bluuebunny/crossref_metadata_2025 huggingface dataset:
Mind the Gaps
Authors: Kidd Graeme
Published: September 2017

Objective: Reflection on 35 years in family medical practice - from home births to home deaths. My own wider understanding of "medical practise" through my personal growth.THE GAPS1) ISAAC NEWTON vs ALBERT EINSTEINMatter versus energy. Current medical practise is still largely perceived through a Newtonian mindset. In recent years the "repair shop" mentality has intensified as we find more sophisticated techniques for managing the ailing human body. We still practise in a reductive world where we believe that we can determine outcomes entirely by understanding the parts. Even a scant understanding of wave particle interactivity can help interpret a more holistic view of disease processes. Metastatic cancer is an enormous challenge and I believe outcomes are related to far more than the conventional invasive treatments.2) LOUIS PASTEUR vs CLAUDE BERNARDGerm theory versus milleu. The debate these two men initiated 170 years ago continues today - even though it is rumoured on his deathbed Louis was heard to say he thought Claude was right. We still practise medicine as if we are fighting an enemy and give scant regard to the milleu that we allow the "enemy" to inhabit. As the mystics and the scientists draw closer together through our quantum understanding, the milleu of our human system appears more complex and more connected to the world that we inhabit.Although I practise conventional family medicine, I use metaphysics, metaphor and an interpretation of energy medicine to help patients understand their disease and enable them to use an holistic approach to intergrate both conventional and complimentary therapies. With increasing audit and protocol driven practise it seems that often humanity gets sidelined. HbA1c's become more important than the relationship the patient has with their disease.Conclusion: The reintegration of humanity into the practise of medicine will help empower patients with insight that will not only enhance their quality of life but will also help save millions of dollars that currently is wasted within the victim / fix it model of medicine. I see the tide turning and this conference is evidence of a resurgence in a broader understanding of medicine through personhood.
Whole Person Team Care
Authors: Komatsu Glen , Hess Denise
Published: September 2017

In the rapidly changing environment of 21st century healthcare, effective interdisciplinary team-based care is a key ingredient in providing whole person care across the continuum. Interdisciplinary teams face significant issues and challenges in providing whole person care given the boundaries that exist between various healthcare disciplines. Systemic institutional barriers and hierarchies commonly work against team communication, cooperation, and collaboration. These work environments contribute to work-related stress, staff turnover, inefficient, lower quality care, burnout, and compassion fatigue. Ultimately team environments that do not foster team member well-being are unlikely to find success in creating environments that foster whole person care. Given these realities, teams who hope to provide whole-person care need strategies for creating and sustaining a team environment of self-awareness, self-compassion, mindfulness and non-judgmental presence.This session will present the outcomes of three innovative approaches to interdisciplinary care team flourishing through case study analysis of hospital-based palliative care teams, and adult/pediatric hospice teams. The first intervention illustrates a process for developing and implementing a team retreat experience. Combining elements of team building, experiential learning and discussion of assigned readings, palliative care and hospice teams exhibit increased team trust, respect and communication across discipline boundaries. The second intervention demonstrates positive meaning-making through the use of a “spiritual narrative.” Through sustained reflection on a guiding metaphor, “spiritual narratives” enhance team identity formation, function, and sustainability. The third intervention outlines a model for group mindfulness meditation. Through regular practice of mindfulness meditation as an integrated component of the work day, team members sought to increase their self-awareness, presence, attunement and compassion in clinical interactions. Attendees of this workshop will be inspired and equipped to with new ways to enrich interdisciplinary team flourishing while providing excellent whole person care.
Restoring Core Values: An International Charter for Human Values in Healthcare
Authors: Rider Elizabeth A. , Ho Ming-Jung , Branch, Jr William T , Slade Diana , Kurtz Suzanne , Pun Kwok Hung Jack
Published: September 2017

Background: The human dimensions of healthcare are fundamental to the practice of compassionate, safe, and ethical relationship-centered care. Attending to the human dimensions improves patient and clinician satisfaction, outcomes and quality of care; however, these dimensions have not received the emphasis necessary to make them central to every healthcare encounter. We established an international collaborative effort to identify and promote the human dimensions of care.Objectives: a) To describe work to date on the International Charter for Human Values in Healthcare; b) To discuss translation of the Charter’s universal values into education, research, and practice.Methods: An international working group of expert educators, clinicians, linguists, and researchers identified initial values that should be present in every healthcare interaction. The working group and four additional groups -- National Academies of Practice (NAP) USA, International Conference on Communication in Healthcare, Interprofessional Patient-Centered Care Conference, American Academy on Communication in Healthcare Forum -- identified values for all healthcare interactions and prioritized top values. The NAP group also prioritized top values for interprofessional interactions. Additional data was gathered via a Delphi process and 2 focus groups of Harvard Macy Institute scholars and faculty.Results: Through iterative content analyses and consensus, we identified 5 categories of core human values that should be present in every healthcare interaction: Capacity for Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare. Through further consensus and Delphi methodology, we identified values within each category.Conclusions: The International Charter for Human Values in Healthcare [1] is a cooperative effort to restore core human values to healthcare around the world. Major healthcare and education partners have joined this international effort. We are working to develop methods to translate the Charter’s universal values into education (teaching, assessment, curricula), research and practice.ReferenceThe International Charter for Human Values in Healthcare. http://charterforhealthcarevalues.org
Therapeutic Conversations with Seriously Ill People and Their Families
Authors: Ingram Cory , Wild Ellen
Published: September 2017

