Weight Inclusive Practice: Shifting the Focus from Weight to Social Justice

2020 ◽  
Vol 81 (3) ◽  
pp. 127-131 ◽  
Author(s):  
Meredith Bessey ◽  
Daphne Lordly

Obesity is framed by mainstream media and health care professionals as an “epidemic” contributing to the ill health of the population. This paper reviews literature related to dominant discourses about weight in dietetics, drawing on literature from other health care disciplines, and how these discourses influence patient care. Emerging, competing discourses are also reviewed. Literature highlighted that dietitians and dietetic students are often biased and hold stigmatizing beliefs toward “overweight” and “obese” patients. No research has been conducted in Canada addressing this question, leaving this as an opportunity for future research. Weight stigma and interventions focused on weight have multiple negative implications for individuals, especially those living in larger bodies, including reluctance to seek health care, poor body image, subsequent weight gain, and increased disordered eating. There are alternative discourses emerging, which shift the focus away from weight and toward social justice. The ways in which dietetic students are trained to “manage” weight, and how dominant discourses influence this training, is an important area of future exploration. Dietetic professionals are encouraged to reflect on their weight biases and educate themselves on weight inclusive approaches to health, such as Health at Every Size and Well Now.

2021 ◽  
Vol 6 ◽  
Author(s):  
Amita Tuteja ◽  
Elisha Riggs ◽  
Lena Sanci ◽  
Lester Mascarenhas ◽  
Di VanVliet ◽  
...  

Interpreters work with health care professionals to overcome language challenges during sexual and reproductive (SRH) health discussions with people from refugee backgrounds. Disclosures of traumatic refugee journeys and sexual assault combined with refugees’ unfamiliarity with Western health concepts and service provision can increase the interpreting challenges. Published literature provides general guidance on working with interpreters in primary care but few studies focus on interpretation in refugee SRH consults. To address this, we explored the challenges faced by providers of refugee services (PRS) during interpreter mediated SRH consultations with Burma born refugees post settlement in Australia. We used qualitative methodology and interviewed 29 PRS involved with migrants from Burma including general practitioners, nurses, interpreters, bilingual social workers, and administrative staff. The interviews were audio-recorded, transcribed, and subjected to thematic analysis following independent coding by the members of the research team. Key themes were formulated after a consensus discussion. The theme of “interpretation related issues” was identified with six sub-themes including 1) privacy and confidentiality 2) influence of interpreter’s identity 3) gender matching of the interpreter 4) family member vs. professional interpreters 5) telephone vs. face-to-face interpreting 6) setting up the consultation room. When faced with these interpretation related challenges in providing SRH services to people from refugee backgrounds, health care providers combine best practice advice, experience-based knowledge and “mundane creativity” to adapt to the needs of the specific patients. The complexity of interpreted SRH consultations in refugee settings needs to be appreciated in making good judgments when choosing the best way to optimize communication. This paper identifies the critical elements which could be incorporated when making such a judgement. Future research should include the experiences of refugee patients to provide a more comprehensive perspective.


2019 ◽  
Vol 36 (11) ◽  
pp. 947-954 ◽  
Author(s):  
Danielle Zweers ◽  
Alexander de Graeff ◽  
Jette Duijn ◽  
Everlien de Graaf ◽  
Petronella O. Witteveen ◽  
...  

Introduction: Anxiety is a common symptom in the palliative phase, and symptom management depends on the competencies of individual professionals. This study aims to get insight into the needs of anxious hospice patients with advanced cancer regarding support. Method: Semi-structured interviews were performed in admitted hospice patients with cancer. Patients admitted from May 2017 till May 2018 were eligible whether or not they were anxious. Interviews were analyzed and coded within predefined topics. Results: Fourteen patients were included: 10 females, median age 71, and median World Health Organization performance score 3. Most patients were highly educated. Thirteen patients were interviewed within 6 months before death. Information, open communication, sense of control, safety, adequate symptom management, and respect for patients’ coping strategy were the 6 main expressed needs. Conclusion: Assessing patients’ needs regarding anxiety provided important angles where health-care professionals can make a difference in order to support anxious patients in their final stage of life to realize tailored palliative care. Future research should focus on the development of a systematic approach for health-care professionals to manage anxiety in daily care of terminal patients.


2012 ◽  
Vol 73 (4) ◽  
pp. 176-180
Author(s):  
Diana Stenlund

Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.


Circulation ◽  
2021 ◽  
Author(s):  
Abbi D. Lane-Cordova ◽  
Gerald J. Jerome ◽  
Amanda E. Paluch ◽  
Eduardo Esteban Bustamante ◽  
Michael J. LaMonte ◽  
...  

