For Our Patients, for Ourselves: The Value of Personal Reflection in Oncology

Author(s):  
Lidia Schapira ◽  
Jane Lowe Meisel ◽  
Ranjana Srivastava

Caring for patients with cancer is a great privilege as well as an emotionally and intellectually challenging task. Stress and burnout are prevalent among oncology clinicians, with serious repercussions for the care of patients. Professional societies must provide guidance for trainees and practicing physicians to mitigate the negative consequences of stress on their personal lives and medical practice. Reflection, reading, and writing about personal experiences provide outlets for fortifying personal reserves and promoting resilience to allow us to recognize the joy and meaning of our work and to forge connections with our peers. Herein, we present some of our own reflections on how and why one might take time to write, and about the power of the written word in oncology and medicine.

Autism ◽  
2021 ◽  
pp. 136236132098131
Author(s):  
Laura Crane ◽  
Lok Man Lui ◽  
Jade Davies ◽  
Elizabeth Pellicano

Little is known about how parents talk about autism with their autistic children, particularly among families in which both a parent and child are autistic. Using an online survey, we gathered quantitative and qualitative data from 34 autistic parents (most of whom had told their children about their diagnosis) to address this knowledge gap. There was considerable overlap between the views and experiences of the autistic parents in this study and the largely non-autistic parent samples in previous research. Specifically, parents emphasised the importance of being open and honest about the diagnosis, disclosing the diagnosis as early as possible, individualising discussions to children’s needs and framing the diagnosis positively. There were, however, areas in which the views and experiences of the current sample differed from previous research on non-autistic samples. First, our sample of autistic parents outlined the benefits of their own experiential expertise, which they felt resulted in heightened understanding and empathy with their children. Second, our sample tended not to express concerns about disclosure potentially having a negative impact. Finally, our participants did not express a want or need for professional support with disclosure. Instead, they reported feeling well equipped to support their children using their own knowledge and lived experience. Lay abstract Previous research examining how parents talk about autism with their children has tended to focus on parents who are not autistic themselves. We collected information on this topic from 34 autistic parents of autistic children (most of whom had told their children about their diagnosis). We found similarities, but also differences, between the views and experiences of autistic parents in this research and those reported in previous research (in studies of largely non-autistic parents). Similarities include the following: it is important to be open and honest about the diagnosis; the diagnosis should be introduced/discussed as early as possible; discussions should be tailored to each individual child’s needs; and we should not overlook the challenges associated with autism, but it is important to focus on positive aspects too. Differences include the following: autistic parents used personal experiences in conversations about autism, which was felt to result in increased understanding and empathy with their children; autistic parents overwhelmingly focused on more positive aspects of an autism diagnosis; our sample did not express concerns that discussions could have negative consequences too (e.g. making children more anxious); and autistic parents did not want or need professional support to talk about autism with their children (instead, they felt confident in using their own knowledge/experiences to guide discussions).


Author(s):  
Benjamin Slotznick

Point-and-Chat®, most simply, is the first software for Instant Messaging with a built-in screen reader, designed to be used in conjunction with Augmentative/Alternative Communication (AAC) devices. For many AAC users, especially those who have difficulty reading and writing, an AAC device is the primary or only way they can communicate with other people. This communication is primarily one-on-one and face-to-face. The goal of Point-and-Chat® is to take the skills that an AAC user has in producing the spoken word and provide scaffolding that will enable the AAC user to use those skills to communicate with the written word. The primary impediment to effective use of Point-and-Chat® by AAC users appears to be a lack of appropriate text-chat vocabularies for poor readers, including vocabulary strategies to re-establish conversations when the conversational thread has been lost.


2019 ◽  
Vol 14 (1) ◽  
pp. 46-49
Author(s):  
John T Fortunato ◽  
Daniel Londyn Menkes

As the median age of practicing physicians increases, ethical dilemmas due to age-related cognitive decline among clinicians will become ever more pressing. Compelling data show that despite acknowledgement of their duty to protect the public, physicians often fail to report themselves, their colleagues, or their physician-patients when cognitive decline appears to impact medical practice adversely. As such, efforts to educate physicians about ethical obligations and various tactful methodologies to report themselves or others seem ineffective. Illustrated by a case report of age-related cognitive decline in a practicing physician, practical recommendations are made both to develop and validate cognitive screening in middle-aged physicians, presumably before the onset of age-related cognitive decline.


Author(s):  
Beverly Moy ◽  
Reshma Jagsi ◽  
Richard B. Gaynor ◽  
Mark J. Ratain

Public scrutiny has increased over potential conflicts of interest among oncology researchers and providers. Given the increased prevalence and complexity of industry relationships, oncologists are increasingly faced with ethical challenges when navigating their financial relationships with industry. Oncologists are continually dealing with changing conflict of interest policies within academic centers and professional societies. With the recent passage of The Sunshine Act, oncologists are beginning to understand the repercussions of this new law. The consequences of the increasing use of direct-to-consumer advertising on patients with cancer are also unclear. Finally, industry's perspective on the evolution of these relationships is not clearly understood. This manuscript discusses issues related to industry's influence on oncology practice and research.