Seriously ill people and those they love encounter health care professionals regularly. Published studies, representing how seriously ill people prefer to be communicated with suggest they would like open, honest and thoughtful communication. Additionally, these studies emphasize that seriously ill people prefer to talk about their illness when they are ready. Medical professionals are often on the frontline of communication with these people. There is a paucity of education on communicating with seriously ill people in professional education spanning many health care professions.Our workshop will empower participants in all capacities to better communicate with seriously ill people. We will teach not how to communicate information but rather how to have a therapeutic interaction that is consistent with what we know to be true about what seriously ill people value in their communication with their health care team.We will use patient narratives both oral and video, role play and reflection to convey an easy to implement framework to therapeutic communication.Session attendees will be able to1. Understand foundational communication desires of seriously ill people and their families.2. Describe a framework to approach difficult conversations with a therapeutic intention.3. Implement practical approaches to enhance their communication with seriously ill patients and families they encounter daily.
Sharing and Supporting the Hopes and Dreams of Students and Faculty in a Canadian BScN Program
Authors: Coffey Sue , Zitzelsberger Hilde , Cochrane Marianne , Cummings Katherine
Published: September 2017

Healthcare educators are in a unique position to support students’ personal and professional development. The UOIT-DC Nursing Program curriculum is founded on caring values that assert a commitment to the primacy of relationships. According to humanistic nursing, caring involves the interrelated concepts of ‘being’ and ‘doing’ in which both require an active presence and willingness to come to know another person (Paterson  and  Zderad, 1976). A deeply held tenet of nursing practice is the notion that when a nurse knows or understands a person, he or she will be better able to care for that person. We believe that this notion also pertains to student and faculty relationships in nursing education, ultimately leading to more effective and meaningful learning opportunities and experiences.This poster will report on a qualitative study exploring undergraduate nursing students’ hopes and dreams when they begin their education and the ways these hopes and dreams may shift and evolve as they progress through the program. The intersections of students’ hopes and dreams for their education and faculty members’ hopes and dreams in teaching students will be presented. The impetus for the project arose from conversations among faculty members about the complex relational nature of nursing education and our hope to enhance relational awareness and practices through a deeper understanding of the aspirations and goals that students hold. Exploration of how the findings may contribute to deeper understandings of and responsiveness to students and the significance of nursing practice and education to them will be presented.ReferencesPaterson, J. G.,  and  Zderad, L. T. (1976). Humanistic nursing. New York: John Wiley and Sons.
Using the Arts to Explore Whole Person Care
Authors: Silberberg Peter , Koppe Hilton
Published: September 2017

There has been an increase in the use of arts in Australian General Practice medical education in recent years. This workshop will aim to continue the Australian journey by exploring how the arts can teach about the whole person care. It will be facilitated by two medical educators experienced in these teaching techniques. Participants will be asked to contribute an example from the arts (film, writing, image, music etc) and be guided via skilled facilitation in how this could be used to explore whole person care. There will be discussion of how these pieces could be used in teaching and clinical practice. Potential benefits and pitfalls will be highlighted. At the conclusion, these resources will be collated for distribution and made freely available.Learning objectives include: (i) how to use the arts in teaching whole person care, (ii) to discuss different methodologies and the pros and cons of each one (iii) to allow participants an opportunity to experiment and participate with different mediums (iv) to collate a list of different examples used from the workshop to distribute to the group.Please note, if you attend this workshop you will need to bring a small contribution of art (film, writing, image, music etc) to share with the group. Electronic versions are welcome. It does not need to be original.
Facilitating Whole Person Care Using Video Reflexive Ethnography
Authors: Collier Aileen , Wyer Mary , Carroll Katherine , Hor Suyin , Lenne Brydan , Iedema Rick
Published: September 2017

