Relational empathy and holistic care in persons with spinal cord injuries.

Science.gov (United States)

LaVela, Sherri L; Heinemann, Allen W; Etingen, Bella; Miskovic, Ana; Locatelli, Sara M; Chen, David

2017-01-01

Describe perceptions of persons with SCI on their receipt of holistic care and relational empathy during health care encounters. Mailed survey. Individuals with SCI who received care from the largest suppliers of SCI care and rehabilitation (Veterans Health Administration and SCI Model Systems). Using a survey and administrative databases, we collected demographic and injury characteristics, health status, health conditions, and the main outcome: Consultation and Relational Empathy (CARE) measure. The sample included 450 individuals with SCI (124 Veterans and 326 civilians). Response rate was 39% (450/1160). Analyses were conducted on patients with complete data (n = 389). Veterans and civilians with SCI differed across many demographic characteristics, age at injury, and etiology, but mean CARE scores were equivalent. Fewer than half of the full SCI cohort had CARE scores above the normative value of 43. Having a recent pressure ulcer showed a trend for lower odds of having a normative or higher CARE score. Odds of having an above-normative CARE score were nearly 2 times greater for individuals with tetraplegia, and odds were higher for those with higher physical and mental health status. Higher physical and mental health status and tetraplegia were each independently associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Limited empathy, communication, and holistic care may arise when providers focus on disease/disease management, rather than on patients as individuals. Frequent health care use and secondary conditions may affect empathy and holistic care in encounters, making it essential to understand and employ efforts to improve the therapeutic relationship between patients with SCI and their providers.

How core nursing textbooks inform holistic spiritual care.

Science.gov (United States)

2016-08-01

National and international health and nursing guidelines recommend that staff attend to patients' spiritual and religious needs, which suggests that spiritual care is an important aspect of holistic care. However, many nurses lack knowledge of the subject, and it is unclear whether core textbooks provide the information they need.

"I'm not trying to be cured, so there's not much he can do for me": hospice patients' constructions of hospice's holistic care approach in a biomedical culture.

Science.gov (United States)

Pederson, Sarah Nebel; Emmers-Sommer, Tara M

2012-01-01

The hospice philosophy was founded on a mission to provide comprehensive and holistic services to individuals at the end of life. Hospice interdisciplinary teams work together to offer therapies such as spiritual services, comfort care, and massage therapy to meet patients' physical, psychological, emotional, and spiritual needs. Although the hospice philosophy is guided toward patient-centered care, limited research has examined how patients understand holistic care services. Through a social constructionist lens and qualitative interviews, we examined hospice patients' understandings of holistic care and argue that these perceptions of care are constructed through the biomedical model of medicine.

Holistic Health Care: A Challenge to Podiatric Medical Practice.

Science.gov (United States)

Levy, Leonard A.; Levine, Peter M.

1980-01-01

As the profession of podiatric medicine becomes more closely identified with the delivery of primary care, it is suggested that it is essential for practicing podiatrists and students to have more educational opportunities in the field of holistic health care, psychiatry, and the behavioral sciences. (Author/MLW)

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

Science.gov (United States)

Henderson, Saras

2002-12-01

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

Forensic nursing interventions with patients with personality disorder: a holistic approach.

Science.gov (United States)

Byrt, Richard

2013-01-01

Research findings suggest that nursing assessment and care and psychotherapy of forensic patients with personality disorder should be based on a holistic approach that addresses a wide range of their needs. Such an approach should be in collaboration with patients, informal carers, and other professionals and informed by appropriate education, training, clinical supervision, and support. Holistic care includes areas (such as physical health, cultural, spiritual, and psychosexual needs) that are addressed to a limited extent in the literature on patients with personality disorder. Despite limitations in research evidence, findings suggest that some patients with personality disorder benefit from psychotherapies, sometimes facilitated by nurse-therapists, and therapeutic community principles. These interventions should take account of patients' cultural and spiritual needs and perspectives. Helping patients to manage anger has potentially positive consequences for their physical health, personal and work relationships, and other areas. Research is needed to consider how to deliver holistic care with limited resources and in organizations, such as prisons, with conflicting goals.

Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

Science.gov (United States)

Foote, Frederick O; Benson, Herbert; Berger, Ann; Berman, Brian; DeLeo, James; Deuster, Patricia A.; Lary, David J; Silverman, Marni N.; Sternberg, Esther M

2018-01-01

In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the “Epidaurus 2” Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and “Star Glyphs.” This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine. PMID:29497586

Development of a culture of sustainability in health care organizations.

Science.gov (United States)

Ramirez, Bernardo; West, Daniel J; Costell, Michael M

2013-01-01

This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

Pengetahuan Dan Keterampilan Perawat Dalam Pelayanan Keperawatan Holistik Di Indonesian Holistic Tourist Hospital

OpenAIRE

Azizatunnisa, Nurul; Suhartini, Suhartini

2012-01-01

Health care nowadays provides holistic concept, which is focus on client's healing as the overall objectives including bio-psycho-socio-cultural-spiritual. This concept should be understood and applied by health practitioner, including nurses. Therefore, study about holistic nursing should be done, especially in Indonesian Holistic Tourist Hospital (IHTH) Purwakarta West Java as the first of health provider in Indonesia that used holistic approach. The objective of this research is to descri...

The influence of culture: holistic versus analytic perception.

Science.gov (United States)

Nisbett, Richard E; Miyamoto, Yuri

2005-10-01

There is recent evidence that perceptual processes are influenced by culture. Westerners tend to engage in context-independent and analytic perceptual processes by focusing on a salient object independently of its context, whereas Asians tend to engage in context-dependent and holistic perceptual processes by attending to the relationship between the object and the context in which the object is located. Recent research has explored mechanisms underlying such cultural differences, which indicate that participating in different social practices leads to both chronic as well as temporary shifts in perception. These findings establish a dynamic relationship between the cultural context and perceptual processes. We suggest that perception can no longer be regarded as consisting of processes that are universal across all people at all times.

Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

Science.gov (United States)

Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

2018-02-01

Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

Holistic treatment of the patient in palliative care – The nurses view

Directory of Open Access Journals (Sweden)

Filej Bojana

2016-12-01

Full Text Available Introduction. Man is a unique, unrepeatable whole in space and time and that is why he requires a holistic treatment, taking into account physical, psychological, social and spiritual factors. The balanced factors can ensure human well-being and his quality of life. Integrated treatment is especially important for patients in palliative care, which was the basic starting point of our research. In our research we wanted to establish whether the patients in palliative care are treated holistically from the perspective of the nurses and where are the specific aspects of palliative care (psychological, physical, social and spiritual more visible - in the hospitals or in the home environment.

Culture and Probability Judgment Accuracy: The Influence of Holistic Reasoning.

Science.gov (United States)

Lechuga, Julia; Wiebe, John S

2011-08-01

A well-established phenomenon in the judgment and decision-making tradition is the overconfidence one places in the amount of knowledge that one possesses. Overconfidence or probability judgment accuracy varies not only individually but also across cultures. However, research efforts to explain cross-cultural variations in the overconfidence phenomenon have seldom been made. In Study 1, the authors compared the probability judgment accuracy of U.S. Americans (N = 108) and Mexican participants (N = 100). In Study 2, they experimentally primed culture by randomly assigning English/Spanish bilingual Mexican Americans (N = 195) to response language. Results of both studies replicated the cross-cultural variation of probability judgment accuracy previously observed in other cultural groups. U.S. Americans displayed less overconfidence when compared to Mexicans. These results were then replicated in bilingual participants, when culture was experimentally manipulated with language priming. Holistic reasoning did not account for the cross-cultural variation of overconfidence. Suggestions for future studies are discussed.

Clinical Holistic Medicine: Holistic Treatment of Mental Disorders

OpenAIRE

Ventegodt, Søren; Andersen, Niels Jørgen; Neikrug, Shimshon; Kandel, Isack; Merrick, Joav

2005-01-01

We believe that holistic medicine can be used for patient's with mental health disorders. With holistic psychiatry, it is possible to help the mentally ill patient to heal existentially. As in holistic medicine, the methods are love or intense care, winning the trust of the patient, getting permission to give support and holding, and daring to be fully at the patient's service. Our clinical experiences have led us to believe that mental health patient's can heal if only you can make him or he...

"Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

Science.gov (United States)

Geist-Martin, Patricia; Bell, Keely K

2009-10-01

Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

Culture and spirituality: essential components of palliative care.

Science.gov (United States)

Speck, Peter

2016-06-01

Palliative care advocates a holistic, multiprofessional approach to the care of people with life-threatening disease. In addition to the control of physical symptoms attention should also be paid to psychosocial, cultural and spiritual aspects of the patient's experience of illness. Guidance documents and research evidence reflect the complexity of the patient's journey and the need to regularly assess these areas of need over time. Cultural background can shape how patients respond to life-threatening illness, as can the beliefs held by the patients, whether religious or more broadly spiritual. Research evidence shows the importance of identifying and addressing cultural and spiritual aspects of care held by patients, families and staff. These are often neglected in clinical practice due to the focus on biomedical concerns and staff discomfort in engaging with beliefs and culture. Recent studies have highlighted gaps in the research, and some methodological difficulties and indicate many patients welcome healthcare staff enquiring about the importance of their beliefs and culture. Identifying research priorities is necessary to guide future research and strengthen the evidence base. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Culture care theory: a major contribution to advance transcultural nursing knowledge and practices.

Science.gov (United States)

Leininger, Madeleine

2002-07-01

This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

Existential and spiritual needs in mental health care: an ethical and holistic perspective.

Science.gov (United States)

Koslander, Tiburtius; da Silva, António Barbosa; Roxberg, Asa

2009-03-01

This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals' mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients' needs are holistically addressed in Western health care systems that neglect patients' existential and spiritual needs, because of their biomedical view of Man which recognizes only patients' physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients' improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.

Alternative therapies for the holistic care of the HIV / AIDS patient ...

African Journals Online (AJOL)

Alternative therapies that can be used for the holistic nursing care of HIV / AIDS infection include psychological, mental and emotional therapies, therapeutic touch, nutrition, vitamins, minerals and nutritional supplements, herbal medicine, Chinese medicine and homeopathy, traditional medicine, lifestyle changes and ...

Holistic Nursing Simulation: A Concept Analysis.

Science.gov (United States)

Cohen, Bonni S; Boni, Rebecca

2018-03-01

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

Effects of holistic nursing course: a paradigm shift for holistic health practices.

Science.gov (United States)

Downey, Marty

2007-06-01

A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

University Students' Perceptions of a Holistic Care Course through Cooperative Learning: Implications for Instructors and Researchers

Science.gov (United States)

Pan, Peter Jen Der; Pan, Gloria Huey-Ming; Lee, Ching-Yieh; Chang, Shona Shih Hua

2010-01-01

The benefits of cooperative learning have been advocated in a wide range of educational contexts in higher education. There is, however, rare information on the contributions of holistic education courses on college students. Using grounded theory methods, this preliminary study was to explore participants' perceptions of a holistic care course…

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

OpenAIRE

Morris, G. Scott

2015-01-01

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia.

Science.gov (United States)

Ho, Rainbow T H; Wan, Adrian H Y; Chan, Caitlin K P

2016-01-01

Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

Science.gov (United States)

Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

Effect of holistic cares with family participation on attitude and preoperative anxiety of patients

Directory of Open Access Journals (Sweden)

Madarshahian F

2015-02-01

Full Text Available Background and Objective: Responding to holistic needs of patients can reduce anxiety. The purpose of this study was to determine the effect of holistic cares with family participation on attitude and preoperative anxiety of patients. Materials and Method: This quasi-experimental study was conducted on all patients undergoing prostate surgery during 2012 at Emam Reza Hospital, Birjand, Iran. Therefore, 68 patients were assigned randomly to two groups of 34. In the intervention group, prior to each preoperative care needs of patients, such as covering the body, were determined through 5 questions and cares were provided accordingly with family participation. The control group received routine cares. Intervention outcomes were the scores of attitude and anxiety of patients. The attitude toward preoperative cares was measured using a 10-item researcher-made questionnaire at admission and before hospital discharge. Anxiety and preoperative information were measured using the Amsterdam Preoperative Anxiety and Information Scale at the beginning of hospitalization and before surgery. Data were analyzed using SPSS software version 16 and chi-square, and independent and paired t-tests. Results: Total score of mean attitude toward preoperative cares of the intervention group (42.44 ± 8.07 was higher than the control group (36.82 ± 9.32 (P = 0.01. Furthermore, the total mean preoperative anxiety score of the intervention group (14.08 ± 2.72 was lower than the control group (16.02 ± 1.56 (P < 0.001 and had reduced compared with pre-intervention (15.32 ± 2.60 (P < 0.001. Conclusion: Providing preoperative holistic cares with family participation was effective in creating positive attitude and reducing anxiety in anxious patients. Thus, its use is recommended in providing all medical and nursing cares.

Negative Affect during a Collective (but Not an Individual Task Is Associated with Holistic Attention in East Asian Cultural Context

Directory of Open Access Journals (Sweden)

Hitoshi Tominaga

2017-08-01

Full Text Available Previous studies have suggested that individuals from East Asian cultures are more likely to show holistic attention—a pattern of attention that incorporates contextual information into focal stimuli—than individuals from North American cultures. Holistic attention is also prevalent in communities that require close cooperation. However, it is not yet known how cooperation is related to holistic attention. We theorized that holistic attention increases when people experience negative affect (e.g., worry, sadness, and frustration during collective tasks (but not during individual tasks because negative affect in social contexts signals the existence of potential threats to social harmony, thus indicating a need to restore social harmony. To examine this hypothesis, an experiment was conducted in which participants performed a musical duet either with another participant (a collective task requiring cooperation, or individually with a computer (an individual task. After the musical task, the Framed Line Task (FLT was administered to examine their holistic attention. Participants also reported their emotional states both before and after the music task. Results suggested that negative affect in the collective task—but not the individual task—was positively correlated with a holistic pattern of attention. The function of negative affect in social contexts as motivation to restore relationships and how this enhances holistic attention is discussed. The moderating effect of social context on the link between negative affect and cognition is also discussed.

Working the way up in neurological rehabilitation: the holistic approach of nursing care.

Science.gov (United States)

Portillo, Mari Carmen; Cowley, Sarah

2011-06-01

To provide understanding of the nurses' role in neurological holistic rehabilitation and identify strategies for the enhancement of rehabilitation services. Although acute and chronic neurological patients and relatives experience emotional and social changes, most rehabilitation programmes do not deal with non-physical needs or involve nurses, leading to a poor definition and specialisation of the nursing role. Action research. The project took place in two neurological wards of a highly specialised hospital in Spain and lasted 30 months. An individualised nurse-led social rehabilitation programme was planned, implemented and evaluated. The nursing role and care in rehabilitation were explored with 37 nurses and 40 neurological patients and 40 relatives (convenience sampling). Semi-structured interviews and participant observations were developed. Content (QSR NUDIST Vivo v.2.0) and statistical (SPSS v. 13.0) analyses were run. The lack of time, knowledge and experience, the poor definition of the nursing role and ineffective communication with users limited holistic care in the wards. Some enhancing nursing strategies were proposed and explored: promotion of acceptance/adaptation of the disease through education, reinforcement of the discharge planning and planning of emotional and social choices based on the assessment of individual needs and resources at home. Nursing professionals are in a privileged position to deal with neurological patients' and carers' holistic needs. Several attributes of the advanced nursing role in rehabilitation teams have been proposed to deal with non-physical aspects of care. • Rehabilitation needs of neurological patients and carers at hospital have been described. • Nurses' perceptions of their work and role in rehabilitation have been presented. • Clinical strategies to develop the advanced nursing role in holistic neurological rehabilitation have been highlighted. © 2010 Blackwell Publishing Ltd.

Holistic Nursing in the Genetic/Genomic Era.

Science.gov (United States)

Sharoff, Leighsa

2016-06-01

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base. © The Author(s) 2015.

The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care: a qualitative study

Science.gov (United States)

Strandberg, Eva Lena; Ovhed, Ingvar; Borgquist, Lars; Wilhelmsson, Susan

2007-01-01

Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs) and district nurses (DNs). Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both GPs and DNs. The word

Holistic self-care for rehabilitation experienced by thai buddhist trauma patients in areas of political and social unrest.

Science.gov (United States)

Songwathana, Praneed; Watanasiriwanich, Wachiraya; Kitrungrote, Luppana

2013-01-01

This study describes the meaning and practice of holistic self-care for rehabilitation among Thai Buddhist trauma patients living in areas of political unrest where acts of terrorism occur. Eleven Thai Buddhist trauma patients were selected as specified. The data were collected by in-depth interviews between November 2011 and April 2012, and analyzed using the Van Manen method.Those interviewed described "holistic self-care for rehabilitation" as learning (1) to acquire a new life and (2) to bear the increased demands of care as a chronic disease. Health care responses fell into 3 categories: (1) improving physical self-sufficiency and rehabilitation by increasing muscle strength, pain management, and pressure sores; (2) improving psychological well-being by applying positive thinking, making an effort to live independently, and following a set of religious practices; and (3) finding harmony in life through caution and a willingness to adjust one's lifestyle. Although the participants seemed to adapt well to their new lifestyles, extensive support from health care professionals was necessary. This study promotes better understanding of the holistic health care experiences the survivors of trauma have as a result of an unstable political situation that includes aspects of social unrest and terrorism.

SELF CARE MANAGEMENT-HOLISTIC PSYCHOSPIRITUAL CARE ON INDEPENDENCE, GLUCOSE LEVEL, AND HBA1C OF TYPE 2 DIABETES MELLITUS PATIENT

Directory of Open Access Journals (Sweden)

Kusnanto Kusnanto

2017-04-01

Full Text Available Introduction: Diabetes mellitus is a kind of incurable chronic disease that actually manageable. The global prevalence tends to increase due to less self management of the disease and the impact of it was health condition declines physically, psychologically, socially, and spiritually. There were so many interventions implemented but failed to give positive improvement in patient's holistic condition which is lead to complications. The purpose of this research was to improve patient independency in managing the disease and to explain changes in blood glucose and HbA1C levels through self care management-holistic psychospiritual care model. Method: Patient newly diagnose with type 2 diabetes mellitus at Public Health Centre Kebonsari was selected with purposive sampling and divided into two groups. Each group contains 25 patients. Intervention group was given self care management model development with self diabetes management module. The intervention was given  five times in three months. Before and after intervention patient was observed for blood glucose level of 2 hours before and after meal, and also HbA1C level. Questionnaire was given to patient. The data then analyzed using wilcoxon, mann whitney, and student-t test. Result: The result of this research showed patient with type 2 diabetes have independency improvement and lower blood glucose level of 2 hours before and after meal and also decreased HbA1C after intervention. Discussion: Self Care Management-Holistic Psychospiritual Care Model improves patient independency in managing their disease, lowering blood glucose and HbA1C levels.

Holistic Medicine: Advances and Shortcomings

OpenAIRE

Shapiro, Edward

1982-01-01

Holistic medicine is an attitudinal approach to health care rather than a particular set of techniques. It addresses the psychological, familial, societal, ethical and spiritual as well as biological dimensions of health and illness. The holistic approach emphasizes the uniqueness of each patient, the mutuality of the doctor-patient relationship, each person's responsibility for his or her own health care and society's responsibility for the promotion of health.

The holistic worldview in action: evolution of holistic nurses certification programs.

Science.gov (United States)

Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Sandor, M Kay; Brekke, Mary E

2013-12-01

The American Holistic Nurses Credentialing Corporation (AHNCC), the only national credentialing body for holistic nurses, has a responsibility to offer valid, reliable, and rigorous certification examinations and to grow and evolve as indicated by social and professional changes. This article describes four major changes in the work of AHNCC since 2004: a detection of an evolution in the domain of holistic nursing through review of the literature; clarification and specification of levels of practice by educational level; development of the nurse coach role in nursing, designed within the precepts of holistic nursing; and AHNCC's response to the social paradigm shift for health care, and nursing's advanced practice registered nurse consensus model. Each of these is discussed in detail describing the circumstances that perpetuated AHNCC's consideration and the actions taken by AHNCC.

Holistic care patient with Early Childhood Caries (ECC: A case report

Directory of Open Access Journals (Sweden)

Intan Maulani

2016-06-01

Full Text Available Early Childhood Caries (ECC is a specific form of severe dental caries that affects infants and young children. ECC progresses rapidly in those who are at high risk, and often goes untreated. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both primary and permanent dentitions. This case showed management holistic care for children with ECC.A five year old boy patient accompanied with her parents were reported to the Pedodontic Clinic Padjadjaran University Dental Hospital with a chief complaint of decayed upper anterior teeth and pain in the molar teeth. Clinical examinations found dental caries almost all teeth in the maxilla and mandible. Based on panoramic radiograph, treatments that can be done are strip crown glass ionomer restorations, pulp treatments, extractions and fixed space maintainer. Patients diagnosed with severe ECC, patient and parents described on this type of caries. During treatment the patient was given oral hygiene instruction and recommend daily use of tooth mouse. After all treatment were completed, fluoride topical, and fissure sealants, recall check up after three months was scheduled. Holistic care needed in handling children with ECC.

CAKES (Cultural Awareness and Knowledge Exchange Scheme): A Holistic and Inclusive Approach to Supporting International Students

Science.gov (United States)

McKay, Jane; O'Neill, Deborah; Petrakieva, Lina

2018-01-01

Transition support for international students has traditionally adopted deficit models which attempt to "fix" assumed academic literacy problems. This study explores a more culturally inclusive initiative which supported international students at a UK university in a holistic and developmental way. The initiative was delivered across an…

Integrative holistic medicine in Minnesota.

