scholarly journals Field notes in the clinic: on medicine, anthropology and pedagogy in South Africa

2018 ◽  
Vol 44 (4) ◽  
pp. e1-e1 ◽  
Author(s):  
Michelle Pentecost
Keyword(s):  
South Africa ◽  
Clinical Practice ◽  
Patient Care ◽  
Ways Of Knowing ◽  
Clinical Work ◽  
Health Sciences ◽  
Knowing That ◽  
Field Note ◽  
Health And Illness ◽  
Field Notes

This commentary is about medicine, anthropology and pedagogy: about the ways of knowing that different disciplinary orientations permit. I draw on a field note taken in the clinic to illustrate how cultures of healthcare and health sciences training in South Africa bracket the historical, social and political contexts of health and illness in this setting, at the expense of patient care and physician wellbeing. I consider what anthropological inquiry can offer to clinical practice, and advocate for critical orientations to clinical work and teaching that extend humanity to patients and providers.

Moral Economy and Moral Capital in the Community of Clinical Practice

2017 ◽  
Vol 28 (4) ◽  
pp. 523-533 ◽  
Author(s):  
Chrystal Jaye ◽  
Jessica Young ◽  
Tony Egan ◽  
Martyn Williamson
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Care ◽  
Health Care Professionals ◽  
Moral Economy ◽  
Clinical Work ◽  
Management Program ◽  
Long Term Conditions ◽  
Care Clinic ◽  
Moral Capital

This New Zealand study used focused ethnography to explore the activities of communities of clinical practice (CoCP) in a community-based long-term conditions management program within a large primary health care clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro-level moral economy within which values such as trust, respect, authenticity, reciprocity, and obligation circulate as a kind of moral capital. As taxpayers, citizens who become patients are credited with moral capital because the public health system is funded by taxes. This moral capital can be paid forward, accrued, banked, redeemed, exchanged, and forfeited by patients and their health care professionals during the course of a patient’s journey. The concept of moral capital offers another route into the “black box” of clinical work by providing an alternative theoretic for explaining the relational aspects of patient care.

scholarly journals Critical orientations for humanising health sciences education in South Africa

2018 ◽  
Vol 44 (4) ◽  
pp. 221-229 ◽  
Author(s):  
Michelle Pentecost ◽  
Berna Gerber ◽  
Megan Wainwright ◽  
Thomas Cousins
Keyword(s):  
Social Sciences ◽  
South Africa ◽  
Integrated Curriculum ◽  
Clinical Work ◽  
Health Sciences ◽  
Biomedical Sciences ◽  
Health Humanities ◽  
Health Sciences Education ◽  
Self Image ◽  
Sources Of Knowledge

In this article, the authors make a case for the ’humanisation' and ’decolonisation' of health sciences curricula in South Africa, usingintegrationas a guiding framework.Integrationrefers to an education that is built on a consolidated conceptual framework that includes and equally values the natural or biomedical sciences as well as the humanities, arts and social sciences, respecting that all of this knowledge has value for the practice of healthcare. An integrated curriculum goes beyond add-on or elective courses in the humanities and social sciences. It is a curriculum that includes previously marginalised sources of knowledge(challenging knowledge hierarchies and decolonising curricula); addresses an appropriate intellectual self-image in health sciences education(challenging the image of the health professional); promotes understanding of history and social context, centring issues of inclusion, access and social justice(cultivating a social ethic)and finally, focuses on care and relatedness as an essential aspect of clinical work(embedding relatedness in practice). The article offers a brief historical overview of challenges in health and health sciences education in South Africa since 1994, followed by a discussion of contemporary developments in critical health sciences pedagogies and the medical and health humanities in South Africa. It then draws on examples from South Africa to outline how these four critical orientations or competencies might be applied in practice, to educate health professionals that can meet the challenges of health and healthcare in contemporary South Africa.

Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Thusile Mabel Gqaleni ◽  
Busisiwe Rosemary Bhengu
Keyword(s):  
South Africa ◽  
Critical Care ◽  
Adverse Events ◽  
Patient Care ◽  
Family Involvement ◽  
Reporting System ◽  
Legal Framework ◽  
Critical Care Nurses ◽  
Kwazulu Natal ◽  
Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

IMPROVING STUDENTS’ LISTENING COMPREHENSION BY USING BOTTOM-UP TECHNIQUE

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Hari Razaki Akbar ◽  
Sofian Maral ◽  
Wardah Wardah
Keyword(s):  
Learning Process ◽  
Listening Comprehension ◽  
Word Processing ◽  
Teaching And Learning ◽  
Test Field ◽  
Bottom Up ◽  
Listening Test ◽  
Field Note ◽  
Tenth Grade ◽  
Field Notes

The aim of this research was to improve students listening comprehension by using Bottom-Up technique. This research is a classroom action research which has done in three cycles. The subject for this research was the tenth grade students in class X TAV. The research was conducted by using Bottom-Up technique which consists of three main stages. There are word processing, phrase processing, and comprehension. The researcher observed students improvement in listening comprehension by collecting data through field notes, observation checklist and listening test. Field note and observation checklist were used to gather the students attitude in learning process. The data of listening was collected through listening test and it was assessed through scoring rubric. The result showed that students problems in understanding the contents of listening and vocabulary had been solved by using Bottom-Up technique. In the first cycle, the students mean score was 76.7. It increased in the second cycle to 82.1, and 83.7 in third cycle. As the conclusion, the technique was able to be used in improving students listening comprehension. The researcher recommends the teacher to use Bottom-Up technique as a technique in teaching and learning process, especially in the teaching listening with the similar setting and difficulty.

IMPLANTATION OF THE INVASIVE BLOOD PRESSURE CATHETER: AN INTEGRATIVE REVIEW OF THE LITERATURE

2018 ◽  
Vol 4 ◽  
Author(s):  
Fabiana Rezer ◽  
Hélio Penna Guimarães ◽  
Grazia Maria Guerra
Keyword(s):  
Blood Pressure ◽  
Patient Care ◽  
Latin American ◽  
Scientific Evidence ◽  
Caribbean Literature ◽  
Health Sciences ◽  
Integrative Review ◽  
Review Of The Literature ◽  
Medical Subject Headings ◽  
Invasive Blood Pressure

Objective: to describe scientific evidence on the implementation and control of the device for measuring invasive blood pressure (IBP). Methods: integrative review of the literature, based on Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), PubMed, through the Descriptors in Health Sciences (DeCS) and the Medical Subject Headings (MesH): hemodynamic; monitoring; blood pressure; invasive. Articles were selected in English, Portuguese and Spanish, published between 2009 and 2018. The search resulted in a sample of 10 articles. Results: The articles were analyzed and presented in 4 thematic groups according to the information they provided regarding the puncture of the IBP catheter, being: 1- Indications for IBP catheter puncture; 2 -Contraindications and complications resulting from the use of the IBP catheter; 3 -Most indicated puncture sites; 4- Implementation and maintenance of IBP catheter. Conclusion: Further research may contribute to patient care with an IAP device, as well as assisting physicians and nurses in patient care, reducing the risks and potential adverse events of the IAP.

scholarly journals Grand Challenges, Feminist Answers

2021 ◽  
Vol 2 (3) ◽  
pp. 263178772110203
Author(s):  
Yvonne Benschop
Keyword(s):  
Knowledge Production ◽  
Ways Of Knowing ◽  
Natural World ◽  
Value Systems ◽  
Situated Knowledge ◽  
Feminist Ethics ◽  
Organization Studies ◽  
Grand Challenges ◽  
Knowing That ◽  
Feminist Organization

Feminist organization theories develop knowledge about how organizations and processes of organizing shape and are shaped by gender, in intersection with race, class and other forms of social inequality. The politics of knowledge within management and organization studies tend to marginalize and silence feminist theorizing on organizations, and so the field misses out on the interdisciplinary, sophisticated conceptualizations and reflexive modes of situated knowledge production provided by feminist work. To highlight the contributions of feminist organization theories, I discuss the feminist answers to three of the grand challenges that contemporary organizations face: inequality, technology and climate change. These answers entail a systematic critique of dominant capitalist and patriarchal forms of organizing that perpetuate complex intersectional inequalities. Importantly, feminist theorizing goes beyond mere critique, offering alternative value systems and unorthodox approaches to organizational change, and providing the radically different ways of knowing that are necessary to tackle the grand challenges. The paper develops an aspirational ideal by sketching the contours of how we can organize for intersectional equality, develop emancipatory technologies and enact a feminist ethics of care for the human and the natural world.