Aim: Explore the application and potential of video reflexive ethnography (VRE) to facilitate whole person care (WPC).Objectives: Discuss the ethical issues associated with VRE; explore the foundations of the methodology; and discuss its potential to facilitate WPC.Description: WPC requires a paradigm shift in how we see those we care for, how we see our co-workers and how we see ourselves. VRE involves videoing real-time everyday clinical practice and or patient and family accounts of care, and then involving participants to analyse the visual data that they feature in or have gathered themselves. Uniquely, video footage can challenge the taken for granted and attune people to dimensions of themselves and others that they might not otherwise have considered. This has the potential to open people up to alternative ways of thinking and perceiving, being and acting. It offers “transformative potential” towards WPC.We draw from our diverse disciplinary perspectives to explore the potential of VRE as a tool to facilitate WPC. Using specific examples from five research studies, this workshop will demonstrate the use of VRE in a variety of health care contexts. The contexts of the studies we draw from include: end of life care; autism diagnostics; infection control, and intensive care.The workshop proceeds in four parts. We first invite you, the participant, to engage in a video reflexive event, where you are expected to reflect on the socio-interactive conduct that you produce as a group in response to a specific task.  We then describe the process of VRE, outline its pedagogic and theoretical foundations, and present some examples from our research. We then invite questions about the theoretical basis and practical approach of VRE. Finally, participants will be asked to project a version of reflexive video onto their 'home' area of research, and reason about potential outcomes.1. Carroll, K., Iedema, R.  and  Kerridge, I. 2008, 'Reshaping ICU Ward Round Practices Using Video Reflexive Ethnography', Qualitative Health Research, vol. 18, no. 3, pp. 380-390.2. Collier, A. 2012, 'Safe Healing Environments', in N. Godbold  and  M. Vaccarella (eds), Autonomous Responsible Alone: The Complexities of Patient Empowerment, Interdisciplinary Press, London, pp. 155-170.3. Iedema, R. 2011, 'Creating Safety by Strengthening Clinicians' Capacity for Reflexivity ', British Medical Journal, vol. 20, pp. S83-S86.4. Iedema, R.  and  Carroll, K. 2011, 'The 'clinalyst': Institutionalising reflexive space to realise safety and flexible systematisation in health care', Journal of Organisational Change Management vol. 4, no. 1, pp. 65-86.5. Iedema, R., Long, D., Forsyth, D.  and  Lee, B.B. 2006, 'Visibilising Clinical Work: Video ethnography in the contemporary hospital', Health Sociology Review, vol. 15, pp. 156-168.
Exercise-Never Too Late: The Meaning of Exercise for Advanced Palliative Care Patients
Authors: Savage Roslyn Joy , Gibbons Jill , Potter Kathy
Published: September 2017

Objective: Increasing evidence supports the role of exercise for palliative care patients through maximizing physical function, improving fatigue and overall quality of life in the face of advancing disease. The objective of this study was to explore the meaning of exercise for these patients and their carers and to increase the understanding and value of exercise for this population.Methods: An emergent qualitative study design was employed using semi structured interviews with patients attending a palliative care gym program and their carers. Thirteen patients and seven carers participated.Interviews were taped and transcribed verbatim and analyzed to identify common themes.Results: Patients and carers identified improvement in strength, confidence and mood that enabled greater participation in life. Access to an open flexible program that allowed patients control of their exercise was important. Exercise contributed to promoting self identity and as a consequence provided a source of inner strength. Benefit was also felt from the shared positive experience in a safe environment. Carers used the session as a form of respite or opportunity for  interaction.Conclusions: Patients perceive exercise as important as it enables independence but it also provides significant psychosocial and spiritual support. Carers similarly identify the benefits beyond improved physical function. Exercise is a positive treatment regime that contributes to wholistic care.
Promoting Resilience with the Mindfulness-Based Stress Reduction Program in Patients With Chronic Illness
Authors: Zhao Qinyi , Bernardi Nicolò , Dobkin Patricia
Published: September 2017

Objectives: Twenty-first century patients need to take a proactive stance with regard to their health in order to cope well with chronic illness.  Mindfulness-Based Stress Reduction (MBSR) is an 8-week structured group program that encourages patients to take responsibility for their health and teaches them to cope with stressors inherent in living with illness.Methods: Patients with chronic illnesses (e.g., breast cancer, chronic pain, multiple sclerosis) participated in the MBSR program from 2006-2012.  They completed questionnaires pertaining to depression, medical symptoms, stress, coping, sense of coherence, and mindfulness pre- and post-MBSR.  They filled out a follow-up questionnaire that asked them to rate the program and its components. A self-care index was created from 5 items.Results: Of the 126 patients, 85.7% were woman, breast cancer was the most common illness (46.8%), and the average age was 52.3 (SD = 13.3). There were significant improvements on the following outcomes: depression, stress, and medical symptoms. With regard to process measures, there were significant increases in: mindfulness, sense of coherence (comprehensibility, manageability, and meaningfulness of life), as well as significant decreases in emotional coping.  Patients rated the program with a mean of 8.94 (1 to 10 scale) for importance. They rank ordered the program components in terms of helpfulness with awareness of breath, the silent retreat day, and yoga practice as the highest of 10 items.  There was a significant positive correlation between self-care index at the end of the course and its perceived importance. Moreover, self-care was positively and significantly correlated with post-MBSR mindfulness and viewing life as meaningful.Conclusions:  Patients who took the MBSR program reported mental and physical health benefits. Furthermore, being mindful enabled them to cope better, take care of themselves, and view life as more coherent such that they became more stress resilient.
Whole Person Care at the Ottawa Integrative Cancer Centre
Authors: Seely Dugald , Weeks Laura , Flower Gillian , Young Sarah , Pitman Anne , Cordell Raina
Published: September 2017

