scholarly journals Affairs of the heart: patients’ personal constructions of a cardiac event and their effect on lifestyle change

Curationis ◽  
2001 ◽  
Vol 24 (1) ◽  
Author(s):  
EC McKibbin ◽  
KG Wilson
Keyword(s):  
Grounded Theory ◽  
Lived Experience ◽  
Cardiac Event ◽  
Goodness Of Fit ◽  
Medical Profession ◽  
Recovery Process ◽  
Lifestyle Changes ◽  
Blood Cholesterol ◽  
Personal Construct ◽  
Central Feature

The issue of why people do not always make appropriate lifestyle changes in response to a cardiac event has and continues to be of central importance to health practitioners. This paper addresses this issue from the perspective of the lived experience of persons who have suffered an acute myocardial infarction (AMI). The experiences of 10 persons admitted to the coronary care unit (CCU) of a South African clinic were richly described, making use of the grounded theory methodology. These descriptions were then used as a basis for the development of a contextualist theory of the experience of heart attacks. A central feature of the results was that the disease was mainly attributed to stress by the participants. This was in contrast to the explanations offered by the medical profession, who attribute this more to other modifiable risk factors such as smoking, high blood cholesterol, high blood pressure, and lack of exercise. This tension between lay and professional constructions of the aetiology of the condition is deemed to be of import in the recovery process. The paper further alludes to the goodness of fit which exists between the proposed grounded theory and the personal construct theory of George Kelly. The importance of personal constructions of the event is then used as the basis for a proposed intervention process aimed at addressing the difficulties AMI patients’ experience in making and sustaining lifestyle changes.

scholarly journals Reflections on a person's experience of mental illness: an innovative teaching pilot for second-year medical students

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S8-S9
Author(s):  
George Blanchard ◽  
Louis Quail ◽  
Grace Yang ◽  
Katherine Terence ◽  
Amisha Kalra ◽  
...  
Keyword(s):  
Mental Illness ◽  
Medical Students ◽  
Lived Experience ◽  
Subjective Experience ◽  
Medical Profession ◽  
Cultural Issues ◽  
Innovative Teaching ◽  
Big Brother ◽  
Stigma Of Mental Illness ◽  
Students Attitudes

AimsWe sought to develop a teaching pilot to help year 2 medical students meet the following learning outcomes: Develop a better understanding of patient and carer experiences of mental illness; Recognise and challenge unhelpful attitudes towards people with mental illness; Promote a broader understanding of cultural issues surrounding mental illness, including stigma and discrimination.Method337 medical students were invited to attend a lecture by author LQ, a documentary photographer who presented a narrative of his brother Justin's lived experience of schizophrenia (louisquail.com/big-brother-introduction). 197 students attended the session, which was recorded and made available online. Students were invited to enter a competition to win a signed copy of LQ's book, ‘Big Brother’ and asked to submit either a 500-word written reflective piece, or a creative work accompanied by a 200-word statement. 13 submissions were received, including paintings, drawings, collage, photography, and poetry, all of which were blind rated by authors SR and GB, based on originality and quality of reflection. Of the six shortlisted, three winning entries were chosen by author LQ.ResultAll reflections moved away from a technical understanding of schizophrenia, towards person-centred interpretations, with dominant themes of ‘stigma’, ‘disempowerment’, ‘understanding people as individuals’, ‘subjective experience of mental illness’, ‘inclusion’ and ‘healing power of nature’.The three prize winners (authors GY, AK and KT) used different mediums: GY painted an osprey over a chaotic collage of disordered and stigmatizing words (the osprey representing empowerment and the “reservoir for wellbeing in nature”); AK's sonnet began as an ode to the chaos of Justin's experience, but the concluding lines reframed this struggle, conveying feelings of hope and beauty; and KT's self-portrait, produced with a slow shutter-speed photograph, powerfully conveyed a sense of disorientation and disturbance. She reflected on how the stigma of mental illness affects self-perception. The talk was well-attended, and reflections were of high quality. A limitation of this pilot was that only a small proportion of students completed the reflective assignment.ConclusionInnovative teaching strategies are needed to address negative attitudes towards mental illness and psychiatry, which are prevalent amongst the medical profession. This pilot provides a model for combining carer-led, reflective, and creative elements in undergraduate psychiatry teaching, with the aim of challenging stigma. This model will be evaluated in a further study involving fifth year medical students, which will use a validated scale to measure change in students’ attitudes towards mental illness and psychiatry.