Science.gov (United States)

Torkelson, Carolyn J; Manahan, Bill

2009-05-01

Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.

Does Language Matter? Exploring Chinese-Korean Differences in Holistic Perception.

Science.gov (United States)

Rhode, Ann K; Voyer, Benjamin G; Gleibs, Ilka H

2016-01-01

Cross-cultural research suggests that East Asians display a holistic attentional bias by paying attention to the entire field and to relationships between objects, whereas Westerners pay attention primarily to salient objects, displaying an analytic attentional bias. The assumption of a universal pan-Asian holistic attentional bias has recently been challenged in experimental research involving Japanese and Chinese participants, which suggests that linguistic factors may contribute to the formation of East Asians' holistic attentional patterns. The present experimental research explores differences in attention and information processing styles between Korean and Chinese speakers, who have been assumed to display the same attentional bias due to cultural commonalities. We hypothesize that the specific structure of the Korean language predisposes speakers to pay more attention to ground information than to figure information, thus leading to a stronger holistic attentional bias compared to Chinese speakers. Findings of the present research comparing different groups of English, Chinese, and Korean speakers provide further evidence for differences in East Asians' holistic attentional bias, which may be due to the influence of language. Furthermore, we also extend prior theorizing by discussing the potential impact of other cultural factors. In line with critical voices calling for more research investigating differences between cultures that are assumed to be culturally similar, we highlight important avenues for future studies exploring the language-culture relationship.

Does language matter? Exploring Chinese-Korean differences in holistic perception

Directory of Open Access Journals (Sweden)

Ann Kristin Rhode

2016-10-01

Full Text Available Cross-cultural research suggests that East Asians display a holistic attentional bias by paying attention to the entire field and to relationships between objects, whereas Westerners pay attention primarily to salient objects, displaying an analytic attentional bias. The assumption of a universal pan-Asian holistic attentional bias has however recently been challenged in experimental research involving Japanese and Chinese participants, which suggests that linguistic factors may contribute to the formation of East Asians’ holistic attentional patterns. The present experimental research explores differences in attention and information processing styles between Korean and Chinese speakers, who have been assumed to display the same attentional bias due to cultural commonalities. We hypothesize that the specific structure of the Korean language predisposes speakers to pay more attention to ground information than to figure information, thus leading to a stronger holistic attentional bias compared to Chinese speakers. Findings of the present research comparing different groups of English, Chinese, and Korean speakers provide further evidence for differences in East Asians’ holistic attentional bias, which may be due to the influence of language. Furthermore, we also extend prior theorizing by discussing the potential impact of other cultural factors. In line with critical voices calling for more research investigating differences between cultures that are assumed to be culturally similar, we highlight important avenues for future studies exploring the language-culture relationship.

Palliative Nursing and Sacred Medicine: A Holistic Stance on Entheogens, Healing, and Spiritual Care.

Science.gov (United States)

Rosa, William E; Hope, Stephanie; Matzo, Marianne

2018-04-01

The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided. Clinical trials show impressive preliminary findings regarding the healing potential of these medicinal agents. While other professions, such as psychology, pharmacy, and medicine, are disseminating data related to patient outcomes secondary to entheogen administration, the nursing literature has not been involved in raising awareness of such advancements. Research is illustrating their effectiveness in achieving integrative experiences for patients confronting advanced serious illness and their ability to promote presence, introspection, decreased fear, and increased joy and acceptance. Evidence-based knowledge surrounding this potentially sensitive topic is necessary to invite understanding, promote scientific knowledge development, and create healing environments for patients, nurses, and researchers alike.

Improving allergy management in the primary care network--a holistic approach.

Science.gov (United States)

Jutel, M; Angier, L; Palkonen, S; Ryan, D; Sheikh, A; Smith, H; Valovirta, E; Yusuf, O; van Wijk, R G; Agache, I

2013-11-01

The incidence, prevalence and costs of allergy have increased substantially in recent decades in many parts of Europe. The dominant model of allergy care within Europe is at the moment specialist-based. This model will become unsustainable and undeliverable with increasing disease prevalence. One solution to increase provision of allergy services is to diversify the providers. A new model for the provision of allergy care in the community with the general practitioner at the forefront is proposed. Pre- and postgraduate allergy education and training, implementation of pathways of care, allergy specialization and political will to generate resources and support are essential to achieve this new model. In parallel the holistic view of allergic diseases should be maintained, including assessment of severity and risk, psychological factors and health-care related costs in the context of the patient-centered decision making process. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

USING BACH FLOWER IN HOLISTIC PSYCHOTHERAPY

Directory of Open Access Journals (Sweden)

Vagner Ferreira do Nascimento

2017-05-01

Full Text Available This is a narrative review from scientific literature that aimed to describe concepts and approaches for indications of the therapeutic use of Bach flower remedies in holistic psychotherapy. The review was developed in February 2016 from books, official documents and articles indexed in Lilacs and Scielo databases. Bach flower remedies is a therapeutic method that aims to restore the balance of human being, restoring its vital energy through holistic care. Because the flower essences act on psychic and emotional dimension of individual, when employed in holistic psychotherapy can provide greater autonomy, self-care and effectiveness compared to other alternative methods. The literature indicated that flower essence therapy is a safe practice and can be used in a complementary to health care, but should be performed by qualified professionals. It has also shown to be a promising and important area for nursing professional, but it still requires greater investment in research in the area to support the practice.

"I'm Not Trying to Be Cured, so There's Not Much He Can Do for Me": Hospice Patients' Constructions of Hospice's Holistic Care Approach in a Biomedical Culture

Science.gov (United States)

Nebel Pederson, Sarah; Emmers-Sommer, Tara M.

2012-01-01

The hospice philosophy was founded on a mission to provide comprehensive and holistic services to individuals at the end of life. Hospice interdisciplinary teams work together to offer therapies such as spiritual services, comfort care, and massage therapy to meet patients' physical, psychological, emotional, and spiritual needs. Although the…

Improvisation and the art of holistic nursing.

Science.gov (United States)

Hanley, Mary Anne; Fenton, Mary V

2013-10-01

The art of improvisation is an essential component of responding on the front lines of caring. Improvisation expresses the nurse's capacity to perceive the changing patterns of patients and their environments in ways that foster creative and innovative approaches to meeting healthcare needs. Many holistic nurses across the country are working on the front lines of caring, improvising and implementing projects to create change within their communities. This article examines improvisation within the context of the art and science of nursing, and proposes that improvisation reflects qualities within holistic nursing that are essential in contemporary health care.

[Holistic therapy of chronic heart failure].

Science.gov (United States)

Feldmann, C; Ertl, G; Angermann, C E

2014-06-01

The rising prevalence and increasing disease-related costs render chronic heart failure a rapidly growing socioeconomic challenge. The concerted action of guideline-adjusted therapy and holistic patient care is essential to achieve improvements in mortality, morbidity, functional status and quality of life of patients with symptomatic heart failure. Holistic care strategies comprise consideration of comorbidities and individual needs, lifestyle recommendations and multidisciplinary management programs for high-risk symptomatic patients in addition to basic medication and surgical therapies. For optimal patient care and coaching, seamless interaction is required between in-hospital treatment and outpatient facilities. Moreover, the palliative needs of heart failure patients need to be considered, a topic that is currently not receiving enough attention.

Holistic ultrasound in trauma: An update.

Science.gov (United States)

Saranteas, Theodosios; Mavrogenis, Andreas F

2016-10-01

Holistic ultrasound is a total body examination using an ultrasound device aiming to achieve immediate patient care and decision making. In the setting of trauma, it is one of the most fundamental components of care of the injured patients. Ground-breaking imaging software allows physicians to examine various organs thoroughly, recognize imaging signs early, and potentially foresee the onset or the possible outcome of certain types of injuries. Holistic ultrasound can be performed on a routine basis at the bedside of the patients, at admission and during the perioperative period. Trauma care physicians should be aware of the diagnostic and guidance benefits of ultrasound and should receive appropriate training for the optimal management of their patients. In this paper, the findings of holistic ultrasound in trauma patients are presented, with emphasis on the lungs, heart, cerebral circulation, abdomen, and airway. Additionally, the benefits of ultrasound imaging in interventional anaesthesia techniques such as ultrasound-guided peripheral nerve blocks and central vein catheterization are described. Copyright © 2016 Elsevier Ltd. All rights reserved.

Language and human nature: Kurt Goldstein's neurolinguistic foundation of a holistic philosophy.

Science.gov (United States)

Ludwig, David

2012-01-01

Holism in interwar Germany provides an excellent example for social and political influences on scientific developments. Deeply impressed by the ubiquitous invocation of a cultural crisis, biologists, physicians, and psychologists presented holistic accounts as an alternative to the "mechanistic worldview" of the nineteenth century. Although the ideological background of these accounts is often blatantly obvious, many holistic scientists did not content themselves with a general opposition to a mechanistic worldview but aimed at a rational foundation of their holistic projects. This article will discuss the work of Kurt Goldstein, who is known for both his groundbreaking contributions to neuropsychology and his holistic philosophy of human nature. By focusing on Goldstein's neurolinguistic research, I want to reconstruct the empirical foundations of his holistic program without ignoring its cultural background. In this sense, Goldstein's work provides a case study for the formation of a scientific theory through the complex interplay between specific empirical evidences and the general cultural developments of the Weimar Republic. © 2012 Wiley Periodicals, Inc.

Research paradigms and methods for investigating holistic nursing concerns.

Science.gov (United States)

Hagedorn, Mary Enzman; Zahourek, Rothlyn P

2007-06-01

Holistic nursing is a discipline focused on healing the whole person and dedicated to understanding and supporting the premise of holistic health of the patient and promoting healing in practitioners, patients, families, social groups, and communities. An explication of knowledge related to caring and healing in the human health experience and in holistic nursing is informed by the individual nurse's paradigmatic stance. Holistic nursing research is complex and focuses on healing, particularly healing of self, others, systems, and communities at large. This article discusses the competing paradigmatic perspectives, theoretic perspectives supporting holistic research, fundamental patterns of knowing and knowledge generation, a framework for holistic research, and the challenges of conducting holistic research. Recommendations for future research agenda are presented.

Spirituality Intervention and Outcomes: Corner stone of Holistic Nursing Practice

Directory of Open Access Journals (Sweden)

Mardiyono Mardiyono

2011-01-01

Full Text Available Background: Holistic nursing results in healing the whole person as human being that has interconnectedness of body mind social cultural spiritual aspect.Objective: The purpose of this paper is to examine the effects of Islamic spirituality interventions on health outcomes in nursing.Method: Databases searched for electronic journals and books that were published since 1994 to 2010 were included.Results: Spirituality intervention mainly composes of prayer, recitation of the holy Qur’an, remembrance of Allah, fasting, charity, prophets’ methods, and modified Islamic methods. Thirteen studies found that various outcomes have been highlighted when applied in several areas of nursing, such as stimulating baby’s cognitive ability in maternal nursing, promoting health during eating halal food, fasting, abstinence of alcohol and tobacco consumption, performing regular exercise, reducing anxiety, and pain in medical-surgical nursing. In mental health nursing, six studies explored effects of prayer and religious psychotherapy to enhance happiness and physical health and alleviate anxiety, and depression. Three studies reported Islamic cognitive therapy to alleviate the auditory hallucination, bereavement, and depression. In critical care nursing, three studies employed reciting the holy Qur’an and talqin in end of life care.Conclusion: Although the literature is limited in the amount and quality of spirituality interventions, some evidences have shown as integrative energy in nursing practice to promote health and minimize some symptoms. Spirituality interventions should be performed to acknowledge the high priority in holistic nursing and support interventions.Keywords: spirituality intervention, holistic nursing, Islam

Bet You Would Not Call a Holistic Plumber

Science.gov (United States)

Mahon, Robert Lee

2007-01-01

In this article, the author examines the misuse of the idea of holistic education. Western culture--and not just science and technology, but finance, politics, arts, crafts, and professions too--is not built on holistic insight or understanding, but on analytic thinking. Therefore, logically, successful teaching in all of the above must be created…

Cultural care of older Greek Canadian widows within Leininger's theory of culture care.

Science.gov (United States)

Rosenbaum, J N

1990-01-01

Cultural care themes were abstracted from a large scale study of older Greek Canadian widows conceptualized within Leininger's theory of Cultural Care Diversity and Universality. Ethnonursing, ethnographic, and life health-care history methods were used. Data were collected using observation-participation and interviews in three Greek Canadian communities with 12 widowed key informants and 30 general informants. Enabling tools used were interview inquiry guides, Leininger's Life History Health Care Protocol, Leininger's Acculturation Rating and Profile Scale of Traditional and Non-Traditional Lifeways, and field journal recordings. Data were analyzed using Leininger's phases of analysis for qualitative data. The two major cultural care themes which were abstracted from the raw data and patterns were: (1) Cultural care for Greek Canadian widows meant responsibility for, reciprocation, concern, love, companionship, family protection, hospitality, and helping, primarily derived from their kinship, religious, and cultural beliefs, and values, and (2) Cultural care continuity diminished the spousal care void and contributed to the health of Greek Canadian widows. These findings will stimulate future nursing research related to cultural care of diverse populations and guide nursing practice to provide culturally congruent care which will assist widows to reduce their spousal care void. The author thanks Dr. Madeleine Leininger, Dr. Judith Floyd, Dr. Marjorie Isenberg, and Dr. Bernice Kaplan for their guidance in completing the large scale study on which this article is based.

Clinical Holistic Medicine: Chronic Pain in Internal Organs

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are “holding” or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are “love” and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain.

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics.

Science.gov (United States)

Shafran, Roz; Bennett, Sophie D; McKenzie Smith, Mhairi

2017-08-16

There are strong calls from many national and international bodies for there to be a 'holistic' and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies. They have shown to impact upon a wide range of outcomes, including psychological distress, pain, physical health, medication adherence, and family outcomes. There is increasing recognition that the holistic goals of the child and family should be prioritised, and that interventions and outcomes should reflect these goals. A focus on holistic goals in therapy can be achieved through a combination of personalised goal-based outcomes in addition to symptom-based measures.

Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

Science.gov (United States)

Kanchense, Jane Handina Murigwa

2006-08-01

The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

A Pilot Randomized Controlled Trial of a Holistic Needs Assessment Questionnaire in a Supportive and Palliative Care Service.

Science.gov (United States)

Ahmed, Nisar; Hughes, Philippa; Winslow, Michelle; Bath, Peter A; Collins, Karen; Noble, Bill

2015-11-01

At present, there is no widely used systematic evidence-based holistic approach to assessment of patients' supportive and palliative care needs. To determine whether the use of a holistic needs assessment questionnaire, Sheffield Profile for Assessment and Referral for Care (SPARC), will lead to improved health care outcomes for patients referred to a palliative care service. This was an open, pragmatic, randomized controlled trial. Patients (n = 182) referred to the palliative care service were randomized to receive SPARC at baseline (n = 87) or after a period of two weeks (waiting-list control n = 95). Primary outcome measure is the difference in score between Measure Yourself Concerns and Wellbeing (MYCAW) patient-nominated Concern 1 on the patient self-scoring visual analogue scale at baseline and the two-week follow-up. Secondary outcomes include difference in scores in the MYCAW, EuroQoL (EQ-5D), and Patient Enablement Instrument (PEI) scores at Weeks 2, 4, and 6. There was a significant association between change in MYCAW score and whether the patients were in the intervention or control group (χ(2)trend = 5.51; degrees of freedom = 1; P = 0.019). A higher proportion of patients in the control group had an improvement in MYCAW score from baseline to Week 2: control (34 of 70 [48.6%]) vs. intervention (19 of 66 [28.8%]). There were no significant differences (no detectable effect) between the control and intervention groups in the scores for EQ-5D and Patient Enablement Instrument at 2-, 4-, or 6-week follow-up. This trial result identifies a potential negative effect of SPARC in specialist palliative care services, raising questions that standardized holistic needs assessment questionnaires may be counterproductive if not integrated with a clinical assessment that informs the care plan. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Clinical Holistic Medicine: Mental Disorders in a Holistic Perspective

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available From a holistic perspective, psychiatric diseases are caused by the patient’s unwillingness to assume responsibility for his life, existence, and personal relations. The loss of responsibility arises from the repression of the fundamental existential dimensions of the patients. Repression of love and purpose causes depersonalization (i.e., a lack of responsibility for being yourself and for the contact with others, loss of direction and purpose in life. Repression of strength in mind and emotions leads to derealization (the breakdown of the reality testing, often with mental delusions and hallucinations. The repression of joy and gender leads to devitalization (emotional emptiness, loss of joy, personal energy, sexuality, and pleasure in life.The losses of existential dimensions are invariably connected to traumas with life-denying decisions. Healing the wounds of the soul by holding and processing will lead to the recovery of the person's character, purpose of life, and existential responsibility. It can be very difficult to help a psychotic patient. The physician must first love his patient unconditionally and then fully understand the patient in order to meet and support the patient to initiate the holistic process of healing. It takes motivation and willingness to suffer on behalf of the patients in order to heal, as the existential and emotional pain of the traumas resulting in insanity is often overwhelming. We believe that most psychiatric diseases can be alleviated or cured by the loving and caring physician who masters the holistic toolbox. Further research is needed to document the effect of holistic medicine in psychiatry.

Clinical holistic medicine: holistic adolescent medicine.

Science.gov (United States)

Ventegodt, Søren; Morad, Mohammed; Press, Joseph; Merrick, Joav; Shek, Daniel T L

2004-08-04

The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine--giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs--is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity--through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents--all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused by disturbances in the personal

Clinical Holistic Medicine: Holistic Adolescent Medicine

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine — giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs — is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity — through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents — all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused

Developing a holistic approach to obesity management.

Science.gov (United States)

Brown, Jenny; Wimpenny, Peter

2011-02-01

The aim of this paper is to discuss the theoretical background and relevance of a holistic approach to obesity management by nurses. There is a global rise in the number of people with obesity, such that it now represents one of the major health challenges. However, nurses are often influenced by physical and dietetic focused approaches and could fail to acknowledge a range of other factors that can impact on weight management. As part of the development of a holistic approach to obesity a literature search was undertaken to establish relevant theoretical perspectives that underpin practice in physical, psychological and social aspects of care (focused on the period 1995-2005). In addition, experiences of working in a secondary care weight management clinic were also drawn upon. Psychobiological, attribution and social support theories were identified that could contribute to a better understanding of obesity. If these theoretical perspectives and supporting evidence can be integrated in a holistic approach to care and management it might be possible to promote better health and well-being in those with obesity. Creating a greater understanding of the range of theoretical perspectives and supporting evidence related to obesity could, it is argued, provide enhanced care and management. © 2011 Blackwell Publishing Asia Pty Ltd.

Holistic Reasoning on the Other Side of the World: Validation of the Analism/Holism Scale in Mexicans

Science.gov (United States)

Lechuga, Julia; Santos, Beatriz Maldonado; Garza-Caballero, Azenett A.; Villarreal, Ricardo

2011-01-01

The universality of cognitive processes has been called into question. Research suggests that individuals from Eastern cultures (e.g., China, Korea) when compared to individuals from Western cultures (e.g., the United States) prefer to reason holistically. This line of research has not been extended to cultural groups far removed from cultures traditionally surveyed in cross-cultural research such as Hispanics. We conducted two studies to understand: 1) the generalizability of the construct of holistic reasoning in Mexicans, and 2) the preferred reasoning style of Mexicans when compared to U.S. Americans. Results support the generalization of the factor structure of holistic reasoning as originally hypothesized by Choi, Koo, and Choi (2007). The results of Study 2 suggest that Mexicans scored higher than U.S. Americans on certain aspects of holistic reasoning. PMID:21787065

Holistic reasoning on the other side of the world: validation of the analysis-holism scale in Mexicans.

Science.gov (United States)

Lechuga, Julia; Santos, Beatriz Maldonado; Garza-Caballero, Azenett A; Villarreal, Ricardo

2011-07-01

The universality of cognitive processes has been called into question. Research suggests that individuals from Eastern cultures (e.g., China, Korea) when compared to individuals from Western cultures (e.g., the United States) prefer to reason holistically. This line of research has not been extended to cultural groups far removed from cultures traditionally surveyed in cross-cultural research such as Hispanics. We conducted two studies to understand: 1) the generalizability of the construct of holistic reasoning in Mexicans, and 2) the preferred reasoning style of Mexicans when compared to U.S. Americans. Results support the generalization of the factor structure of holistic reasoning as originally hypothesized by Choi, Koo, and Choi (2007). The results of Study 2 suggest that Mexicans scored higher than U.S. Americans on certain aspects of holistic reasoning.

Cultural Humility: An Active Concept to Drive Correctional Nursing Practice.

Science.gov (United States)

Steefel, Lorraine

Correctional nursing practice is focused on a unique patient population: inmates who present with their own ethnicities and have an imposed culture from the prison structure. As such, culture must be considered to provide holistic care. Madeleine Leininger's Theory of Culture Care Diversity and Universality, which maintains that care is the essence of nursing (without inclusion of culture, there is no care), suggests three nursing actions: to maintain the patient's culture, make accommodations for it, and/or repattern cultural ways that may be unhealthful. Given that correctional nurses work within the context (and culture) of custody, Leininger's nursing actions may not always be feasible; however, showing an underlying attitude of cultural humility is. In this article, cultural humility, the basis of culturally competent care, is described in a manner that can drive nursing practice in corrections.