scholarly journals More than a method: trusting relationships, productive tensions, and two-way learning as mechanisms of authentic co-production

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sarah E. Knowles ◽  
Dawn Allen ◽  
Ailsa Donnelly ◽  
Jackie Flynn ◽  
Kay Gallacher ◽  
...  
Keyword(s):  
Patient Involvement ◽  
Ways Of Knowing ◽  
Knowledge Mobilisation ◽  
Academic Knowledge ◽  
Willingness To Change ◽  
Different Types ◽  
Hybrid Knowledge ◽  
Key Issues ◽  
Field Notes ◽  
The Relationship

Abstract Background Knowledge mobilisation requires the effective elicitation and blending of different types of knowledge or ways of knowing, to produce hybrid knowledge outputs that are valuable to both knowledge producers (researchers) and knowledge users (health care stakeholders). Patients and service users are a neglected user group, and there is a need for transparent reporting and critical review of methods used to co-produce knowledge with patients. This study aimed to explore the potential of participatory codesign methods as a mechanism of supporting knowledge sharing, and to evaluate this from the perspective of both researchers and patients. Methods A knowledge mobilisation research project using participatory codesign workshops to explore patient involvement in using health data to improve services. To evaluate involvement in the project, multiple qualitative data sources were collected throughout, including a survey informed by the Generic Learning Outcomes framework, an evaluation focus group, and field notes. Analysis was a collective dialogic reflection on project processes and impacts, including comparing and contrasting the key issues from the researcher and contributor perspectives. Results Authentic involvement was seen as the result of “space to talk” and “space to change”. "Space to talk" refers to creating space for shared dialogue, including space for tension and disagreement, and recognising contributor and researcher expertise as equally valuable to the discussion. ‘Space to change’ refers to space to adapt in response to contributor feedback. These were partly facilitated by the use of codesign methods which emphasise visual and iterative working, but contributors emphasised that relational openness was more crucial, and that this needed to apply to the study overall (specifically, how contributors were reimbursed as a demonstration of how their input was valued) to build trust, not just to processes within the workshops. Conclusions Specific methods used within involvement are only one component of effective involvement practice. The relationship between researcher and contributors, and particularly researcher willingness to change their approach in response to feedback, were considered most important by contributors. Productive tension was emphasised as a key mechanism in leading to genuinely hybrid outputs that combined contributor insight and experience with academic knowledge and understanding.

scholarly journals Nurses’ Clinical Work Experience during Pregnancy

Healthcare ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Hyunjung Lee ◽  
Hyoung Eun Chang ◽  
Jiyeon Ha
Keyword(s):  
Work Experience ◽  
Qualitative Data ◽  
Clinical Work ◽  
Working Environment ◽  
Organizational Characteristics ◽  
Main Question ◽  
Field Notes ◽  
Colaizzi's Method ◽  
Induced Changes ◽  
Depth Interviews

The working environment of nurses contains numerous hazards that can be particularly harmful to pregnant women. In addition, pregnancy-induced changes can themselves cause discomfort. Therefore, it is necessary to analyze pregnant nurses’ experiences of clinical work. This qualitative study analyzed data collected through in-depth interviews. From January to June in 2020, 12 shift-work nurses who had experienced pregnancy within three years were interviewed. The main question was “Could you describe your clinical work experience during pregnancy?” Qualitative data from field notes and transcriptions of the interviews were analyzed using Colaizzi’s method. Six categories were extracted that described the nurses’ clinical work experience during pregnancy, as follows: “enduring alone,” “organizational characteristics of nursing,” “risky work environment,” “strengths that sustain work during pregnancy,” “growth as a nurse,” and “methods to protect pregnant nurses.” Pregnant nurses experienced various difficulties due to physical and mental changes during pregnancy, and the clinical working environment did not provide them with adequate support. The findings of this study will be helpful for developing and implementing practical maternity protection policies and work guidelines.