Psychosocial experiences in the context of life-threatening illness: The cardiac rehabilitation patient

2014 ◽  
Vol 13 (3) ◽  
pp. 749-756 ◽  
Author(s):  
Gerard N. Holder ◽  
William C. Young ◽  
Sheeba R. Nadarajah ◽  
Ann M. Berger
Keyword(s):  
Cardiac Rehabilitation ◽  
Cardiac Event ◽  
Healthy Lifestyle ◽  
Lifestyle Changes ◽  
Psychosocial Experiences ◽  
Life Threatening Illness ◽  
Successful Recovery ◽  
Psychosocial Concerns ◽  
Life Threatening ◽  
Motivating Factor

AbstractObjective:One of the most prevalent life-threatening illnesses is heart disease. The initial trauma of being diagnosed with a life-threatening illness or having a cardiac event can begin a psychosocial chain reaction that results in a transformation of the lives of these patients. The goal of our study was to investigate the lived experiences of psychosocial healing in rehabilitation of cardiac patients using a qualitative written interview.Method:A purposive sample of 14 cardiac event survivors was recruited. Participants were interviewed after informed consent and screening. We used a qualitative analysis and model-revision approach similar to the procedure outlined by Charmaz (2006).Results:Participants consistently mentioned that a heightened awareness of mortality was a motivating factor that led to participants focusing more on their family and relationships, having an enhanced outlook on life, and making healthy lifestyle changes.Significance of results:If clinicians are able to employ a measure to better understand the nature of a patient's progression from cardiac event to successful recovery, interventions such as cardiac rehabilitation can be implemented earlier and more effectively during the course of the illness and recovery phases of treatment. Theoretically, this early detection of a patient's progression could reduce the time spent recovering from a cardiac event, and it would allow treatments for these conditions to better alleviate the psychosocial concerns faced by patients.

Education of the medical profession to facilitate delivery of transgender health care in an Australian health district

2020 ◽  
Vol 26 (1) ◽  
pp. 17
Author(s):  
Maansi Arora ◽  
Kaete Walker ◽  
Judy Luu ◽  
Robbert J. Duvivier ◽  
Tinashe Dune ◽  
...  
Keyword(s):  
Health Care ◽  
New England ◽  
Lived Experience ◽  
Medical Profession ◽  
Healthcare Providers ◽  
Health District ◽  
Easy Access ◽  
Local Health ◽  
Community Members ◽  
Transgender Health

Transgender individuals who desire medical transition need to access care through their local healthcare system. This is the first study to explore the perceptions of the community and attitudes of healthcare providers towards the delivery of transgender health care in an Australian context. An anonymous survey was conducted of trans and gender-diverse community members; and physicians and trainees in the Hunter New England Local Health District of New South Wales, Australia. Community members were surveyed about their healthcare experiences. Medical students, GPs and hospital physicians were surveyed on their attitudes towards the delivery of transgender health care before and after a 1-h education session that included the lived experience of a community member. Community members expressed a need for increased education for healthcare providers in transgender medicine. Following the intervention, significantly more healthcare providers felt confident to facilitate transgender health care for adults, adolescents and children; and more healthcare providers agreed that medical and surgical treatment should be offered to transgender patients if desired. The positive safety profile of treatment was felt to be the most persuasive factor for the provision of care. Healthcare providers identified a need for health education in transgender medicine; easy access to evidence-based resources; and local referral pathways as key strategies to improving transgender health care.