Samoan Philosophy of Nursing: a basis for culturally proficient care and policy.

Science.gov (United States)

Enoka, I S; Petrini, M A; Turale, S

2014-09-01

To explore nurses' perspectives about the Samoan Philosophy of Nursing, and determine its feasibility for nursing care of Samoans internationally. This philosophy is the conceptual cultural framework for nursing law, practice, education and research in Samoa, and was developed by Samoan nurses who recognized the need for guidance to deliver quality, culturally competent and proficient health care. A mixed method study, employing a questionnaire and ethnographic methods. The Samoan Philosophy of Nursing Questionnaire sought demographic data and aspects about the philosophy from 95 registered nurse clinicians, administrators and educators throughout Samoa during 2012. Descriptive statistics were used for data analysis. Additionally, 19 focus groups (5-6 participants each) and 19 in-depth interviews were held to further explore these aspects, as well as participant observations. Descriptive statistics were used to analyse quantitative data, and Spradley's ethnographic method was adopted for analysing the qualitative data. Of 95 questionnaires analysed, 70% of participants reported using the philosophy all the time, and 30% most of the time. They placed a high satisfaction rate, value and importance on this philosophy. From the ethnography, six major themes emerged: valuable framework of learning; conceptual framework for holistic assessment; benchmark for regulating and monitoring practice improving interaction and culturally proficient practice; potential use for Samoans overseas; and maintaining quality health and the dignity of people. This first-time study evaluated the Samoan Philosophy of Nursing and adds to nursing knowledge. Findings confirmed its usefulness as a culturally based conceptual framework to facilitate, regulate and monitor education, research and practice for sustainable health outcomes in Samoa, and for Samoans living abroad. It is important that Samoans living abroad receive culturally proficient care, but this requires the support of

Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

Science.gov (United States)

Delaney, Colleen; Barrere, Cynthia

2012-01-01

The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented.

Medical doctors and complementary and alternative medicine: the context of holistic practice.

Science.gov (United States)

Winnick, Terri A

2006-04-01

Consumers, health care financing, external and internal competition are factors identified in the medical literature as prompting change within medicine. I test these factors to determine if they also prompt regular doctors to define themselves as 'holistic MDs' and align themselves with complementary and alternative medicine (CAM). State-level regression analyses on the number of MDs advertising in referral directories for CAM therapies find holistic practice a function of practice locale. The proportion of holistic MDs increases in states with an older population, where more patients survive despite serious disabilities, and where non-physician providers pose a competitive threat. Consumer demand, specialization and licensing do not significantly influence adoption of CAM treatments in these analyses. Health care financing has disparate effects. Indemnity insurance constrains holistic practice while HMO penetration enhances it. These results suggest that holistic practice may be an integral part of the regular profession's ongoing professionalization project.

Holistic care of complicated tuberculosis in healthcare settings with limited resources.

Science.gov (United States)

Duke, Trevor; Kasa Tom, Sharon; Poka, Harry; Welch, Henry

2017-12-01

In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries. The care of these children requires a holistic clinical and continuous quality improvement approach. This includes timely decisions on the commencement of treatment often when diagnoses are not certain, identification and management of acute respiratory, neurological and nutritional complications, identification and treatment of comorbidities, supportive care, systematic monitoring of treatment and progress, rehabilitation, psychological support, ensuring adherence, and safe transition to community care. New diagnostics and imaging can assist this, but meticulous attention to clinical detail at the bedside and having a clear plan for all aspects of care that is communicated well to staff and families are essential for good outcomes. The care is multidimensional: biomedical, rehabilitative, social and economic, and multidisciplinary: medical, nursing and allied health. In the era of the Sustainable Development Goals, approaches to these dimensions of healthcare are needed within the reach of the poorest people who access district hospitals in low-income countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cross-cultural barriers to health care.

Science.gov (United States)

Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

2015-01-01

Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

Use of the Culture Care Theory and ethnonursing method to discover how nursing faculty teach culture care.

Science.gov (United States)

Mixer, Sandra J

2008-04-01

As the world becomes increasingly multicultural, transcultural nursing education is critical to ensuring a culturally competent workforce. This paper presents a comprehensive review of literature and results of an ethnonursing pilot study using the Culture Care Theory (CCT) to discover how nursing faculty teach culture care. The literature revealed that despite 50 years of transcultural nursing knowledge development through theory, research and practice, there remains a lack of formal, integrated culture education in nursing. The importance of faculty providing generic and professional care to nursing students and using an organising framework to teach culture care was discovered. Additionally, care was essential for faculty health and well-being to enable faculty to teach culture care. This unique use of the theory and method demonstrates its usefulness in discovering and describing the complex nature of teaching culture care. Larger scale studies are predicted to further substantiate the CCT, building the discipline of nursing.

Holistic Care in the US Military I-The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001-2012.

Science.gov (United States)

Foote, Frederick O; Bulger, Roger J; Frampton, Susan B; Pellegrino, Edmund D

2012-05-01

This article describes the history and findings of the Epidaurus Project, a Uniformed Services University-affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS "healing environments" and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war.

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

Science.gov (United States)

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Attitudes towards holistic complementary and alternative medicine: a sample of healthy people in Turkey.

Science.gov (United States)

Erci, Behice

2007-04-01

This study aimed to investigate the attitude towards holistic complementary and alternative medicine of healthy people, and to evaluate the relationship between attitude towards holistic complementary and alternative medicine and the characteristics of the participants. Complementary and alternative medicines are becoming more accepted. This study used descriptive and correlational designs. The study included healthy individuals who attended or visited a primary care centre for healthcare services. The sample of the study consisted of 448 persons who responded to the questionnaire. The Attitude towards Holistic Complementary and Alternative Medicine scale consisted of 11 items on a six-point, and two subscales. The mean score of holistic complementary and alternative medicine was studied in relation to attributes and holistic complementary and alternative medicine. The mean score on the scale was 58.1 SD 4.1 point, and in terms of the mean score of the scale, the sample group showed a negative attitude towards holistic complementary and alternative medicine and one subscale. Demographic characteristics of the sample group affected attitudes towards holistic complementary and alternative medicine and both subscales. In light of these results, it is clear that healthy Turkish population have a tendency towards conventional medicine. Health professionals caring for healthy people should provide comprehensive care that addresses the physical, psychosocial and spiritual needs of the individual; they could provide the consultation regarding to different patterns of complementary therapies.

Exploring Holistic Comfort in Children Who Experience a Clinical Venipuncture Procedure.

Science.gov (United States)

Bice, April A; Hall, Joanne; Devereaux, Matthew J

2018-06-01

Children often experience the uncomfortable effects of invasive procedures as a part of primary care and during times of illness. Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child's perspective. In this study, holistic comfort related to an invasive venipuncture procedure was explored in children age 5 to 7 years and their caregivers of all ages. A qualitative descriptive design described by Sandelowski was used. The philosophical underpinnings of naturalistic inquiry of Guba and Lincoln were used. Semistructured interviews were conducted with 13 child and 15 caregiver participants. Children also drew pictures to help describe their perceptions. Traditional thematic content analysis described by Hsieh and Shannon yielded four overarching themes of holistic comfort related to venipuncture procedures in children: Body Comfort, Cognitive and Emotional Comfort, Comfort in the Procedure Surroundings, and Comfort Play. Numerous recommendations for future research are included. Implications for nursing and related health sciences, organizational and administrative policy, invasive procedures, theory, and methods were found and are discussed. Findings from this study will assist nurses in providing procedure management for children from a holistic care perspective.

Working with culture: culturally appropriate mental health care for Asian Americans.

Science.gov (United States)

Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

2011-11-01

The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

[Holistic Healthcare for the Aged: Concepts and Strategies].

Science.gov (United States)

Wang, Jing-Jy; Yang, Yueh-Ying; Liu, Mei-Yin

2018-04-01

Advancing medical technology continues to extend the average human life span, resulting in population aging globally as well as in Taiwan. The challenges posed by aging society increase not only medical and care costs but also the burden on pension funds and the social welfare system. In addition, there is currently a desperate need for many well-trained health providers as well as a friendly and comprehensive long-term care system. However, attention should not simply focus on medical payments and long-term care, as this may prolong the length of unhealthy living years for the aged and further strain national finances. Holistic healthcare for the aged should be introduced as early as possible in order to respond effectively to global aging by assisting the aged to maintain their health, to live independently, and to extend their social functions. The purposes of this report are to: 1. analyze the demographic characteristics of Taiwanese older adults; 2. introduce the concept of holistic healthcare as advocated by the World Health Organization (WHO); 3. discuss the promotion of physical-psychological health and the development of age-friendly environments; 4. strengthen the framework of long-term care policies; and 5. recommend the development of a holistic healthcare model for the aged based on the WHO Global Strategy and Action Plan on Aging and Health, announced in 2016. We hope to facilitate active aging, successful aging, self-esteem, and a high quality of life for the elderly in Taiwan.

Holistic Care in the US Military I—The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001–2012

Science.gov (United States)

Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.

2012-01-01

This article describes the history and findings of the Epidaurus Project, a Uniformed Services University–affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS “healing environments” and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war. PMID:24278818

Holistic Health: Does It Really Include Mental Health?

OpenAIRE

McClanahan, Kimberly K.; Huff, Marlene B.; Omar, Hatim A.

2006-01-01

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate publi...

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

Science.gov (United States)

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

Exploring the concept of "caring cultures": A critical examination of the conceptual, methodological and validity issues with the "caring cultures" construct.

Science.gov (United States)

Gillin, Nicola; Taylor, Ruth; Walker, Susan

2017-12-01

To critically examine the conceptual, methodological and validity issues with the "caring cultures" construct. Post the Francis Report, "caring cultures" and alternative terminology such as "culture/s of care/caring/compassionate care" have gained prominence in the literature, especially within a UK policy context. However, in order to understand the value these "caring cultures" hold in terms of clinical practice, the concept itself first needs to be understood. A discussion and critical examination of the concept of "caring cultures" and associated terminology. Grey literature, database, library and reference list searches were conducted. It is implied that "caring cultures" influence patient care. However, evidence which verifies this assertion is limited. In this article, the concept of "caring cultures" is deconstructed and its validity explored. An alternative to "caring cultures" is proposed in terms of research, whereby the concept of culture is instead explored in detail, on a microsystem level, using appropriate methodology. The concept of "caring cultures", although attractive in terms of its apparent simplicity, is not considered the most useful nor appropriate phrases in terms of advancing research. Instead, research which examines the established concept of "culture" in relation to outcomes such as patient care, doing so with an appropriate methodology, is viewed as a more suitable alternative. Clarifying concepts and terminology relating to "caring cultures" is essential for research to progress and the impact of culture on clinical practice to be better understood. © 2017 John Wiley & Sons Ltd.

Incorporating Peplau's Theory of Interpersonal Relations to Promote Holistic Communication Between Older Adults and Nursing Students.

Science.gov (United States)

Deane, William H; Fain, James A

2016-03-01

With the increased life expectancy, older adults will interact with multiple health care providers to manage acute and chronic conditions. These interactions include nursing students who use various health care settings to meet the clinical practicum requirements of their programs. Nursing faculty are charged with facilitating students' learning throughout the program from basic human needs, to holistic communication, to advanced medical surgical concepts. Despite educating students on holistic communication, there remains a lack of a reliable framework to undertake the task of teaching holistic communication skills. Nursing students preparing to function as licensed practitioners need to develop appropriate knowledge to holistically care for older adults. The purpose of this article is to examine Hildegard Peplau's interpersonal relations theory as a framework to assist nursing students to understand holistic communication skills during their encounters with older adults. Peplau's theory provides nursing a useful set of three interlocking and oftentimes overlapping working phases for nurses' interaction with patients in the form of the nurse-patient relationship. Nursing education could adopt the three phases of Peplau's interpersonal relations theory to educate students on holistically communicating with older adults. © The Author(s) 2015.

Social care informatics as an essential part of holistic health care: a call for action.

Science.gov (United States)

Rigby, Michael; Hill, Penny; Koch, Sabine; Keeling, Debbie

2011-08-01

The authors identified the need for a cross-disciplinary research view of issues to ensure an integrated citizen-centric support to achieve optimal health of individual citizens and, in particular, the role of informatics to inform and coordinate support towards integrated and holistic care. An Exploratory Workshop was approved and sponsored by the European Science Foundation. Twenty-three participants from 15 countries attended, covering a full range of health, social care and informatics professions and disciplines. The participants found strong common ground in identifying key issues to be addressed if citizens with compromised health are to receive integrated and coordinated support to a common set of objectives, while also ensuring appropriate choice and support for citizen, family and other informal carers. At the same time, optimal health was identified as a fundamental human right, and that achieving this is a necessary priority of a caring society. Moreover, Europe has a commitment to researching and developing health informatics (e-health), though not yet giving a priority to this integration of health and social care. Specifically the following main informatics challenges to be addressed were identified: (1) to identify available information and communication needs related to different scenarios of use in the intersection between health and social care, (2) to develop and map shared ontologies, and standards for integration and/or brokerage, (3) to enable planned information access and sharing, shaping a system of trust where the patient is an active partner and policies are established considering all partners/interests, (4) to investigate the use of automatic/intelligent knowledge based and context-relevant services, and (5) empowering the citizen (or their selected agent) as co-producer through modern informatics tools, while carefully avoiding selective disempowerment of the most vulnerable. The Exploratory Workshop resulted in a unanimous

Trends in Contemporary Holistic Nursing Research: 2010-2015.

Science.gov (United States)

Delaney, Colleen; McCaffrey, Ruth G; Barrere, Cynthia; Kenefick Moore, Amy; Dunn, Dorothy J; Miller, Robin J; Molony, Sheila L; Thomas, Debra; Twomey, Teresa C; Susan Zhu, Xiaoyuan

2018-01-01

The purpose of this study was to describe and summarize the characteristics of contemporary holistic nursing research (HNR) published nationally. A descriptive research design was used for this study. Data for this study came from a consecutive sample of 579 studies published in six journals determined as most consistent with the scope of holistic nursing from 2010 to 2015. The Johns Hopkins level of evidence was used to identify evidence generated, and two criteria-power analysis for quantitative research and trustworthiness for qualitative research-were used to describe overall quality of HNR. Of the studies, 275 were considered HNR and included in the analysis. Caring, energy therapies, knowledge and attitudes, and spirituality were the most common foci, and caring/healing, symptom management, quality of life, and depression were the outcomes most often examined. Of the studies, 56% were quantitative, 39% qualitative, and 5% mixed-methods designs. Only 32% of studies were funded. Level III evidence (nonexperimental, qualitative) was the most common level of evidence generated. Findings from this study suggest ways in which holistic nurse researchers can strengthen study designs and thus improve the quality of scientific evidence available for application into practice and improve health outcomes.

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis.

Science.gov (United States)

Morris, G Scott

2015-11-05

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry, optometry, counseling, social work, and nutrition and fitness education, to promote wellness in every dimension of life. A 2012 economic analysis estimated that a $1 contribution to the CHC provided roughly $8 in health services. The CHC has trained >1200 Congregational Health Promoters to be health leaders and is conducting research on the effectiveness of faith community nurses partnering with congregations to assist in home care for patients recently discharged from Memphis hospitals. The MEMPHIS Plan, CHC's employer-sponsored health care plan for small business and the self-employed, offers uninsured people in lower-wage jobs access to quality, affordable health care. The CHC also conducts replications workshops several times a year to share their model with leaders in other communities. The Institute for Healthcare Improvement (IHI) recently completed a case study that concluded: "The CHC is one of a very few organizations successfully embodying all three components of the IHI Triple Aim by improving population health outcomes, enhancing the individual's health care experience, and controlling costs. All three have been part of the Center's DNA since its inception, and as a transforming force in the community, the model is well worth national attention."

The Culture Care theory and the Old Order Amish.

Science.gov (United States)

Wenger, A F

1991-11-01

This chapter discussed knowledge about culture care and culture context in relation to Old Order Amish culture. Leininger's theory of Cultural Care Diversity and Universality and Hall's concept of high-context culture were used to study culture care of the Old Order Amish. This study provided new findings about the culture, especially as related to culture care and high context. These findings also are important to guide nurses and other health care professionals in providing culture-specific care to the Old Order Amish. Leininger's Cultural Care theory has provided a comprehensive theoretical framework to explicate embedded care constructs and patterns of daily living within this culture. Hall's concepts helped to value and discover the importance of high context within the Old Order Amish culture and its relation to the phenomenon of care.

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics

OpenAIRE

Shafran, Roz; Bennett, Sophie D.; McKenzie Smith, Mhairi

2017-01-01

There are strong calls from many national and international bodies for there to be a ‘holistic’ and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have...

[Personalized holistic approach to a patient with mixed leg ulcer].

Science.gov (United States)

Kovacević, Jadranka; Sinozić, Tamara

2014-10-01

Holistic approach as the philosophical orientation to care underpins the fundamental wholeness of human being and emphasizes the importance of balance within the person and between the person and his/her environment. It includes elements of the physiological, sociological, economic, psychological and spiritual dimensions, and thus providesan opportunity to assess the patient as a whole and in relation to his/ her living context. Such an integrated approach is part of the basic knowledge and skills of general practitioners/family doctors and makes them equal members of a multidisciplinary team in chronic wound patient care. In this case report on a patient with mixed leg ulcer, we will try to bring closer holistic approach in care for this kind of patients in daily practice of general practitioners/family doctors.

Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

Science.gov (United States)

Jurewicz, Izabela

2015-04-01

In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults. © 2015 Royal College of Physicians.

A Holistic Model of Care to Support Those Living with and beyond Cancer

Science.gov (United States)

Cadet, Tamara; Davis, Cindy; Elks, Jacinta; Wilson, Patricia

2016-01-01

Background: Globally, the burden of cancer continues to increase and it is well-documented that while not a homogeneous population, cancer patients and cancer survivors face many physical, psychological, social, spiritual, and financial issues. Cancer care is shifting from a disease-focused to a patient-centered approach resulting in an increased need to address these concerns. Methods: Utilizing a quality improvement approach, this paper describes an integrated cancer care model at Bloomhill Cancer Center (BCC) in Queensland, Australia that demonstrates the ability to meet the holistic needs of patients living with and beyond cancer and to identify opportunities for better practice and service provision. Results: Survey results indicate that 67% and 77% of respondents were very satisfied and 27% and 17% were satisfied with their first contact and very satisfied with their first meeting with a nurse at BCC. Clients also reported being very satisfied (46%) or satisfied (30%) with the emotional support they received at BCC and over 90% were very satisfied or satisfied with the touch therapies that the received. Conclusion: Due to the early success of the interventions provided by BCC, the model potentially offers other states and countries a framework for supportive cancer care provision for people living with and beyond cancer. PMID:27869728

Confidence in critical care nursing.

Science.gov (United States)

Evans, Jeanne; Bell, Jennifer L; Sweeney, Annemarie E; Morgan, Jennifer I; Kelly, Helen M

2010-10-01

The purpose of the study was to gain an understanding of the nursing phenomenon, confidence, from the experience of nurses in the nursing subculture of critical care. Leininger's theory of cultural care diversity and universality guided this qualitative descriptive study. Questions derived from the sunrise model were used to elicit nurses' perspectives about cultural and social structures that exist within the critical care nursing subculture and the influence that these factors have on confidence. Twenty-eight critical care nurses from a large Canadian healthcare organization participated in semistructured interviews about confidence. Five themes arose from the descriptions provided by the participants. The three themes, tenuously navigating initiation rituals, deliberately developing holistic supportive relationships, and assimilating clinical decision-making rules were identified as social and cultural factors related to confidence. The remaining two themes, preserving a sense of security despite barriers and accommodating to diverse challenges, were identified as environmental factors related to confidence. Practice and research implications within the culture of critical care nursing are discussed in relation to each of the themes.

Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences.

Science.gov (United States)

Tavallali, Azar Gashasb; Jirwe, Maria; Kabir, Zarina Nahar

2017-03-01

Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters. © 2016 Nordic College of Caring Science.

Integration of Latino/a cultural values into palliative health care: a culture centered model.

Science.gov (United States)

Adames, Hector Y; Chavez-Dueñas, Nayeli Y; Fuentes, Milton A; Salas, Silvia P; Perez-Chavez, Jessica G

2014-04-01

Culture helps us grapple with, understand, and navigate the dying process. Although often overlooked, cultural values play a critical and influential role in palliative care. The purpose of the present study was two-fold: one, to review whether Latino/a cultural values have been integrated into the palliative care literature for Latinos/as; two, identify publications that provide recommendations on how palliative care providers can integrate Latino/a cultural values into the end-of-life care. A comprehensive systematic review on the area of Latino/a cultural values in palliative care was conducted via an electronic literature search of publications between 1930-2013. Five articles were identified for reviewing, discussing, or mentioning Latino/a cultural values and palliative care. Only one article specifically addressed Latino/a cultural values in palliative care. The four remaining articles discuss or mention cultural values; however, the cultural values were not the main focus of each article's thesis. The results of the current study highlight the lack of literature specifically addressing the importance of integrating Latino/a cultural values into the delivery of palliative care. As a result, this article introduces the Culture-Centered Palliative Care Model (CCPC). The article defines five key traditional Latino/a cultural values (i.e., familismo, personalismo, respeto, confianza, and dignidad), discusses the influence of each value on palliative health care, and ends with practical recommendations for service providers. Special attention is given to the stages of acculturation and ethnic identity.

Holistic Health: Does It Really Include Mental Health?

