Research

8 pages, 205 KiB

Open AccessArticle

Professional Well-Being of Practicing Physicians: The Roles of Autonomy, Competence, and Relatedness

by Oksana Babenko

Healthcare 2018, 6(1), 12; https://doi.org/10.3390/healthcare6010012 - 02 Feb 2018

Cited by 15 | Viewed by 5636

This study investigated the roles of basic psychological needs—autonomy, competence, and relatedness—in physicians’ professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; [...] Read more.

This study investigated the roles of basic psychological needs—autonomy, competence, and relatedness—in physicians’ professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; 49% were family medicine (FM) physicians, with the rest of the participants practicing in various non-FM specialties (e.g., internal medicine, pediatrics, surgery); and 47% were in the early-career stage (≤10 years in practice). Multivariate regression analyses indicated that of the three psychological needs, the need for relatedness had the largest unique contributions to physicians’ satisfaction with professional life, work-related engagement, and exhaustion, respectively. The unique contributions of the needs for autonomy and competence were relatively small. These findings extend basic psychological needs theory to the work domain of practicing physicians in an attempt to examine underpinnings of physicians’ professional well-being, a critical component of quality patient care. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

195 KiB

Open AccessArticle

“Found Performance”: Towards a Musical Methodology for Exploring the Aesthetics of Care

by Stuart Wood

Healthcare 2017, 5(3), 59; https://doi.org/10.3390/healthcare5030059 - 18 Sep 2017

Cited by 6 | Viewed by 5726

Abstract

Concepts of performance in fine art reflect key processes in music therapy. Music therapy enables practitioners to reframe patients as performers, producing new meanings around the clinical knowledge attached to medical histories and constructs. In this paper, music therapy practices are considered in [...] Read more.

Concepts of performance in fine art reflect key processes in music therapy. Music therapy enables practitioners to reframe patients as performers, producing new meanings around the clinical knowledge attached to medical histories and constructs. In this paper, music therapy practices are considered in the wider context of art history, with reference to allied theories from social research. Tracing a century in art that has revised the performativity of found objects (starting with Duchamp’s “Fountain”), and of found sound (crystallised by Cage’s 4′ 33) this paper proposes that music therapy might be a pioneer methodology of “found performance”. Examples from music therapy and contemporary socially engaged art practices are brought as potential links between artistic methodologies and medical humanities research, with specific reference to notions of Aesthetics of Care. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

1010 KiB

Open AccessArticle

Paint it Black: Using Change-Point Analysis to Investigate Increasing Vulnerability to Depression towards the End of Vincent van Gogh’s Life

by Arnold A. P. Van Emmerik and Ellen L. Hamaker

Healthcare 2017, 5(3), 53; https://doi.org/10.3390/healthcare5030053 - 04 Sep 2017

Cited by 1 | Viewed by 6143

Abstract

This study investigated whether Vincent van Gogh became increasingly self-focused—and thus vulnerable to depression—towards the end of his life, through a quantitative analysis of his written pronoun use over time. A change-point analysis was conducted on the time series formed by the pronoun [...] Read more.

This study investigated whether Vincent van Gogh became increasingly self-focused—and thus vulnerable to depression—towards the end of his life, through a quantitative analysis of his written pronoun use over time. A change-point analysis was conducted on the time series formed by the pronoun use in Van Gogh’s letters. We used time as a predictor to see whether there was evidence for increased self-focus towards the end of Van Gogh’s life, and we compared this to the pattern in the letters written before his move to Arles. Specifically, we examined Van Gogh’s use of first person singular pronouns (FPSP) and first person plural pronouns (FPPP) in the 415 letters he wrote while working as an artist before his move to Arles, and in the next 248 letters he wrote after his move to Arles until his death in Auvers-sur-Oise. During the latter period, Van Gogh’s use of FPSP showed an annual increase of 0.68% (SE = 0.15, p < 0.001) and his use of FPPP showed an annual decrease of 0.23% (SE = 0.04, p < 0.001), indicating increasing self-focus and vulnerability to depression. This trend differed from Van Gogh’s pronoun use in the former period (which showed no significant trend in FPSP, and an annual increase of FPPP of 0.03%, SE = 0.02, p = 0.04). This study suggests that Van Gogh’s death was preceded by a gradually increasing self-focus and vulnerability to depression. It also illustrates how existing methods (i.e., quantitative linguistic analysis and change-point analysis) can be combined to study specific research questions in innovative ways. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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636 KiB

Open AccessArticle

Nurse Perceptions of Artists as Collaborators in Interprofessional Care Teams

by Jill Sonke, Virginia Pesata, Jenny Baxley Lee and John Graham-Pole

Healthcare 2017, 5(3), 50; https://doi.org/10.3390/healthcare5030050 - 30 Aug 2017

Cited by 9 | Viewed by 8073

Abstract

Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists [...] Read more.

Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists are contributing to interprofessional care teams. A secondary directed content analysis of interviews with 31 nurses on a medical-surgical care unit investigated the roles and impacts of professional artists on the interprofessional care team. The investigation utilized established domains of interprofessional care, including values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork, and created the domain of quality of care. Findings suggest that artists are valued by nurses as members of the interprofessional care team, that they enhance the provision of patient-centered care, and that they improve quality of care by providing holistic dimensions of caring, including cognitive and social engagement, and meaningful interaction. The presence of artists on interprofessional teams provides a cost-effective and welcome resource for clinical staff and builds a culture in which creativity and interdisciplinary collaboration are more highly valued and activated. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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627 KiB

Open AccessArticle

Using Jazz as a Metaphor to Teach Improvisational Communication Skills

by Paul Haidet, Jodi Jarecke, Chengwu Yang, Cayla R. Teal, Richard L. Street, Jr. and Heather Stuckey

Healthcare 2017, 5(3), 41; https://doi.org/10.3390/healthcare5030041 - 04 Aug 2017

Cited by 18 | Viewed by 8465

Abstract

Metaphor helps humans understand complex concepts by “mapping” them onto accessible concepts. The purpose of this study was to investigate the effects of using jazz as a metaphor to teach senior medical students improvisational communication skills, and to understand student learning experiences. The [...] Read more.

Metaphor helps humans understand complex concepts by “mapping” them onto accessible concepts. The purpose of this study was to investigate the effects of using jazz as a metaphor to teach senior medical students improvisational communication skills, and to understand student learning experiences. The authors designed a month-long course that used jazz to teach improvisational communication. A sample of fourth-year medical students (N = 30) completed the course between 2011 and 2014. Evaluation consisted of quantitative and qualitative data collected pre- and post-course, with comparison to a concurrent control group on some measures. Measures included: (a) Student self-reports of knowledge and ability performing communicative tasks; (b) blinded standardized patient assessment of students’ adaptability and quality of listening; and (c) qualitative course evaluation data and open-ended interviews with course students. Compared to control students, course students demonstrated statistically significant and educationally meaningful gains in adaptability and listening behaviors. Students’ course experiences suggested that the jazz components led to high engagement and creativity, and provided a model to guide application of improvisational concepts to their own communication behaviors. Metaphor proved to be a powerful tool in this study, partly through enabling increased reflection and decreased resistance to behaviors that, on the surface, tended to run counter to generally accepted norms. The use of jazz as a metaphor to teach improvisational communication warrants further refinement and investigation. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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514 KiB

Open AccessArticle

Healtheatre: Drama and Medicine in Concert

by Ian K. Walsh and Paul Murphy

Healthcare 2017, 5(3), 37; https://doi.org/10.3390/healthcare5030037 - 28 Jul 2017

Cited by 4 | Viewed by 5721

Abstract

Introduction: Clinical practice includes expressing empathy and understanding key features of humanity, such as mortality and illness. The Stanislavski “System” of actor training negotiates a journey from the unconscious via feeling, will and intellect to a proposed supertask. This study explored these areas [...] Read more.

