Critical Approaches to Life-Writing

Author(s):  
Allison Crawford

This chapter describes some of the tools and methods for critically reading life-writing texts, including memoirs and autobiography, with an emphasis on life-writing by health professionals and/or in the context of healthcare. Life-writing texts allow research into the internal and lived experiences of those who provide healthcare, such as physicians and nurses, and those who receive healthcare. Texts by life-writing subjects from different historical periods, geographic locations, genders, diagnoses, and stages and contexts of training can offer shifting perspectives on a range of topics from the development of health professional identity, what it means to be sick, and about how these experiences relate to the practices and institutions of healthcare. Steps in the research process and methods for analyzing life-writing texts are outlined, along with relevant resources. The field of life-writing offers many possibilities for health humanities researchers and can be enriched by bringing interdisciplinary theories to the analysis of life-writing texts.

Author(s):  
Umair Majid

In this book review, I examine the functionality and usability of Critical Approaches to Life Writing Methods in Qualitative Research by Mulvihill and Swaminathan by interrogating my own preconceptions of life writing and how they informed my purview. The authors of this book map out distinct life writing methods by building on seminal literary and scholarly work. Through their use of metaphors, theory, and frameworks, the authors paint each life writing method canvas in a way that is tangible and appropriate to both novice and seasoned investigators. By coalescing life writing with critical theory, the authors describe an important perspective on life writing, and how it may be integrated into the research process.


2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1288.1-1289
Author(s):  
I. Mcnicol ◽  
A. Bosworth ◽  
C. Jacklin ◽  
J. Galloway

Background:NRAS follows best practice, evidence-based standards in all we do. Whilst huge strides have been made in the diagnosis and treatment of RA, the impact on quality of life can be significant and for many this disease remains hard to come to terms with. NRAS services and resources can improve the outcomes of people with RA/Adult JIA through a framework of supported self-management resources tailored to individual need. It is particularly important to provide the right support at the beginning of a person’s journey with RA, when unhelpful health beliefs, anxiety and incorrect information can influence how someone responds to prescribed medication and treatment thus impeding their ability to achieve the best outcomes. We know, for example, that many people do not take their medication as prescribed which reduces their chances of achieving remission or low disease activity state.Objectives:To demonstrate that by referring patients online as part of a quality improvement programme to NRAS Right Start Service, we can show improved outcomes for patients with early RA when measured by the MSKHQ. Referred patients will benefit by: a) Better understanding what RA is; b) knowing how it can affect them; c) getting the right support; d) feeling more in control; receiving a tailored pack of information that meets their personal needs; e) be able to talk to a like-minded person who has lived with RA. It’s a 4 step process which starts with the health professional referring their patient to NRAS on line. NICE Quality Standard 3 states that “Adults with rheumatoid arthritis are given opportunities throughout the course of their disease to take part in educational activities that support self-management.” Our service enables health professionals to meet their responsibilities against this national quality standard.Methods:In preparation for the introduction of this service at BSR congress 2019, an audit of the NRAS helpline service was undertaken at the end of 2018 and remains on going. Currently we have 224 responses which have been analysed against specific criteria. An Advisory Board comprising 7 clincians, from different hospitals was appointed to work with NRAS on this important research.Results:In the helpline audit, when asked ‘how concerned are you about your disease’?, alarmingly, 78% of those surveyed scored their level of concern about their disease at 7 or higher out of 10, while only 8% scored it at 5 or below. When asked about the emotional effects of their RA, 62% scored it as 7 or more where 10 was the worst possible impact. 94% of survey respondents said that they would definitely or very likely recommend NRAS and its services to another person. These results led to the development of New2RA Right Start launched in 2019, whereby health professionals across the UK can refer their patients directly to NRAS via a consented online referral which is fully GDPR compliant. To date (31stJan, 2020), we have made calls to 101 patients, from 24 referring hospitals of which 55 have been successfully completed, 34 have had information sent through the post although our helpline team were unable to speak to them, and 12 remain open. Data analysis on the service is being carried out by King’s College Hospital London, comparing the results of patients who have been referred to Right Start within the national audit who have completed a baseline and 3 month follow up MSKHQ and patients in the audit who have not participated in Right Start.Conclusion:Anecdotally, we have had a tremendous response to this service from both patients and referring health professionals. We await data from King’s on the above figures, which we will have within the next 2 months and further data, should this abstract be accepted, will be available prior to June 2020. Right Start enables health professionals to comply with QS3 above, of the NICE Quality Standards in RA, one of the key standards against which they are being audited in the NEIAA national audit. Once data and write up in a peer review journal has been published we plan to roll this service out to people with more established disease.References:[1]To be done, not included in word count.Acknowledgments:I would like to thank Ailsa Bosworth MBE, Clare Jacklin, and James GallowayDisclosure of Interests:Iain McNicol Shareholder of: GSK, Ailsa Bosworth Speakers bureau: a number of pharmaceutical companies for reasons of inhouse training, advisory boards etc., Clare Jacklin Grant/research support from: NRAS has received grants from pharmaceutical companies to carry out a number of projects, Consultant of: I have been paid a speakers fee to participate in advisory boards, in house training of staff and health professional training opportunities, Speakers bureau: Various pharma companies, James Galloway: None declared


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kathleen Leslie ◽  
Jean Moore ◽  
Chris Robertson ◽  
Douglas Bilton ◽  
Kristine Hirschkorn ◽  
...  