Directory of Open Access Journals (Sweden)

Kimberly K. McClanahan

2006-01-01

Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Holistic health: does it really include mental health?

Science.gov (United States)

McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

Science.gov (United States)

Dyess, Susan MacLeod

2015-01-01

It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

Breast Cancer: Exploring the Facts and Holistic Needs during and beyond Treatment.

Science.gov (United States)

Ng, Zhi Xuan; Ong, Mei Shan; Jegadeesan, Tamilarasi; Deng, Shuo; Yap, Celestial T

2017-05-24

Breast cancer patients face challenges throughout the journey of diagnosis, treatment, post-treatment, and recovery. The breast cancer patient is exposed to a multidisciplinary team including doctors, nurses, therapists, counselors, and psychologists. While the team assembled together aims to address multiple facets in breast cancer care, the sub-specialized nature of individual professional practices may constrain the overview of patients' holistic needs and a comprehensive approach to cancer management. This paper aims to provide an overview of the holistic needs of breast cancer patients at each stage of their cancer journey, addressing their complex physical, psychological, and social needs. As every patient is different, cancer care has to be tailored to each patient based on a holistic needs assessment. This paper also explores how support can be provided from the perspectives of the healthcare providers, family members and caretakers. Examples of general practices at healthcare institutions worldwide as well as supportive care provided by support groups are discussed. The needs of breast cancer patients extend beyond the resolution of cancer as a disease, and the restoration of health as far as possible is a critical component of healing. Understanding the complex issues involved in the journey of breast cancer will aid healthcare providers to be better equipped to sensitively address their concerns and focus on healing the patient holistically. This paper provides a literature review of validated practices in different countries and elaborates on the holistic needs of patients at various stages of recovery. This review is based on more than a decade of publications sourced from multiple resources including PubMed journal articles; books and official websites of breast cancer organizations.

Breast Cancer: Exploring the Facts and Holistic Needs during and beyond Treatment

Science.gov (United States)

Ng, Zhi Xuan; Ong, Mei Shan; Jegadeesan, Tamilarasi; Deng, Shuo; Yap, Celestial T.

2017-01-01

Breast cancer patients face challenges throughout the journey of diagnosis, treatment, post-treatment, and recovery. The breast cancer patient is exposed to a multidisciplinary team including doctors, nurses, therapists, counselors, and psychologists. While the team assembled together aims to address multiple facets in breast cancer care, the sub-specialized nature of individual professional practices may constrain the overview of patients’ holistic needs and a comprehensive approach to cancer management. This paper aims to provide an overview of the holistic needs of breast cancer patients at each stage of their cancer journey, addressing their complex physical, psychological, and social needs. As every patient is different, cancer care has to be tailored to each patient based on a holistic needs assessment. This paper also explores how support can be provided from the perspectives of the healthcare providers, family members and caretakers. Examples of general practices at healthcare institutions worldwide as well as supportive care provided by support groups are discussed. The needs of breast cancer patients extend beyond the resolution of cancer as a disease, and the restoration of health as far as possible is a critical component of healing. Understanding the complex issues involved in the journey of breast cancer will aid healthcare providers to be better equipped to sensitively address their concerns and focus on healing the patient holistically. Methodology: This paper provides a literature review of validated practices in different countries and elaborates on the holistic needs of patients at various stages of recovery. This review is based on more than a decade of publications sourced from multiple resources including PubMed journal articles; books and official websites of breast cancer organizations. PMID:28538673

Is there a place for a holistic approach in surgical training?

Science.gov (United States)

Atayoglu, Timucin; Buchholz, Noor; Atayoglu, Ayten Guner; Caliskan, Mujgan

2014-03-01

The holistic approach in medicine is a framework that considers and treats all aspects of a patient's needs, as it relates to their health. The goal of such an approach is to prevent illness, and to maximise the well-being of individuals and families. Holistic medicine is also referred to as integrative, which has been interpreted by some professionals as the combination of evidence-based medicine and complementary medicine. The speciality of Family Medicine (FM) is often referred to as General Practice (GP), a terminology which emphasises the holistic nature of that discipline. Furthermore, GP/FM professional bodies in some countries have incorporated the holistic and integrative approach into curricula and guidelines for doctors in training, which reflects its acceptance as a component of medical training. However, despite this validation, and despite research showing the effectiveness of such strategies in enhancing the outcomes of surgery, a holistic framework or integrative approach has not been equally integrated into speciality training for would-be surgeons. We argue that it would be advisable to include holistic approaches into surgical training and help surgeons to recognise their role in the continuum of care.

A framework for cultural competence in health care organizations.

Science.gov (United States)

Castillo, Richard J; Guo, Kristina L

2011-01-01

Increased racial and ethnic diversity in the United States brings challenges and opportunities for health care organizations to provide culturally competent services that effectively meet the needs of diverse populations. The need to provide more culturally competent care is essential to reducing and eliminating health disparities among minorities. By removing barriers to cultural competence and placing a stronger emphasis on culture in health care, health care organizations will be better able to address the unique health care needs of minorities. Organizations should assess cultural differences, gain greater cultural knowledge, and provide cultural competence training to deliver high-quality services. This article develops a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.

Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team

Science.gov (United States)

Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

2017-01-01

Background The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Objective Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. Methods A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Results Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to

Patient safety culture in primary care

NARCIS (Netherlands)

Verbakel, N.J.

2015-01-01

Background A constructive patient safety culture is a main prerequisite for patient safety and improvement initiatives. Until now, patient safety culture (PSC) research was mainly focused on hospital care, however, it is of equal importance in primary care. Measuring PSC informs practices on their

Culture brokerage as a form of caring

Directory of Open Access Journals (Sweden)

Saidy Eliana Arias-Murcia

2013-12-01

Full Text Available Objective. To identify the meanings, uses, and contexts of applying the culture brokerage concept in nursing articles published from 1995 to 2011. Methodology. A total of 32 articles were identified from the following databases: Cuiden, SciElo, Ovid Nursing, Ovid, Medline and Pubmed. Results. It was found that 56.2% of the articles were about research, 37.5% on reflection, and 6.2% topic revision. Five categories emerged from the analysis: culture brokerage concepts, culture brokerage and cultural competence, culture brokerage and the performers, culture brokerage in the care of immigrants, and culture brokerage in the care of individuals with chronic diseases. Conclusion. Culture brokerage is a type of emerging care; it has various approaches and applications in both the community and hospital environments. Its conceptualization helps in the development of the nursing discipline.

Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study.

Science.gov (United States)

Schrank, Beate; Rumpold, Tamara; Amering, Michaela; Masel, Eva Katharina; Watzke, Herbert; Schur, Sophie

2017-06-01

In increasingly globalized societies, patient-centered cancer care requires culture-sensitive approaches in order to ensure patients well-being. While migrant patients' needs are frequently reported in the literature, staff members' perception of work with migrant patients, associated challenges, or individual work approaches are largely unknown. This study addresses this research gap through qualitative exploration of experiences of multicultural health care professionals in supportive oncology and palliative care, working with patients from different cultural backgrounds. This study aims to understand staff experience of the impact of culture on cancer care. This study was conducted at the Medical University of Vienna, including staff from different settings of oncology and palliative care, in different professional positions, and with a range of individual migration backgrounds. Semistructured interviews were conducted with 21 staff members working with patients from different cultural backgrounds. Interviews explored views on the impact of culture on care were audio-taped, transcribed, and analyzed using a rigorous method of thematic analysis, enhanced with grounded theory techniques. Interviews revealed 4 key topics: culture-specific differences, assumed reasons for differences, consequences of multicultural care, and tools for culture-sensitive care. Strategies to better deal with migrant patients and their families were suggested to improve work satisfaction amongst staff. This study identifies relevant staff challenges in work with migrant patients. Concrete suggestions for improvement include measures on an organizational level, team level, and personal tools. The suggested measures are applicable to improve work satisfaction and culture-sensitive care not only in cancer care but also in other areas of medicine. Copyright © 2016 John Wiley & Sons, Ltd.

The development and evaluation of a holistic needs assessment and care planning learning package targeted at cancer nurses in the UK.

Science.gov (United States)

Henry, R; Hartley, B; Simpson, M; Doyle, N

2014-01-01

A project team from the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing the holistic needs of people with cancer. The project team identified three areas which were integral to an holistic needs assessment (HNA) implementation project. These were project support information, project management skills, and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents, and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created. www.hnaforcancer.com was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These subjects are packaged as videoed presentations with supporting learning material and can be accessed via the UKONS website. By the end of the programme participants were equipped to identify and explore the essential requirements for HNA and care planning, more able to recognise potential need, and initiate care to prevent or minimise the risk of complications. Participants had also developed confidence and competency in new skills, including basic project management.

Indigenous Knowledge - A Holistic View Through a Food Security Lens

Science.gov (United States)

Angnaboogok, V.; Behe, C.; Daniel, R. G.

2017-12-01

Rapid changes occurring within the Arctic heighten the need to understand the multiple drivers pushing change and their cumulative impacts. Most importantly to better understand Arctic change a holistic view is needed that can only be achieved through bringing together multiple knowledge systems and scientific disciplines. Inuit have called the Arctic home from time immemorial acquiring a knowledge system. The Inuit knowledge system continues to grow, and holds methodologies and assessment processes that provide a pathway for holistically understanding the Arctic. This holistic view is largely attributed to a focus on relationships between system components, close attention to food webs, and a unique understanding of interconnecting systems. The Alaskan Inuit understanding of food security represents an Indigenous way of viewing the world - where food security encompasses complex and interlinked cultural and environmental systems. These systems are comprised of connections among the health of people, animals, and plants; the different states of land, sea, and air; and the cultural fabric held together by language, cultural expression, and social integrity. Within the Inuit knowledge system, it is impossible to disentangle some of these relationships; when we discuss an Inuit food security perspective, it is this interconnectivity and these relationships that we refer to. This presentation will offer an introduction to what it means to adopt a food security lens approach - a view needed to build our knowledge of the changes that are occurring and further our understanding of cumulative impacts while illuminating the nexus between all pieces that make up Arctic ecosystems.

Holistic nurses' stories of personal healing.

Science.gov (United States)

Smith, Marlaine C; Zahourek, Rothlyn; Hines, Mary Enzman; Engebretson, Joan; Wardell, Diane Wind

2013-09-01

The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts. The study employed a qualitative descriptive design with methods of narrative and story inquiry. Participants were nurse attendees at an American Holistic Nurses' Association conference who volunteered for the study. They were invited to share a story about healing self or another. Twenty-five stories were collected; seven were about personal healing, and these are the focus of this analysis. Data were analyzed using a hybrid approach from narrative and story inquiry methods. Eleven themes were clustered under three story segments. The themes within the Call to the Healing Encounter are the following: recognition of the need to resolve a personal or health crisis, knowledge of or engagement in self-care practices, and reliance on intuitive knowing. Themes under the Experience of Healing are the following: connections; profound sensations, perceptions, and events; awareness of the reciprocal nature of healing; inner resolution: forgiveness, awakening, and acceptance; use of multiple holistic approaches; and witnessing manifestations of healing. The themes for Insights are the following: gratitude and appreciation and ongoing journey. A metastory synthesizing the themes is presented, and findings are related to existing literature on healing.

A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

Science.gov (United States)

Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-01-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and/or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility — more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. PMID:21225585

Cultural aspects of communication in cancer care.

Science.gov (United States)

Surbone, Antonella

2008-03-01

Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and practices of communication of the truth and of decision-making styles throughout the world. Cultural competence always presupposes oncology professionals' awareness of their own cultural beliefs and values. To be able to communicate with cancer patients in culturally sensitive ways, oncologists should have knowledge of the concept of culture in its complexity and of the risks of racism, classism, sexism, ageism, and stereotyping that must be avoided in clinical practice. Oncologists should develop a sense of appreciation for differences in health care values, based on the recognition that no culture can claim hegemony over others and that cultures are evolving under their reciprocal influence on each other. Medical schools and oncology training can teach communication skills and cultural competence, while fostering in all students and young doctors those attitudes of humility, empathy, curiosity, respect, sensitivity, and awareness that are needed to deliver effective and culturally sensitive cancer care.

Improvement characteristics shown in holistic regeneration of Ballymun toward sustainable community

Energy Technology Data Exchange (ETDEWEB)

Lee, Yeunsook; Lim, Soohyun; Kim, Gunhyoung [Department of Housing and Interior Design, Yonsei University, Seoul (Korea)

2010-02-15

Substantial numbers of urban and residential environments constructed in the 20th century are experiencing degeneration and the importance of challenging to revitalize community holistically is getting more seriously recognized. There, however, has been limitation in grasping the holistic regeneration information as urban regeneration usually goes through a long-term and complicated procedure. Yet, the urban and housing regeneration's direction is required to be holistic in the 21st Century. Any precedent case that had tried the holistic regeneration needs to be checked thoroughly and thereby the result needs to be applied to the future attempts as a reference and knowledge base. The purpose of this study was to delineate improvement characteristics that appeared during the course of holistic regeneration in Ballymun of Ireland. This research is an archival research in nature which also used content analysis technique since it deals with reports and newsletters as archival records that were accumulated on a regular base throughout the whole process. The leading projects continued over ten years of improvement were scrutinized in the perspective of physical, social, economic, cultural, and environmental dimensions of regeneration. The main results were, first, a series of improvement activities and projects to regenerate each of five dimensions were delineated for comprehensive understanding. Second, connected patterns for synergistic improvement were identified and patterns were described to show the detailed contents as examples. This study would provide communities that face holistic regeneration, an insight, planning skills, creative and realistic ideas for implementation, thereby empowers planning capability toward holistic regeneration. (author)

Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team.

Science.gov (United States)

Nanton, Veronica; Appleton, Rebecca; Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

2017-07-28

The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by

Exploring the development of a cultural care framework for European caring science.

Science.gov (United States)

Albarran, John; Rosser, Elizabeth; Bach, Shirley; Uhrenfeldt, Lisbeth; Lundberg, Pranee; Law, Kate

2011-01-01

The aim of this paper is to discuss the development of a cultural care framework that seeks to inform and embrace the philosophical ideals of caring science. Following a review of the literature that identified a lack of evidence of an explicit relationship between caring science and cultural care, a number of well-established transcultural care frameworks were reviewed. Our purpose was to select one that would resonate with underpinning philosophical values of caring science and that drew on criteria generated by the European Academy of Caring Science members. A modified framework based on the work of Giger and Davidhizar was developed as it embraced many of the values such as humanism that are core to caring science practice. The proposed caring science framework integrates determinants of cultural lifeworld-led care and seeks to provide clear directions for humanizing the care of individuals. The framework is offered to open up debate and act as a platform for further academic enquiry.

Differences in holistic processing do not explain cultural differences in the recognition of facial expression.

Science.gov (United States)

Yan, Xiaoqian; Young, Andrew W; Andrews, Timothy J

2017-12-01

The aim of this study was to investigate the causes of the own-race advantage in facial expression perception. In Experiment 1, we investigated Western Caucasian and Chinese participants' perception and categorization of facial expressions of six basic emotions that included two pairs of confusable expressions (fear and surprise; anger and disgust). People were slightly better at identifying facial expressions posed by own-race members (mainly in anger and disgust). In Experiment 2, we asked whether the own-race advantage was due to differences in the holistic processing of facial expressions. Participants viewed composite faces in which the upper part of one expression was combined with the lower part of a different expression. The upper and lower parts of the composite faces were either aligned or misaligned. Both Chinese and Caucasian participants were better at identifying the facial expressions from the misaligned images, showing interference on recognizing the parts of the expressions created by holistic perception of the aligned composite images. However, this interference from holistic processing was equivalent across expressions of own-race and other-race faces in both groups of participants. Whilst the own-race advantage in recognizing facial expressions does seem to reflect the confusability of certain emotions, it cannot be explained by differences in holistic processing.

The association between culture, climate and quality of care in primary health care teams.

Science.gov (United States)

Hann, Mark; Bower, Peter; Campbell, Stephen; Marshall, Martin; Reeves, David

2007-09-01

Culture and climate represent shared beliefs and values that may influence quality of care in health care teams, and which could be manipulated for quality improvement. However, there is a lack of agreement on the theoretical and empirical relationships between climate and culture, and their relative power as predictors of quality of care. This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care. The data were derived from a cross-sectional survey of 492 professionals in 42 general practices in England. Self-report measures of culture (the Competing Values Framework) and climate (the Team Climate Inventory) were used, together with validated measures of quality of care from medical records and self-report. The majority of practices could be characterized as 'clan' culture type. Practices with a dominant clan culture scored higher on climate for participation and teamwork. There were no associations between culture and quality of care, and only limited evidence of associations between climate and quality. The current analysis would not support the hypothesis that culture and climate are important predictors of quality of care in primary care. Although larger studies are required to provide a definitive test, the results may suggest the need for a more complex model of the associations between culture, climate and outcomes, and further research may be required into the interaction between culture and climate with other determinants of behaviour such as internal and external incentives.

Culturally competent care for members of sexual minorities.

Science.gov (United States)

Gonser, P A

2000-01-01

Culture has historically been interpreted as the beliefs, mores, and lifeways of groups of people primarily related to race and ethnicity. However, individuals who self identify as being lesbian, gay, bisexual and/or transgendered experience ethnocentrism when seeking care from medical and health professionals. Using the principles and concepts of Lenninger's theory of Culture Care Diversity and Universality, members of sexual minorities can assist their health care providers to provide culturally sensitive and ethical care.

Cultural and spiritual considerations in palliative care.

Science.gov (United States)

Long, Carol O

2011-10-01

Culture is a fundamental part of one's being. Spirituality is integrated with culture and both play a significant role in a person's journey through life. Yet, culture and spirituality are often misunderstood and may not seem to be important in healthcare settings. For adults with cancer and their families, this cannot be ignored. This paper reviews The Purnell Model of Cultural Competence as a framework for considering culture and spirituality in healthcare and discusses the importance of acknowledging and incorporating practices that support culture and spirituality in healthcare settings. Examples of how to include cultural and spiritual care in palliative and end-of-life care in healthcare settings are provided.

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

Science.gov (United States)

Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L

2017-04-01

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.

Clinical Holistic Medicine: Holistic Sexology and Acupressure Through the Vagina (Hippocratic Pelvic Massage

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2006-01-01

Full Text Available Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions released by the technique, i.e., regression to earlier traumas from childhood sexual abuse. This review discusses the theory behind vaginal acupressure, ethical aspects, and presentation of a case story. This procedure helped the patient to become present in her pelvis and to integrate old traumas with painful emotions. Holistic gynecology and sexology can help the patient to identify and let go of negative feelings, beliefs, and attitudes related to sex, gender, sexual organs, body, and soul at large. Shame, guilt, helplessness, fear, disgust, anxiety, anger, hatred, and other strong feelings are almost always an important part of a sexual or functional problem as these feelings are “held” by the tissue of the pelvis and sexual organs. Acupressure through the vagina/pelvic massage must be done with great care by an experienced physician, with a third person present, after obtaining consent and the necessary trust of the patient. It must be followed by conversational therapy and further holistic existential processing.

Cultural competency and diversity among hospice palliative care volunteers.

Science.gov (United States)

Jovanovic, Maja

2012-05-01

This case study examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area (GTA). Because of changing demographic trends and ethnic minorities underutilizing hospice palliative care services, this research examined the current state of culturally competent care in a hospice setting, and the challenges to providing culturally competent care in a hospice in the GTA. A case study was conducted with a hospice and included in-depth interviews with 14 hospice volunteers. The findings reveal that volunteers encountered cultural clashes when their level of cultural competency was weak. Second, volunteers revealed there was a lack of adequate cultural competency training with their hospice, and finally, there was a lack of ethnic, cultural, and linguistic diversity among the hospice volunteers.

Cultural competency: providing quality care to diverse populations.

Science.gov (United States)

Betancourt, Joseph R

2006-12-01

The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence

Social Media for the Promotion of Holistic Self-Participatory Care: An Evidence Based Approach. Contribution of the IMIA Social Media Working Group.

Science.gov (United States)

Miron-Shatz, T; Hansen, M M; Grajales, F J; Martin-Sanchez, F; Bamidis, P D

2013-01-01

As health information is becoming increasingly accessible, social media offers ample opportunities to track, be informed, share and promote health. These authors explore how social media and holistic care may work together; more specifically however, our objective is to document, from different perspectives, how social networks have impacted, supported and helped sustain holistic self-participatory care. A literature review was performed to investigate the use of social media for promoting health in general and complementary alternative care. We also explore a case study of an intervention for improving the health of Greek senior citizens through digital and other means. The Health Belief Model provides a framework for assessing the benefits of social media interventions in promoting comprehensive participatory self-care. Some interventions are particularly effective when integrating social media with real-world encounters. Yet not all social media tools are evidence-based and efficacious. Interestingly, social media is also used to elicit patient ratings of treatments (e.g., for depression), often demonstrating the effectiveness of complementary treatments, such as yoga and mindfulness meditation. To facilitate the use of social media for the promotion of complementary alternative medicine through self-quantification, social connectedness and sharing of experiences, exploration of concrete and abstract ideas are presented here within. The main mechanisms by which social support may help improve health - emotional support, an ability to share experiences, and non-hierarchal roles, emphasizing reciprocity in giving and receiving support - are integral to social media and provide great hope for its effective use.

Event-related potentials during individual, cooperative, and competitive task performance differ in subjects with analytic vs. holistic thinking.