2018 ◽  
Vol 28 (2) ◽  
pp. 9-27
Author(s):  
Brian P. Peppers ◽  
Janice U. Blumer ◽  
Robert W. Hostoffer ◽  
Michael P. Rowane ◽  
Kevin A. Thomas ◽  
...  

Abstract Discrimination, whether by conscious or unconscious means, can have significant and often long-lasting negative consequences on the afflicted group or individual. The osteopathic culture and field of medical practice has long fought for equal rights and recognition among their allopathic medical peers. Almost 90 years have passed since Congress, in 1929, declared allopathic and osteopathic medical degrees equivalent. Despite this, key resources and positions within the medical and research profession continue to be inequitable for the osteopathic community. There exists a severe paucity of osteopathic involvement at the National Institutes of Health today and throughout its history. Herein, the historic and current unequal representation of the osteopathic culture from the National Institutes of Health and MEDLINE is investigated.


2017 ◽  
Vol 35 (2) ◽  
pp. 297-303 ◽  
Author(s):  
Austin J. Lammers ◽  
Dana M. Zive ◽  
Susan W. Tolle ◽  
Erik K. Fromme

Introduction: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients. Methods: Retrospective cohort study including all deaths due to cancer in Oregon between January 1, 2010, and December 31, 2011. Death certificates were matched to POLST forms in the Oregon POLST Registry, and the signing physician’s specialty was determined using the Oregon Medical Board’s database. Results: A total of 14 979 people died of cancer in Oregon in 2010 to 2011. Of which, 6145 (41.0%) had at least 1 POLST form in the Registry. Oncology specialists signed 14.9% of POLST forms, compared to 53.7% by primary care, 15.3% by hospice/palliative care, 12.8% by advanced practice providers, and 2.7% by other specialists; 51.8% of oncology specialists did not sign a POLST form, whereas 12.5% completed 10 or more. Conclusion: Oncology specialists play a central role in caring for patients with cancer through the end of their lives, but not in POLST completion. Whether or not they actually sign their patients’ POLST forms, oncology specialists in the growing number of POLST states should integrate POLST into their goals of care conversations with patients nearing the end of life.


Author(s):  
M.R Salimova ◽  
◽  
G.K Khudoykulova ◽  
N.I Mamiraliyev ◽  
◽  
...  

The study examined the situation of patients and nurses in Uzbekistan during the COVID-19 pandemic, the nurse and the work process, the proper use of personal protective equipment and the misuse of personal protective equipment. The impact of the nurses’ work process on their personal lives was also partially covered. COVID-19 It also describes the knowledge and skills that nurses have during the pandemic. He sought to understand how disruptions in patient-nurse relationships, as well as the COVID-19 pandemic, affected the mental and emotional well-being of nurses, its negative consequences, and the underlying problems that followed. Psychological instability in nurses during the early stages of the pandemic and changes in attitudes toward patients with COVID - 19 were also reported the difficulties of the work of nurses in clinics specializing in the treatment of a number of COVID-19 diseases, biological and technical problems in the conduct of work, lack of resources were also listed. In the second place, there is a shortage of nursing staff and the fear of infecting family members with the virus in the fight against the pandemic, and the causes of deaths as a result.


2019 ◽  
pp. 164-181
Author(s):  
Arthur M. Nezu ◽  
Christine Maguth Nezu ◽  
Lauren B. Johnson

Interventions based on problem-solving principles have been found to be effective therapies for a variety of clinical disorders and across various age groups. Informal caregivers of patients with cancer, including spouses, partners, family members, and friends, provide essential support and care throughout the cancer experience. Because these caregivers potentially experience significant emotional difficulties, these therapeutic approaches can serve to mitigate such negative consequences. This chapter provides a description of problem-solving therapy interventions for both cancer patients and their caregivers, as well as the underlying rationale for why such approaches are appropriate for these individuals. In addition to providing a brief summary of the relevant research, also included is an overview of specific clinical guidelines.


1989 ◽  
Vol 12 (3) ◽  
pp. 369-384 ◽  
Author(s):  
Iris Levin ◽  
Liliana Tolchinsky Landsmann

Preschoolers' conception of the written system was analysed with respect to their use of referential and phonetic strategies in reading and writing. Referential writing involves writing a word using elements related to the features of the referent (e.g. writing "snake" with more signs than "butterfly" because a snake is longer). Similarly, referential reading involves relating to the graphic features of the written word (e.g. choosing the longer word as representing "snake"). Phonetic strategies relate written words to the sound pattern of spoken words. Children were asked to write pairs of spoken nouns. They were then shown pairs of cards on which these same nouns had been written, and were asked to decide which of the nouns appeared on which of the cards and to justify their decision. As predicted, there was a shift with age from the use of referential to phonetic strategies both in children's writing and in their reading although different referential links to the object's features were established when writing and when reading. The findings are interpreted as an outcome of the different processes involved in reading and writing, and of the particular constraints of the written system.


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