Introduction: Clinical practice includes expressing empathy and understanding key features of humanity, such as mortality and illness. The Stanislavski “System” of actor training negotiates a journey from the unconscious via feeling, will and intellect to a proposed supertask. This study explored these areas during collaborative learning amongst undergraduate medical and drama students. Materials and Methods: Each of two interactive sessions involved teams of final year medical students rotating through challenging simulated clinical scenarios, enacted by undergraduate drama students, deploying key techniques from the Stanslavski system of actor training. Team assessment of performance was via a ratified global scoring system and dynamic debriefing techniques. Results: Medical students reported an enhanced immersive experience within simulated clinical scenarios. Drama students reported increased challenge and immersion within their roles. Medical faculty and standardised patients reported positive utility and value for the approach. Clinical team assessment scores increased by 47% (p < 0.05) with this intervention. Discussion: Qualitative and quantitative data demonstrated the merit and utility of such interdisciplinary learning. All students and faculty appreciated the value of the activity and described enhanced learning. Collaborative dynamic debriefing allowed for a continuation of the immersive experience and allowed for an exploration of arenas such as empathy. Conclusions: The deployment of drama students trained in the Stanislavski system significantly enriched medical and drama student experience and performance. Team assessment scores further demonstrated the effectiveness of this approach. Feedback from students, faculty and standardised patients was uniformly positive. The approach facilitated exploration of empathy. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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Review

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359 KiB

Open AccessReview

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review

by Samuel R. Weber, James W. Lomax II and Kenneth I. Pargament

Healthcare 2017, 5(2), 19; https://doi.org/10.3390/healthcare5020019 - 05 Apr 2017

Cited by 4 | Viewed by 5835

Abstract

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. [...] Read more.

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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Other

Jump to: Research, Review

10 pages, 196 KiB

Open AccessViewpoint

The Applicability of N: Ancient Debates and Modern Experimental Design

by Katherine D. Van Schaik

Healthcare 2018, 6(3), 118; https://doi.org/10.3390/healthcare6030118 - 19 Sep 2018

Cited by 1 | Viewed by 2995

Abstract

Medicine has always been characterized by a tension between the particular and the general. A clinician is obligated to treat the individual in front of her, yet she accomplishes this task by applying generalized knowledge that describes an abstract average but not necessarily [...] Read more.

Medicine has always been characterized by a tension between the particular and the general. A clinician is obligated to treat the individual in front of her, yet she accomplishes this task by applying generalized knowledge that describes an abstract average but not necessarily a specific person. Efforts to systematize this process of moving between the particular and the general have led to the development of randomized controlled trials and large observational studies. Inclusion of tens of thousands of people in such studies, it is argued, will enhance the applicability of the data to more individual circumstances. Yet, as genetic sequencing data have become more widely obtained and used, there has been an increased focus on what has been broadly termed “precision medicine”, a highly individualized approach to therapeutics. Moreover, advances in statistical methods have enabled researchers to use N-of-1 study data—traditionally considered too individualized to be broadly applicable—in new ways. This paper contextualizes these apparently modern debates with reference to historical arguments about methods of disease diagnosis and treatment, and earlier physicians’ concerns about the tension between the particular and the general that is intrinsic to medical practice. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

179 KiB

Open AccessPerspective

Force and Presence in the World of Medicine

by Alan Bleakley

Healthcare 2017, 5(3), 58; https://doi.org/10.3390/healthcare5030058 - 13 Sep 2017

Cited by 12 | Viewed by 4143

Abstract

Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between ‘Force’ and ‘Presence’—the former can be read as combative, the latter as pacific. Modern [...] Read more.

Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between ‘Force’ and ‘Presence’—the former can be read as combative, the latter as pacific. Modern medicine has been shaped historically by the combative metaphor of a ‘war against disease’, turning medicine into a quasi-militaristic culture fond of hierarchy. This is supplemented by the metaphor of the ‘body as machine’, reducing the complex and unpredictable body to a linear, if complicated, apparatus. The two metaphors align medicine with the modern industrial–military complex that is masculine, heroic, and controlling in character. In an era in which medicine is feminising and expected to be patient-centred, collaborative (inter-professional) and transparent to the public as a democratic gesture, the industrial–military metaphor complex should no longer be shaping medicine—yet its influence is still keenly felt, especially in surgery. This continuing dominance of Force over Presence matters because it is a style running counter to the collaborative, team-based medicine needed for high levels of patient safety. Medicine will authentically democratise only as new, pacific shaping metaphors emerge: those of ‘Presence’, such as ‘hospitality’. Hospitals can once again become places of hospitality. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

186 KiB

Open AccessConcept Paper

Performable Case Studies in Ethics Education

by Richard Robeson and Nancy M. P. King

Healthcare 2017, 5(3), 57; https://doi.org/10.3390/healthcare5030057 - 12 Sep 2017

Cited by 6 | Viewed by 5530

Abstract

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the [...] Read more.

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. Full article

(This article belongs to the Special Issue Humanities and Healthcare)

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