'You’re the best liar in the world’: a grounded theory study of rowing athletes’ experience of low back pain

2020 ◽  
pp. bjsports-2020-102514
Author(s):  
Fiona Wilson ◽  
Leo Ng ◽  
Kieran O'Sullivan ◽  
J P Caneiro ◽  
Peter PB O'Sullivan ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Grounded Theory ◽  
Back Pain ◽  
Lived Experience ◽  
Support Staff ◽  
Theory Approach ◽  
Low Back ◽  
Cross Sectional ◽  
Grounded Theory Approach ◽  
Do So

ObjectivesLow back pain (LBP) is common in rowers and leads to considerable disability and even retirement. The athlete voice can help clinicians to better understand sport-related pain disorders. We aimed to capture the lived experience of LBP in rowers.MethodsCross-sectional qualitative study using a grounded theory approach. Adult competitive rowers with a rowing-related LBP history were recruited in Australia and Ireland. Data were collected through interviews that explored: context around the time of onset of their LBP and their subsequent journey, experiences of management/treatment, perspectives around present beliefs, fears, barriers and expectations for the future.ResultsThe 25 rowers (12 women/13 men) who participated were aged 18–50 years; they had a mean 12.1 years of rowing experience. They discussed a culture of concealment of pain from coaches and teammates, and fear of being judged as ‘weak’ because of the limitations caused by LBP. They reported fear and isolation as a result of their pain. They felt that the culture within rowing supported this. They reported inconsistent messages regarding management from medical staff. Some rowers reported being in a system where openness was encouraged—they regarded this a leading to better outcomes and influencing their LBP experience.ConclusionsRowers’ lived experience of LBP was influenced by a pervasive culture of secrecy around symptoms. Rowers and support staff should be educated regarding the benefits of early disclosure and rowers should be supported to do so without judgement.

scholarly journals Body Reprogramming: Reframing the Fibromyalgia narrative and providing an integrative therapeutic model

2020 ◽  
Vol 7 (2) ◽  
pp. 205510292097149
Author(s):  
Anthony Fitzdonald Davies ◽  
Patrick Hill ◽  
Daniel Fay ◽  
Annily Dee ◽  
Cosima Locher
Keyword(s):  
Lived Experience ◽  
Goodness Of Fit ◽  
Current Evidence ◽  
Emergent Properties ◽  
Therapeutic Effects ◽  
Evidence Based ◽  
Illness Narrative ◽  
System A ◽  
Complex Adaptive ◽  
Therapeutic Model

We propose a theory known as the Hyland model to help conceptualise Fibromyalgia within a complex adaptive control system. A fundamental assumption is that symptom generating mechanisms are causally connected, forming a network that has emergent properties. An illness narrative has been developed which has a ‘goodness of fit’ with the lived experience of those with Fibromyalgia. The theory guides management within the clinical setting and incorporates current evidence-based therapeutic strategies, within a multi-modal intervention described as ‘Body Reprogramming’. This intervention focuses on non-pharmacological and lifestyle-based considerations. The theoretical framework also helps explain why modest therapeutic effects are gained from current pharmacological options.

Recovery-oriented support work: the perspective of people with lived experience

2019 ◽  
Vol 14 (6) ◽  
pp. 457-468
Author(s):  
Dagmar Narusson ◽  
Jean Pierre Wilken
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Health Care Services ◽  
Recovery Process ◽  
Structured Interview ◽  
Personal Recovery ◽  
Content Type ◽  
Care Services ◽  
Mental Health Difficulties ◽  
Support Work

Purpose The purpose of this paper is to focus on individuals who experience mental health difficulties with the services they receive from “support workers” as part of a personal recovery model, this study will obtain individuals reflections, experiences and opinions on how support helps them stay well and facilitates their personal recovery process. Recovery is seen through the lens of the CHIME framework (Connectedness–Hope–Identity–Meaning–Empowerment). Design/methodology/approach The sample size included 13 people who experience mental health difficulties and are receiving support from mental health care services. The structured interview was designed based on the INSPIRE measurement and the CHIME framework structure. The qualitative content analyses, discursive framing approach and CHIME as a framework made it possible to examine the key activities of recovery-oriented support work revealed in the data. Findings Participants valued the enhancement of hope provided by support workers and also expressed it was important as they were non-judgemental. Identity and meaning in recovery could be enhanced by sharing powerful stories about the individuals’ own life and health experiences, and those of support workers or others. Inclusive behaviour in public spaces and trying out new interest-based activities together were considered as empowering. Originality/value This research helps to understand the value of personal recovery support activities given the societal changes (tension between survival vs self-expression values) and highlights the need for value-based recovery-oriented education and practice.

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