Objectives: An interprofessional team of healthcare practitioners at the Ottawa Integrative Cancer Centre (OICC) provides individualized and whole person care in an effort to bridge the gap between conventional and complementary cancer care. The objective of this presentation is to describe the population receiving care at the OICC in terms of demographic and disease-related characteristics, in addition to their experience receiving care in terms of therapies received and preliminary outcomes.Methods: All people receiving care at the OICC are invited to complete a registration package that documents demographic and disease-related characteristics in addition to baseline quality of life (EORTC-QLQ C30), cancer-related symptom (ESAS) and patient-identified concerns or problems (MYCaW). Every 3 months, a follow up assessment is completed for continuing patients.Results: In the 18 months since opening, more than 600 unique people have received care at the OICC. Most commonly people consult a naturopathic doctor, often in combination with a general practitioner, nutritionist, acupuncturist, physiotherapist, or counselor. The majority of people seek care to manage cancer and treatment-related side effects, including pain, neuropathy, energy, and digestive concerns. Other people are seeking supportive interventions to their prescribed standard care, to control or cure their cancer, or to prevent a recurrence. Approximately one half of people self-identify as under distress for at least one common cancer-related symptom. Preliminary results will be presented regarding quality of life, cancer related symptoms and patient-identified concerns, stratified as possible by age, sex, cancer type, stage and types of treatment received.Conclusions: The results presented here contribute to an understanding of who seeks integrative and whole person care as well as the growing body of literature regarding potential benefits. Results will be used to guide development of a clinical trial designed to assess the feasibility, safety, effectiveness, and cost-effectiveness of integrative, whole person cancer care.
Healing as Recycling Energy from Negative to Positive
Authors: Aung Steven
Published: September 2017

Objectives: For many practitioners and patients, the most critical aspect of medical practice is healing. Healing requires compassion in order to elevate clinical practices above the skills of a medical technician. At the same time, the act of healing is deeply involved. When practitioners heal, they must take care not to experience physical, mental, or spiritual fatigue or injury to themselves. By practicing healing as recycling energy from negative to positive, practitioners develop contemplative compassion. The more practitioners treat patients, the more they understand how to recycle and heal, and the better the practitioner they become.Methods: Healing recycling involves practitioners engaging their own chakra system on the physical, mental, and spiritual levels. Negative energy is drawn from the patient and flows through the practitioner to their solar plexus, where it is converted to positive energy. The practitioner then returns the positive energy to the patient as a vital healing force. In order to avoid injury through this process, practitioners must purify and harmonize themselves through practice and discipline in body, mind, and spirit exercises.Results: Traditional Chinese Medical philosophy will be introduced and used to examine the concepts of energy, healing, discipline, and holistic medicine. The various modalities of healing recycling will be demonstrated, including through the hand, the eye, the nose, and the third eye. By practicing healing recycling, practitioners will avoid becoming “wounded healers”, and improve their overall ability to heal.Conclusions: Practitioners who can contemplate compassion in their medical practice become healers. Without compassion, there is no healing. Without healing, there is no medicine. Therefore, the practice of medicine needs a better understanding of how to recycle energy. At the same time, greater healing will translate into improved quality of life for patients.
Perceived Effects of a Somatic Psychopedagogy (SPP) Program in Nurse Training: An Exploratory Study
Authors: Lachance Josée , Paillé Pierre , Desbiens Jean-François , Xhignesse Marianne
Published: September 2017

Background: Developed in Europe in the 1980’s, somatic psychopedagogy (SPP) is a formative practice geared toward care giving and support. Characterized as a type of mind-body medicine, it examines how the use of the body and its movement allows for the development of one’s conscience, one’s sense of self and of others, which are all desirable qualities for professionals within the health care sector.Purpose: To explore if and how SPP training followed by nurses modifies their perception of the quality of their self awareness, their presence in regard to others, as well as their relationship with respect to health and their professional practice.Methods: Qualitative research based on two types of semi-structured interviews: comprehensive and elicitation. Exploratory interviews with three nurses trained (or in training) in SPP. The content of the interviews was first analyzed thematically then grouped by categories.Findings: The three participants perceived a change in the quality of their presence with respect to themselves and to others as well as changes within the nature of their relationships with their patients, colleagues and healthcare team members. Content analysis of the interviews has allowed us to conclude that relationships with the health care team evolved into a better ability to give recognition and a better quality of interaction between members. Participants also reported an increased ability to express their opinions in both their personal and professional lives. A second level of analysis has allowed for the identification of differences between nurses just finishing their first year of training and those having completed the full four-year course.Conclusion: Interesting transformations are reported at different levels confirming the relevance of a second phase of the project. The latter will permit to identify whether physicians trained in SPP experience changes similar to those of the nurses, and if so, whether they perceive these as having an impact on their practice.
Doctor, You Can Be Less Error Prone Right Now
Authors: Meagher John
Published: September 2017