Science.gov (United States)

Apanovich, V V; Bezdenezhnykh, B N; Sams, M; Jääskeläinen, I P; Alexandrov, YuI

2018-01-01

It has been presented that Western cultures (USA, Western Europe) are mostly characterized by competitive forms of social interaction, whereas Eastern cultures (Japan, China, Russia) are mostly characterized by cooperative forms. It has also been stated that thinking in Eastern countries is predominantly holistic and in Western countries analytic. Based on this, we hypothesized that subjects with analytic vs. holistic thinking styles show differences in decision making in different types of social interaction conditions. We investigated behavioural and brain-activity differences between subjects with analytic and holistic thinking during a choice reaction time (ChRT) task, wherein the subjects either cooperated, competed (in pairs), or performed the task without interaction with other participants. Healthy Russian subjects (N=78) were divided into two groups based on having analytic or holistic thinking as determined with an established questionnaire. We measured reaction times as well as event-related brain potentials. There were significant differences between the interaction conditions in task performance between subjects with analytic and holistic thinking. Both behavioral performance and physiological measures exhibited higher variance in holistic than in analytic subjects. Differences in amplitude and P300 latency suggest that decision making was easier for the holistic subjects in the cooperation condition, in contrast to analytic subjects for whom decision making based on these measures seemed to be easier in the competition condition. The P300 amplitude was higher in the individual condition as compared with the collective conditions. Overall, our results support the notion that the brains of analytic and holistic subjects work differently in different types of social interaction conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical Holistic Medicine: Holistic Rehabilitation

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Quality of life, health, and ability are often lost at the same time and most often in one decaying existential movement over 5 or 10 years. This “lost life” is mostly too slow to be felt as life threatening, but once awakened to reality, it provokes the deepest of fears in patients: the fear of death itself and destruction of our mere existence. The horrible experience of having “lost life””, often without even noticing how it happened, can be turned into a strong motivation for improvement. Personal development is about finding the life deeply hidden within in order to induce revitalization and rehabilitation. Rehabilitation is about philosophy of life with the integration of the repressed painful feelings and emotions from the past and the letting go of the associated negative beliefs and decisions. The holistic medical toolbox builds on existential theories (the quality of life theories, the life mission theory, the theory of character, the theory of talent, and the holistic process theory and seems to have the power to rehabilitate the purpose of life, the character of the person, and fundamental existential dimensions of man: (1 love; (2 strength of mind, feelings, and body; and 3 joy, gender, and sexuality; allowing the person once again to express and realize his talents and full potential. The principles of rehabilitation are not very different from other healing, but the task is often more demanding for the holistic physician as the motivation and resources often are very low and the treatment can take many years.

Interventions for confusion and dementia. 5: Changing cultures.

Science.gov (United States)

Woodrow, P

Previous articles in this series (Vol 7(15): 891-94; Vol 7(17): 1018-20; Vol 7(19): 1145-49; Vol 7(20): 1247-50) have explored the promotion of quality of life for people with dementia and how this can be achieved through existing interventions. This final article moves from discussing specific interventions to cover wider issues around healthcare beliefs and values. A brief historical overview of dementia care is given, outlining the inherited structures and values. Much valuable work has been carried out by the Bradford Dementia Group, who has described changes in dementia care as moving from an 'old' to a 'new' culture. This 'new culture', offering a comprehensive person-centred approach to holistic care, is explored with reference to the work of Kitwood, who has done much to promote quality of life for people suffering from dementia.

Cultural and communicative competence in the caring relationship with patients from another culture.

Science.gov (United States)

Hemberg, Jessica Anne Viveka; Vilander, Susann

2017-12-01

The global and multicultural society of today creates challenges that require multicultural competence among individuals, especially within caring contexts. This study assumes an intercultural perspective, and the aim is to uncover a new understanding of the caring community between nurses and patients when these do not speak the same language. The research question is: What is the significance of communication in a caring community when nurses and patients do not speak the same language? This qualitative study uses a hermeneutical approach. The material was collected through questionnaires with eight nurses and two adults from another culture. The texts were analysed through latent content analysis. Study participation, data storage and handling for research purposes were approved by the participants when they provided their informed consent. Permission to conduct the study was granted by an ethical committee of a hospital organisation. Human love is the basis for a caring relationship since it reaches beyond the limits of cultural differences. Integrity is vital for cultural respect and especially for the consideration of spiritual needs in the caring relationship. An affirming presence is essential for communion. Creative courage is fundamental for communication, and continuous information is vital for establishing trust within the caring relationship. One limitation to this study might be the limited number of participants (ten). Caring for a patient from another culture requires that nurses are open-minded and have the courage to encounter new challenges. It is essential for nurses to respect the patient's integrity but also to acquire knowledge in order to improve their cultural competence. Further research within this area should focus on the role of next of kin in intercultural caring and on how leadership may contribute to improving cultural competence within health organisations. © 2017 Nordic College of Caring Science.

Somatic symptoms and holistic thinking as major dimensions behind modern health worries.

Science.gov (United States)

Köteles, Ferenc; Simor, Péter

2014-01-01

Modern health worries (MHWs) were related to somatic symptoms and to preference of holistic healing methods in previous studies. The study aimed to investigate the contribution of symptom-related and holism-related factors to MHWs. Participants (visitors of an Internet news portal; N = 16152; 64.1 % males) completed a questionnaire assessing MHWs, somatosensory amplification, somatic symptoms, positive and negative affect, spirituality, holistic health beliefs, and various aspects of health care utilization (both conventional and alternative). Exploratory factor analysis with oblique rotation revealed two independent dimensions ("Somatic symptom distress" and "Holism") MHWs were involved with factor loadings of 0.294 and 0.417, respectively. The existence of two factors was supported by the results of confirmatory factor analysis. No practically significant interaction between the two factors was found in binary logistic regression analysis. Positive and negative affect, somatosensory amplification, spirituality, and holistic health beliefs were positively connected, while self-rated health status was negatively connected to MHWs even after controlling for socio-demographic and treatment-related variables. Holistic thinking and symptom-related behavioral and psychological factors are independently associated with MHWs. Modern health worries can be conceptualized as symptom-related by-products of a holistic-spiritual worldview.

Intercultural palliative care: do we need cultural competence?

Science.gov (United States)

Gunaratnam, Yasmin

2007-10-01

Recognition of the importance of 'cultural competence' is now central to health care policy and to nurse education and training across the international spectrum. Detailed engagement with models of cultural competence is comparatively recent in palliative care nursing. This article presents the findings from a development project on elders and carers from 'minority ethnic' groups, funded by the Department of Health, to increase awareness of palliative care and to improve understanding of the needs of these groups of service users. The article describes the experiences of nurses involved in the delivery of palliative care who were interviewed in focus groups as a part of the project. It draws attention to the complicated relationships between cultural knowledge and practice and to the non-rational and visceral dimensions of intercultural care. These aspects of nursing are marginalised in current approaches to cultural competence, which emphasise the rational acquisition and application of cultural knowledge and skills by practitioners. It is suggested that recognition of these marginalised experiences can contribute to the development of new approaches to intercultural nursing that are also more attuned to the ethos and values of palliative care.

Mixed messages: residents' experiences learning cross-cultural care.

Science.gov (United States)

Park, Elyse R; Betancourt, Joseph R; Kim, Minah K; Maina, Angela W; Blumenthal, David; Weissman, Joel S

2005-09-01

An Institute of Medicine report issued in 2002 cited cross-cultural training as a mechanism to address racial and ethnic disparities in health care, but little is known about residents' training and capabilities to provide quality care to diverse populations. This article explores a select group of residents' perceptions of their preparedness to deliver quality care to diverse populations. Seven focus groups and ten individual interviews were conducted with 68 residents in locations nationwide. Qualitative analysis of focus-group and individual interview transcripts was performed to assess residents' perceptions of (1) preparedness to deliver care to diverse patients; (2) educational climate; and (3) training experiences. Most residents in this study noted the importance of cross-cultural care yet reported little formal training in this area. Residents wanted more formal training yet expressed concern that culture-specific training could lead to stereotyping. Most residents had developed ad hoc, informal skills to care for diverse patients. Although residents perceived institutional endorsement, they sensed it was a low priority due to lack of time and resources. Residents in this study reported receiving mixed messages about cross-cultural care. They were told it is important, yet they received little formal training and did not have time to treat diverse patients in a culturally sensitive manner. As a result, many developed coping behaviors rather than skills based on formally taught best practices. Training environments need to increase training to enhance residents' preparedness to deliver high-quality cross-cultural care if the medical profession is to achieve the goals set by the Institute of Medicine.

Holistic needs assessment in advanced, intensively treated multiple myeloma patients.

Science.gov (United States)

Boland, E G; Boland, J W; Ezaydi, Y; Greenfield, D M; Ahmedzai, S H; Snowden, J A

2014-10-01

It is recommended that patients with multiple myeloma should be assessed for unmet holistic needs at key times in their disease trajectory. The aim of this exploratory study was to characterise the holistic needs of advanced, intensively treated multiple myeloma using a structured assessment tool. Patients with multiple myeloma who had undergone a haematopoietic stem cell transplantation and subsequent treatment for at least one episode of progressive disease but were in stable plateau phase were included in the study. Patients' holistic needs were assessed using the self-reporting tool, Sheffield Profile for Assessment and Referral for Care (SPARC). Thirty-two patients with a median age of 60 years at assessment and a median of 5.5 years from diagnosis were recruited. Using the SPARC, half of the patients reported tiredness as 'quite a bit/very much,' while one third complained that daytime somnolence and insomnia were 'quite a bit/very much.' Forty-four percent of patients reported pain. One third of patients were bothered and distressed by the side effects from their treatment and were worried about long-term effects of their treatment. Thirty-one percent of patients felt that the effect of their condition had an impact on their sexual life, and 40 % were worried about the effect that their illness was having on their family or other people. This is the first study to use a self-reported holistic needs assessment tool in multiple myeloma. A multidimensional structured questionnaire like the SPARC could provide a useful first step in the effective delivery of supportive and palliative care for patients with multiple myeloma.

Holistic education and complexity thinking

NARCIS (Netherlands)

Jörg, T.

2007-01-01

Paper proposal for the SIG Holistic Education at AERA 2007 Title: Holistic Education and Complexity Thinking Ton Jörg IVLOS Institute of Education University of Utrecht The Netherlands A.G.D.Jorg@ivlos.uu.nl ABSTRACT In this paper I link complexity thinking with Holistic Education (HE). It is a

Successful engagement: CBM's holistic approach to the work in the area of ear care, deafness, hard of hearing and deafblindness.

Science.gov (United States)

Tesni, Sian; Santana-Hernández, Diego

2014-09-01

CBM is an international Christian development organisation, committed to improving the quality of life of persons with disabilities in disadvantaged societies. CBM aims at achieving this in partnership with local organisations and in cooperation with stakeholders at regional and international levels. This article aims at sharing CBM's holistic approach for successful engagement in the work area of ear care, deafness, hard of hearing and deafblindness. Review of CBM supporting documents, including strategies, position papers, technical guidelines, criteria of success and information related to partners, centres of excellence and model projects. Description of how partner programmes use participatory methods of planning and implementation, involving persons with disabilities and the community. Recommendations on how to develop national or sub-national strategies to impact the lives, and advocate with governments for the rights and inclusion, of persons with disabilities. CBM's holistic approach to work in the area of ear care; deafness; hard of hearing and deafblindness includes intervention at all levels of health care provision, Education, CBR and Audiological, Speech Therapy and other interdisciplinary services. This article presents CBM's core principles and shares specific strategic planning and results, together with lessons learnt while searching a sustainable engagement for field work. Rehabilitation, in its widest conception, should be approached as a multidisciplinary strategy, and developed in close cooperation with other local, national and international agencies. CBM is positioned in a strategic point from where it can play a key role in the facilitation of an international forum for agencies and stakeholders to reach a consensus to decrease the burden of ear disease and hearing loss, through early intervention and re/habilitation.

A Holistic Approach to Manufacturing System Design in the Defense Aerospace Industry

National Research Council Canada - National Science Library

Vaughn, Amanda

2002-01-01

.... Also, manufacturing systems are complex systems that need to be carefully designed in a holistic manner and there are shortcomings with available tools and methods to assist in the design of these systems...

A Comparison of Surgery and Family Medicine Residents' Perceptions of Cross-Cultural Care Training of Cross-Cultural Care Training

OpenAIRE

Chun, Maria BJ; Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-01-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruc...

Bridging generic and professional care practices for Muslim patients through use of Leininger's culture care modes.

Science.gov (United States)

Wehbe-Alamah, Hiba

2008-04-01

The purpose of this article is to provide knowledge of traditional Muslim generic (folk) care beliefs, expressions and practices derived from research and descriptive sources, in order to assist nurses and other health care professionals to integrate generic (folk) into professional care practices. Muslim generic (folk) care beliefs and practices related to the caregiving process, health, illness, dietary needs, dress, privacy, modesty, touch, gender relations, eye contact, abortion, contraception, birth, death and bereavement were explored. A discussion involving the use of Leininger's culture care preservation and/or maintenance, culture care accommodation and/or negotiation and culture care repatterning and/or restructuring action modes to bridge the gap between generic (folk) and professional (etic) care practices and to consequently promote culturally congruent care is presented.

Holistic Medicine IV: Principles of Existential Holistic Group Therapy and the Holistic Process of Healing in a Group Setting

Directory of Open Access Journals (Sweden)

Soren Ventegodt

2003-01-01

Full Text Available In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person�s wholeness. This includes the body, the person�s philosophy of life, and often also love, purpose of life, and the spiritual dimension, to the same extent as it addresses the emotional psyche and sexuality, and it is thus much broader than traditional psychotherapy.Where existential psychotherapy is rather depressing concerning the fundamental human condition, existential holistic therapy conceives life to be basically good. The fundamentals in existential holistic therapy are that everybody has the potential for healing themselves to become loving, joyful, sexually attractive, strong, and gifted, which is a message that most patients welcome. While the patient is suffering and fighting to get through life, the most important job for the holistic therapist is to keep a positive perspective of life. In accordance with these fundamentals, many participants in holistic group therapy will have positive emotional experiences, often of an unknown intensity, and these experiences appear to transform their lives within only a few days or weeks of therapy.An important idea of the course is Bohm�s concept of �holo-movement� in the group, resulting from intense coherence between the group members. When the group comes together, the individual will be linked to the totality and the great movement forward towards love, consciousness, and happiness will happen collectively � if it happens at all. This gives the individual the feeling that everything that happens is right, important, and valuable for all the participants at the same time. Native Americans and other premodern people refer to this

Holistic medicine IV: principles of existential holistic group therapy and the holistic process of healing in a group setting.

Science.gov (United States)

Ventegodt, Søren; Andersen, Niels Jørgen; Merrick, Joav

2003-12-23

In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person"s wholeness. This includes the body, the person's philosophy of life, and often also love, purpose of life, and the spiritual dimension, to the same extent as it addresses the emotional psyche and sexuality, and it is thus much broader than traditional psychotherapy. Where existential psychotherapy is rather depressing concerning the fundamental human condition, existential holistic therapy conceives life to be basically good. The fundamentals in existential holistic therapy are that everybody has the potential for healing themselves to become loving, joyful, sexually attractive, strong, and gifted, which is a message that most patients welcome. While the patient is suffering and fighting to get through life, the most important job for the holistic therapist is to keep a positive perspective of life. In accordance with these fundamentals, many participants in holistic group therapy will have positive emotional experiences, often of an unknown intensity, and these experiences appear to transform their lives within only a few days or weeks of therapy. An important idea of the course is Bohm's concept of "holo-movement" in the group, resulting from intense coherence between the group members. When the group comes together, the individual will be linked to the totality and the great movement forward towards love, consciousness, and happiness will happen collectively--if it happens at all. This gives the individual the feeling that everything that happens is right, important, and valuable for all the participants at the same time. Native Americans and other premodern people refer to this experience as "the spiritual design

The Holistic Medicine Wheel: An Indigenous Model of Teaching and Learning.

Science.gov (United States)

Pewewardy, Cornel

1999-01-01

Based on the Medicine Wheel, a culturally relevant model for holistic teaching and curriculum development in indigenous education is centered on the self, then expands to four domains (mental, spiritual, physical, emotional) operationalized via eight multiple intelligences. Outer circles portray societal values and a global view of the world. A…

Cultural aspects of communication in cancer care.

Science.gov (United States)

Surbone, A

2006-01-01

Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase, and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care leads to improved therapeutic outcome and it may decrease disparities in medical care. Cultural competence in medicine is a complex multilayered accomplishment, requiring knowledge, skills and attitudes whose acquisition is needed for effective cross-cultural negotiation in the clinical setting. Effective cultural competence is based on knowledge of the notion of culture; on awareness of possible biases and prejudices related to stereotyping, racism, classism, sexism; on nurturing appreciation for differences in health care values; and on fostering the attitudes of humility, empathy, curiosity, respect, sensitivity and awareness. Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. A culturally competent healthcare system must consider in their separateness and yet in there reciprocal influences social, racial and cultural factors. By providing a framework of reference to interpret the external world and relate to it, culture affects patients' perceptions of disease, disability and suffering; degrees and expressions of concern about them; their responses to treatments and their relationship to individual physicians and to the healthcare system. Culture also influences the interpretation of ethical norms and principles, and especially of individual autonomy, which can be perceived either as synonymous with freedom or with isolation depending on the cultural context. This, in turn, determines the variability of truth-telling attitudes and practices worldwide as well as the different roles of family in the information and decision-making process of

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

Science.gov (United States)

Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

Science.gov (United States)

Shaw, Susan J; Armin, Julie

2011-06-01

Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.

Don't neglect cultural diversity in oncology care.

Science.gov (United States)

Muñoz-Antonia, Teresita

2014-05-01

The growing Hispanic population in the United States mandates the need for oncology providers to become more familiar with disease patterns and cultural belief systems that can impact cancer care. "Culturally competent care" should be the mandate of all providers. This comprises awareness of cultural differences, communication in a manner that the patient understands, and respect. Copyright © 2014 by the National Comprehensive Cancer Network.

Clinical holistic medicine: holistic sexology and treatment of vulvodynia through existential therapy and acceptance through touch.

Science.gov (United States)

Ventegodt, Søren; Morad, Mohammed; Hyam, Eytan; Merrick, Joav

2004-08-04

Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient"s sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often "held" by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus) or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a written therapeutic

Clinical Holistic Medicine: Holistic Sexology and Treatment of Vulvodynia Through Existential Therapy and Acceptance Through Touch

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient's sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often “held” by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a

The Holistic Health Movement.

Science.gov (United States)

Gross, Stanley J.

1980-01-01

Provides a conceptual framework for understanding the holistic health field so counselors may consider its implications in addressing a new service area. Holistic health has unique emphases on positive wellness, environmental concerns, self-responsibility, and such practices as meditation, fitness, nourishment, vitality, and spirituality. (Author)

Transcultural nursing: providing culturally congruent care to the Hausa of Northwest Africa.

Science.gov (United States)

Chmielarczyk, V

1991-01-01

Research around the world is now beginning to validate the theory of Cultural Care as an important means to provide culturally congruent care to clients, families, and groups of diverse cultures. Knowledge of Leininger's Theory of Cultural Care Diversity and Universality can provide meaningful care to clients who have different traditional and current beliefs and values. The Leininger Sunrise Model can serve as a valuable guide to discover care meanings and practices related to the theory, and to provide practical and meaningful culture specific care decisions and actions by nurses. The three major modes of action, namely, cultural care maintenance or preservation, accommodation or negotiation, and repatterning or restructuring, are important differential means to provide culturally congruent care to clients within their own cultural setting. This article considers the application of such care for the Hausa of Northwest Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

Managing pressures ulcers in a resource constrained situation: A holistic approach

Directory of Open Access Journals (Sweden)

Abhijit Dam

2011-01-01

Full Text Available Managing pressure ulcers remain a challenge and call for a multidisciplinary team approach to care. Even more daunting is the management of such patients in remote locations and in resource constrained situations. The management of pressure sores in a patient with progressive muscular atrophy has been discussed using resources that were locally available, accessible, and affordable. Community participation was encouraged. A holistic approach to care was adopted.

De verklaringskracht van cultuur [The explanatory power of culture

NARCIS (Netherlands)

Graaf, N.D. de

2002-01-01

'Culture' is a popular concept for the explanation of various kinds of behavior in various contributions in the social sciences. Anthropologists and sociologists who use the holistic approach are particularly prone to stress the importance of culture. I argue that popular holistic explanations have

Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

Science.gov (United States)

Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

2007-08-01

Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

Holistic Processing of Chinese Characters

Directory of Open Access Journals (Sweden)

Alan Chun-Nang Wong

2011-05-01

Full Text Available Enhanced holistic processing (obligatory attention to all parts of an object has been associated with different types of perceptual expertise involving faces, cars, fingerprints, musical notes, English words, etc. Curiously Chinese characters are regarded as an exception, as indicated by the lack of holistic processing found for experts (Hsiao and Cottrell, 2009. The ceiling performance of experts, however, may have caused this null effect. We revisit this issue by adopting the often-used face-composite sequential-matching task to two-part Chinese characters. Participants matched the target halves (left or right of two characters while ignoring the irrelevant halves. Both Chinese readers (experts and non-Chinese readers (novices showed holistic processing. Follow-up experiments suggested different origins of the effects for the two groups. For experts, holistic processing was sensitive to the amount of experience with the characters, as it was larger for words than non-words (formed by swapping the two parts of a valid character. Novices, however, showed similar degree of holistic processing to words and non-words, suggesting that their effects were more related to their inefficient decomposition of a complex, character-like pattern into parts. Overall these findings suggest that holistic processing may be a marker of expertise with Chinese characters, contrary to previous claims.

