scholarly journals Dealing with Death: Medical Students' Experiences with Patient Loss

2014 ◽  
Vol 68 (3) ◽  
pp. 207-228 ◽  
Author(s):  
Regina Pessagno ◽  
Carrie E. Foote ◽  
Robert Aponte
Keyword(s):  
Medical Students ◽  
Human Error ◽  
Emotional Responses ◽  
Stress Coping ◽  
Death Rituals ◽  
Dying Patients ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews ◽  
Dying Patient

This article explores medical students' experiences and coping strategies when confronting patient loss in their 3rd and 4th years of their programs. Much of the literature on the impact of patient losses focuses on physicians. This article joins a handful of works aimed at how medical students experience and cope with patient loss. In-depth interviews with 20 medical students provided rich descriptions of their varying experiences coping with death. Consistent with previous work, students experience substantial emotional stress coping with patient deaths, though some were more difficult to bear than others, such as when the dying patient was a child or when treatment errors could have contributed to deaths. Common coping mechanisms included talking through their emotions, thrusting themselves into continuing their rounds, crying, participating in infant death rituals, and turning to religion. When deaths occurred, senior personnel who exhibited empathy toward the deceased and tolerance toward the students' emotional responses were lauded and made the process easier. Also emotionally daunting, in many instances, was dealing with the families of dying patients. Most of the students did not view death as a failure, contrary to much earlier literature, except in instances in which human error or decision making may have played a part in causing the death of a patient.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

scholarly journals The impact of death and dying on the personhood of medical students: a systematic scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chong Yao Ho ◽  
Cheryl Shumin Kow ◽  
Chin Howe Joshua Chia ◽  
Jia Ying Low ◽  
Yong Hao Melvin Lai ◽  
...  
Keyword(s):  
Medical Students ◽  
Scoping Review ◽  
Death And Dying ◽  
Support Mechanism ◽  
Resource Limited ◽  
Dying Patients ◽  
Concurrent Use ◽  
Effective Training ◽  
Longitudinal Support ◽  
The Impact

Abstract Background The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to best support them. Methods We adopt Krishna’s Systematic Evidence Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on the impact of death and dying on medical students. This structured search process and concurrent use of thematic and directed content analysis of data from six databases (Split Approach) enhances the transparency and reproducibility of this review. Results Seven thousand six hundred nineteen were identified, 149 articles reviewed and 52 articles included. The Split Approach revealed similar themes and categories that correspond to the Innate, Individual, Relational and Societal domains in the Ring Theory of Personhood. Conclusion Facing death and dying amongst their patients affect how medical students envisage their personhood. This underlines the need for timely, holistic and longitudinal support systems to ensure that problems faced are addressed early. To do so, there must be effective training and a structured support mechanism.

scholarly journals Emotional responses and coping strategies of medical students during the COVID-19 pandemic

2022 ◽  
Vol 43 (1) ◽  
pp. 61-66
Author(s):  
Sayyada Ifrah Naaz ◽  
Rana M. Hussein ◽  
Hiba B. Khan ◽  
Mohamed M. Hussein ◽  
Shoukat A. Arain
Keyword(s):  
Medical Students ◽  
Coping Strategies ◽  
Emotional Responses ◽  
And Coping

Patient experiences and implications for consultation outcomes and treatment adherence using mHealth applications among health care professionals (Preprint)

2018 ◽  
Author(s):  
Zuhal Kathy Keeling
Keyword(s):  
Health Care ◽  
Treatment Adherence ◽  
Health Care Professionals ◽  
Clinical Training ◽  
Healthcare Services ◽  
Coping Behaviors ◽  
Services Delivery ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

BACKGROUND mHealth is a broad term for the use of mobile communication devices for healthcare services delivery. The use of mobile devices by health care professionals (HCPs) has transformed many aspects of clinical training and practice. However, there are still gaps in knowledge concerning patient perception of the use of mHealth technologies by HCP during secondary care consultations. OBJECTIVE To explore the impact on patient experience and implications for consultation outcomes and treatment adherence. Introduction of new technological application into interactions that have very set expectations and roles and possibility for attendant disruption of patient expectations. METHODS This paper explores, via in-depth interviews, patient opinions regarding the usage of mHealth applications by health care professionals (HCPs) during consultations, identifying the paradoxes and coping behaviors to deal with those paradoxes. This qualitative study recruited ten respondents using purposive sampling and snowballing techniques through in-depth interviews. RESULTS The results comprise paradoxes and coping behaviors. They showed that convenience, time savings, accuracy of diagnosis and reduction of errors are the important elements for using mHealth for both HCP and patient. In addition, respondents perceived that mobile health apps facilitate HCP engagement of patients and assist explanations and better patient understanding. Interaction and the quality of the interaction were acknowledged as significant in HCP-patient communication and patient compliance with treatment. CONCLUSIONS To sum, many patients were responsive to the idea of mHealth, both by the doctor and themselves, but wanted to have regulation of use of apps, better involvement and explanations and not have the doctor lose focus on the patient, that is, the feeling of personalized treatment. They also were worried that the HCP might seem to ignore the patient or withdraw from the type of interaction that makes the consultation ‘human.’

