Training clinicians in whole person-centred healthcare

2016 ◽  
Vol 4 (2) ◽  
pp. 402
Author(s):  
Brian Broom
Keyword(s):  
New Zealand ◽  
Health Sector ◽  
Clinical Settings ◽  
Whole Person ◽  
Mind And Body ◽  
Expert Clinician ◽  
Physical Diseases ◽  
Health Institutions ◽  
Many Sources ◽  
Disease Focus

Since 1987 in New Zealand a form of person-centred healthcare has emerged, which was originally loosely  referred to as ‘medicine and story’ and then developed into a University program titled MindBody Healthcare, but more recently has been described in clinical settings and publications as the Whole Person Approach. This paper emphasises the co-emergence of physicality and subjectivity from conception and the harm that comes from keeping mind and body apart in the treatment of physical illness of all kinds. Symbolic physical diseases provide particularly vivid and glaring examples of the need to attend to patient subjectivity as a part of treatment. Clinicians must learn to deal with whole persons and the patient’s story is a practical doorway into the complexity of this whole. Training clinicians over two decades to become whole person-focussed and competent has revealed that clinicians need sustained education to move from the typical Western healthcare dualistic view of patients with physical disease to a unitive, non-dualistic, whole person understanding. It takes time, practice, support and supervision for this to be expressed comfortably in clinical settings. The shift from expert clinician-to-disease focus to a more human-to-human dynamic, underwriting everything that is done, can be very challenging for some clinicians. Specific attitudes are required and some skills in eliciting relevant story can be learned quite easily. There are many sources of resistances to these changes in the health institutions and clinicians are more of a problem than patients. Each clinical discipline within the health sector tends to have unique problems. But the rewards for whole person practice are great for both clinicians and patients.

Psychosomatic disorders and its management through Ayurveda

2016 ◽  
Vol 5 (01) ◽  
pp. 4764
Author(s):  
Anil Kumar Singh ◽  
Ram Krushna Panda ◽  
Shriram Chandra Mishra ◽  
Manish Singh ◽  
Akhil N. Parida
Keyword(s):  
Mental Status ◽  
Psychosomatic Disorders ◽  
Psychosomatic Disorder ◽  
Physical Disease ◽  
Diagnosis And Management ◽  
Mind And Body ◽  
Single Identity ◽  
Physical Diseases ◽  
Proper Diagnosis ◽  
As Stress

Psychosomatic - psyche (mind) and soma (body) -A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental conditions such as stress and anxiety. Your current mental status can influence how bad a physical disease is, at any given time. Both mind and body are a single identity, so the involvements of one definitely affect the others. So the bidirectional approach should be done to proper diagnosis and management of psychosomatic disorders. In Ayurveda detail description is given about psychic (Manasika), Somatic (Sharirika) and psychosomatic disorders (Manodaihika Vyadhi), their mode of treatment, they are as follows.

scholarly journals Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029525
Author(s):  
Tamasin Taylor ◽  
Wendy Wrapson ◽  
Ofa Dewes ◽  
Nalei Taufa ◽  
Richard J Siegert
Keyword(s):  
Bariatric Surgery ◽  
New Zealand ◽  
Health Literacy ◽  
Health Professionals ◽  
Health Sector ◽  
Publicly Funded ◽  
Attrition Rates ◽  
Pacific Health ◽  
Emotional Safety ◽  
Minority Ethnic

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend.ObjectivesThe present study explored structural barriers contributing to Pacific patients’ disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ.SettingPublicly-funded bariatric surgery programmes based in the wider Auckland area, NZ.DesignSemi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach.ResultsTwo primary themes were identified: (1) Confidence negotiating the medical system, which included Emotional safety in clinical settings and Relating to non-Pacific health professionals and (2) Appropriate support to achieve preoperative goals, which included Cultural considerations, Practical support and Relating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals.ConclusionsHealth professionals’ accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients’ preoperative health goals and improving patients’ health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.

Accounting systems and systems of accountability in the New Zealand health sector

1997 ◽  
Vol 10 (5) ◽  
pp. 665-683 ◽  
Author(s):  
S. Lawrence ◽  
M. Alam ◽  
D. Northcott ◽  
T. Lowe
Keyword(s):  
New Zealand ◽  
Health Sector ◽  
Accounting Systems

scholarly journals Social Gender Perceptions of Women Working in the Healthcare Sector in Turkey

2021 ◽  
Keyword(s):  
Demographic Data ◽  
Health Sector ◽  
Female Gender ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Gender Perceptions ◽  
The Family ◽  
Health Institutions ◽  
Questionnaire Method ◽  
One Way Anova

The aim of this study is to evaluate the gender perceptions of women working in the health sector. The study was conducted questionnaire method in private health institutions determined by researchers in Istanbul and Ankara. Demographic data were obtained by means of a questionnaire, t-Test and One-Way ANOVA tests were performed. As a result of the research, it was determined that the opinions of the women working in the health sector were not only in the decision of the men in the decisions taken in the family; there is no discrimination between men, girls, and boys. Keywords: Female, Gender, Healthcare Services, Social Gender, Healthcare Workers

scholarly journals Enseñanza clínica en enfermería: escenario del aprendizaje y sus actores