The Problem:From moment to moment, while tending their patients, physicians can slip from: patience to impatience; genuine enquiry to assumptions; attention to the task-at-hand to inattention; certain doubt to doubtful certainty; and from doing what is inconvenient to doing what is convenient. In summary, one can slip from neo-cortex to archi-cortex (reptilian brain) emphasis. (The hazardous attitudes associated with aviation and medical mishaps are reptilian in character). This is expressed: to err is human, the reptilian part.Objectives: Therefore, to improve decisions, one needs to reclaim the new-brain emphasis, the advocate for the patient’s interests.Method: To be aware which emphasis one commands, ask oneself a few reptilian-revealing questions. Then counter the reptilian attitude by specific and or generic antidotes to be less error prone.Conclusion: Doctors should realize that there is also another patient one is tending: the patient called oneself, whose symptoms are haste, egoism and apathy and whose diagnosis is the reptilian brain. While this lesion is inoperable and the prognosis is guarded, yet amid the uncertainty and demands of our medical tending, one can toggle back to patience and doing the inconvenient to reach after fact and reason.
Mindfulness-Based Medical Practice: Exploring the Link between Self-Compassion and Wellness
Authors: Irving Julie Anne , Dobkin Patricia L , Park-Saltzman Jeeseon , Fitzpatrick Marilyn R. , Hutchinson Tom A
Published: September 2017

Objectives: In light of the detrimental impact of burnout upon clinicians and their patients, the identification of means through which the well-being of health care professionals can be fostered and protected is timely and important.  The present study explored outcomes associated with participation in Mindfulness-Based Medical Practice (MBMP), a program modeled after Mindfulness-Based Stress Reduction which included additional mindful communication exercises to foster the integration of mindfulness in various clinical settings.Methods: Physicians, nurses, psychologists, occupational therapists, and social workers enrolled in the 8-week MBMP program.  Participants (N = 110) between the age of 24 and 82 years (M = 46.5, SD = 11.4: 73% women) completed self-report measures prior to and following the program; the Maslach Burnout Inventory, Perceived Stress Scale-10 and the Ryff Scales of Psychological Well-Being. Two process measures designed to capture mechanisms of change were administered: the Mindful Attention Awareness Scale, and the Neff Self-Compassion Scale.Results: Results from paired-sample t-tests indicated that health care professionals enrolled in MBMP can benefit from the program. Analyses demonstrated significant decreases upon measures of perceived stress [p= .000], emotional exhaustion [p= .000], depersonalization [p= .000], and an increase in personal accomplishment [p= .000] as well as mindfulness [p=.000], self-compassion [p= .000], and well-being [p= .000].  Hierarchical regression analyses indicated that change scores on perceived stress (Beta = -1.46, p LT 0.000) and self-compassion (Beta = 9.02, p LT 0.006) predicted changes in well-being in this sample. Additionally, participants rate perceived importance of having taken part in the course using a Likert-scale from 1-10 (M=8.5, SD = 1.51).Conclusions: This study suggests that for health care professionals enrolled in MBMP may experience a variety of benefits associated with participation in the program. Further, increases in self-compassion may hold particular implications for well-being in this population.
A Role for Cancer Nurses: Responding to Distress in Cancer Patients
Authors: Fitch Margaret , McLeod Deborah , Howell Doris , Green Esther
Published: September 2017