Exploring the place of spirituality in Canadian health promotion

2021 ◽  
Author(s):  
Karina Gerhardt-Strachan
Keyword(s):  
Health Promotion ◽  
Qualitative Interviews ◽  
Ways Of Knowing ◽  
Holistic Approach ◽  
Sampling Frame ◽  
Health And Wellbeing ◽  
Knowing That ◽  
Canadian Health ◽  
Commission Report ◽  
Social Environmental

Abstract The field of health promotion advocates a socioecological approach to health that addresses a variety of physical, social, environmental, political and cultural factors. Encouraging a holistic approach, health promotion examines many aspects of health and wellbeing, including physical, mental, sexual, community, social and ecological health. Despite this holism, there is a noticeable absence of discussion surrounding spirituality and spiritual health. This research study explored how leading scholars in Canadian health promotion understand the place of spirituality in health promotion. Using the fourth edition of Health Promotion in Canada (Rootman et al., 2017) as the sampling frame of recognized leaders in the field, 13 semi-structured qualitative interviews were conducted with authors from the book. This study is situated within a critical health promotion approach that utilizes methodologies aiming for social justice, equity and ecological sustainability. I argue that by avoiding spirituality within health promotion frameworks and education, the secularism of health promotion and its underlying values of Eurocentric knowledge production and science remain invisible and rarely critiqued. This study intends to open up possibilities for centering spiritual and non-Western epistemologies and ways of knowing that have been marginalized, such as Indigenous understandings of health and wellbeing. Restoring right relations with Indigenous peoples in Canada has taken on new urgency with the calls to action of the Truth & Reconciliation Commission report (NCTR, 2015). This is one important way that health promotion can fulfill its promise of being inclusive, relevant and effective for human and planetary wellbeing.

scholarly journals Use of alternative consultation forms in Danish general practice in the initial phase of the COVID-19 pandemic – a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tina Drud Due ◽  
Thorkil Thorsen ◽  
Julie Høgsgaard Andersen
Keyword(s):  
Patient Care ◽  
Initial Phase ◽  
Health Care Systems ◽  
Qualitative Interviews ◽  
Clinical Work ◽  
Health Issues ◽  
Short Term ◽  
Diagnostic Uncertainty ◽  
Face To Face ◽  
Care Systems

Abstract Background Attempts to manage the COVID-19 pandemic have led to radical reorganisations of health care systems worldwide. General practitioners (GPs) provide the vast majority of patient care, and knowledge of their experiences with providing care for regular health issues during a pandemic is scarce. Hence, in a Danish context we explored how GPs experienced reorganising their work in an attempt to uphold sufficient patient care while contributing to minimizing the spread of COVID-19. Further, in relation to this, we examined what guided GPs’ choices between telephone, video and face-to-face consultations. Methods This study consisted of qualitative interviews with 13 GPs. They were interviewed twice, approximately three months apart in the initial phase of the pandemic, and they took daily notes for 20 days. All interviews were audio recorded, transcribed, and inductively analysed. Results The GPs re-organised their clinical work profoundly. Most consultations were converted to video or telephone, postponed or cancelled. The use of video first rose, but soon declined, once again replaced by an increased use of face-to-face consultations. When choosing between consultation forms, the GPs took into account the need to minimise the risk of COVID-19, the central guidelines, and their own preference for face-to-face consultations. There were variations over time and between the GPs regarding which health issues were dealt with by using video and/or the telephone. For some health issues, the GPs generally deemed it acceptable to use video or telephone, postpone or cancel appointments for a short term, and in a crisis situation. They experienced relational and technical limitations with video consultation, while diagnostic uncertainty was not regarded as a prominent issue Conclusion This study demonstrates how the GPs experienced telephone and video consultations as being useful in a pandemic situation when face-to-face consultations had to be severely restricted. The GPs did, however, identify several limitations similar to those known in non-pandemic times. The weighing of pros and cons and their willingness to use these alternatives shifted and generally diminished when face-to-face consultations were once again deemed viable. In case of future pandemics, such alternatives seem valuable, at least for a short term.

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