Holding Secrets While Living With Life-Threatening Illness: Normalizing Patients’ Decisions to Reveal or Conceal

2019 ◽  
Vol 30 (5) ◽  
pp. 655-665 ◽  
Author(s):  
Anne Bruce ◽  
Rosanne Beuthin ◽  
Laurene Sheilds ◽  
Anita Molzahn ◽  
Kara Schick-Makaroff
Keyword(s):  
Health Care Providers ◽  
Narrative Analysis ◽  
Social Practice ◽  
Narrative Approach ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Health And Illness ◽  
Life Threatening ◽  
Normative Practice

Communicating openly and directly about illness comes easily for some patients, whereas for others fear of disclosure keeps them silent. In this article, we discuss findings about the role of keeping secrets regarding health and illness. These findings were part of a larger project on how people with life-threatening illnesses re-story their lives. A narrative approach drawing on Frank’s dialogical narrative analysis and Riesman’s inductive approach was used. Interviews were conducted with 32 participants from three populations: chronic kidney disease, HIV/AIDS, and cancer. Findings include case exemplars which suggest keeping secrets is a social practice that acts along continuums of connecting–isolating, protecting–harming, and empowering–imprisoning. Keeping secrets about illness is a normative practice that is negotiated with each encounter. Findings call health-care providers to rethink the role of secrets for patients by considering patient privilege, a person’s right to take the lead in revealing or concealing their health and illness experience.

The Role of Children and Adolescents in Decision Making About Life-Threatening Illness

2021 ◽  
pp. 104-117
Author(s):  
Victoria A. Miller ◽  
Melissa K. Cousino
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Children And Adolescents ◽  
Health Care Providers ◽  
Control Treatment ◽  
Future Research ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
And Control

The concept of decision-making involvement (DMI) recognizes that children and adolescents can be involved in decision making in numerous ways and that parents and health care providers have an important role in supporting and guiding youth. Facilitating DMI may enhance youth decision-making skills, self-efficacy and control, treatment adherence, and satisfaction with care. Given the loss of control children and adolescents typically feel when diagnosed with a serious, life-threatening illness, DMI may be especially important. Parents and health care providers can facilitate child and adolescent involvement by seeking their opinions and concerns, soliciting questions, asking for information, and checking for understanding. Additional tools are available for facilitating youth involvement in decision making at the end of life. Future research is needed to develop and evaluate strategies to enhance different aspects of DMI in multiple settings and contexts across development.

The Role of Spirituality in Coping With Chronic Illness: What Health Care Providers Need to Know for Advance Directive Decision Making

2016 ◽  
Vol 9 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Mary Lewis
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Chronic Illness ◽  
Health Care Providers ◽  
Advance Directive ◽  
Care Providers ◽  
Beliefs And Values ◽  
Health And Illness

Spirituality is recognized by health care providers as having a significant influence on an individual’s ability to cope. The role of spirituality in coping with chronic illness as well as what providers need to know about spirituality in advance directive decision making (ADDM), however, are poorly understood phenomena. With the growing population of people with chronic illness combined with escalating costs and disease burden, providers must understand and use the role of spirituality in the care of their patients who have demanding states of health and illness. Research has demonstrated the power of spirituality in managing chronic illness as well as the importance of spirituality during end-of-life care planning. The purpose of this case study is to illustrate the necessity of recognizing and understanding an individual’s spiritual beliefs and values during chronic illness and how this knowledge, or lack of knowledge, affects ADDM.

scholarly journals Ouders als helden : De moeilijkheden en mogelijkheden van vaccinatieverhalen in gezondheidscommunicatie

2019 ◽  
Vol 41 (3) ◽  
pp. 485-513
Author(s):  
José Sanders ◽  
Kobie van Krieken ◽  
Lisa Vandeberg
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Care Providers ◽  
Narrative Approach ◽  
Care Providers ◽  
Target Groups ◽  
Interactive Storytelling ◽  
Different Types ◽  
The Government

Abstract This article addresses the questions if and how storytelling in health education can counterbalance the declining willingness to vaccinate. It is argued that stories in health communication can both create problems ánd provide solutions. The problems are illustrated with an analysis of online personal stories of parents who doubt or deny the necessity of vaccinating their children. The analysis shows how these stories put health care providers in the archetypical role of Ruler who deprives parents from their agency. Narrator and reader are put into the archetypical role of Good Mother, implying that not vaccinating is the only possibility to regain agency and be a responsible parent. Responses to these stories by the government and health care providers are typically formulated in terms of factual, statistical information that is usually incapable of convincing vaccine-hesitant and vaccine-rejecting parents. A narrative approach can be a powerful alternative, provided that stories are first listened to before tailored stories are developed and told. These stories can unite different views about the possibilities to act and the consequences thereof, and can transform parents into Heroes protecting not only their own children but also the children of others. Such “story bridging” combines different types of stories in an interactive storytelling model for health education, which does justice to the target groups’ growing need for agency.