Background: Although all patients experience distress, between 35-45% experience clinically significant levels of distress such as anxiety, depression and adjustment difficulties. Early identification of distress and the provision of relevant interventions is a standard of quality cancer care. Nurses have a critically important role in identifying individuals with distress and providing interventions to manage distress.Objectives: Our objectives are to define the role of cancer nurses in responding to emotional distress experienced by cancer patients and to document the best practices for implementing a program of screening for distress in ambulatory settings.Methods: A programmatic approach to screening for distress (6th vital sign) has been implemented in several cancer facilities across Canada. The program includes protocols for screening, algorithms for assessment, and guidelines for evidenced based interventions. Introduction of the programs have included relevant education of nurses and close attention to uptake and utilization of practice guidelines. Implementation has been mounted within the context of continuous quality improvement and the use of rapid cycle evaluation.Results: Evaluation of successful program implementation has shown increased patient satisfaction with care. Patient concerns provide the focus for opening conversations with individuals and the basis for planning person-centered approaches to care. Patient concerns are identified through the screening maneuver beyond those related to tumor and side effect management. Nurses are in an excellent position to respond to scores on a standardized distress screening tool as part of their patient assessments. The assessments provide a foundation for individualized or tailored interventions.Conclusions: Using a concrete programmatic approach, including screening, focused evidence-based assessment and interventions, offers benefits in achieving person-centered care for cancer patients. In busy clinical settings, an intentional effort is needed to implement a programmatic approach to screening followed by appropriate assessment and intervention.
Achieving Person-centered Care: The Need for Multiple Strategies
Authors: Fitch Margaret , Nicoll Irene , Bennie Fay
Published: September 2017

Background: Evidence from patient satisfaction surveys, needs assessments, and stakeholder forums provide a clear picture that cancer patients are not receiving the full range of supportive care services that could be of benefit to them. The cancer system needs to undergo a shift toward person-centered care. Such a cultural shift requires concerted effort and multiple strategies to be successful.Objective: The purpose of the Cancer Journey Action Group of the Canadian Partnership Against Cancer is to provide leadership to achieve person-centered care in the Canadian cancer care system.Methods: The Cancer Journey Action Group has developed and implemented several initiatives to demonstrate how person-centered care can be achieved. The initiatives include programs in screening for distress (6th vital sign), patient navigation, on-line support groups, survivorship care plans projects, cancer transition education, and palliative care/end-of-life education. Tools to support this work have been designed including evidence-based practice guidelines, algorithms, and on-line education modules. Evaluation has focused on program uptake, educational effectiveness, inter-professional teamwork and patient satisfaction.Results: All initiatives have been evaluated by patients/survivors as helpful. Issues of importance to patients/survivors are the focus of conversations with, and assessments by, health care professionals. Critical success factors across the respective programs for achieving person-centered care include clarity of a shared vision, leadership, persistent and concerted effort, and consistent messaging in communications.Conclusions: Demonstration projects undertaken for each topic area have provided an excellent opportunity to learn about best practices to implement the respective approaches. Guiding principles for implementation and relevant tools/resources have been developed as a result. Although progress toward person-centered care is evident, intentional and concerted efforts are necessary to sustain momentum of these efforts in routine clinical practice.
The International Centre for Communication in Healthcare: Creating Safer and More Compassionate Healthcare Systems around the World
Authors: Slade Diana , Matthiessen Christian M.I.M. , Rider Elizabeth A. , Pun Kwok Hung Jack
Published: September 2017

Background: The role of communication in healthcare receives increasing attention, yet little research exists that brings together perspectives from interprofessional healthcare researchers and practitioners with linguists and communication specialists. The International Centre for Communication in Healthcare[1] is a response to increasing recognition of the central role of communication and relationships in the delivery of safe, effective and compassionate healthcare.Objective: To develop a worldwide, multidisciplinary collaborative of internationally recognized healthcare professionals and communication experts working together to translate research into education and practice to improve patient safety, communication and relationships in healthcare.Methods: The International Collaborative for Communication in Healthcare (a precursor to the Centre) began in 2010, and was founded at Hong Kong Polytechnic University (PolyU) in March 2011. We initiated research collaborations and presented colloquia, workshops and papers at international conferences.Results: The Centre, co-convened by PolyU and University of Technology, Sydney, was formally launched at PolyU in June 2013 with over 50 members from over 10 countries. The Centre is developing a strategic research agenda for communication in healthcare to improve the quality and safety of patient care, and to mobilize knowledge and expertise gained from research to guide teaching and implementation of communication skills and compassionate care in healthcare education and practice.  In an early initiative in 2011, we created the International Charter for Human Values in Healthcare[2], a collaborative effort involving people, organizations and institutions around the world working together to restore core human values to healthcare. The values of the International Charter inform the Centre’s research, education and practice initiatives.Conclusions: Effective communication is increasingly recognized as integral to safe, effective, and compassionate healthcare. The International Centre for Communication in Healthcare brings together interdisciplinary researchers, educators and practitioners from diverse disciplines to explore and improve communication and relationships in healthcare settings around the world.References1. The International Centre for Communication in Healthcare.  Hong Kong Polytechnic University and University of Technology, Sydney. http://icchweb.org2. The International Charter for Human Values in Healthcare. December 2, 2012. http://charterforhealthcarevalues.org
Understanding Patient Perspectives of Self-Care in the Management of Chronic Disease
Authors: Burgess Jean , Clark Roberta , De'Bell Kieth
Published: September 2017