scholarly journals Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study

2019 ◽  
pp. bmjspcare-2019-001853 ◽  
Author(s):  
Geoffrey Wells ◽  
Julia Montgomery ◽  
Andreas Hiersche
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
End Of Life ◽  
Thematic Analysis ◽  
End Of Life Care ◽  
Undergraduate Teaching ◽  
Life Care ◽  
Dying Patients ◽  
Medical Undergraduate ◽  
Dying Patient

BackgroundUndergraduate teaching currently fails to adequately prepare doctors to deliver ‘end-of-life’ care. Despite much evidence supporting simulation-based teaching, its use in medical undergraduate palliative and ‘end-of-life’ care curricula remain low.AimThis study assesses whether simulation can improve the confidence and preparedness of medical students to provide holistic care to dying patients and their families, from clinical assessment to symptom management, communication and care after death.MethodsSix fourth-year medical students undertook individual simulations involving a dying patient (high-fidelity simulator) and family member (actor). Intentional patient death occurred in four of the six scenarios (although unexpected by students). Pre-simulation/post-simulation thanatophobia questionnaires measured student attitudes towards providing care to dying patients. Thematic analysis of post-simulation focus group transcripts generated qualitative data regarding student preparedness, confidence and value of the simulations.ResultsThematic analysis revealed that students felt the simulations were realistic, and left them better prepared to care for dying patients. Students coveted the ‘safe’ exposure to dying patient scenarios afforded by the simulations. Observed post-simulation reduction in mean thanatophobia scores was not found to be statistically significant (p=0.07).ConclusionsResults suggest a feasible potential for simulations to influence undergraduate medical student teaching on the care of a dying patient and their family. We believe that this study adds to the limited body of literature exploring the value of simulation in improving the confidence and preparedness of medical students to provide ‘end-of-life’ care. Further research into the cost-effectiveness of simulation is required to further support its application in this setting.

scholarly journals Truth-telling and the Asymmetry of the Attitude to Truth-telling to Dying Patients in Latvia

2013 ◽  
pp. 55-78
Author(s):  
Ivars Neiders ◽  
Vija Sile ◽  
Vents Silis
Keyword(s):  
Medical Students ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Group Interviews ◽  
Truth Telling ◽  
Dying Patients ◽  
Gradual Evolution ◽  
Students Attitudes ◽  
Group Interviews ◽  
Dying Patient

This article deals with concerns related to truth-telling in interaction between the doctor and the dying patient, exploring such issues as conflicting duties of veracity and non-maleficence, truthfulness and deception, and reasons behind physicians' decisions either to withhold or to disclose information about patients' diagnoses and prognoses. It focuses on various attitudes to truth-telling to dying patients, such as symmetry and asymmetry, both of which can be positive and negative. The empirical part of the article reports on the methods and results of the qualitative study carried out in Latvia during the summer of 2012. This study was based on the assessment of three case scenarios from the quantitative instrument designed by Dalla-Vorgia et al. in 1992. By means of semi-structured and focus-group interviews, evidence was gathered about physicians' and medical students' attitudes towards truth-telling, which allows the drawing of conclusions about the presence of asymmetry and symmetry in both cases. Additionally, an insight about the standards used for making decisions in case scenarios was gained and the origins of these standards were explored, revealing the aftermath of a gradual evolution from the ethics of the Soviet era to modern standards of medical ethics. 

Two Decades of Research on Dying: What do we Know about the Patient?

1988 ◽  
Vol 18 (4) ◽  
pp. 299-317 ◽  
Author(s):  
Richard Schulz ◽  
Janet Schlarb
Keyword(s):  
Systematic Study ◽  
Empirical Data ◽  
Emotional Responses ◽  
Future Research ◽  
The Third ◽  
Dying Patients ◽  
Impending Death ◽  
Number Of Individuals ◽  
Dying Patient ◽  
Representative Samples

The systematic study of dying is an important endeavor that deserves attention from sophisticated researchers in many disciplines. It would be especially useful to bring dying into the mainstream of stress research. Although much information is available regarding the demographic aspects of death, it is remarkable that there is so little generalizable empirical data about the process of dying and the experiences of dying persons. Most of the available data are either methodologically flawed, limited in scope, or based on small and non-representative samples. This article reviews the literature on terminal patients and the nature of their experiences during the time before their death. The discussion is divided into four parts. First, we examine the magnitude of the problem by identifying the number of individuals each year who must confront their own death. Second, we discuss the emotional responses of dying patients to their impending death. The third section deals with interventions for the dying patient, and the fourth identifies areas for future research.

