies be adaptable to the heterogeneity of the primary care clinic, in both the diverse populations it serves and broad spectrum of resource availability.Conclusions: The rapid pace at which genomic technology has fundamentally altered the direction of medical research scene is extraordinary to say the least. The potential benefits for incorporating these innovations depict a clinical landscape that predicts and prevents disease before it manifests, and cares for patients using treatments that are tailored to their own genetic person. The primary care arena presents unique challenges to the evaluation, diffusion and translation of genomic technologies. Yet the same aspects that present limitations also reinforce the reasons why the primary care setting is a critical forum in which to operationalize genomic medicine in practice. With so much dialogue generated around ushering in a new era of medicine, it is unclear whether this is celebrating the novelty of the genomic revolution, or the reinvigoration of a longstanding clinical tradition in patient-centered primary care
Mind the Gaps
No full textObjective: Reflection on 35 years in family medical practice - from home births to home deaths. My own wider understanding of "medical practise" through my personal growth.THE GAPS1) ISAAC NEWTON vs ALBERT EINSTEINMatter versus energy. Current medical practise is still largely perceived through a Newtonian mindset. In recent years the "repair shop" mentality has intensified as we find more sophisticated techniques for managing the ailing human body. We still practise in a reductive world where we believe that we can determine outcomes entirely by understanding the parts. Even a scant understanding of wave particle interactivity can help interpret a more holistic view of disease processes. Metastatic cancer is an enormous challenge and I believe outcomes are related to far more than the conventional invasive treatments.2) LOUIS PASTEUR vs CLAUDE BERNARDGerm theory versus milleu. The debate these two men initiated 170 years ago continues today - even though it is rumoured on his deathbed Louis was heard to say he thought Claude was right. We still practise medicine as if we are fighting an enemy and give scant regard to the milleu that we allow the "enemy" to inhabit. As the mystics and the scientists draw closer together through our quantum understanding, the milleu of our human system appears more complex and more connected to the world that we inhabit.Although I practise conventional family medicine, I use metaphysics, metaphor and an interpretation of energy medicine to help patients understand their disease and enable them to use an holistic approach to intergrate both conventional and complimentary therapies. With increasing audit and protocol driven practise it seems that often humanity gets sidelined. HbA1c's become more important than the relationship the patient has with their disease.Conclusion: The reintegration of humanity into the practise of medicine will help empower patients with insight that will not only enhance their quality of life but will also help save millions of dollars that currently is wasted within the victim / fix it model of medicine. I see the tide turning and this conference is evidence of a resurgence in a broader understanding of medicine through personhood