Ethical Issues in Concussion Management

2017 ◽  
Vol 22 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Timothy Neal
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Sports Medicine ◽  
Ethical Issues ◽  
Well Being ◽  
Negative Consequences ◽  
Ethical Challenges ◽  
Optimal Care ◽  
Concussion Management

Athletic health care professionals, team physicians, and athletic trainers have an ethical obligation to safeguard the short- and long-term well-being of the athlete they care for. The potential long-term negative consequences to the student-athlete’s physical, cognitive, and mental health as a result of concussions and their mismanagement is a reality. How the athletic health care professional attends to this top priority of providing optimal health care to the concussed athlete while navigating the mitigating circumstances and influences of nonmedical entities found in competitive athletics is one of the great ethical challenges of present day sports medicine. Effectively navigating the complex challenges faced by athletic health care professionals is as important as the care delivered. Understanding the ethical challenges faced by athletic health care decision makers should be a central focus in providing the optimal care the patient deserves.

Teaching Interspiritual Dialogue to Health Care Professionals

2017 ◽  
Author(s):  
Kelly R. Arora
Keyword(s):  
Health Care ◽  
Doctoral Students ◽  
Health Care Professionals ◽  
Well Being ◽  
Course Structure ◽  
Beliefs And Practices ◽  
Pedagogical Choices ◽  
Dimensions Of Teaching ◽  
Contemporary Context ◽  
Made In

Interspiritual conversations are becoming more common in health care settings as providers recognize that patients’ diverse spiritual/religious values, beliefs, and practices may influence their health care decision-making and general well-being. This essay explores the practical dimensions of teaching health care professionals how to use an interspiritual dialogue approach grounded in values and particularism through a course entitled “Faith, Spirituality and Culture in Health Care,” which was designed for and taught to doctoral students at a Denver, Colorado, School of Pharmacy. After considering the contemporary context for teaching interspiritual dialogue to healthcare professionals, the essay reflects upon and relates the pedagogical choices made in designing and teaching the course, as well as the course structure, outline, objectives, and schedule.

Concussion, neuroethics, and sport: Policies of the past do not suffice for the future

2017 ◽  
Author(s):  
Brad Partridge ◽  
Wayne Hall
Keyword(s):  
Mental Health ◽  
Head Trauma ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Cognitive Impairments ◽  
Concussion Management ◽  
Design And Implementation ◽  
The Past ◽  
Management Policies

Concussion management policies have become a major priority worldwide for sports that involve frequent collisions between participants because repeated head trauma has been associated with long-term cognitive impairments, mental health problems, and some forms of neurological degeneration. A number of concussion management policies have been developed by professional bodies and subsequently adopted by various sporting leagues. These have offered little guidance on how to navigate ethical issues in identifying and managing concussion. This chapter discusses ethical issues that arise in the diagnosis of concussion, debates about the longer-term consequences of repeated concussion injuries, and the design and implementation of policies that aim to prevent and manage concussion injuries in sporting matches.

scholarly journals #MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

2020 ◽  
Author(s):  
Candace L Kemp
Keyword(s):  
Family Involvement ◽  
Long Term Care ◽  
Research Policy ◽  
Well Being ◽  
Direct Care ◽  
Negative Consequences ◽  
Public Health Response ◽  
Term Care ◽  
Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

Sport Concussion Education and Prevention

2012 ◽  
Vol 6 (3) ◽  
pp. 293-301 ◽  
Author(s):  
Charles H. Tator
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Educational Strategies ◽  
Short Term ◽  
Sports Organizations ◽  
Sport Concussion ◽  
Data Collection Program ◽  
Collection Program ◽  
Concussion Education

There has been a remarkable increase in the past 10 years in the awareness of concussion in the sports and recreation communities. Just as sport participants, their families, coaches, trainers, and sports organizations now know more about concussions, health care professionals are also better prepared to diagnose and manage concussions. As has been stated in the formal articles in this special issue on sport-related concussion, education about concussion is one of the most important aspects of concussion prevention, with the others being data collection, program evaluation, improved engineering, and introduction and enforcement of rules. Unfortunately, the incidence of concussion appears to be rising in many sports and thus, additional sports-specific strategies are required to reduce the incidence, short-term effects, and long term consequences of concussion. Enhanced educational strategies are required to ensure that individual participants, sports organizations, and health care professionals recognize concussions and manage them proficiently according to internationally recognized guidelines. Therefore, this paper serves as a “brief report” on a few important aspects of concussion education and prevention.

scholarly journals Health-care Workforce Training to Effectively Support Family Caregivers of Seniors in Care

2020 ◽  
Vol 23 (2) ◽  
pp. 160-171
Author(s):  
Rachel Fisher ◽  
Jasneet Parmar ◽  
Wendy Duggleby ◽  
Peter George J. Tian ◽  
Wonita Janzen ◽  
...  
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Workforce Training ◽  
Community Dwelling ◽  
Canadian Health Care System ◽  
Care Services ◽  
Qualitative Thematic Analysis

Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.

scholarly journals Efficacy of a brief online mindfulness-based intervention on the psychological well-being of health care professionals and trainees during the COVID-19 pandemic: A mixed method design

2021 ◽  
Vol 26 ◽  
Author(s):  
Iram Osman ◽  
Shaista Hamid ◽  
Veena S. Singaram
Keyword(s):  
South Africa ◽  
Health Care ◽  
Mixed Method ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Well Being ◽  
Personal Accomplishment ◽  
Intervention Analysis ◽  
Health Crisis ◽  
The Impact

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.

scholarly journals Making the Transition to Insulin Therapy: The Experiences of Samoan People with Type 2 Diabetes in New Zealand

2021 ◽  
Author(s):  
◽  
Sera Tapu-Ta'ala
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
New Zealand ◽  
Insulin Therapy ◽  
Health Care Professionals ◽  
Pacific People ◽  
Qualitative Descriptive

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>

“I’m Just Forgetting and I Don’t Know Why”: Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties

2018 ◽  
Vol 28 (6) ◽  
pp. 859-872 ◽  
Author(s):  
Alexander R. Terpstra ◽  
Catherine Worthington ◽  
Francisco Ibáñez-Carrasco ◽  
Kelly K. O’Brien ◽  
Aiko Yamamoto ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Well Being ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cognitive Difficulties ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

Getting Senior Leadership on Board

2020 ◽  
pp. 61-72
Author(s):  
Stephen J. Swensen ◽  
Tait D. Shanafelt
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Business Strategy ◽  
Well Being ◽  
Business Case ◽  
Organizational Environment ◽  
Senior Leadership ◽  
Senior Leaders

Optimizing the organizational environment to promote esprit de corps can’t happen without senior leadership prioritizing the issues and dedicating time, attention, and other resources to address them. For meaningful and sustainable results, the commitment by leadership must be authentic. In other words, leaders must embrace this quest because they genuinely care, not just because they believe it is a good business strategy. There are four triggers for senior leaders to become committed to the well-being of the health care professionals in their organization: the moral/ethical case, the business case, the regulatory case, or the tragic case.

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