Narrative, trauma, and self-interpretation

2016 ◽  
Vol 26 (1) ◽  
pp. 108-129
Author(s):  
William Affleck ◽  
Gaëlle Fiasse ◽  
Mary Ellen Macdonald
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Phenomenological Study ◽  
Secondary Analysis ◽  
Paul Ricoeur ◽  
Past Research ◽  
Theoretical Framework ◽  
Moral Experience ◽  
Mortality And Morbidity ◽  
Moral Framework

Although past research has explored the experience of bereaved fathers, few attempts have been made to situate this experience within a pre-existing theoretical framework. This article demonstrates how the narrative moral framework of the philosopher Paul Ricœur, known as his “Petite éthique” can help illuminate some of the features within this experience that contribute to the high rates of mortality and morbidity among these men. To demonstrate its utility, this framework is explored through a secondary analysis of data collected in an earlier phenomenological study that explored the moral experience of bereaved fathers. By clarifying some of the nuance and complexity of the experience of bereaved fathers, Ricœur’s “Petite éthique” framework has implications for health-care professionals, bereaved families, and bereaved fathers themselves.

Involving Parents in Decisions to Forego Life-Sustaining Treatment for Critically Ill Infants and Children

1990 ◽  
Vol 1 (1) ◽  
pp. 206-214 ◽  
Author(s):  
Cindy Hylton Rushton ◽  
Jacqueline J. Glover
Keyword(s):  
Health Care ◽  
Critically Ill ◽  
Communication Networks ◽  
Health Care Professionals ◽  
Critically Ill Children ◽  
Best Interest ◽  
Moral Framework ◽  
Proper Role ◽  
Life Sustaining Treatment ◽  
Networks Of Support

A moral framework based on principles of beneficence and respect for persons requires shared decision-making. In the best interest of critically ill children, parents should be the primary decisionmakers in collaboration with health care professionals. When parents are unable to function in their proper role as surrogate, health care professionals must seek an alternative surrogate decisionmaker. A balanced partnership between parents and professionals can be supported by attention to the environmental stressors, enhanced communication, networks of support and institutional mechanisms for conflict resolution.

Acknowledging Dependence: a MacIntyrean perspective on relationships involving Alzheimer’s Disease

2004 ◽  
Vol 11 (4) ◽  
pp. 400-410
Author(s):  
Janie B Butts ◽  
Karen L Rich
Keyword(s):  
Health Care ◽  
Cognitive Decline ◽  
Health Care Professionals ◽  
Family Health ◽  
Alasdair Macintyre ◽  
Human Beings ◽  
Human Flourishing ◽  
Moral Framework ◽  
Disease Experience ◽  
Person With Dementia

As people living with Alzheimer ’s disease experience their lifetime of memories slowly slipping away, they become dependent on society’s independent practical reasoners - family, health care professionals and society. Many people grow accustomed to the cognitive decline and begin to view the person with dementia as less than a person. In Dependent rational animals, Alasdair MacIntyre emphasized a moral framework that encompasses two sets of virtues needed for human beings to flourish in society and to achieve genuine common goods - the virtues of independent practical reasoners and the virtues of acknowledged dependence. Virtues of acknowledged dependence are discussed ethically in terms of benevolence towards those who are disabled or dependent upon people who are strong and independent. The authors propose that using MacIntyre’s perspective of the two sets of virtues is valuable in the care of persons with Alzheimer ’s disease. According to MacIntyre, independent reasoners who understand and practice these two sets of virtues will help those people in communities who are dependent and vulnerable, and, subsequently, human flourishing can occur.

Prognosticating futures and the human experience of hope

2007 ◽  
Vol 5 (3) ◽  
pp. 227-239 ◽  
Author(s):  
Sally Thorne ◽  
Valerie Oglov ◽  
Elizabeth-Anne Armstrong ◽  
T. Gregory Hislop
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Secondary Analysis ◽  
Human Experience ◽  
Clinical Encounter ◽  
Care Providers ◽  
Health Care Communication ◽  
Patients With Cancer

Objectives: Communication between health care providers and patients with cancer and other chronic diseases typically references probabilities that certain future events will or will not occur. Beyond the context of diagnostic encounters and the transmission of “bad news,” such “prognostic” communications take place in various forms throughout the illness trajectory. It is well known that such information transmitted badly can have devastating psychosocial consequences for patients and their families and, conversely, that difficult information exchanged with sensitivity can lend tremendous support. This study aimed to extend our understanding of how such communications are received and interpreted by patients, so that we might optimally apply what we know about general principles of effective communication within the particularly challenging context of predicting futures.Methods: We conducted a combined secondary analysis of two prior qualitative studies into patient perceptions of helpful and unhelpful health care communication with 200 cancer patients and 30 persons with chronic illness. These data sets offered a rich resource for comparing perceptions across a range of contextual variables, and secondary analysis focused on future-oriented interactions, including both prognostication and prediction.Results: The accounts of patients with cancer and chronic illness reveal various ways in which health care communications involving future projections interact with their human experience of hope, powerfully shaping their capacity to make sense of and live with serious illness. They include a synthesis of what patients recommend health care professionals know and understand about this challenging dynamic.Significance of results: The findings of this study offer a distinct angle of vision onto the various communications that involve future predictions, illuminating a patient perspective with the potential to inform health care communication approaches that are both informative and therapeutic. As such, the study supports a dynamic understanding of the tenuous balance between hope and honesty in the clinical encounter.