This workshop will provide participants with an understanding of how appreciative inquiry based methods can help us learn from patient experience, develop self-care plans and identify the roles of various support groups within those plans, and develop a framework for chronic disease management which is based on lessons learnt from patient experience.Understanding patient experience with and perspectives on what supports on-going self care to manage chronic disease is critical to a whole person approach to chronic disease care. While the individual’s experience of chronic disease self-management may vary from individual to individual, our recent work demonstrates that appreciative enquiry is an effective tool for understanding the key support structures for effective management of self-care. This work also points to appreciative inquiry as an effective tool for patients and care-givers in developing approaches to individual self-care plans.After a brief presentation of our recent findings, workshop participants will have an opportunity to use a modified appreciative inquiry approach to consider aspects of chronic disease care and particularly to discuss those factors that support chronic disease management. Appreciative Inquiry, as a positive form of narrative inquiry will elicit stories that make these supportive factors more concretely visible and comprehensible. Workshop participants will also be provided with a brief overview of thematic analysis as a way of identifying common themes in the appreciative inquiry data and developing a model of self-care support.
Faut-il parler de l'âme? Réflexions à propos de 2 patients.
Authors: Kopferschmitt-Kubler M-Christine , Fraisse Philippe , Kocher Annick , Muller Alexa , Graffi Jonathan , Ledogar Denis , Quoix Elisabeth
Published: September 2017

Deux patients souffrant d’un cancer broncho-pulmonaire métastatique ont évoqué l’âme.Patient 1 : il ne signale aucune inquiétude face à la mort « je suis au clair avec ma spiritualité ». Il croit en une vie après la mort, avec lumière et amour, dans la paix de Dieu. De retour à domicile, il écrit par mail avant son décès : « je crois avoir trouvé une approche pour parler de la spiritualité. Référez-vous aux temps anciens et aux médecines orientales ou africaines, quand les médecins étaient aussi des médecins de l’âme »Patient 2 : une forte angoisse a cessé brutalement « Docteur, j’ai découvert que j’avais une âme et qu’elle est belle ». Cette découverte est liée à la discussion avec un chaman, accompagnant sa famille. Ce patient a évoqué un grandissement de son âme, et son immortalité.Des étudiants hospitaliers (EH, 26/31) ont participé à une étude par questionnaire sur la perception face à la fin de vie. Pour 21 EH (81%) l’âme existe. Leurs définitions parlent de souffle, présence, croyance, entité abstraite, invisible, ce qui donne la vie, ce qui reste après la mort, Divine ou moléculaire. Parmi eux, 10 pensent que l’âme est immortelle, 2 non, 7 doutent et 2 ne savent pas. La croyance la plus fréquente est l’existence de l’âme (81%), suivie de l’existence de Dieu/Puissance supérieure (62%), puis d’une forme de vie après la mort (54%).Conclusion : Un patient évoque l’âme et son immortalité. L’autre souhaite un médecin de l’âme. Même si notre civilisation ne parle plus de l’âme, l’existence de l’âme est une croyance forte chez les étudiants hospitaliers. Face à une souffrance spirituelle, faut-il aborder la question de l’âme et en parler? En médecine globale, faut-il redonner, à côté du corps, une place à l’âme ?
Transforming Challenging Patients into Interesting People - Creative Writing as Burnout Prevention for Health Professionals
Authors: Koppe Hilton
Published: September 2017

And now for something completely different….. As health practitioners, we are involved in writing “stories” every day. The patient record is our interpretation of our patients’ stories (History) and a summary of our response to this (Examination and Management Plan).This record does not allow for much creativity on the part of the writer, and is very limited in its ability to assist the health practitioner in making sense of what has gone on for them at a personal level. To assist in remedying this problem, this workshop will use creative writing as a tool to assist in burnout prevention.The workshop will allow participants an opportunity to experience the use of stories and creative writing as a means of helping them to better manage some of the more challenging aspects of their working life, and to better make sense of what it means to be a health practitioner.Practical writing exercises across a range of styles will assist participants in reflecting on the effect their clinical practice has on their lives with the goal of increasing their enjoyment of work, and of life in general. These simple writing exercises will magically transform challenging patients into interesting people. No previous writing experience is required. Most of all, it will be an opportunity for some light hearted fun with colleagues.Learning Objectives: By the end of the workshop, participants will have had the opportunity to1. Learn knew skills in creative writing2. Reflect on what it means to be a health practitioner through the use of structured writing exercises3. Develop skills in using reflective writing as a way of personal debriefing about experiences at work4. Reignite previously lost passions for creativity5. Marvel at the brilliance of their colleagues6. Share some of their creative brilliance with colleagues, if they choose to.
Doing 'Technological' Time in a Pediatric Hemodialysis Unit
Authors: Zitzelsberger Hilde , McKeever Patricia , Chambon Adrienne , Morgan Kathryn , Spalding Karen
Published: September 2017