Clinical Holistic Medicine: Chronic Pain in the Locomotor System

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Most pains from the locomotor system arise due to involuntary, chronic tensions in the muscles or other tissues. When the patient is motivated, the pain is easily cured in most of the cases by using the tools of consciousness-based medicine, primarily therapeutic touch, conversation, and coaching the patient in a positive philosophy of life. The pains are often caused by “blockages” that may cause problems other than just pain. Often it turns out that the blocked areas develop actual physical damage over time: a slipped disk in the back, articular degeneration, or osteoarthritis when the cartilage is affected, can often be explained in this way. Apparently, the exact areas where the blockage is situated cause cellular problems, disrupting cellular order. The holistic process theory of healing and the related quality of life theories state that return to the natural state of being is possible, whenever the person gets the resources needed for existential healing. The resources needed are “holding” in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for holistic healing are trust and the intention for the healing to take place. Case stories of holistic treatment of patients with chronic back pain, low back pain, muscle problems, knee pain, and symptoms of rheumatoid arthritis are discussed with exercises relevant for patients with these conditions in the holistic clinic.

Intuitive Face Judgments Rely on Holistic Eye Movement Pattern.

Science.gov (United States)

Mega, Laura F; Volz, Kirsten G

2017-01-01

Non-verbal signals such as facial expressions are of paramount importance for social encounters. Their perception predominantly occurs without conscious awareness and is effortlessly integrated into social interactions. In other words, face perception is intuitive. Contrary to classical intuition tasks, this work investigates intuitive processes in the realm of every-day type social judgments. Two differently instructed groups of participants judged the authenticity of emotional facial expressions, while their eye movements were recorded: an 'intuitive group,' instructed to rely on their "gut feeling" for the authenticity judgments, and a 'deliberative group,' instructed to make their judgments after careful analysis of the face. Pixel-wise statistical maps of the resulting eye movements revealed a differential viewing pattern, wherein the intuitive judgments relied on fewer, longer and more centrally located fixations. These markers have been associated with a global/holistic viewing strategy. The holistic pattern of intuitive face judgments is in line with evidence showing that intuition is related to processing the "gestalt" of an object, rather than focusing on details. Our work thereby provides further evidence that intuitive processes are characterized by holistic perception, in an understudied and real world domain of intuition research.

The ethical dimensions of delivering culturally congruent nursing and health care.

Science.gov (United States)

Zoucha, R; Husted, G L

2000-01-01

This article discusses the ethical parameters of giving culturally congruent care to individual patients by health care professionals. Leininger's Cultural Care Diversity and Universality theory (Leininger, 1995) is used to demonstrate the importance of culture in a person's life and Husted's and Husted's (1995) bioethical theory is used to create a mind-set of ethical interaction and to direct the analysis of a bioethical dilemma involving cultural differences between persons of the same culture, a depressed Mexican-American woman and her husband. The differences between transculturalism and multiculturalism are explored. We defend the position that a patient's culture is only a useful tool in caring for a patient if the individual person is made the primary focus of care.

Clinical holistic health: advanced tools for holistic medicine.

Science.gov (United States)

Ventegodt, Søren; Clausen, Birgitte; Nielsen, May Lyck; Merrick, Joav

2006-02-24

According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called "gestalts", are integrated in the present "now". The advanced holistic physician's expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of "stepping up" the therapy by using more and more "dramatic" methods to get access to repressed emotions and events has led us to a "therapeutic staircase" with ten steps: (1) establishing the relationship; (2) establishing intimacy, trust, and confidentiality; (3) giving support and holding; (4) taking the patient into the process of physical, emotional, and mental healing; (5) social healing of being in the family; (6) spiritual healing--returning to the abstract wholeness of the soul; (7) healing the informational layer of the body; (8) healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, "controlled violence" and "acupressure through the vagina"; (9) mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10) techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient). We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the efficiency of the advanced holistic

Clinical Holistic Health: Advanced Tools for Holistic Medicine

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2006-01-01

Full Text Available According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called “gestalts”, are integrated in the present “now”. The advanced holistic physician’s expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of “stepping up” the therapy by using more and more “dramatic” methods to get access to repressed emotions and events has led us to a “therapeutic staircase” with ten steps: (1 establishing the relationship; (2 establishing intimacy, trust, and confidentiality; (3 giving support and holding; (4 taking the patient into the process of physical, emotional, and mental healing; (5 social healing of being in the family; (6 spiritual healing — returning to the abstract wholeness of the soul; (7 healing the informational layer of the body; (8 healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, “controlled violence” and “acupressure through the vagina”; (9 mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10 techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient.We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the

Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

Science.gov (United States)

Young, Susan; Guo, Kristina L

2016-01-01

The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

Lean management beyond manufacturing a holistic approach

CERN Document Server

Bhasin, Sanjay

2015-01-01

Exploring Lean manufacturing in a holistic manner, this book helps organizations to implement Lean principles successfully by offering theoretical, empirical and practical knowledge. It empirically demonstrates how a successful Lean initiative can improve organizational efficiency, and incorporates valuable primary research to substantiate findings. It argues that Lean principles need to be applied throughout the value chain in order to be successful , and suggests that these tools need to be aligned with culture and change management. Chapters examine issues including Lean cultures, impediments to Lean, Lean and performance measurement, and the impact of Lean. Viewing Lean as a never-ending journey, this book provides a valuable resource to practising Lean managers, and specialist researchers and students, and also offers an important reference for organizations embarking on their Lean voyage.

The relationship between organizational culture and family satisfaction in critical care.

Science.gov (United States)

Dodek, Peter M; Wong, Hubert; Heyland, Daren K; Cook, Deborah J; Rocker, Graeme M; Kutsogiannis, Demetrios J; Dale, Craig; Fowler, Robert; Robinson, Sandra; Ayas, Najib T

2012-05-01

Family satisfaction with critical care is influenced by a variety of factors. We investigated the relationship between measures of organizational and safety culture, and family satisfaction in critical care. We further explored differences in this relationship depending on intensive care unit survival status and length of intensive care unit stay of the patient. Cross-sectional surveys. Twenty-three tertiary and community intensive care units within three provinces in Canada. One thousand two-hundred eighty-five respondents from 2374 intensive care unit clinical staff, and 880 respondents from 1381 family members of intensive care unit patients. None. Intensive care unit staff completed the Organization and Management of Intensive Care Units survey and the Hospital Survey on Patient Safety Culture. Family members completed the Family Satisfaction in the Intensive Care Unit 24, a validated survey of family satisfaction. A priori, we analyzed adjusted relationships between each domain score from the culture surveys and either satisfaction with care or satisfaction with decision-making for each of four subgroups of family members according to patient descriptors: intensive care unit survivors who had length of intensive care unit stay 14 days, and intensive care unit nonsurvivors who had length of stay relationships between most domains of organizational and safety culture, and satisfaction with care or decision-making for family members of intensive care unit nonsurvivors who spent at least 14 days in the intensive care unit. For the other three groups, there were only a few weak relationships between domains of organizational and safety culture and family satisfaction. Our findings suggest that the effect of organizational culture on care delivery is most easily detectable by family members of the most seriously ill patients who interact frequently with intensive care unit staff, who are intensive care unit nonsurvivors, and who spend a longer time in the intensive

Meanings, mechanisms, and measures of holistic processing.

Science.gov (United States)

Richler, Jennifer J; Palmeri, Thomas J; Gauthier, Isabel

2012-01-01

Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term "holistic" has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that "holistic processing" is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference.

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

Science.gov (United States)

Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

2007-01-01

Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

PERCEPTIONS OF CULTURE CARE IN HUMANITARIAN WORK BY THE STUDENTS OF MASTERS' DEGREE IN GLOBAL HEALTH CARE

OpenAIRE

Kering, Naomy

2016-01-01

As the world is increasingly becoming multicultural, the need for cultural competence education to students of health care is essential to ensure a culturally competent workforce. The main purpose of this study is to determine the students’ perceptions of culture care and its importance in their work contexts. The main aim is to identify how students’ worldview, cultural and socio-cultural factors influence the way of care to people of diverse cultures. Qualitative method was used in this stu...

End of life care - the importance of culture and ethnicity.

Science.gov (United States)

Clark, Katherine; Phillips, Jane

2010-04-01

Australia is a culturally and ethnically diverse country. Within such diversity there will be differing beliefs systems about death and dying. This may be a challenging prospect for health professionals. This article discusses how cultural diversity may impact care and provides some strategies for the general practitioner when considering the provision of end of life care. This article does not attempt to provide GPs with a prescriptive approach to multicultural care, as this would run the risk of stereotyping individuals. Rather, it discusses the barriers to end of life care among different cultural and ethnic groups, and suggests ways in which to improve understanding of different cultural needs in end of life care.

Politics and care: a study of Czech Americans within Leininger's theory of culture care diversity and universality.

Science.gov (United States)

Miller, J

1997-01-01

The domain of inquiry for this study was the influence of the American political environmental context on professional and generic care patterns, expressions, and meanings of Czech American immigrants. The purpose of the research was to document, describe, interpret, and analyze the diversities and universalities of professional and generic care for this cultural group, to provide culturally congruent care to Czech Americans, and to explicate the role of politics as an influence on care patterns, health, and well being. The researcher's former transcultural ethnonursing study in Prague, Czechoslovakia in 1991 served as a stimulus for this in-depth study on politics and care. Twelve key and twenty general informants were interviewed. Five major themes were identified. The researcher discovered that the capitalist economic market structure of the United States influenced informant lifeways in all dimensions of Leininger's Theory of Culture Care Diversity and Universality, as depicted in the Sunrise Model. Specific care patterns discovered included care as choice, care as responsibility, and care as helping each other. Findings related to professional and generic care supported researcher predictions that generic culture care patterns would be important to immigrants. Provisions for culturally congruent nursing care were articulated based on research findings.

Cultures for performance in health care

National Research Council Canada - National Science Library

Mannion, Russell; Davies, Huw T.O; Marshall, Martin N

2005-01-01

... in performance are intrinsically linked to cultural changes within health care settings. Using theories from a wide range of disciplines including economics, management and organization studies, policy studies and the health sciences, this book sets out definitions of cultures and performance, in particular the specific characteristics that help...

Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

Science.gov (United States)

Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

2017-11-01

In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

Caregivers as the fulcrum of care for mentally ill in the community: The urban rural divide among caregivers and care giving facilities

Directory of Open Access Journals (Sweden)

R C Jiloha

2016-01-01

Full Text Available Illness trends, health beliefs, healthcare pathways, level of awareness, access to health care resources, level of social support, perceived stigma, burden, coping strategies, care giving appraisal, and cultural acceptance of modes of treatment are different in urban and rural settings along with different caregivers profile. This review will highlight these differences in light of their overall characteristics, and health seeking behavior. This further calls for empowering caregivers, understanding and exploring new dimensions of caregiving, and implementing holistic intervention for patients as well as caregiver′s well-being.

Organizational culture, intersectoral collaboration and mental health care.

Science.gov (United States)

Mitchell, Penelope Fay; Pattison, Philippa Eleanor

2012-01-01

This study aims to investigate whether and how organizational culture moderates the influence of other organizational capacities on the uptake of new mental health care roles by non-medical primary health and social care services. Using a cross-sectional survey design, data were collected in 2004 from providers in 41 services in Victoria, Australia, recruited using purposeful sampling. Respondents within each service worked as a group to complete a structured interview that collected quantitative and qualitative data simultaneously. Five domains of organizational capacity were analyzed: leadership, moral support and participation; organizational culture; shared concepts, policies, processes and structures; access to resource support; and social model of health. A principal components analysis explored the structure of data about roles and capacities, and multiple regression analysis examined relationships between them. The unit of analysis was the service (n = 41). Organizational culture was directly associated with involvement in two types of mental health care roles and moderated the influence of factors in the inter-organizational environment on role involvement. Congruence between the values embodied in organizational culture, communicated in messages from the environment, and underlying particular mental health care activities may play a critical role in shaping the emergence of intersectoral working and the uptake of new roles. This study is the first to demonstrate the importance of organizational culture to intersectoral collaboration in health care, and one of very few to examine organizational culture as a predictor of performance, compared with other organizational-level factors, in a multivariate analysis. Theory is developed to explain the findings.

A legacy building model for holistic nursing.

Science.gov (United States)

Lange, Bernadette; Zahourek, Rothlyn P; Mariano, Carla

2014-06-01

This pilot project was an effort to record the historical roots, development, and legacy of holistic nursing through the visionary spirit of four older American Holistic Nurses Association (AHNA) members. The aim was twofold: (a) to capture the holistic nursing career experiences of elder AHNA members and (b) to begin to create a Legacy Building Model for Holistic Nursing. The narratives will help initiate an ongoing, systematic method for the collection of historical data and serve as a perpetual archive of knowledge and inspiration for present and future holistic nurses. An aesthetic inquiry approach was used to conduct in-depth interviews with four older AHNA members who have made significant contributions to holistic nursing. The narratives provide a rich description of their personal and professional evolution as holistic nurses. The narratives are presented in an aesthetic format of the art forms of snapshot, pastiche, and collage rather than traditional presentations of research findings. A synopsis of the narratives is a dialogue between the three authors and provides insight for how a Legacy Model can guide our future. Considerations for practice, education, and research are discussed based on the words of wisdom from the four older holistic nurses.

A meta-ethnography of organisational culture in primary care medical practice.

Science.gov (United States)

Grant, Suzanne; Guthrie, Bruce; Entwistle, Vikki; Williams, Brian

2014-01-01

Over the past decade, there has been growing international interest in shaping local organisational cultures in primary healthcare. However, the contextual relevance of extant culture assessment instruments to the primary care context has been questioned. The aim of this paper is to derive a new contextually appropriate understanding of the key dimensions of primary care medical practice organisational culture and their inter-relationship through a synthesis of published qualitative research. A systematic search of six electronic databases followed by a synthesis using techniques of meta-ethnography involving translation and re-interpretation. A total of 16 papers were included in the meta-ethnography from the UK, the USA, Canada, Australia and New Zealand that fell into two related groups: those focused on practice organisational characteristics and narratives of practice individuality; and those focused on sub-practice variation across professional, managerial and administrative lines. It was found that primary care organisational culture was characterised by four key dimensions, i.e. responsiveness, team hierarchy, care philosophy and communication. These dimensions are multi-level and inter-professional in nature, spanning both practice and sub-practice levels. The research contributes to organisational culture theory development. The four new cultural dimensions provide a synthesized conceptual framework for researchers to evaluate and understand primary care cultural and sub-cultural levels. The synthesised cultural dimensions present a framework for practitioners to understand and change organisational culture in primary care teams. The research uses an innovative research methodology to synthesise the existing qualitative research and is one of the first to develop systematically a qualitative conceptual framing of primary care organisational culture.

Use of culture care theory with Anglo- and African American elders in a long-term care setting.

Science.gov (United States)

McFarland, M R

1997-01-01

The purpose of this study was to discover the care expressions, practices, and patterns of elderly Anglo- and African American elders. The domain of inquiry was the cultural care of elderly residents within the environmental context of a long-term care institution. The ethnonursing qualitative research method was used to conduct the study which was conceptualized within Leininger's theory of culture care diversity and universality. Four major themes were discovered: (a) Residents expressed and lived generic care to maintain their preadmission lifeways; (b) The nursing staff provided aspects of professional care to support satisfying lifeways for residents; (c) Institutional care patterns and expressions were viewed as a continuing life experience but with major differences between the apartment section and nursing home units; and (d) An institutional culture of the retirement home was discovered which reflected unique lifeways and shared care and health expressions and practices. These themes substantiated the culture care theory and revealed new modes of care for the elderly in an institutional setting.

Holistic processing of face configurations and components.

Science.gov (United States)

Hayward, William G; Crookes, Kate; Chu, Ming Hon; Favelle, Simone K; Rhodes, Gillian

2016-10-01

Although many researchers agree that faces are processed holistically, we know relatively little about what information holistic processing captures from a face. Most studies that assess the nature of holistic processing do so with changes to the face affecting many different aspects of face information (e.g., different identities). Does holistic processing affect every aspect of a face? We used the composite task, a common means of examining the strength of holistic processing, with participants making same-different judgments about configuration changes or component changes to 1 portion of a face. Configuration changes involved changes in spatial position of the eyes, whereas component changes involved lightening or darkening the eyebrows. Composites were either aligned or misaligned, and were presented either upright or inverted. Both configuration judgments and component judgments showed evidence of holistic processing, and in both cases it was strongest for upright face composites. These results suggest that holistic processing captures a broad range of information about the face, including both configuration-based and component-based information. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The application of holistic risk management in the banking industry

OpenAIRE

2008-01-01

The banking industry in South Africa is facing three main challenges, namely: continuous change, foreign competition, and increasing levels of risk. These problems flow mainly from cultural diversity, globalisation, and rapid technological development in systems and communication. Decreasing predictability stems to a great extent from a lack of foreknowledge of how globalisation will develop, and how it can influence the South African banking industry in general and holistic risk management (...

The intersection of culture in the provision of dementia care: A systematic review.

Science.gov (United States)

Brooke, Joanne; Cronin, Camille; Stiell, Marlon; Ojo, Omorogieva

2017-08-09

To understand the intersection of healthcare professionals' and care workers' culture and their provision of person-centred care for people with dementia. Due to the nature of global immigration and recruitment strategies, health care is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals' and care workers' cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently, there is a lack of clarity regarding the intersection of culture in the provision of person-centred dementia care. A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1st January 2006 to 31st July 2016. A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals' and care workers' culture in relation to their provision of person-centred dementia care. A meta-synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people; impact of cultural perceptions on service use; acculturation of the workforce; and cross-cultural communication. Limited evidence was found on the impact of healthcare professionals' and care workers' culture on their provision of person-centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person-centred dementia care. Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent person

‘Holistic Mothers’ or ‘Bad Mothers’? Challenging Biomedical Models of the Body in Portugal

Directory of Open Access Journals (Sweden)

Anna Fedele

2016-06-01

Full Text Available This paper is based on early fieldwork findings on ‘holistic mothering’ in contemporary Portugal. I use holistic mothering as an umbrella term to cover different mothering choices, which are rooted in the assumption that pregnancy, childbirth and early childhood are important spiritual occasions for both mother and child. Considering that little social scientific literature exists about the religious dimension of alternative mothering choices, I present here a first description of this phenomenon and offer some initial anthropological reflections, paying special attention to the influence of Goddess spirituality on holistic mothers. Drawing on Pamela Klassen’s ethnography about religion and home birth in America (2001, I argue that in Portugal holistic mothers are challenging biomedical models of the body, asking for a more woman-centred care, and contributing to the process, already widespread in certain other European countries, of ‘humanising’ pregnancy and childbirth.

Intuitive Face Judgments Rely on Holistic Eye Movement Pattern

Directory of Open Access Journals (Sweden)

Laura F. Mega

2017-06-01

Full Text Available Non-verbal signals such as facial expressions are of paramount importance for social encounters. Their perception predominantly occurs without conscious awareness and is effortlessly integrated into social interactions. In other words, face perception is intuitive. Contrary to classical intuition tasks, this work investigates intuitive processes in the realm of every-day type social judgments. Two differently instructed groups of participants judged the authenticity of emotional facial expressions, while their eye movements were recorded: an ‘intuitive group,’ instructed to rely on their “gut feeling” for the authenticity judgments, and a ‘deliberative group,’ instructed to make their judgments after careful analysis of the face. Pixel-wise statistical maps of the resulting eye movements revealed a differential viewing pattern, wherein the intuitive judgments relied on fewer, longer and more centrally located fixations. These markers have been associated with a global/holistic viewing strategy. The holistic pattern of intuitive face judgments is in line with evidence showing that intuition is related to processing the “gestalt” of an object, rather than focusing on details. Our work thereby provides further evidence that intuitive processes are characterized by holistic perception, in an understudied and real world domain of intuition research.

Islamic Cultures: Health Care Beliefs and Practices.

Science.gov (United States)

Kemp, Charles

1996-01-01

Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…

Holistic evaluations of learning materials

DEFF Research Database (Denmark)

Bundsgaard, Jeppe; Hansen, Thomas Illum

2011-01-01

The aim of this paper is to present a holistic framework for evaluating learning materials and designs for learning. A holistic evaluation of learning material comprises investigations of - the potential learning potential, i.e. the affordances and challenges of the learning material...

[Representations of Care of Migrants from the former Soviet Union with Alcohol or Drug Problems in Germany].

Science.gov (United States)

Röhnsch, Gundula; Flick, Uwe

2015-10-01

Which representations of care can be found in migrants with alcohol or drug problems from the former Soviet Union? How do they correspond with views in the care system? Episodic interviews with 46 migrants, expert interviews with 33 service providers; analysis with thematic coding. For migrants and experts holistic care is important, which include spiritual-religious components but are also control-oriented. The cultural specificity of migrants' care representations should be acknowledged by the health care system much more. © Georg Thieme Verlag KG Stuttgart · New York.

Organizational culture, team climate and diabetes care in small office-based practices.