scholarly journals Athletes with Neurodegenerative Disease: A Phenomenological Exploration of Family Members’ Experiences

2021 ◽  
Author(s):  
Matthew Smith ◽  
Georgia Young ◽  
John Batten ◽  
Keith Parry ◽  
Rosie Collins ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Neurodegenerative Disease ◽  
Coping Strategies ◽  
Lived Experiences ◽  
Family Members ◽  
Emotional Responses ◽  
Raising Awareness ◽  
And Coping ◽  
Depth Interviews ◽  
Phenomenological Exploration

This qualitative study involved in-depth interviews with 15 family members (mainly partners and children) of deceased athletes who experienced deterioration in their neurological health towards the end of their life. The purpose of this study was to examine the stressors these family members experienced with the ailed players, their emotional responses to their family member’s condition, as well as the coping strategies they used. Vertical and horizontal thematic analyses were conducted on the data, which revealed five distinct temporal stages, a range of emotional responses, as well as accompanying stressors and coping strategies at each temporal stage. The findings are presented as an ethnodrama, capturing the lived experiences of participants. This ethnodrama aims to resonate with those caring for family members who are experiencing deteriorating neurological health, while also raising awareness of the various emotional responses of the individuals in these situations, as well as inviting dialogue and reflection about these issues.

Temporary migrants as an uneasy presence in immigrant societies: Reflections on ambivalence in Australia

2019 ◽  
Vol 60 (1-2) ◽  
pp. 91-109 ◽  
Author(s):  
Claudia Tazreiter
Keyword(s):  
Migrant Workers ◽  
Emotional Responses ◽  
Original Data ◽  
Temporary Migration ◽  
The Status ◽  
Temporary Migrants ◽  
The Impact ◽  
Depth Interviews ◽  
Insight Into

This article explores the status of temporariness in international migration. The focus is on the impact of temporary status on migrants’ actions, behavior, and emotional responses to the daily circumstances in negotiating everyday life. Ambivalence is evaluated as an explanatory category that allows particular insight into strategies of resistance used by temporary migrants as they navigate a host society besides maintaining connections with home. Original data obtained from in-depth interviews with Indonesian migrant workers and students undertaking temporary migration projects in Australia is discussed. The case study explored in this article identifies some of the core problems temporary migrants face as encapsulated by a deficit of rights and protections that, at the same time, are expected by members of liberal states. Temporary status turns migrants into nomadic global laborers. The article argues that actions and responses that appear to be ambivalent are far from irrational, hasty, or disloyal. Rather, migrants’ decision-making in response to the uncertain and shifting economic and sociocultural environments that they enter often comprises subtle calibrations and switching actions, observable as ambivalence, in adjusting to the unanticipated demands of a new society.

scholarly journals Student Stress Management and Wellness Programs among Colleges of Pharmacy

2021 ◽  
Vol 12 (2) ◽  
pp. 14
Author(s):  
Sally Arif ◽  
Kelly Moran ◽  
Ana Quinones-Boex ◽  
Shareen El-Ibiary
Keyword(s):  
Academic Advising ◽  
Time Management ◽  
Well Being ◽  
Relationship Building ◽  
Stress Coping ◽  
Student Stress ◽  
Stress Levels ◽  
Building Activities ◽  
And Coping ◽  
The Impact

Objective: To describe the programmatic stress-related interventions that colleges of pharmacy are providing for their students. Methods: A paper-based questionnaire was distributed to 80 college teams who attended two consecutive offerings of the American Association of Colleges of Pharmacy institute focused on promoting student well-being. The five-part questionnaire consisted of: 1) tracking and assessment of perceived student stress levels, 2) the types and formats of stress-coping interventions that are offered, 3) the measured impacts of any stress-coping interventions, 4) the level of faculty/staff training and involvement in student stress remediation, and 5) institutional demographics. Results: Of the 40 college teams responding to the survey there were similar numbers of private (44%) and public (56%) institutions. More than half (57.5%) reported measuring student stress levels. The most common interventions offered were counseling (95%), academic advising (82%), physical exercise support (77%), and relationship building activities (70%). Topics offered in the curriculum were most often related to handling substance abuse (50%), time-management (45%), and finances (40%).  A majority (79.5%) of schools reported they do not offer formal training on student stress and mental health to faculty and staff and do not formally assess the impact of stress and coping interventions.                                                                   Conclusion: Colleges of pharmacy are addressing student stress and well-being, yet variability exists in terms of assessment, interventions, and didactic offerings. Multiple barriers to improvement remain and mediating barriers and determining assessments for coping and interventions may be next steps for Colleges of Pharmacy.

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