Study objectives: For Canadian children living with end-stage renal disease, hemodialysis is a common intervention and usually received in a specialized ambulatory hospital-based unit. Although children spend up to 12 hours a week receiving hemodialysis, little is known about how they perceive and respond to hospital-based hemodialysis. The study’s purpose is to describe and interpret the children’s embodied situatedness in the temporal, spatial and technological regimes and relations of a pediatric hospital-based hemodialysis unit.Methods: An ethnography was undertaken at a Canadian urban pediatric hospital. Time, space, and technology are viewed as significant interrelated aspects of the hemodialysis unit and the unit is conceived as nested in the broader contexts of the children’s everyday lives. The theoretical framework merges concepts of human embodiment and contemporary human geographical perspectives and philosophy of technology.Results: The dominant theme emerging from the study findings is the notion of the children doing ‘technological’ time. The pervasiveness and reach of hemodialysis technologies upon the children profoundly textures their situations, shapes their perspectives, evaluations and expectations and impacts how they are seen by caregivers in the unit.Conclusions: Crucial changes in practices are essential to envision ways to create with children an overall positive place that merges and balances technological care with child focused care. The inclusion of children’s views is critical because many settings typically occupied by children have been designed and designated by authoritative or professional adults as “places for children” (Rasmussen, 2004, p. 155) without children being involved. Exploration of the findings may contribute to the ways that healthcare providers, funders, administrators and policy-makers can facilitate the inclusion of children in the design and care provision of hemodialysis units as well as other high-tech hospital-based units.ReferencesRasmussen, K. (2004). Places for children – children’s places. Childhood, 11(2), 155-173.
Narrative and Palliative Care Team Identity Formation
Authors: Hess Denise
Published: September 2017

Palliative care is whole person care that attends to the physical, psychosocial, and spiritual needs of persons with a serious or life-limiting illness. This care is provided by a team of clinicians from several disciplines including physicians, nurses, social workers, and chaplains. The palliative care team functions as a dynamic system whose ability to provide quality care is dependent upon the ability of the team members to form and maintain an ongoing collaborative alliance. This alliance requires that team members maintain dual commitments to both the care receivers and to their fellow team members. Just as persons with illness express the human propensity toward meaning making in the face of suffering, so palliative care teams thrive when they are supported in reflective processes that enhance their ability to find meaning in their work. Creation of and attention to team narratives and their role in team identity formation can enhance team members’ flourishing by placing team identity in the context of a larger story. Narratives of rescuing and fixing foster a sense of control and expertise while narratives of containing and healing nurture attention to mindful presence and human-to-human encounter.
Finding My Voice in Residency: Reflections on Integrative Family Medicine
Authors: Minichiello Vincent Joseph
Published: September 2017

The author discusses how self awareness and healing play a key role within the evolving field of integrative family medicine.
Mindful medical practice and the therapeutic alliance
Authors: Dobkin Patricia Lynn , Lucena Ricardo J. M.
Published: September 2017

This review article focuses on how the therapeutic relationship is central to clinician-client/patient relationships in psychiatry as well as other medical and psychotherapeutic encounters.  Crucial to this relationship is the alliance formed between the caregiver and the person who seeks their care.  The threats to the therapeutic alliance in psychiatry are discussed as is the importance of facing them. How mindfulness enables clinicians to build such bonds and foster well-being in themselves and in those they treat is examined in the context of quantitative and qualitative studies.
Carrying the healer’s baton
Authors: Briedis Jonas
Published: September 2017

The story of a relatively brief interaction I had with a ward patient that taught me how little effort it can sometimes take to completely change a patient's experience of their hospital admission.
Pilgrims together: leveraging community partnerships to enhance workplace resilience
Authors: Frolic Andrea Nadine
Published: September 2017

Many of today’s healthcare personnel find themselves in a double-bind. The question is: How to remain connected, caring and compassionate with patients, while mitigating the impact of chronic workplace stress? Mindfulness is emerging as a means for addressing this dilemma as it has the potential to both reduce workplace stress and boost employee resilience, while enhancing the patient experience. This article describes the development of a unique collaboration between local hospitals, primary care teams and a university, aimed at bringing mindfulness to life in healthcare. This is a conventional story of program development and evaluation, as well as an unconventional story of personal discovery, community-building, and organizational transformation. Each section of the paper highlights a critical success factor that we have uncovered in our journey, and poses a series of questions for contemplation.  This paper aims to fill a gap in the literature by describing the key ingredients for developing and sustaining a community-wide collaboration aimed at integrating mindfulness into the healthcare system.
Reflections on Technology and Its Impact on Cardiac Patient Care
Authors: Dobkin Dennis L.
Published: September 2017

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The Medium Is the Message: And the Problem?
Authors: Hutchinson Tom
Published: September 2017

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