scholarly journals Reverse Triage and People Whose Disabilities Render Them Dependent on Ventilators

2021 ◽  
Author(s):  
Nathan Emmerich ◽  
Pat McConville
Keyword(s):  
Chronic Illness ◽  
Chronically Ill ◽  
State Of Health ◽  
Ethical Reflection ◽  
Allocation Of Resources ◽  
Clinical Prognosis ◽  
Chronically Ill Patients ◽  
Specific Concern ◽  
Satisfactory Manner ◽  
Do So

The COVID-19 pandemic has occasioned a great deal of ethical reflection both in general and on the issue of reverse triage; a practice that effectively reallocates resources from one patient to another on the basis of the latter having a more favourable clinical prognosis. This paper addresses a specific concern that has arisen in relation to such proposals: the potential reallocation of ventilators relied upon by disabled or chronically ill patients. This issue is examined via three morally parallel scenarios. First, the standard reallocation of a ventilator in accordance with reverse triage protocols; second, the reallocation of a personal ventilator from a chronically ill patient ordinarily reliant on it; and, third, the reallocation of a personal ventilator owned by a financially privileged individual but who is not ordinarily reliant on it. This paper suggests that whilst property rights cannot resolve these scenarios in a satisfactory manner, it may be possible to do so if we draw on the resources of phenomenology. However, in contradistinction to a recent paper on this topic (Reynolds et al. 2021), we argue that ethical claims to ventilators are not well grounded by the overly demanding notion that they are embodied objects. We suggest that the alternative phenomenological notion of homelikeness provides for a more plausible resolution of the issue. The personal ventilators of individuals who commonly rely upon them become part of their ordinary, everyday or homelike being. They are a necessary part of the continuation or maintenance of their basic state of health or wellbeing and the reallocation of such objects is unethical. Keywords: Phenomenology, COVID-19, Pandemic, Triage, Reverse triage, Ventilation, Chronic illness, Allocation of resources

scholarly journals The effects of storytelling in the promotion of physical activity for chronically ill patients: an integrative review

2020 ◽  
Vol 27 (8) ◽  
pp. 1-13
Author(s):  
Charlotte Byrne ◽  
Andy Soundy
Keyword(s):  
Physical Activity ◽  
Chronic Illness ◽  
Chronically Ill ◽  
Integrative Review ◽  
Group Environment ◽  
Promotion Of Physical Activity ◽  
Three Stages ◽  
Chronically Ill Patients ◽  
Main Effects ◽  
Perceived Outcomes

Background/Aims Physical activity is regarded as an essential component of self-management for people with chronic illness. Storytelling is an approach that successfully uses a group environment to influence change in physical activity intentions and behaviours. The aim of this study was to develop an understanding of what a storytelling intervention entails, its main effects and how this leads to the promotion of physical activity in chronically ill patients. Methods An integrative review was undertaken in three stages: search, appraisal and synthesis. Studies were included if they represented participants with a chronic illness, used a storytelling approach for the intervention and had physical activity as a component of the intervention. Results A total of 14 articles were identified that included a total of 818 participants (191 male, 348 female, 279 unknown). No articles were identified as flawed and all were included in the synthesis. Four themes were identified: ideal processes within interventions; psychosocial factors that influenced storytelling; perceived outcomes relating to storytelling; and perceived benefits of physical activity. Conclusions This review develops a deeper understanding of the required processes, associated factors and outcomes of storytelling interventions for people with chronic illness. It provides evidence of how storytelling can be used to promote physical activity. Further research into storytelling interventions is required.

Probabilistic Thinking: A Principle-Based Concept Analysis in the Context of Uncertainty in Chronic Illness

2021 ◽  
pp. RTNP-D-20-00183
Author(s):  
Jasmin Meichlinger ◽  
Andrea Kobleder ◽  
Hanna Mayer
Keyword(s):  
Chronic Illness ◽  
Probabilistic Reasoning ◽  
Chronically Ill ◽  
Concept Analysis ◽  
Positive Thinking ◽  
Web Searching ◽  
Data Set ◽  
Probabilistic Thinking ◽  
Definition Of ◽  
Chronically Ill Patients