scholarly journals Typhoon eye effect versus ripple effect: the role of family size on mental health during the COVID-19 pandemic in Pakistan

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Tooba Lateef ◽  
Jiyao Chen ◽  
Muhammad Tahir ◽  
Teba Abdul Lateef ◽  
Bryan Z. Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Anxiety Disorders ◽  
Family Size ◽  
Health Care Providers ◽  
Vulnerable Groups ◽  
Ripple Effect ◽  
Health Issues ◽  
Care Providers ◽  
Populous Country

Abstract Background The recent outbreak of COVID-19 has impacted adversely upon the mental health of millions of people worldwide. Impacts on the mental health conditions and the associated predictors relating to adults in Pakistan, the fifth most populous country in the world, during the COVID-19 remain understudied. Our aim was to investigate distress, anxiety, and overall mental health and their associated predictors among Pakistani adults in this pandemic. We specifically examine mental health issues based on the distance from the epicenter, (a predictor that has revealed opposing evidence in other countries) based on the theories of typhoon eye effect and ripple effect. The sample consisted of 601 adults who were surveyed online about 2.5 months into the outbreak across Pakistan with varying distances from the epicenter of COVID-19 of Karachi. Results The results showed that 9.2 and 19.0% of the participants surpassed the cut-off criteria for distress and anxiety disorders, respectively. Overall, the distance from the epicenter positively predicted the mental health of adults in Pakistan, and family size negatively moderated this effect. The distance from the epicenter negatively predicted distress and anxiety disorders for adults in large families, which are quite common in Pakistan. Conclusion The evidence of the study interestingly finds that the prediction of the mental health of people by their distance from the epicenter depends on family size. The evidence of this study can help to provide initial indicators for mental health care providers to screen vulnerable groups in Pakistan, a populous country that continues struggling to cope with the COVID-19 pandemic.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

Commentary on “Diabetes and people with learning disabilities: issues for policy, practice and education”

2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Health Care Providers ◽  
Diabetes Care ◽  
Future Research ◽  
Care Providers ◽  
Family Carers ◽  
Content Type ◽  
Policy Practice

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

scholarly journals The role of community pharmacists in increasing access and use of self-care interventions for sexual and reproductive health in the Eastern Mediterranean Region: examples from Egypt, Jordan, Lebanon and Somalia

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Luna El Bizri ◽  
Laila Ghazi Jarrar ◽  
Wael K. Ali Ali ◽  
Abdifatah H. Omar
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Eastern Mediterranean ◽  
Self Care ◽  
Eastern Mediterranean Region ◽  
Community Pharmacists ◽  
Health Coverage ◽  
Care Providers ◽  
Universal Health

Abstract Background Self-care interventions offer a solution to support the achievement of three goals of the World Health Organization (WHO): to improve universal health coverage, reach people in humanitarian situations, and improve health and well-being. In light of implementing WHO consolidated guidelines on self-care interventions to strengthen sexual and reproductive health (SRH) in the Eastern Mediterranean Region (EMR), especially during the COVID-19 pandemic, pharmacists from four different EMR countries discussed the current SRH situation, inequality gaps, barriers to SRH service access and the pharmacist’s crucial role as a first-line responder to patients before, during and after COVID-19. Case presentation Self-care interventions for SRH allow health care providers to serve a greater number of patients, improve progress toward universal health coverage, and reach people in humanitarian crises. In fact, these interventions can be significantly enhanced by utilizing community pharmacists as first-line health care providers. This review highlights the important role of community pharmacists in promoting self-care interventions and empowering individuals, families and communities. As a result, well-informed individuals will be authoritative in their health decisions. Exploring self-care interventions in the EMR was done through reviewing selected SRH services delivery through community pharmacists before and during the COVID-19 pandemic in Egypt, Jordan, Lebanon and Somalia. Before the COVID-19 pandemic, community pharmacists were found to be excluded from both governmental and nongovernmental SRH programmes. During the pandemic, community pharmacists managed to support patients with self-care interventions, whether voluntarily or through their pharmacy associations. This highlights the need for the health care decision-makers to involve and support community pharmacists in influencing policies and promoting self-care interventions. Conclusion Self-care interventions can increase individuals’ choice and autonomy over SRH. Supporting community pharmacists will definitely strengthen SRH in the EMR and may help make the health system more efficient and more targeted.

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