scholarly journals The Experience of Providing Physical Therapy in a Changing Health Care Environment

2002 ◽  
Vol 82 (7) ◽  
pp. 648-657 ◽  
Author(s):  
Rosemary Blau ◽  
Sarah Bolus ◽  
Terrence Carolan ◽  
Daniel Kramer ◽  
Elizabeth Mahoney ◽  
...  
Keyword(s):  
Health Care ◽  
Work Environment ◽  
Health Care Professionals ◽  
Phenomenological Study ◽  
Physical Therapists ◽  
Medical Center ◽  
Systemic Change ◽  
Academic Medical Center ◽  
Health Care Environment ◽  
Care Environment

Abstract Background and Purpose. The changes in the health care environment during the last decade have had an impact on the roles and responsibilities of all health care professionals. The purpose of this phenomenological study was to describe the experience of staff physical therapists during a time of systemic change within a large urban academic medical center. Subjects and Methods. Participants were 5 physical therapists working in various clinical settings within the medical center. The participants were interviewed and asked the question “Over the past 4 years, there have been major changes in your work environment. What has it been like for you working as a clinician during this time of change?” Interviews were recorded, transcribed, and analyzed to find thematic patterns of responses. Results. Four common themes emerged in which participants described experiencing loss of control, stress, discontent, and disheartenment. A fifth theme showed that despite these negative feelings, participants were able to “find the silver lining” in their daily work lives (ie, they were able to find positive aspects of their professional lives despite the perceived unpleasant changes with which they had to cope). Discussion and Conclusion. This study provides insight into the experiences of a group of staff physical therapists during a time of systemic change in their work environment. Although the themes reflect largely unsettling and negative experiences, there seems to be an underlying ability to find affirmative aspects of work.

scholarly journals A pharmacovigilance study in patients of chronic non-infective respiratory diseases attending outpatient department of pulmonary medicine in a tertiary care teaching hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 675
Author(s):  
Saket S. Gaidhane ◽  
Akash A. Khobragade ◽  
Abhijeet Joshi ◽  
Monisha S. Chavan ◽  
Likith H. V. ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Respiratory Diseases ◽  
Health Care Expenditure ◽  
Tertiary Care ◽  
Interstitial Lung Diseases ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Mortality And Morbidity ◽  
Care Teaching

Background: Adverse drug reactions (ADR) are the known dangers of any medicinal therapy. They are not only responsible for increasing the mortality and morbidity but also for multiplying the health care expenditure. It is important to monitor the adverse effects of the drugs in the patients on treatment for chronic non-infective respiratory diseases attending OPD of pulmonary medicine in a tertiary care teaching hospitalMethods: The study was single-centric, non-randomized and observational hospital-based study which was carried out for a period of 1 and a half years in JJ Hospital. The patients who were included in the study suffered from either of the 4 diseases-Chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis or interstitial lung diseases (ILD). Data were analyzed by using Microsoft excel sheet. Based on the outcome of modified Hartwig and Siegel severity assessment scale, ADRs were grouped into various severity categories.Results: One hundred and thirty-two number of ADRs were seen in 69 out of 352 patients (19.6 %) of the study population. The occurrence of ADR was found slightly higher in males i.e., 53.62% as compared to females i.e., 46.38%. The patients who were on treatment for ILD showed highest percentage of ADRs i.e., 57.89% which is followed by bronchiectasis (17.39%), COPD (16.17%) and lastly asthma (10.26%). The ADRs belonging to GIT system were highest in number i.e., 80. The most frequently occurring ADR in the study was palpitation which occurred in 14 cases i.e., 20.29%. Out of 132 ADRs observed, 96 i.e., 72.73% belonged to the mild category and 36 ADRs i.e., 27.27% belonged to the moderate category. Not a single severe ADR was found in the study.Conclusions: It was found that 19.6% of the patient population suffered from ADRs, which is a considerable number. It is essential that health care professionals should support ADR monitoring process for the safety of the medicinal product. Proper implementation of ADR monitoring will help to reduce the harmful effects by early detection of drug safety problems in patients, assessing the risk-benefit in an individual and the population, improving the selection, rational use of drugs through the provision of timely warning to healthcare professionals.

scholarly journals The lived experience among Somali women of giving birth in Sweden: an interpretive phenomenological study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Susanne Wallmo ◽  
Karin Allgurin ◽  
Carina Berterö
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Study ◽  
Care Seeking ◽  
Snowball Sampling ◽  
Somali Women ◽  
Pregnancy And Birth