2015 ◽  
Vol 4 (7) ◽  
pp. 44
Author(s):  
Norma Ivette Beltran Lugo ◽  
Betsy Flores Atilano ◽  
Dulce María Guillén Cadena
Keyword(s):  
Actual World ◽  
Clinical Teaching ◽  
Clinical Settings ◽  
Clinical Practices ◽  
Continuous Formation ◽  
Great Responsibility ◽  
Health Institutions ◽  
Personnel Needs ◽  
The Moment ◽  
Sobre Todo

<div>La ense&ntilde;anza se concibe como la tarea m&aacute;s peculiar de la escuela, cuyas funciones educativas deben estructurarse (P&eacute;rez G&oacute;mez, 1992) en torno a dos funciones. El acto de ense&ntilde;ar no es responsabilidad totalmente del docente universitario, sino que involucra al personal operativo de las instituciones de salud. La ense&ntilde;anza cl&iacute;nica es el momento donde se tiene contacto con el mundo real y los diferentes ambientes que se generan para la construcci&oacute;n de nuevos h&aacute;bitos profesionales, el desarrollo de la empat&iacute;a con la disciplina y hasta el gusto de ser enfermero. La problem&aacute;tica que tenemos actualmente es que a veces el personal de Enfermer&iacute;a da por hecho que los y las estudiantes ya tienen los conocimientos pero sobre todo las habilidades pr&aacute;cticas para ejecutar intervenciones que implican gran responsabilidad, pero cuando la alumna demuestra que no tiene esas habilidades es desplazada y limitada a la observaci&oacute;n. El profesorado debe tener una formaci&oacute;n continua y tambi&eacute;n debe salir a hacer pr&aacute;cticas cl&iacute;nicas para que de esta forma no pierda las habilidades y destrezas en la ejecuci&oacute;n de diversos procedimientos de Enfermer&iacute;a. Aunque existe el programa de estancias cl&iacute;nicas para profesores, &eacute;stos deben ser comprometidos a ejecutarlas independientemente de que laboren en alg&uacute;n otro lugar, ya que de &eacute;sta forma se pueden actualizar en las nuevas tecnolog&iacute;as del cuidado y tendr&aacute;n herramientas muy &uacute;tiles durante su ense&ntilde;anza.</div><div><br /></div><div><div>Teaching is conceived as the most peculiar task of the school, which educative functions must be structured (P&eacute;rez G&oacute;mez, 1992) around two functions. The act of teaching isn&rsquo;t the universitarian teacher&rsquo;s responsibility completely, but also the health institutions&rsquo; personnel&acute;s. Clinical teaching is the moment when contact is had with the actual world and the different environments created to construct new professional habits, development of empathy and even the joy of being a nurse. The issue we currently have is that sometimes nursing personnel take for granted that students already have all the knowledge, but mostly all the practical abilities to perform interventions that imply great responsibility, but when the student shows the lack those skills, they&rsquo;re set aside and limited to observation only. Teaching personnel needs to have a continuous formation and they also have to do clinical practices so this way they won&acute;t lose the abilities and dexterities on the execution of different nursing procedures. Even though there&rsquo;s the clinical settings program for teachers, they have to be committed to execute it, whether they work or not at other place, so this way caring technologies can be updated and they&rsquo;ll have very useful tools for teaching.</div></div><div><br /></div>

Impact of Employees' Empowerment on Perceived Quality of Service Delivery in the Tertiary Health Institutions

2021 ◽  
pp. 2014-2030
Author(s):  
Michael Abayomi Fowowe ◽  
Kayode K. Arogundade
Keyword(s):  
Quality Assurance ◽  
Quality Of Service ◽  
Service Delivery ◽  
Health Sector ◽  
Healthcare Services ◽  
Perceived Quality ◽  
Health Institutions ◽  
Market Needs ◽  
Acute Healthcare

In this current 21st-century global competitive market, employee empowerment plays a significant role in building the internal resource-based capacity of business survival towards meeting and exceeding ever-increasing market needs. The tertiary health institutions saddled with the responsibility of providing acute healthcare services significantly require effective commitment of their healthcare workers in promoting quality of service delivery towards achieving result-oriented healthcare quality assurance outcome. However, the Nigerian health sector has been characterised with diverse challenges in sustaining quality assurance due to lack of leadership commitment in empowering caregivers in the sector effectively. To a large extent, this has weakened the adequate performance of employees, and also, contributed to the observed increase in morbidity and mortality rate in the Nigerian health centres. This aim of this paper is to critically analyse the impact of employees' empowerment on the perceived quality of service delivery in the context of the Nigerian healthcare institutions.