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase–specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health–promoting behaviors.


2021 ◽  
Author(s):  
Maja Bertram ◽  
Urs Steiner Brandt ◽  
Rikke Klitten Hansen ◽  
Gert Tinggaard Svendsen

Abstract Background: Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption. Methods: Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6,000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives. Results: Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system. Conclusion: It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.


2015 ◽  
Vol 4 (4) ◽  
Author(s):  
Rhona Macdonald ◽  
Malcolm Boyle

IntroductionThe Journal of Emergency Primary Health Care (JEPHC) is a subscription free, peerreviewed online publication, intended to promote the publication of emergency primary health care research covering original studies, editorials and reviews. Data collected from annual surveys have been utilised since 2003 to provide the journal’s Editorial Team and Management Committee with readers’ preferences and perceptions of the journal in relation to planning and development of quality standards and content appropriate to the journal’s readership. This study provides a comparative analysis of survey results from the 2004 and 2006 surveys. The objective of this study was to provide the journal’s Editorial Team and Management Committee with results from the survey to assist future planning.MethodsA cross-sectional methodology based on data collected from questionnaire surveys utilised in 2004 and 2006, was used to solicit the views and content requirements of visitors to JEPHC. Data collected from all survey responses (n=100 in 2006 and n=44 in 2004) was intended to provide a snapshot of the journal’s readership in relation to professional status, content preferences and usefulness of editorial standards as means of supporting research needs, and encouraging future research content. As this article evaluates and reports the results of a quality audit, ethics approval was not required.ResultsThe majority of respondents from both surveys were identified mainly as paramedics, while remaining respondents represented a cross section of other health professionals, educators and researchers. Reasons given by most respondents for visiting JEPHC were to locate peerreviewed articles and case histories relevant to clinical practice. Most respondents rated JEPHC equally with other peer-reviewed journals. The majority of respondents (86%) indicated that they would consider writing for the journal, while 50% of those who indicated that they would not, expressed a lack of skills, motivation or knowledge as being the main reasons. Less than 50% of respondents in the 2006 survey indicated that they knew about the Journal Impact Factor or its usefulness to research.ConclusionAs the majority of respondents in both surveys were identified mainly as paramedics, results from the study cannot be generalised to the wider population of emergency primary health care professionals. The large difference in sample sizes between the 2004 and 2006 surveys renders inferential statistics relating to quality, as problematic. Identification and consistency of content that is of most interest to readers is evident in both surveys. However, to more accurately determine relevance and quality of content, and the significance of publishing standards which are representative of the journal’s wider readership, modification of the survey design and/or setting may be required to attract a higher response rate in future surveys.


2019 ◽  
Author(s):  
Anna Robinson ◽  
Andrew K Husband ◽  
Robert D Slight ◽  
Sarah P Slight

BACKGROUND The internet has become an important medium within health care, giving patients the opportunity to search for information, guidance, and support to manage their health and well-being needs. Online forums and internet-based platforms appear to have changed the way many patients undergoing bariatric surgery view and engage with their health, before and after weight loss surgery. Given that significant health improvements result from sustained weight loss, ensuring patient adherence to recommended preoperative and postoperative guidance is critical for bariatric surgery success. In a patient cohort with high information needs preoperatively, and notoriously high attrition rates postoperatively, online forums may present an underutilized method of support. OBJECTIVE The aim of this study was to conduct a narrative review focusing on the developing roles that online forums can play for patients with bariatric conditions preoperatively and postoperatively. METHODS A literature search was conducted in October-November 2019 across 5 electronic databases: Scopus, EMBASE, PsycINFO, CINAHL, and MEDLINE. Qualitative or mixed methods studies were included if they evaluated patients undergoing bariatric surgery (or bariatric surgery health care professionals) engaging with, using, or analyzing online discussion forums or social media platforms. Using thematic analysis, themes were developed from coding patterns within the data to identify the roles and challenges of online forums for patients undergoing bariatric surgery. RESULTS A total of 8 studies were included in this review, with 5 themes emerging around (1) managing expectations of a <i>new life</i>; (2) decision making and signposting; (3) supporting information seeking; (4) facilitating connectedness: peer-to-peer social and emotional support; and (5) enabling accessibility and connectivity with health care professionals. CONCLUSIONS Online forums could offer one solution to improving postoperative success by supporting and motivating patients. Future research should consider how best to design and moderate online forums for maximal effectiveness and the sharing of accurate information. The surgical multidisciplinary team may consider recommendations of online peer-support networks to complement care for patients throughout their surgical journey.