Abstract Background The health care-seeking behaviour among Somali women is different from Swedish women’s behaviour, and this may have consequences for birth giving. The aim of the study was to identify and describe Somali women’s lived experience of birth giving in Sweden. Methods Qualitative individual interviews were conducted in Swedish with seven Somali women. The sample was purposeful, and the snowball sampling method was used. The interviews were digitally recorded and transcribed verbatim. Data were analysed using interpretative phenomenological analysis. Results Four themes emerged during the analysis which revealed the Somali women’s lived experiences of giving birth in Sweden. a) Being recognised and confirmed as a woman. Somali women consider it important to be confirmed as a woman by the surrounding and professionals during pregnancy and birth giving. b) Communication is important for the women’s independence. There is a need to provide a structure for how this information is given and adaptation regarding content and format .c) Something naturally becomes unknown and complicated. Somali women come from a different culture, which affects their lived experiences of pregnancy and birth giving. There is a need for improved and clearer information for these Somali women regarding pregnancy and birth giving in another culture- the Swedish context d) Professional and competent taking care of. The women appreciate if they are treated with competency and professionalism; they do not want to be discriminated. The women feel confidence in health care when they meet competent and professional health care professionals. Conclusions The findings in the study indicate that reproductive health care for Somali women should be improved with regard to cultural differences and lived experiences, as this affects their experience of pregnancy and childbirth in Sweden. There is a need for both knowledge and understanding in order to provide good quality care for these Somali women, especially those who have been genitally mutilated.

Parents’ Perceptions of Access to Services for Their Adult Children Diagnosed With Autism Spectrum Disorder

2020 ◽  
Vol 101 (2) ◽  
pp. 190-204 ◽  
Author(s):  
Christina N. Marsack-Topolewski ◽  
Arlene N. Weisz
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Adult Children ◽  
Health Care Professionals ◽  
Social Life ◽  
Phenomenological Study ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Service Access ◽  
Adults With Asd

The purpose of this phenomenological study was to investigate parents’ perceptions of service access for their adult children with autism spectrum disorder (ASD). Access includes accommodation, acceptability, availability, and affordability (4 As) of services. This study examined which of the 4 As presented the biggest challenges across multiple types of services needed. Fifty-one parents of adult children with ASD participated in semistructured interviews sharing perceptions of support services available for their adult children. Parents discussed eight types of services (case management, educational programs, employment and employment supports, physical/mental health care, housing, day program or respite care, social life and recreation, and transportation). Based on parent perceptions, services were inconsistently accessible, difficult to obtain, and inadequate. Trained social workers and health care professionals are needed to provide and coordinate services for adults with ASD.

scholarly journals Understanding the Influence of Ghanaian Women’s Migration Patterns on Access to Health Care 

2021 ◽  
Author(s):  
Michelle Malagón ◽  
Laiba Rizwan ◽  
Solina Richter
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Professionals ◽  
Secondary Analysis ◽  
Well Being ◽  
Determinants Of Health ◽  
Primary Study ◽  
Female Migrants

Abstract Background: In recent years, there has been a noted increase in migration rates with trends marking a rise in women seeking relocation as means to access employment or academic opportunities; this growth is referred to as the feminization of migration. Migration stimulates female empowerment, increases access to financial opportunities, and promotes cultural diversity; all while simultaneously exposing women to detrimental conditions that impose risks to their physical and psychological well-being. Health is a fundamental human right that female migrants often get deprived of due to various social, cultural, political and economic factors in the destination region. These factors catalyze inhabitable environments in which migrant women are further exposed to harm, stimulating their status as vulnerable populations. Methods: We performed a secondary analysis to explore how the social determinants of health, specifically socioeconomic status, culture, and education impact health outcomes and health care access of Ghanaian women who migrated internally within Ghana or externally to Canada. Fourteen interview transcripts, seven from each primary study dataset, were analyzed using thematic analysis and an intersectionality approach. Ethical approval was received for the primary studies and our secondary analysis via the Ethics Review Board at the University of Alberta, Canada. Results: Ghanaian female migrants experienced varying obstacles in terms of accessing health care services. The barriers were identified as cultural, financial, social, and lack of health insurance. Ghanaian women’s health outcomes were influenced by the conditions surrounding their migration including working conditions, separation from family, altered social support systems, and financial constraints. Conclusion: Areas requiring further research and development were identified by assessing migrants’ social determinants of health in the destination country and the associated-barriers in accessing health services. We hope our findings will serve as a foundation for improving health outcomes for female migrant populations and support health care professionals' practice of cultural competence.

scholarly journals Blurred lines

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Omar Dewachi
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Humanitarian Law ◽  
Global War On Terror ◽  
Moral Framework ◽  
Us Military ◽  
Polio Vaccination ◽  
The Us ◽  
Global War ◽  
Vaccination Campaigns

The neutrality of medicine and health care professionals in different conflict settings in the Middle East have come under scrutiny in recent human rights reports, and should be seen as part of the broader fallout of the US-led ‘global war on terror.’ The last two decades of US military attacks on health infrastructures in Iraq and the use of polio-vaccination campaigns to track down ‘terrorists’ are acts of war that have further blurred the lines between health care and warfare. The failure of international legal processes and institutions to prevent such assaults or to prosecute those responsible raises questions about the Eurocentric system of checks and balances that shape international humanitarian law and its invocation as a ‘legal’ and ‘moral’ framework.

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