Background and PurposeThe Reconceptualized Uncertainty in Illness Theory (RUIT) includes the concept of “probabilistic thinking” intending to explain the positive reappraisal of uncertainty in chronic illness. However, the description of the concept is vague, thereby limiting the understanding of the theory. Thus, the aim was to develop a theoretical definition of probabilistic thinking in order to increase the explanatory value of RUIT.MethodsWe conducted a principle-based concept analysis by means of a conceptually driven literature search. Methods consisted of database, dictionary, lexicon, and free web searching as well as citation tracking. We analyzed the concept in terms of (a) epistemology, (b) pragmatics, (c) logic, and (d) linguistics.ResultsThe final data set included 27 publications, 14 of them from nursing. (a) Probabilistic thinking is a coping strategy to handle uncertainty. It involves a focus on either possibilities (in nursing) or probabilities (in other disciplines). (b) There is a lack of operationalization in nursing, though three measurements focusing the handling of probabilities are offered in psychology. (c) Nursing authors interpreting probabilistic thinking as accepted uncertainty lacked logical appropriateness, since probability negotiates uncertainty. (d) Probabilistic thinking is used synonymously with positive thinking and probabilistic reasoning.Implications for PracticeNurses working with chronically ill patients should consider the findings for the application of RUIT. They should recognize whether uncertainty is perceived as a danger and encourage probabilistic thinking. Efforts are necessary to achieve a common language between nursing and other disciplines in order to avoid misunderstandings in clinical practice and research.

Patients' Psychological Reactions to Chronic Illness: Are they Associated with Rehabilitation

1982 ◽  
Vol 13 (2) ◽  
pp. 38-44 ◽  
Author(s):  
Linda L. Viney ◽  
Mary T. Westbrook
Keyword(s):  
Chronic Illness ◽  
Social Relationships ◽  
Leisure Activities ◽  
Chronically Ill ◽  
Psychological Reactions ◽  
Illness Uncertainty ◽  
Psychological Reaction ◽  
Positive Feelings ◽  
Chronically Ill Patients ◽  
Anxiety Depression

The responses of 88 chronically ill patients to an open-ended question about their current experiences were content analysed to yield a set of measures assessing their psychological reactions to their illness. Uncertainty, anxiety, depression, anger expressed directly and indirectly, feelings of helplessness and competence, sociability and positive feelings were assessed by this means. Patients were interviewed during hospitalization and seven months later in the community. On both occasions they rated their handicaps in the areas of mobility, leisure activities, self-care and social relationships. These ratings were combined to provide four measures of rehabilitation. The findings indicate that psychological reactions to chronic illness predict rehabilitation. Improvement in mobility and relationships is perceived by patients who, during earlier hospitalization, experience anxiety and depression, express their anger directly rather than indirectly, and believe social supports to be available to them. They also experience few feelings of helplessness. The psychological reaction experienced concurrently wsith perceived improvement in all handicap Q-reas consisted of more good-feelings and less uncertainty and anxiety. Improvement in mobility and relationships was also associated with an intensification in the pattern of expression of anger described above and an increase in feelings of competence. Unexpectedly, increased depression was also characteristic of this last pattern of reaction to chronic illness.

Patterns of Utilization of Medical Care and Perceptions of the Relationship between Doctor and Patient with Chronic Illness Including Chronic Fatigue Syndrome

1997 ◽  
Vol 80 (2) ◽  
pp. 643-658 ◽  
Author(s):  
Stuart W. Twemlow ◽  
Lolafaye Coyne ◽  
Samuel L. Bradshaw ◽  
Barbara H. Lerma
Keyword(s):  
Chronic Illness ◽  
Chronic Fatigue Syndrome ◽  
Chronically Ill ◽  
Chronic Fatigue ◽  
Medical Patients ◽  
Fatigue Syndrome ◽  
Health And Illness ◽  
Patterns Of Utilization ◽  
Chronically Ill Patients ◽  
The Relationship