Tackling radicalization and terrorism in Dutch mental health institutions: Outcomes of a Dutch population survey

2021 ◽  
pp. 229-240
Author(s):  
Carl H.D. Steinmetz
Keyword(s):  
Mental Health ◽  
The Netherlands ◽  
Population Survey ◽  
Health Sector ◽  
Dutch Population ◽  
Health Institutions ◽  
Mental Health Institutions

Virtually no data are available on mental health institutions working on radicalization and terrorism. In the Netherlands we conducted a survey of all mental health institutions (n = 65) in 2016. Fifty-seven per cent responded. The result is that mental health institutions in the Netherlands have started to take small steps towards tacking radicalization and terrorism. These small steps, even by 2016, are a contrast to the reality of radicalization and terrorist incidents and attacks in the Netherlands since 2000. This outcome may have been caused by the resistance of Dutch psychiatrists in the mental health sector (often heard in the Greater Amsterdam region) to the idea that radicalisation and terrorist incidents and attacks are not their work either. For their view is, it is not our job if there is no DSM disorder.

scholarly journals Determinants of Implanon Discontinuation among Women Who Use Implanon at Bahir Dar Town Health Institutions, Northwest Ethiopia, 2019: A Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tsegaw Yehuala ◽  
Ergoye Melese ◽  
Kassawmar Angaw Bogale ◽  
Baye Dagnew
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Case Control Study ◽  
Health Sector ◽  
Case Control ◽  
Northwest Ethiopia ◽  
Bahir Dar ◽  
Limited Information ◽  
Health Institutions ◽  
Control Study

Background. Implanon is a long-acting reversible contraceptive method that is 99% effective in preventing unintended pregnancy. Despite its effectiveness, the rate of Implanon discontinuation is high. In Ethiopia, there is limited information about determinants of Implanon discontinuation. Therefore, this study aimed to identify the determinants of Implanon discontinuation among women who used Implanon at Bahir Dar town health institutions. Methods. We employed an unmatched case-control study to find out the determinants of Implanon discontinuation at Bahir Dar town health institutions from March to June 2019 using the multistage stratified sampling technique to select study participants. Cases were women who had discontinued Implanon before completion of 3 years, and controls were women who had removed Implanon at the date of appointment (3 years). A pretested, structured questionnaire with face-to-face interviews was used. Binary logistic regression was performed to identify determinants of Implanon discontinuation. In the final model, variables with a p value of <0.05 were considered significant at 95% confidence interval and the strength of association was measured using odds ratio. Results. Primary education (AOR = 0.104, 95% CI (0.02–0.48)), secondary education (AOR = 0.48, 95% CI (0.24–0.952)), women who have no child (AOR = 2.04, 95% CI (1.2–3.4)), women who had no discussion with their partner (AOR = 2.2, 95% CI (1.39–3.57)), mass counseling (AOR = 3.5, 95% CI (1.75–7.01)), women who had no counseling about side effects (AOR = 1.7, 95% CI (1.07–2.07)), women who experienced side effects (AOR = 2.2, 95% CI (1.4–3.4)), and purpose of family planning use (AOR = 2.5, 95% CI (1.14–4.8)) were determinants of Implanon discontinuation. Conclusion. Implanon discontinuation is attributed by multifactorial involvement. Women’s educational status, nulliparity, no counseling, not informed of side effects, and no partner discussion are significant factors. Health sector stakeholders need to tailor counseling services at individual level to bolster family planning utilization until the desired time.

scholarly journals The New Zealand podiatry profession – a workforce in crisis?

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew Carroll ◽  
Hannah Jepson ◽  
Prue Molyneux ◽  
Angela Brenton-Rule
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Private Practice ◽  
Sports Medicine ◽  
Online Survey ◽  
Health Sector ◽  
New Graduates ◽  
The North ◽  
New Graduate ◽  
Survey Responses

Abstract Background This is the first study to explore workforce data from the Podiatrists Board of New Zealand. The study analysed data from an online survey which New Zealand podiatrists complete as part of their application for an Annual Practising Certificate. Methods Survey responses between 2015 and 2019 were analysed. Data was related to work setting, employment status, work hours, location, professional affiliations, and number of graduates entering practice. Survey data was downloaded by a second party who provide data security for the Podiatrists Board of New Zealand workforce data. All data supplied for analysis were deidentified and could not be re-linked to an individual practitioner. Results In 2019 there were 430 podiatrists who held an Annual Practising Certificate. Eighty percent of podiatrists who work in New Zealand are in private practice, with 8% employed in the public health sector. Podiatrist’s work is a mix of general podiatry, diabetes care and sports medicine. The majority are self-employed (40%) or business owners (19%). Approximately 40% work between 31 to 40 h per week and 46 to 50 weeks per year. The majority are female (67%) with most practising in the North Island (69%) and located in the Auckland region (33%). On average 76% of new graduates were issued an Annual Practising Certificate between 2015 and 2019. Conclusion The New Zealand podiatry profession is small and growing at a slow rate, consequently there is evidence of a workforce shortage. To maintain a per-capita ratio of podiatrists approximate to Australia and the United Kingdom an additional 578 podiatrists are required in the New Zealand workforce. There are not enough new graduate practitioners entering the workforce and once practising, the majority enter private practice in the face of limited public health employment opportunities.

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