The International Journal of Whole Person Care
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The Expectations of Low and High Risk Pregnant Women Who Seeking Obstetrical Care in a Highly Specialized Hospital
No full textBackground: In the context of a highly specialized hospital, birth care might be is expected to be more medicalized and technocratic for both low and high risk pregnant women.Objective: This study aimed to explore the expectation of low and high risk pregnant women who seeking an obstetrical care in a highly specialized hospital.Methods: A single case study design was chosen for this study. The case under study was a tertiary and university affiliated hospital in Montreal, Canada. The data were collected through semi-structured interviews, field notes, participant observations and self-administered questionnaire. An inductive qualitative content analysis was used.Results: As a whole 157 women were participated in the study. The analysis of data showed that both high and low risk women felt more satisfied with the care they received if they were provided with informed choices, had the right to participate in the decision-making process and were surrounded by competent care providers and obstetric technology. The presence of an attentive care provider during labour who humanly cared for women and her family considered as essential component of birth care by women participant.Conclusion: A birth care provider in a tertiary hospital setting should aim to meet both physiological and psychological aspects of birth care, including respect of the fears, beliefs, values, and needs of women and their families. Integration of competent and caring professionals, as well as the use of obstetric technology, could enhance the level of certainty and assurance in both high-risk and low risk women in a tertiary hospital
Whole Person Team Care
No full textIn the rapidly changing environment of 21st century healthcare, effective interdisciplinary team-based care is a key ingredient in providing whole person care across the continuum. Interdisciplinary teams face significant issues and challenges in providing whole person care given the boundaries that exist between various healthcare disciplines. Systemic institutional barriers and hierarchies commonly work against team communication, cooperation, and collaboration. These work environments contribute to work-related stress, staff turnover, inefficient, lower quality care, burnout, and compassion fatigue. Ultimately team environments that do not foster team member well-being are unlikely to find success in creating environments that foster whole person care. Given these realities, teams who hope to provide whole-person care need strategies for creating and sustaining a team environment of self-awareness, self-compassion, mindfulness and non-judgmental presence.This session will present the outcomes of three innovative approaches to interdisciplinary care team flourishing through case study analysis of hospital-based palliative care teams, and adult/pediatric hospice teams. The first intervention illustrates a process for developing and implementing a team retreat experience. Combining elements of team building, experiential learning and discussion of assigned readings, palliative care and hospice teams exhibit increased team trust, respect and communication across discipline boundaries. The second intervention demonstrates positive meaning-making through the use of a “spiritual narrative.” Through sustained reflection on a guiding metaphor, “spiritual narratives” enhance team identity formation, function, and sustainability. The third intervention outlines a model for group mindfulness meditation. Through regular practice of mindfulness meditation as an integrated component of the work day, team members sought to increase their self-awareness, presence, attunement and compassion in clinical interactions. Attendees of this workshop will be inspired and equipped to with new ways to enrich interdisciplinary team flourishing while providing excellent whole person care
Creating Significant Life Rituals in Neuro-Palliative Care
No full textRitual can be described as an act which helps make sense of life, “there is what many people recognize as a spiritual quality to life, which in suffering, confronts people with questions and possibilities that reach beyond the immediate dilemmas of physical insult.” (Cobb and Robshaw, 1998); in this vein, ritual serves as a vehicle to navigate the inherent moments of sorrow and suffering in our lives. Fred Bird describes ritual as something which allows for communication, representation, meaning making, validation and relationing. (Bird, 1995)This presentation explores the ways in which creating accessible and significant contemporary rituals, within a hospital setting, may serve as a means to crystallize our deepest sensitivities for life, and living. It looks at some of the ways rituals can serve as a bridge to wholing and healing, within the patient, with family members and with health care professionals interacting with patient. Through examples from spiritual care counseling, within a multidisciplinary team setting, in neuro-palliative care, a path is set for some simple ways to ritually nurture quality of life issues, as part of a whole person care health protocol
Reiki for Whole Person Care: Case Studies in Oncology Patients, a Preliminary Report
No full textObjective: Reiki has been introduced as part of the complementary therapy program for oncology patients in two major university hospitals to which our institution is affiliated, with the objective to provide whole person care. Reiki is a deep relaxation technique that promotes balance, healing and harmony in all aspects of the person – body, mind, emotions and spirit. A Reiki session is given using very light or no touch on a fully clothed individual, sitting or lying down. Reiki is best understood by actually experiencing a session.The objective of this preliminary study is to document how Reiki can support and benefit oncology patients in facing the day-to-day challenges related to their illness.Methodology: Weekly Reiki sessions lasting from 20 to 60 minutes have been conducted with adult patients. Inclusion criteria: any patient living with cancer: all stages, from pre-diagnosis to diagnosis, ongoing treatment (in and out-patients), post-treatment and palliative care. Data has been collected using a questionnaire and a symptom scale, before and after sessions, as applicable. Qualitative experiences from palliative care patients will also be obtained from staff and family caregivers.Results: Preliminary results after each session indicate a significant reduction of anxiety and stress, in addition to improving regulation of pain, fatigue, emotional state, and digestive issues. Patients commonly express a feeling of serenity, calmness, and peace. Qualitative results will be presented.Conclusion: Data collected so far suggests that Reiki as a complementary therapy, improves overall quality of life for patients. A more relaxed and less anxious patient facilitates the intervention of medical staff and lightens the efforts of caregivers and family. Closer communication between the medical and complementary therapies staff can manifestly enrich the whole person care
Person-Centred Dentistry: When Do We Start?