To what extent do personal constructs affect the relationship between doctor and patient when the ill patient does not readily recover with treatment? Questionnaires were returned anonymously by 609 patients with a self-reported diagnosis of chronic fatigue syndrome, who were considered chronically ill. Findings were compared with those of an earlier study of a population of 397 general medical patients. The chronically ill patients lost an average of 65 days of work per year due to illness compared to general medical patients who missed six or fewer days per year because they were ill. The chronically ill patients also reported a 66% higher frequency of iatrogenic illness, spent more money on health care, took more medication, saw more specialists, and were more litigious than the general medical population. Research suggested several patterns of relationships between doctors and patients, and attitudes to health and illness, which may alert doctors to patients' perceptions, beliefs, encoded constructs, and patterns of relating that affect responses to treatment. More attention by doctors to patients who are experiencing the stress of chronic illness is indicated.

scholarly journals Modalities and costs of familiar and social support to chronically ill patients

2006 ◽  
Vol 3 (2) ◽  
Author(s):  
Michele Petrinco ◽  
Silvia Snidero ◽  
Miriam Totis ◽  
Mario Casini ◽  
Anuška Ferligoj ◽  
...  
Keyword(s):  
Social Support ◽  
Chronic Illness ◽  
Chronically Ill ◽  
Point Of View ◽  
Network Support ◽  
Home Based ◽  
Chronically Ill Patients ◽  
Home Based Care ◽  
The Impact

The main objective of this study was to quantify the characteristics of social networks in a sample of elderly ill patients. These patients who had chronic illness were receiving home based care, in an Italian district during 2001. Both patients and caregivers were interviewed. The analysis of the caregivers' questionnaire was conducted to avoid missing answers when gathered from the patients. This method also enabled a better understanding of the impact of social support on chronic illness pathologies. Further more, it allowed the investigation of the patients' network, the caregivers' point of view, the costs, the quality of care and the assessment of sociodemographical data of both. Results highlighted the particular situation of patients, characterized by high dependence from other persons especially for every day activities. Most of the caregivers were family members for the number of persons involved and for the time spent for the care. The network support maintenance and mobilization costs evaluation was faced suggesting three different strategies, according to three different ways of time-opportunity calculation, of the informal caregivers.

Prevalence and correlates for stress among caregivers for chronically ill patients at Ndola teaching hospital

2017 ◽  
Vol 4 (3) ◽  
pp. 107-111
Author(s):  
Davies Simukoko ◽  
◽  
David Mulenga ◽  
Victor Mwanakasale ◽  
◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Chronically Ill ◽  
Chronically Ill Patients

PatientConcept App � an innovative tool to improve therapy adherence and to implement risk management plans. (Preprint)

2018 ◽  
Author(s):  
Michael Lang ◽  
Martin Mayr ◽  
Stefan Ringbauer ◽  
Lukas Cepek
Keyword(s):  
Risk Management ◽  
Disease Management ◽  
Chronically Ill ◽  
Patient Reported Outcome ◽  
Outcome Data ◽  
Daily Routine ◽  
Software Application ◽  
Patient Reported ◽  
Management Plans ◽  
Chronically Ill Patients

UNSTRUCTURED Background: Adherence constitutes a great challenge for disease management, particularly when treating chronically ill patients facing an extensive, complex and long-term therapy. Earlier studies emphasize the relevance of adherence for improving therapy benefits. Besides the positive impact of increased patient support, the use of mobile health applications has gained importance in disease management. Objective: We aimed to develop a software application providing innovative features to simplify the contact between patients and treating physicians in order to overcome adherence barriers, to implement risk management plans and to collect patient reported outcome data. Methods: A novel software application ensuring data security was developed. Various innovative modules have been implemented, enabling bidirectional communication between treating physicians and patients, supporting therapy monitoring and management and allowing the collection of large sets of anonymous patient data. Results: The PatientConcept app is freely available for download and is tested since 2016, with more than 1800 generated patient IDs and 279 patients documenting health data according to risk management plans online in 2017. The impact on adherence issues is currently tested in larger patient populations. Conclusion: This innovative app provides a feasible and cost-optimized possibility to intensify and simplify the communication between patients and their treating physicians across indications, thus promising an exceptional benefit to both. It may not only support chronically ill patients in managing their daily life and improving adherence, but can also facilitate the implementation of risk management plans through automated monitoring, thus supporting physicians in their daily routine. Furthermore, patient reported outcome data can be collected. Importantly, a secure ID-associated data management ensures patient anonymity complying with highest data safety standards.

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