2020 ◽  
Vol 24 (4) ◽  
pp. 217-228
Author(s):  
Joy M. Rooney

Purpose This paper aims to systematically review the current literature on compassion in mental health from a historical, service user and carer (SUAC)/academic researcher perspective with respect to the current paradigm/biomedical model. Design/methodology/approach Searches were conducted in CIANHL Complete, Academic Search Complete, British Education Index, ERIC, MEDLINE, PsycArticles, Scorpus, Proquest Central using a simplified PRISM approach. Findings In the UK, the SUAC-movement facilitated the adoption of more compassionate mental health in statutory services. Across the world, compassion-based approaches may be viewed as beneficial, especially to those experiencing a biomedical model “treatment”. Health-care workers, suffering burnout and fatigue during neoliberal economics, benefit from compassion training, both in their practice and personally. Randomised control trials (RCTs) demonstrate compassion-type interventions are effective, given sufficient intervention timing, duration and design methodology. Psychology creates outcome measures of adequacies and deficiencies in compassion, demonstrating their importance statistically, with reservations. The effective protection of mental health by self-compassion in both SUACs and health care professionals is evident. It is clear from qualitative research that SUACs prefer compassionate mental health. It also makes a large difference to mental health in general populations. Implications for practice and suggestions for future research are given, including a necessity to fund RCTs comparing compassionate mental health interventions with the biomedical model. Unless statutory mental health services adopt this emerging evidence base, medics and their SUACs will continue to rely on pharmaceuticals. Originality/value This is the first integrated literature review of compassion in mental health from a historical, SUAC/academic researcher viewpoint using all research methodologies.


2014 ◽  
Vol 151 (5) ◽  
pp. 765-769 ◽  
Author(s):  
Neil Bhattacharyya

Objective To determine the prevalence of dysphagia, reported etiologies, and impact among adults in the United States. Study Design Cross-sectional analysis of a national health care survey. Subjects and Methods The 2012 National Health Interview Survey was analyzed, identifying adult cases reporting a swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for swallowing problems, diagnoses given, and severity of the swallowing problem were analyzed. The relationship between swallowing problems and lost workdays was assessed. Results An estimated 9.44 ± 0.33 million adults (raw N = 1554; mean age, 52.1 years; 60.2% ± 1.6% female) reported a swallowing problem (4.0% ± 0.1%). Overall, 22.7% ± 1.7% saw a health care professional for their swallowing problem, and 36.9% ± 0.1.7% were given a diagnosis. Women were more likely than men to report a swallowing problem (4.7% ± 0.2% versus 3.3% ± 0.2%, P < .001). Of the patients, 31.7% and 24.8% reported their swallowing problem to be a moderate or a big/very big problem, respectively. Stroke was the most commonly reported etiology (422,000 ± 77,000; 11.2% ± 1.9%), followed by other neurologic cause (269,000 ± 57,000; 7.2% ± 1.5%) and head and neck cancer (185,000 ± 40,000; 4.9% ± 1.1%). The mean number of days affected by the swallowing problem was 139 ± 7. Respondents with a swallowing problem reported 11.6 ± 2.0 lost workdays in the past year versus 3.4 ± 0.1 lost workdays for those without a swallowing problem (contrast, +8.1 lost workdays, P < .001). Conclusion Swallowing problems affect 1 in 25 adults, annually. A relative minority seek health care for their swallowing problem, even though the subjective impact and associated workdays lost with the swallowing problem are significant.


2017 ◽  
Vol 79 (2) ◽  
pp. 174-190 ◽  
Author(s):  
Gulsen Ulas Karaahmetoglu ◽  
Nesibe Sumeyye Kutahyalioglu

This study aims to examine perceptions and attitudes toward euthanasia among university students who are pursuing bachelor’s degrees. Although the legalization and application of euthanasia are discussed commonly by health-care professionals and partially by lawyers, the ideas of other segments of society, especially university students, are taken place very rarely. The research was conducted descriptively to determine the ideas of 1,170 students at Kastamonu University from six different departments: arts and sciences, theology, tourism, nursing, school of physical education, and sports with using a questionnaire. Findings demonstrated that 73.2% of the students do not approve euthanasia. Also, it was found that there are significant differences depending on age, gender, department of study, income level, place of living, and the loss of kinsmen. This study serves as a resource for future research to understand the effects of sociodemographic characteristics on the decision of euthanasia.


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