No full textObjectives: Although most health professions have adopted person-centred approaches in the last decades, dental professionals still rely on traditional paternalistic models. The objective of this research was to develop a model of person-centred care in dental practice.Methods: Adopting an action-research approach, we started our process by adapting Stewart and colleagues' model of person-centred care to the field of dentistry. We then implemented and tested the new clinical approach in a private dental office of Montreal, Canada. During several months, an academic researcher observed the clinical activities of a dental practitioner, who was also the first researcher. At the end of each appointment, the observer and the practitioner shared their observations about the encounter and evaluated the clinical approach. Both suggested improvements to the model and implemented solutions to the next patients. After 39 rounds of observation-evaluation-improvement, a form of saturation was reached in the development of the clinical approach.Results: The clinical encounter goes through four different stages. The first stage is how the relationship is built through an open dialogue on illness, fears and expectations. The second stage consists in gathering clinical information through examination, tests and questioning. The third stage is a disease-centered presentation of the results of the examination. The final stage is the development of a treatment plan after establishing a common ground through frank discussions and shared decision making. From this approach, a model emerged consisting in a stage of understanding, followed by planning, intervention, then back to understanding. This cycle takes place within the context of a patient-dentist relationship with mutual trust. This relationship, central to the encounter, acknowledges the whole-person dimension and psychosocial context of each party.Conclusions: We hope this model will inspire other professionals and teaching institutions to develop their own approaches by using it as a theoretical framework
Proposed Consensus-Based Canadian Integrative Oncology Research Priorities
No full textObjectives: An increasing number of integrative oncology programs are being established across Canada that offer a combination of complementary and conventional medical treatments in a shift towards whole-person cancer care. It was our objective to identify consensus-based research priorities within a coherent research agenda to guide Canadian integrative oncology practice and policy moving forward.Methods: Members of the Integrative Canadian Oncology Research Initiative and the Ottawa Integrative Cancer Centre organized a 2-day consensus workshop, which was preceded by a Delphi survey and stakeholder interviews.Results: Eighty-one participants took part in Round 1 of the Delphi survey, 52 in Round 2 (66.2%) and 45 (86.5%) in Round 3. Nineteen invited stakeholders participated in the 2-day workshop held in Ottawa, Canada. Five inter-related priority research areas emerged as a foundation for a Canadian research agenda: Effectiveness; Safety; Resource and Health Services Utilization; Knowledge Translation; and Developing Integrative Oncology Models. Research is needed within each priority area from a range of different perspectives (e.g., patient, practitioner, health system) and that reflects a continuum of integration from the addition of a single complementary intervention within conventional cancer care to systemic change. Participants brainstormed strategic directions to implement the developing research agenda and identified related opportunities within Canada. A voting process helped to identify working groups to pursue strategic directions within the interest and expertise of meeting participants.Conclusion: The identified research priorities reflect the needs and perspectives of a spectrum of integrative oncology stakeholders. Ongoing stakeholder consultation, including engagement from new stakeholders, is needed to ensure appropriate uptake and implementation of the Canadian research agenda