Abstract Background Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals. Methods Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice. Results/conclusions Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rubinelli

Abstract The paternalistic approach to health professional-patient communication is often no longer successful. The main reasons for this include the fact that trust in medicine and health professionals is no longer taken for granted. In many domains, the concepts of 'expert' and 'science' are in shadow. Moreover, patients can access all sorts of health information, including information that is or seems inconsistent with the advice given by their health professionals. This talk aims to illustrate some basic approaches to communication that can enhance health professional-patient interaction. First, health professionals should consider their communication with patients as a form of persuasion. Persuasion, that does not equal manipulation, is a way to communicate that takes into consideration the knowledge, beliefs, and attitudes of interlocutors. By adopting a person-centered style, health professionals should present their advice by contextualizing it into the emotional and cognitive setting of the patients. Second, communication should consider the lived experience of patients, that is the impact that a health condition or a preventive behavior has on their quality of life and their experience of pleasure. Indeed, managing health conditions is not just applying health advice: it often demands a change in lifestyles that can negatively impact how patients live their lives. Third, health professionals should develop clear strategies to engage with information that patients find from other sources. Health professionals must ask patients if they disagree with them, and to clarify any eventual difference of opinion. The information age has positively favored a democratization of health information. Yet, it imposes that health systems care for their communication. This talk concludes by presenting main evidence from on how to reinforce hospitals, public health institutions, and health services in communication so that patients want to listen.


2021 ◽  
Vol 32 (8) ◽  
pp. 308-311
Author(s):  
Sarah Kipps

Sexual history can be neglected in a routine nursing or medical assessment. Sarah Kipps gives tips to assist in making a sexual history taking session as comfortable as possible for both health professional and patient Practitioners in primary care are in a unique position to improve the sexual health of men and women. They can do this by introducing the topic of sexual health into their everyday consultations and thereby normalising the subject as part of routine health for the patient. There is evidence that health professionals find sexual history taking to be one of the more challenging aspects of a consultation. There are a number of different reasons for this: feeling not equipped to ask questions of such a sensitive nature; fear of opening a ‘can of worms’ which cannot be dealt with; and the general social embarrassment and difficulties experienced talking about sex in general. This article will give health professionals some tips and guides to assist in making a sexual history taking session as comfortable as possible for both health professional and patient.


1977 ◽  
Vol 11 (2) ◽  
pp. 92-93
Author(s):  
Richard J. Levine

All health professionals must be responsive and accountable to the patients they serve. Pharmacists can be responsive and accountable. The use of MINI-CHARTS would eliminate some of the fragmentation that currently exists in our health service system and would insure accountability of the health professional to the patient. MINI-CHARTS also represent a mechanism to educate the patient, the consumer of services.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Copperstone ◽  
M Bonello

Abstract Background Addressing health inequalities is a crucial public health issue. It is thus imperative that health professionals are equipped with explicit competences to recognise and address health inequalities. Methods This is a multi-phase mixed-methods study exploring health inequalities and training within professional health curricula at the University of Malta. Phase One consists of a scoping study which explores whether and how health inequalities feature within the health professions' undergraduate curricula. This involved a systematic search of undergraduate health professional curricula, including competency profiles in each programme of study, using information available in the public domain. Academic year reviewed was 2019-2020. To ensure harmonisation, the two independent reviewers used the following search strategy: a) using a keyword descriptive approach (MeSH terms divided into two levels: direct, level one, and more general keywords, level two) and b) a more subjective approach to assess wider topic elements. Results Preliminary results emanating from mapping of 19 different programmes of study will be presented. A wide range of occurrences, from zero occurrences in some programmes to a maximum of one occurrence for level one and 12 for level two keywords in other programmes, was observed. Conclusions There is a wide disparity between the awareness of and training of inequalities across different professional training programmes. This provides the groundwork for Phase Two of this research during which public health stakeholders' attitudes and perceptions on health professional training and current practices will be explored. Findings from this study will provide the evidence and the impetus for possible interdisciplinary modules and/or continuous professional development programmes in health inequalities. Key messages The need for developing short courses/reviewing health curricula to incorporate health inequalities is encouraged. Public health professionals have a responsibility to address health inequalities in their professional practice.


Author(s):  
Gabrielle Brand

This article describes how writing personal research narratives during my doctoral research journey challenged my role as a health professional and my personal beliefs and values in fundamental ways. In qualitative narrative inquiry, the reflexive account of the research experience is a key element in conducting ethical, rigorous, and meaningful forms of qualitative research. However, as a novice researcher, I was unprepared for the unlearning journey I experienced during the research process. This uncomfortable experience cut to the core of my identity by dismantling unexamined belief and value systems that lay dormant and hidden from my everyday consciousness as a health professional. In the spirit of transparency, reflexivity and “good” qualitative research, this article presents an explicit account of my exquisite and sometimes excruciating reflexive research journey that profoundly changed how I relate and work with people. I believe health care professionals should adopt a narrative view of experience that creates the “looking glass space” to locate their own stories within the broader socio-cultural and historical context of their lives, especially in relation to their health professional identity. Exchanging diminishing dialogue with deeper dialogue honours both the complexities of young peoples’ lives and social worlds and encompasses socially-conscious methodologies of promise and hope.


Author(s):  
Patrick Kiernan

In this chapter, Patrick Kiernan presents two very different but equally complex narratives illustrating the professional identity development of long-term eikaiwa teachers. The lived experiences of these two professionals reveals a great deal about the ways in which teachers negotiate multiple desired and undesired identities over the course of their careers. The complexity found in these teacher narratives provides a convincing counter perspective to the overly simplistic and often derogatory way that the professional lives of eikaiwa teachers are framed in both the ELT field and Japanese society at large.


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