This book explores how women make meaning at various health flashpoints in their lives, overcoming fear, anxiety, and anger to draw upon self-advocacy, research, and crucial decision-making. Combining focus group research, content analysis, autoethnography, and textual inquiry, the book argues that the making and remaking of what we call “patient epistemologies” is a continual process wherein a health flashpoint—sometimes a new diagnosis, sometimes a reoccurrence or worsening of an existing condition or the progression of a natural process—can cause an individual to be thrust into a discourse community that was not of their own choosing. This study will interest students and scholars of health communication, rhetoric of health and medicine, women’s studies, public health, healthcare policy, philosophy of medicine, medical sociology, and medical humanities.
In healthcare, nurses often have a great deal of contact with patients on a 24-hour basis. They are in a position to hear the patient’s stories not only while giving care, but also during more informal communication throughout the day. This puts them in a position to use their response to patients in a more conscious manner and realize therapeutic aims by exploiting narrative means in a methodological way. This book extensively describes how this can be accomplished, not only through a theoretical exposé, but also using case studies. In addition to this pragmatic focus, it explains how narrative relates to larger concepts such as self-management, shared decision making, recovery and person-centred care, and shows that narrative can be a vehicle to these desired outcomes. The book also considers organizational aspects of narrative-oriented healthcare by introducing a model in which narrative plays an important role. As such, it will allow nurses in the field to make a paradigmatic switch from a perspective dominated by delivery of care to one that is person-centred, recovery-oriented and dialogic in nature.
In the last fifteen years, the field of palliative care has experienced a surge in interest in spirituality as an important aspect of caring for seriously ill and dying patients. While spirituality has been generally recognized as an essential dimension of palliative care, uniformity of spiritual care practice has been lacking across health care settings due to factors like varying understandings and definitions of spirituality, lack of resources and practical tools, and limited professional education and training in spiritual care. In order to address these shortcomings, more than forty spiritual and palliative care experts gathered for a national conference to discuss guidelines for incorporating spirituality into palliative care. Their consensus findings form the basis of Making Health Care Whole. This important new resource provides much-needed definitions and charts a common language for addressing spiritual care across the disciplines of medicine, nursing, social work, chaplaincy, psychology, and other groups. It presents models of spiritual care that are broad and inclusive, and provides tools for screening, assessment, care planning, and interventions. This book also advocates a team approach to spiritual care, and specifies the roles of each professional on the team. Serving as both a scholarly review of the field as well as a practical resource with specific recommendations to improve spiritual care in clinical practice, Making Health Care Whole will benefit hospices and palliative care programs in hospitals, home care services, and long-term care services. It will also be a valuable addition to the curriculum at seminaries, schools of theology, and medical and nursing schools.
The second edition of Making Sense Together provides a greater examination of the clinical practice of the intersubjective perspective. Listening and responding intersubjectively is concerned with attuning to affect, putting words to affective experience, and maintaining a caring relationship that offers the kind of needed self-objective experience missing in development. In addition, the intersubjective perspective co-constructs a developmental narrative that contextualizes the evolution of the person’s troubles. In this new and updated edition, authors Peter Buirski, Pamela Haglund, and Emily Markley draw on more than twenty years of combined experience teaching and supervising in the practice of the intersubjective perspective.
Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ([8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Making Sense utilises art practice as a pro-active way of thinking that helps us to make sense of the world. It does this by developing an applied understanding of how we can use art as a method of healing and as a critical method of research. Drawing from poststructuralist philosophy, psychoanalysis, arts therapies, and the creative processes of a range of contemporary artists, the book appeals to the fields of art theory, the arts therapies, aesthetics and art practice, whilst it opens the regenerative affects of art-making to everyone. It does this by proposing the agency of 'transformative therapeutics', which defines how art helps us to make sense of the world, by activating, nourishing and understanding a particular world view or situation therein. The purpose of the book is to question and understand how and why art has this facility and power, and make the creative and healing properties of certain modes of expression widely accessible, practical and useful.
"A member of the palliative care team meets Alicia for the first time. They meet in the infusion bay, where the thin curtains offer symbolic privacy. Alicia is in her early 60s, and had gone to the doctor with a persistent cough. Subsequent tests revealed metastatic lung cancer. She has just finished her first cycle of first line chemotherapy, which she tolerated well. A quick review of her chart reveals no obvious physical symptoms such as pain or shortness of breath. Her social history is notable for the recent death of her husband. She has one adult child, who lives nearby"--
This is a well-written and useful book, particularly for those healthcare professionals who, with a little more confidence, and perhaps some Chaplaincy support, are well able to support their patients on their spiritual journeys. It would be an excellent tool for learning sessions between Chaplaincy and nursing staff, along with other relevant professional groups.' - Signpost 'This book considers why the spiritual needs of individuals are important. In an attempt to explain, the book uses case studies, which show the relationship of theory to practice. It is an interactive book encouraging reflection to explore the meaning of spirituality to patients and health care professionals. The exercises also attempt to explain the importance of a team approach to spiritual assessment as part of a holistic assessment. The book gives clear explanations of spirituality in the context of Holism and the different sections give plenty of food for thought. There are excellent references and suggestions for further reading. It is not a book for light reading but would be invaluable when encountering difficulties with a spiritual assessment or situation.' - Journal of Community Nursing Caring for the spiritual needs of patients is a highly significant yet often neglected and misunderstood aspect of health care. This results, in part, from a general lack of guidance and instruction given to healthcare professionals on the subject. This new edition of an established introductory guide to spirituality and health care practice draws extensively on case studies illustrating the application of theory to practice. It encourages the exploration, through reflective activities, of what spirituality means, both to patients and to the healthcare professionals caring for them. This book provides a comprehensive introduction to spiritual care for heath care professionals in all areas of practice.