Science.gov (United States)

Bosch, Marije; Dijkstra, Rob; Wensing, Michel; van der Weijden, Trudy; Grol, Richard

2008-08-21

Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory) and organizational culture (Competing Values Framework), and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. A strong group culture was negatively associated to the quality of diabetes care provided to patients (beta = -0.04; p = 0.04), whereas a more 'balanced culture' was positively associated to diabetes care quality (beta = 5.97; p = 0.03). No associations were found between organizational culture, team climate and clinical patient outcomes. Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea that aspects of redesigning care such as teamwork and culture

Organizational culture, team climate and diabetes care in small office-based practices

Directory of Open Access Journals (Sweden)

van der Weijden Trudy

2008-08-01

Full Text Available Abstract Background Redesigning care has been proposed as a lever for improving chronic illness care. Within primary care, diabetes care is the most widespread example of restructured integrated care. Our goal was to assess to what extent important aspects of restructured care such as multidisciplinary teamwork and different types of organizational culture are associated with high quality diabetes care in small office-based general practices. Methods We conducted cross-sectional analyses of data from 83 health care professionals involved in diabetes care from 30 primary care practices in the Netherlands, with a total of 752 diabetes mellitus type II patients participating in an improvement study. We used self-reported measures of team climate (Team Climate Inventory and organizational culture (Competing Values Framework, and measures of quality of diabetes care and clinical patient characteristics from medical records and self-report. We conducted multivariate analyses of the relationship between culture, climate and HbA1c, total cholesterol, systolic blood pressure and a sum score on process indicators for the quality of diabetes care, adjusting for potential patient- and practice level confounders and practice-level clustering. Results A strong group culture was negatively associated to the quality of diabetes care provided to patients (β = -0.04; p = 0.04, whereas a more 'balanced culture' was positively associated to diabetes care quality (β = 5.97; p = 0.03. No associations were found between organizational culture, team climate and clinical patient outcomes. Conclusion Although some significant associations were found between high quality diabetes care in general practice and different organizational cultures, relations were rather marginal. Variation in clinical patient outcomes could not be attributed to organizational culture or teamwork. This study therefore contributes to the discussion about the legitimacy of the widespread idea

A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies

Science.gov (United States)

van Limburg, Maarten; Ossebaard, Hans C; Kelders, Saskia M; Eysenbach, Gunther; Seydel, Erwin R

2011-01-01

Background Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders. Objective The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector. Methods To identify the potential and limitations of current eHealth frameworks (1999–2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework. Results A total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a

Cultural health capital and the interactional dynamics of patient-centered care.

Science.gov (United States)

Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

2013-09-01

As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mentor Service Themes Emergent in a Holistic, Undergraduate Peer-Mentoring Experience

Science.gov (United States)

Ward, Elijah G.; Thomas, Earl E.; Disch, William B.

2014-01-01

Little research has focused carefully on the means by which peer mentors foster development in undergraduate protégés. Two faculty members developed a holistic, peer-mentoring project in which 26 upperclassmen mentored 74 underclassmen at a midsize, 4-year institution. Mentor journal notes, open-ended protégé responses, and participant…

Challenges Encountered by Vietnamese Nurses When Caring for Patients With Cancer.

Science.gov (United States)

Thuy Nguyen, Ly; Clemenceau Annoussamy, Lourdes; LeBaron, Virginia T

2017-03-01

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Cultural safety as an ethic of care: a praxiological process.

Science.gov (United States)

McEldowney, Rose; Connor, Margaret J

2011-10-01

New writings broadening the construct of cultural safety, a construct initiated in Aotearoa New Zealand, are beginning to appear in the literature. Therefore, it is considered timely to integrate these writings and advance the construct into a new theoretical model. The new model reconfigures the constructs of cultural safety and cultural competence as an ethic of care informed by a postmodern perspective. Central to the new model are three interwoven, co-occurring components: an ethic of care, which unfolds within a praxiological process shaped by the context. Context is expanded through identifying the three concepts of relationality, generic competence, and collectivity, which are integral to each client-nurse encounter. The competence associated with cultural safety as an ethic of care is always in the process of development. Clients and nurses engage in a dialogue to establish the level of cultural safety achieved at given points in a care trajectory.

Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

Science.gov (United States)

Milberg, Anna; Torres, Sandra; Ågård, Pernilla

2016-01-01

The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care. Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges

Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study

Science.gov (United States)

Torres, Sandra; Ågård, Pernilla

2016-01-01

Objective The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals’ understandings of cross-cultural interaction during end-of-life care. Methods Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. Results The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, ‘unusual’ emotional and pain expressions, the expectation that these patients’ families would be ‘different’ and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting “the unknown”. In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. Conclusions The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as �

Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

Directory of Open Access Journals (Sweden)

Anna Milberg

Full Text Available The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care.Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis.The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients.The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety

Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic study.

Science.gov (United States)

Van Keer, Rose-Lima; Deschepper, Reginald; Francke, Anneke L; Huyghens, Luc; Bilsen, Johan

2015-12-22

Conflicts during communication in multi-ethnic healthcare settings is an increasing point of concern as a result of societies' increased ethno-cultural diversity. We can expect that conflicts are even more likely to arise in situations where difficult medical decisions have to be made, such as critical medical situations in hospital. However, in-depth research on this topic is rather scarce. During critical care patients are often unable to communicate. We have therefore investigated factors contributing to conflicts between healthcare professionals and family members from ethnic minority groups in critical medical situations in hospital. Ethnographic fieldwork was done in one intensive care unit of a multi-ethnic urban hospital in Belgium over 6 months (January 2014 to June 2014). Data were collected through negotiated interactive observation, in-depth interviews with healthcare professionals, from patients' medical records, and by making notes in a logbook. Data were analysed by using grounded theory procedures. Conflicts were essentially related to differences in participants' views on what constitutes 'good care' based on different care approaches. Healthcare professionals' views on good care were based predominantly on a biomedical care model, whereas families' views on good care were mainly inspired by a holistic lifeworld-oriented approach. Giving good care, from the healthcare professionals' point of view, included great attention to regulations, structured communication, and central decision making. On the other hand, good care from the families' point of view included seeking exhaustive information, and participating in end-of-life decision making. Healthcare professionals' biomedical views on offering good care were strengthened by the features of the critical care context whereas families' holistic views on offering good care were reinforced by the specific characteristics of families' ethno-familial care context, including their different ethno-cultural

The Exploration of Culturally Sensitive Nursing Care in Pediatric Setting: a Qualitative Study

Directory of Open Access Journals (Sweden)

Leila Valizadeh

2017-02-01

Full Text Available Background: One of the essential aspects of the provision of care is cultural issues. Cultural sensitivity is the key for cultural care. The aim of this study was to explore culturally sensitive care in pediatric nursing care in Iran.Materials and Methods: This study was a conventional content analysis. Participants were consisted of 25 nurses and 9 parents selected through purposive sampling from three pediatric referral centers in Tabriz and Tehran, Iran. Data was collected using semi-structured interviews and field notes and were concurrently analyzed by using Graneheim and Lundman (2004 method. Data was transcribed verbatim, words, sentences, and phrases were considered meaning units, abstracted, labeled and compared for developing categories.Results: Culturally sensitive care of a sick child was consisted of three themes: ‘cultural exposure’, ‘intercultural communication’ and ‘the reconciliation of cultural conflict in families/care’. During the ‘cultural exposure’ nurses were informed of the cultural manifestations, strived to identify and understand patients/families with cultural diversities and respect their cultural beliefs. The nurse used the native language in ‘intercultural communication’ or a combination of verbal and nonverbal communication methods to reach a common understanding. Finally, a nurse in the conflict between the culture of child/family and care took actions for making decisions to develop a compliance between care and the family culture and amended parents’ harmful desires through negotiation and appropriate care.Conclusion: Understanding the concept of culturally sensitive care, can help with resolving the problems of cultural exchanges in Pediatric wards. Providing cultural facilities and interpreters to communicate with patients/family increase their satisfaction.

Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings.

Science.gov (United States)

McFarland, Marilyn M; Eipperle, Marilyn K

2008-04-01

Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.

Holistic processing of fingerprints by expert forensic examiners.

Science.gov (United States)

Vogelsang, Macgregor D; Palmeri, Thomas J; Busey, Thomas A

2017-01-01

Holistic processing is often characterized as a process by which objects are perceived as a whole rather than a compilation of individual features. This mechanism may play an important role in the development of perceptual expertise because it allows for rapid integration across image regions. The present work explores whether holistic processing is present in latent fingerprint examiners, who compare fingerprints collected from crime scenes against a set of standards taken from a suspect. We adapted a composite task widely used in the face recognition and perceptual expertise literatures, in which participants were asked to match only a particular half of a fingerprint with a previous image while ignoring the other half. We tested both experts and novices, using both upright and inverted fingerprints. For upright fingerprints, we found weak evidence for holistic processing, but with no differences between experts and novices with respect to holistic processing. For inverted fingerprints, we found stronger evidence of holistic processing, with weak evidence for differences between experts and novices. These relatively weak holistic processing effects contrast with robust evidence for holistic processing with faces and with objects in other domains of perceptual expertise. The data constrain models of holistic processing by demonstrating that latent fingerprint experts and novices may not substantively differ in terms of the amount of holistic processing and that inverted stimuli actually produced more evidence for holistic processing than upright stimuli. Important differences between the present fingerprint stimuli and those in the literature include the lack of verbal labels for experts and the absence of strong vertical asymmetries, both of which might contribute to stronger holistic processing signatures in other stimulus domains.

Perceived Safety, Quality and Cultural Competency of Maternity Care for Culturally and Linguistically Diverse Women in Queensland.

Science.gov (United States)

Mander, Sarah; Miller, Yvette D

2016-03-01

Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.

Culture and biomedical care in Africa: the influence of culture on biomedical care in a traditional African society, Nigeria, West Africa.

Science.gov (United States)

Chukwuneke, F N; Ezeonu, C T; Onyire, B N; Ezeonu, P O

2012-01-01

Biomedical Care in Africa and the influence of culture on the health-seeking behaviour of Africans can not be underestimated; many African cultures have different understanding of the causes of disease which more often affect our public health system, policy, planning and implementations. The traditional African healer unlike a doctor trained in western biomedicine, looks for the cause of the patient's ailments as misfortune in relationship between the patient and the social, natural and spiritual environments. The complexity of African society with different cultural and religious practices also reflects on the people's attitude and understanding of their health matters. This paper is an overview of the cultural influence on biomedical care in a traditional African society, Nigeria, West Africa. A research on the patients' health seeking behaviour and Primary Health Care service organization in 10 health centres in the five eastern states of the Federal Republic of Nigeria was carried out using a multistage cross-sectional study. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth semi- structured interview was also conducted. We observed there is underutilization of health care services at the primary level because most people do not accept the model of health care system provided for them. Most people believe diseases are caused by supernatural beings, the handiwork of neighbours or vengeance from an offended god as a result of transgressions committed in the past by an individual or parents. This group of people therefore prefers seeking traditional medicine to seeking orthodox medicine and often ends up in the hands of witch doctors who claim to have cure to almost all the diseases. Biomedical care in Africa is influence by culture because of different understanding of what ailment is and also due to limited knowledge of health matters, poverty and ignorance. There is a need therefore to focus on health

Understanding Muslim patients: cross-cultural dental hygiene care.

Science.gov (United States)

Sirois, M L; Darby, M; Tolle, S

2013-05-01

Healthcare providers who understand the basic pillars of Islamic beliefs and common religious practices can apply these concepts, anticipate the needs of the Muslim patient and family, and attract Muslim patients to the practice. Cross cultural knowledge can motivate dental hygienists to adopt culturally acceptable behaviors, strengthen patient-provider relationships and optimize therapeutic outcomes. Trends in Muslim population growth, Islamic history and beliefs, modesty practices, healthcare beliefs, contraception, childbearing, childrearing, pilgrimage, dietary practices, dental care considerations and communication are explained. This paper reviews traditional Muslim beliefs and practices regarding lifestyle, customs, healthcare and religion as derived from the literature and study abroad experiences. Recommendations are offered on how to blend western healthcare with Islamic practices when making introductions, appointments, eye contact, and selecting a practitioner. The significance of fasting and how dental hygiene care can invalidate the fast are also discussed. The ultimate goal is for practitioners to be culturally competent in providing care to Muslim patients, while keeping in mind that beliefs and practices can vary widely within a culture. © 2012 John Wiley & Sons A/S.

A holistic model for the selection of environmental assessment indicators to assess the impact of industrialization on indigenous health.

Science.gov (United States)

Kryzanowski, Julie A; McIntyre, Lynn

2011-01-01

Mainstream environmental assessment (EA) methodologies often inadequately address health, social and cultural impacts of concern for Canadian indigenous communities affected by industrialization. Our objective is to present a holistic, culturally-appropriate framework for the selection of indigenous health indicators for baseline health assessment, impact prediction, or monitoring of impacts over time. We used a critical population health approach to explore the determinants of health and health inequities in indigenous communities and conceptualize the pathways by which industrialization affects these determinants. We integrated and extended key elements from three indigenous health frameworks into a new holistic model for the selection of indigenous EA indicators. The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Potential applications are discussed using case study examples involving indigenous communities affected by industrialization. Industrialization can worsen indigenous health inequities by perpetuating the health, social and cultural impacts of historic environmental dispossession. To mitigate impacts, EA should explicitly recognize linkages between environmental dispossession and the determinants of health and health inequities and meaningfully involve indigenous communities in the process.

Resident and family member perceptions of cultural diversity in aged care homes.

Science.gov (United States)

Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

2017-03-01

Similar to many developed nations, older people living in residential aged care homes in Australia and the staff who care for them have become increasingly multicultural. This cultural diversity adds challenges for residents in adapting to the care home. This study explores: (i) residents' and family members' perceptions about staff and cultural diversity, and (ii) culturally and linguistically diverse residents' and family members' experiences. An interpretive study design employing a thematic analysis was applied. Twenty-three residents and seven family members participated in interviews. Four themes were identified from interpreting residents and family members' perceptions of the impact of cultural diversity on their adaptation to aged care homes: (i) perceiving diversity as an attraction; (ii) adapting to cross-cultural communication; (iii) adjusting to diet in the residential care home; and (iv) anticipating individualized psychosocial interactions. The findings have implications for identifying strategies to support staff from all cultural backgrounds in order to create a caring environment that facilitates positive relationships with residents and supports residents to adjust to the care home. © 2016 John Wiley & Sons Australia, Ltd.

Holistic Admissions in Nursing: We Can Do This.

Science.gov (United States)

Glazer, Greer; Clark, Angela; Bankston, Karen; Danek, Jennifer; Fair, Malika; Michaels, Julia

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools' knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone's buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of holistic

Holistic Admissions in Nursing: We Can Do This

Science.gov (United States)

GLAZER, GREER; CLARK, ANGELA; BANKSTON, KAREN; DANEK, JENNIFER; FAIR, MALIKA; MICHAELS, JULIA

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools’ knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone’s buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of

Culture as anchor or culture as impediment? The plight of child care ...

African Journals Online (AJOL)

The authors document the nature of the conflict, highlighting how the care workers adopted 'mothering roles' based on African cultural parenting practices, resulting in the need to perform culturally prescribed rituals, and how this brought about challenges within the workplace. The need for integrating traditional methods of ...

Palliative Care in Cancer

Science.gov (United States)

... care is usually provided by palliative care specialists, health care practitioners who have received special training and/or certification in palliative care. They provide holistic care to the patient and family or caregiver ...

Care and cultural context of Lebanese Muslim immigrants: using Leininger's theory.

Science.gov (United States)

Luna, L

1994-01-01

The purpose of this ethnonursing study was to describe and analyze the meanings and experiences of care for Lebanese Muslims as influenced by cultural context in selected natural and community settings. Leininger's theory of Cultural Care Diversity and Universality served as the conceptualizing frame-work for the study. Research questions focused on discovering the meanings and experiences of care as influenced by world view, social structure, and cultural context in the hospital, clinic, and home. Ethno-nursing research methods were used with key and general informants in an urban US community. The majority of informants were new immigrants living less than 10 years in the US. Universal themes of care that were similar in the three contexts reflected care as a religious obligation in Islam, care as equal but different gender role responsibilities, and care as individual and collective meanings of honor. This article also presents findings related to gender role responsibilities. Nursing decisions and actions using Leininger's three modes were identified to achieve culturally congruent nursing care.

Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

Science.gov (United States)

Grealish, Laurie; Henderson, Amanda

2016-10-01

Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

Outcome analysis of a research-based didactic model for education to promote culturally competent nursing care in Sweden--a questionnaire study.

Science.gov (United States)

Gebru, Kerstin; Khalaf, Azzam; Willman, Ania

2008-09-01

To describe and analyse to what extent the goals of the education in promoting culturally competent nursing care have been achieved from a student perspective. As Sweden has transformed into a multicultural society over the past 50 years, there is a need to specify, at all levels of the nursing programme, transcultural concepts for the success of integration. A research-based didactic model was designed for the nursing programme at Malmö University and this was followed by investigations of its outcome. The study is a prospective cohort study with an outcome analysis. A descriptive research study with a longitudinal design was performed, with the focus on Swedish nursing students' experiences of transcultural nursing knowledge and their attitudes before and after implementation of the didactic model. The students evaluate highly their competence to meet demands of multicultural health and medical service. Additionally, their ability to recognise and understand the consequences of international migration on health also received a high mean. The study revealed the knowledge and experience acquired by Swedish students in transcultural nursing. The assumption was that a visible development of knowledge should occur during the three years of education. Interpreting the findings, such effectiveness can be found and hopefully the students will be able to give holistic nursing care based on a person's individual culture.

Patient safety culture in care homes for older people: a scoping review

Directory of Open Access Journals (Sweden)

Emily Gartshore

2017-11-01

Full Text Available Abstract Background In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. Methods A scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Results Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Conclusions Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.

Developing an holistic assessment protocol on a hospice inpatient ward: staff engagement and my role as a practice development facilitator

Directory of Open Access Journals (Sweden)

John Lansdell

2016-05-01

Full Text Available Background: In 2014 I received the Richard Tompkins Nurse Development Scholarship, granted through the Foundation of Nursing Studies and including attendance at a five-day International Practice Development Collaborative practice development school, followed by a year’s mentorship. The scholarship aims to foster the delivery of person-centred care, which I hoped to achieve by enhancing holistic nursing assessment on a hospice inpatient ward. Aims: This article is a critical reflection on my learning through the scholarship, specifically related to staff engagement and my role as a practice development facilitator. Conclusions: While the project has not yet reached its conclusion, the learning has been invaluable. I have deepened my understanding of the need for collaboration, inclusion and participation to foster engagement and cultural change. More fundamentally, understanding how different aspects of my role enable change has proved both challenging and constructive, resulting in greater self-awareness and confidence. I remain committed to refining holistic nursing assessment to allow a greater degree of person-centred care in the hospice. Implications for practice: Practice development combines a variety of approaches to realise a shared vision; collaboration, inclusion and participation are central to fostering engagement Balancing different elements of a role (for instance, leader-manager-facilitator has the potential to be confusing and contradictory; awareness of how these elements interrelate promotes effectiveness when introducing change Individuals in a practice development role must ensure they have good sources of support

Evaluating holistic needs assessment in outpatient cancer care--a randomised controlled trial: the study protocol.

Science.gov (United States)

Snowden, Austyn; Young, Jenny; White, Craig; Murray, Esther; Richard, Claude; Lussier, Marie-Therese; MacArthur, Ewan; Storey, Dawn; Schipani, Stefano; Wheatley, Duncan; McMahon, Jeremy; Ross, Elaine

2015-05-11

People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impacts on the dynamics of the clinical consultation. This study aims to establish (1) how HNA affects the type of conversation that goes on during a clinical consultation and (2) how these putative changes impact on shared decision-making and self-efficacy. The study is hosted by 10 outpatient oncology clinics in the West of Scotland and South West England. Participants are patients with a diagnosis of head and neck, breast, urological, gynaecological and colorectal cancer who have received treatment for their cancer. Patients are randomised to an intervention or control group. The control group entails standard care--routine consultation between the patient and clinician. In the intervention group, the patient completes a holistic needs assessment prior to consultation. The completed assessment is then given to the clinician where it informs a discussion based on the patient's needs and concerns as identified by them. The primary outcome measure is patient participation, as determined by dialogue ratio (DR) and preponderance of initiative (PI) within the consultation. The secondary outcome measures are shared decision-making and self-efficacy. It is hypothesised that HNA will be associated with greater patient participation within the consultation, and that shared decision-making and feelings of self-efficacy will increase as a function of the intervention. This study has been given a favourable opinion by the West of Scotland Research Ethics Committee and NHS Research & Development. Study findings will be disseminated through peer-reviewed publications and conference attendance. Clinical Trials.gov NCT02274701. Published by the BMJ Publishing Group Limited. For

Holistic processing from learned attention to parts.

Science.gov (United States)

Chua, Kao-Wei; Richler, Jennifer J; Gauthier, Isabel

2015-08-01

Attention helps us focus on what is most relevant to our goals, and prior work has shown that aspects of attention can be learned. Learned inattention to parts can abolish holistic processing of faces, but it is unknown whether learned attention to parts is sufficient to cause a change from part-based to holistic processing with objects. We trained subjects to individuate nonface objects (Greebles) from 2 categories: Ploks and Glips. Diagnostic information was in complementary halves for the 2 categories. Holistic processing was then tested with Plok-Glip composites that combined the kind of part that was diagnostic or nondiagnostic during training. Exposure to Greeble parts resulted in general failures of selective attention for nondiagnostic composites, but face-like holistic processing was only observed for diagnostic composites. These results demonstrated a novel link between learned attentional control and the acquisition of holistic processing. (c) 2015 APA, all rights reserved).

Recurrent autoassociative networks and holistic computations

NARCIS (Netherlands)

Stoianov, [No Value; Amari, SI; Giles, CL; Gori, M; Piuri,

2000-01-01

The paper presents an experimental study of holistic computations over distributed representations (DRs) of sequences developed by the Recurrent Autoassociative Networks (KAN). Three groups of holistic operators are studied: extracting symbols at fixed position, extracting symbols at a variable

Cultural Safety and the Duty of Care.

Science.gov (United States)

Fulcher, Leon C.

2002-01-01

Examines the notion of cultural safety in relation to the duty of care mandate assigned to child welfare workers when the state intervenes in family life, focusing on the vulnerabilities of rural and indigenous youth in New Zealand to cultural racism. Asserts that child welfare professionals have a professional obligation to enhance their cultural…

Integrating Spiritual Care into a Baccalaureate Nursing Program in Mainland China.

Science.gov (United States)

Yuan, Hua; Porr, Caroline

2014-09-01

Holistic nursing care takes into account individual, family, community and population well-being. At the level of individual well-being, the nurse considers biological, psychological, social, and spiritual factors. However, in Mainland China spiritual factors are not well understood by nursing students. And accordingly, nursing faculty and students are reluctant to broach the topic of spirituality because it is either unknown to students or students believe that the provision of spiritual care is beyond their capabilities. We wonder then, what can we do as nurse educators to integrate spiritual care into a baccalaureate nursing program in Mainland China? The purpose of this article is to propose the integration of Chinese sociocultural traditions (namely religious/spiritual practices) into undergraduate nursing curricula as a means to enter into dialogue about spiritual well-being, to promote spiritual care; and to fulfill the requirements of holistic nursing care. However, prior to discussing recommendations, an overview of the cultural context is in order. Thus, this article is constructed as follows: first, the complexity of Chinese society is briefly described; second, the historical evolution of nursing education in Mainland China is presented; and, third, strategies to integrate Chinese religious/spiritual practices into curricula are proposed. © The Author(s) 2014.

Successful chronic disease care for Aboriginal Australians requires cultural competence.

Science.gov (United States)

Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret

2011-06-01

To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Innovative culture in long-term care settings: the influence of organizational characteristics.

Science.gov (United States)

Nieboer, Anna P; Strating, Mathilde M H

2012-01-01

Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings. The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector. A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy. The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively. The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by

Guiding the Process of Culturally Competent Care With Hispanic Patients: A Grounded Theory Study.

Science.gov (United States)

Sobel, Linda L; Metzler Sawin, Erika

2016-05-01

To explore nursing care actions that lead to culturally competent care for Hispanic patients. Nurses report apprehension when delivering nursing care because of language barriers and a lack of Hispanic cultural understanding. Research is needed to inform culturally aware nursing practice actions for Hispanic patients. The study used a qualitative, grounded theory design to address the questions: (a) What cultural knowledge should nurses have when caring for Hispanic patients and families and (b) What nursing actions should nurses take to provide culturally competent care? Hispanic lay health promoters and Hispanic community members were interviewed to make recommendations for care. A model was identified that informs culturally competent nursing care. "Connectedness," the central phenomenon, describes nursing actions and contains subthemes explaining influences on nursing care. "Up to You" and "At the Mercy of the System" are descriptive themes influencing connectedness. Connectedness is central to culturally well-informed nurse-patient interactions. © The Author(s) 2014.

Caring for a Bedouin Female Patient with Breast Cancer: An Application of Leininger’s Theory of Culture Care Diversity and Universality

Directory of Open Access Journals (Sweden)

Abdul Qadir J. Nashwan

2013-01-01

Full Text Available Leininger’s theory is to provide care measures that are in harmony with an individual or group’s cultural beliefs, practices, and values. In the 1960’s she coined the term culturally congruent care, which is the primary goal of Transcultural nursing practice. Recently, there is a noticeable increase in the usage of the advanced hospitals’ health services by the Bedouin; as their awareness developed in term of health issues, and this put the health care providers (especially nurses in a great chance to face this Bedouin’s culture in clinical areas. So we have to enrich our understanding of the Bedouin’s culture to deliver a culturally congruent and satisfying care. A personal experience of two oncology nurses in working with a female patient with breast cancer and her Bedouin family described, with application of Madeleine Leininger’s theory of culture care diversity and universality. Concluding that understanding, considering and valuing cultural differences when delivering nursing care are vital to ensure providing a culturally congruent nursing care as well as avoid conflicts.

Caring for a Bedouin Female Patient with Breast Cancer: An Application of Leininger’s Theory of Culture Care Diversity and Universality

Directory of Open Access Journals (Sweden)

Abdul Qadir J. Nashwan

2013-07-01

Full Text Available Leininger’s theory is to provide care measures that are in harmony with an individual or group’s cultural beliefs, practices, and values. In the 1960’s she coined the term culturally congruent care, which is the primary goal of Transcultural nursing practice. Recently, there is a noticeable increase in the usage of the advanced hospitals’ health services by the Bedouin; as their awareness developed in term of health issues, and this put the health care providers (especially nurses in a great chance to face this Bedouin’s culture in clinical areas. So we have to enrich our understanding of the Bedouin’s culture to deliver a culturally congruent and satisfying care. A personal experience of two oncology nurses in working with a female patient with breast cancer and her Bedouin family described, with application of Madeleine Leininger’s theory of culture care diversity and universality. Concluding that understanding, considering and valuing cultural differences when delivering nursing care are vital to ensure providing a culturally congruent nursing care as well as avoid conflicts.

Validation of a patient-centered culturally sensitive health care office staff inventory.

Science.gov (United States)

Tucker, Carolyn M; Wall, Whitney; Marsiske, Michael; Nghiem, Khanh; Roncoroni, Julia

2015-09-01

Research suggests that patient-perceived culturally sensitive health care encompasses multiple components of the health care delivery system including the cultural sensitivity of front desk office staff. Despite this, research on culturally sensitive health care focuses almost exclusively on provider behaviors, attitudes, and knowledge. This is due in part to the paucity of instruments available to assess the cultural sensitivity of front desk office staff. Thus, the objective of the present study is to determine the psychometric properties of the pilot Tucker-Culturally Sensitive Health Care Office Staff Inventory-Patient Form (T-CSHCOSI-PF), which is an instrument designed to enable patients to evaluate the patient-defined cultural sensitivity of their front desk office staff. A sample of 1648 adult patients was recruited by staff at 67 health care sites across the United States. These patients anonymously completed the T-CSHCOSI-PF, a demographic data questionnaire, and a patient satisfaction questionnaire. Findings Confirmatory factor analyses of the TCSHCOSI-PF revealed that this inventory has two factors with high internal consistency reliability and validity (Cronbach's αs=0.97 and 0.95). It is concluded that the T-CSHCOSI-PF is a psychometrically strong and useful inventory for assessing the cultural sensitivity of front desk office staff. This inventory can be used to support culturally sensitive health care research, evaluate the job performance of front desk office staff, and aid in the development of trainings designed to improve the cultural sensitivity of these office staff.

Cultural factors in preventive care: Latinos.

Science.gov (United States)

Diaz, Victor Alejandro

2002-09-01

For many, the term "Hispanic" places undue emphasis on the European influence of Spanish colonialism and may even have negative connotations for some. "Latino" is a more encompassing term that gives recognition to the influences of the indigenous and African cultures on modern day Latin Americans. Nevertheless, recognition of typical Latino attitudes and beliefs may assist health care providers. Poverty, unemployment, and low level of education usually account for adverse health in this population. Anti-immigrant sentiment and discrimination in health care and education add adversity to the immigrant's experience. Lack of health insurance and access to quality health care typically plague the adult immigrant. For many, the nearest emergency department is their only source of medical care.

Assessing Online Discussions: A Holistic Approach

Science.gov (United States)

Wang, Yu-mei; Chen, Der-Thanq

2017-01-01

This article reports a holistic approach to assessing online discussions. This holistic approach integrates three assessment methods: assessment of learning, assessment for learning, and assessment as learning. Assessment of learning directly examines students' learning products to decide whether they have achieved the expected learning through…

A Shape-Based Account for Holistic Face Processing

Science.gov (United States)

Zhao, Mintao; Bülthoff, Heinrich H.; Bülthoff, Isabelle

2016-01-01

Faces are processed holistically, so selective attention to 1 face part without any influence of the others often fails. In this study, 3 experiments investigated what type of facial information (shape or surface) underlies holistic face processing and whether generalization of holistic processing to nonexperienced faces requires extensive…

Contextual facilitators and maintaining of compassion-based care: An ethnographic study

Directory of Open Access Journals (Sweden)

Sima Babaei

2017-01-01

Full Text Available Background: Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. Materials and Methods: This ethnographic study was conducted in 2014–2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin. Results: Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors. Conclusions: The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing.

Fast and Careless or Careful and Slow? Apparent Holistic Processing in Mental Rotation Is Explained by Speed-Accuracy Trade-Offs

Science.gov (United States)

Liesefeld, Heinrich René; Fu, Xiaolan; Zimmer, Hubert D.

2015-01-01

A major debate in the mental-rotation literature concerns the question of whether objects are represented holistically during rotation. Effects of object complexity on rotational speed are considered strong evidence against such holistic representations. In Experiment 1, such an effect of object complexity was markedly present. A closer look on…

Patient-centered care: the key to cultural competence.

Science.gov (United States)

Epner, D E; Baile, W F

2012-04-01

Much of the early literature on 'cultural competence' focuses on the 'categorical' or 'multicultural' approach, in which providers learn relevant attitudes, values, beliefs, and behaviors of certain cultural groups. In essence, this involves learning key 'dos and don'ts' for each group. Literature and educational materials of this kind focus on broad ethnic, racial, religious, or national groups, such as 'African American', 'Hispanic', or 'Asian'. The problem with this categorical or 'list of traits' approach to clinical cultural competence is that culture is multidimensional and dynamic. Culture comprises multiple variables, affecting all aspects of experience. Cultural processes frequently differ within the same ethnic or social group because of differences in age cohort, gender, political association, class, religion, ethnicity, and even personality. Culture is therefore a very elusive and nebulous concept, like art. The multicultural approach to cultural competence results in stereotypical thinking rather than clinical competence. A newer, cross cultural approach to culturally competent clinical practice focuses on foundational communication skills, awareness of cross-cutting cultural and social issues, and health beliefs that are present in all cultures. We can think of these as universal human beliefs, needs, and traits. This patient centered approach relies on identifying and negotiating different styles of communication, decision-making preferences, roles of family, sexual and gender issues, and issues of mistrust, prejudice, and racism, among other factors. In the current paper, we describe 'cultural' challenges that arise in the care of four patients from disparate cultures, each of whom has advanced colon cancer that is no longer responding to chemotherapy. We then illustrate how to apply principles of patient centered care to these challenges.

Clinicians' interpretations of point of care urine culture versus laboratory culture results: analysis from the four-country POETIC trial of diagnosis of uncomplicated urinary tract infection in primary care.

Science.gov (United States)

Hullegie, Saskia; Wootton, Mandy; Verheij, Theo J M; Thomas-Jones, Emma; Bates, Janine; Hood, Kerenza; Gal, Micaela; Francis, Nick A; Little, Paul; Moore, Michael; Llor, Carl; Pickles, Timothy; Gillespie, David; Kirby, Nigel; Brugman, Curt; Butler, Christopher C

2017-08-01

Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI). Primary care clinicians used the Flexicult™-POCT, recorded their findings and took a photograph of the result, which was interpreted by microbiology laboratory technicians. Urine samples were additionally processed in routine care laboratories. Cross tabulations were used to identify important differences in organism identification, quantification and antibiotic susceptibility between these three sources of data. The influence of various laboratory definitions for UTI on culture were assessed. Primary care clinicians identified 202/289 urine samples (69.9%) as positive for UTI using the Flexicult™-POCT, whereas laboratory culture identified 94-190 (32.5-65.7%) as positive, depending on definition thresholds. 82.9% of samples identified positive for E. coli on laboratory culture were also considered positive for E. coli using the Flexicult™ -POCT, and susceptibilities were reasonably concordant. There were major discrepancies between laboratory staff interpretation of Flexicult™ photographs, clinicians' interpretation of the Flexicult™ test, and laboratory culture results. Flexicult™-POCT overestimated the positivity rate of urine samples for UTI when laboratory culture was used as the reference standard. However, it is unclear whether point-of-care or laboratory based urine culture provides the most valid diagnostic information. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cultural health capital and the interactional dynamics of patient-centered care

OpenAIRE

Dubbin, Leslie A.; Chang, Jamie Suki; Shim, Janet K.

2013-01-01

As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a speci...

Improving Electronic Resources through Holistic Budgeting

Science.gov (United States)

Kusik, James P.; Vargas, Mark A.

2009-01-01

To establish a more direct link between its collections and the educational goals of Saint Xavier University, the Byrne Memorial Library has adopted a "holistic" approach to collection development. This article examines how traditional budget practices influenced the library's selection of resources and describes how holistic collection…

Ethics of cancer palliative care in Sri Lanka. A cross- cultural perspective.

Directory of Open Access Journals (Sweden)

Dayasiri MBKC

2010-12-01

Full Text Available The diagnosis of cancer is associated with an unexpected breakdown of the physical, psychological and social well being. In addition to cancer related physical outcomes, cross-cultural issues are known to hasten patients’ clinical deterioration and can impact upon orientation as a healthy human being in society. As members of a developing nation in the second world, to provide patient oriented quality care while maintaining high standards of ethical practice, health care workers in Sri Lanka have to be culturally competent. In Sri Lanka, the cross-cultural ethical issues related to patients with a diagnosis of cancer include, awareness of one’s own cultural identity, gaining knowledge of different cultural issues, verbal and non verbal communication skills, respect for patients’ autonomy, involvement of the family and the relatives, addressing moral and spiritual backgrounds, development of effective communication skills and provision of social support. Therefore in the management of cancer patients in Sri Lanka, cultural issues should be given a high priority to maintain ethical standards and quality in palliative care. Culturally competent Health care workers safeguard the rights of patients, as well as providing optimal medical and surgical care.

Reflections on Palliative Care from the Jewish and Islamic Tradition

Directory of Open Access Journals (Sweden)

Michael Schultz

2012-01-01

Full Text Available Spiritual care is a vital part of holistic patient care. Awareness of common patient beliefs will facilitate discussions about spirituality. Such conversations are inherently good for the patient, deepen the caring staff-patient-family relationship, and enhance understanding of how beliefs influence care decisions. All healthcare providers are likely to encounter Muslim patients, yet many lack basic knowledge of the Muslim faith and of the applications of Islamic teachings to palliative care. Similarly, some of the concepts underlying positive Jewish approaches to palliative care are not well known. We outline Jewish and Islamic attitudes toward suffering, treatment, and the end of life. We discuss our religions' approaches to treatments deemed unnecessary by medical staff, and consider some of the cultural reasons that patients and family members might object to palliative care, concluding with specific suggestions for the medical team.

Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers

Directory of Open Access Journals (Sweden)

Seeleman Conny

2012-07-01

Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.

Validation of the Vanderbilt Holistic Face Processing Test.

Science.gov (United States)

Wang, Chao-Chih; Ross, David A; Gauthier, Isabel; Richler, Jennifer J

2016-01-01

The Vanderbilt Holistic Face Processing Test (VHPT-F) is a new measure of holistic face processing with better psychometric properties relative to prior measures developed for group studies (Richler et al., 2014). In fields where psychologists study individual differences, validation studies are commonplace and the concurrent validity of a new measure is established by comparing it to an older measure with established validity. We follow this approach and test whether the VHPT-F measures the same construct as the composite task, which is group-based measure at the center of the large literature on holistic face processing. In Experiment 1, we found a significant correlation between holistic processing measured in the VHPT-F and the composite task. Although this correlation was small, it was comparable to the correlation between holistic processing measured in the composite task with the same faces, but different target parts (top or bottom), which represents a reasonable upper limit for correlations between the composite task and another measure of holistic processing. These results confirm the validity of the VHPT-F by demonstrating shared variance with another measure of holistic processing based on the same operational definition. These results were replicated in Experiment 2, but only when the demographic profile of our sample matched that of Experiment 1.

Validation of the Vanderbilt Holistic Face Processing Test.

Directory of Open Access Journals (Sweden)

Chao-Chih Wang

2016-11-01

Full Text Available The Vanderbilt Holistic Face Processing Test (VHPT-F is a new measure of holistic face processing with better psychometric properties relative to prior measures developed for group studies (Richler et al., 2014. In fields where psychologists study individual differences, validation studies are commonplace and the concurrent validity of a new measure is established by comparing it to an older measure with established validity. We follow this approach and test whether the VHPT-F measures the same construct as the composite task, which is group-based measure at the center of the large literature on holistic face processing. In Experiment 1, we found a significant correlation between holistic processing measured in the VHPT-F and the composite task. Although this correlation was small, it was comparable to the correlation between holistic processing measured in the composite task with the same faces, but different target parts (top or bottom, which represents a reasonable upper limit for correlations between the composite task and another measure of holistic processing. These results confirm the validity of the VHPT-F by demonstrating shared variance with another measure of holistic processing based on the same operational definition. These results were replicated in Experiment 2, but only when the demographic profile of our sample matched that of Experiment 1.

About-face on face recognition ability and holistic processing.

Science.gov (United States)

Richler, Jennifer J; Floyd, R Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically.

Holistic concept of marketing performance

OpenAIRE

Yu.V. Robul

2011-01-01

The scope of the article is to provide a critical analysis of ROMI as a metric of marketing performance, and to propose a more comprehensive construct of marketing efficiency, which considers a holistic nature of the concept of modern marketing. It is argued that ROMI be crucial insufficient as a marketing performanceindicator. In the holistic framework, a complex set of marketing performance metrics to be developed is outlined.

Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making.

Science.gov (United States)

Cain, Cindy L; Surbone, Antonella; Elk, Ronit; Kagawa-Singer, Marjorie

2018-05-01

Palliative care is gaining acceptance across the world. However, even when palliative care resources exist, both the delivery and distribution of services too often are neither equitably nor acceptably provided to diverse population groups. The goal of this study was to illustrate tensions in the delivery of palliative care for diverse patient populations to help clinicians to improve care for all. We begin by defining and differentiating culture, race, and ethnicity, so that these terms-often used interchangeably-are not conflated and are more effectively used in caring for diverse populations. We then present examples from an integrative literature review of recent research on culture and palliative care to illustrate both how and why varied responses to pain and suffering occur in different patterns, focusing on four areas of palliative care: the formation of care preferences, communication patterns, different meanings of suffering, and decision-making processes about care. For each area, we provide international and multiethnic examples of variations that emphasize the need for personalization of care and the avoidance of stereotyping beliefs and practices without considering individual circumstances and life histories. We conclude with recommendations for improving palliative care research and practice with cultural perspectives, emphasizing the need to work in partnerships with patients, their family members, and communities to identify and negotiate culturally meaningful care, promote quality of life, and ensure the highest quality palliative care for all, both domestically and internationally. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Hemispheric asymmetry in holistic processing of words.

Science.gov (United States)

Ventura, Paulo; Delgado, João; Ferreira, Miguel; Farinha-Fernandes, António; Guerreiro, José C; Faustino, Bruno; Leite, Isabel; Wong, Alan C-N

2018-05-13

Holistic processing has been regarded as a hallmark of face perception, indicating the automatic and obligatory tendency of the visual system to process all face parts as a perceptual unit rather than in isolation. Studies involving lateralized stimulus presentation suggest that the right hemisphere dominates holistic face processing. Holistic processing can also be shown with other categories such as words and thus it is not specific to faces or face-like expertize. Here, we used divided visual field presentation to investigate the possibly different contributions of the two hemispheres for holistic word processing. Observers performed same/different judgment on the cued parts of two sequentially presented words in the complete composite paradigm. Our data indicate a right hemisphere specialization for holistic word processing. Thus, these markers of expert object recognition are domain general.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

Science.gov (United States)

Northam, Holly L; Hercelinskyj, Gylo; Grealish, Laurie; Mak, Anita S

2015-11-01

Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning

HIV health-care providers' burnout: can organizational culture make a difference?

Science.gov (United States)

Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan

2014-01-01

One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p organizational communication interventions might protect HIV health-care providers from burnout.

The Affordable Care Act: the ethical call to transform the organizational culture.

Science.gov (United States)

Piper, Llewellyn E

2014-01-01

The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

Understanding the workplace culture of a special care nursery.

Science.gov (United States)

Wilson, Valerie J; McCormack, Brendan G; Ives, Glenice

2005-04-01

This paper presents findings from the first phase of a research study focusing on implementation and evaluation of emancipatory practice development strategies. Understanding the culture of practice is essential to undertaking effective developments in practice. Culture is a dominant feature of discussions about modernizing health care, yet few studies have been undertaken that systematically evaluate the development of effective practice cultures. The study intervention is that of emancipatory practice development with an integrated evaluation approach based on Realistic Evaluation. The aim of Realistic Evaluation is to evaluate relationships between Context (setting), Mechanism (process characteristics) and Outcome (arising from the context-mechanism configuration). This first phase of the study focuses on uncovering the context (in particular the culture) of the Special Care Nursery in order to evaluate the emancipatory practice development processes and outcomes. Data collection methods included survey, participant observation and interview. Cognitive mapping, constant comparative method and coding were used to analyse the data. Findings. Four key categories were identified: Teamwork, Learning in Practice, Inevitability of Change and Family-Centred Care and collectively these formed a central category of Core Values and Beliefs. A number of themes were identified in each category, and reflected tensions that existed between differing values and beliefs within the culture of the unit. Understanding values and beliefs is an important part of understanding a workplace culture. Whilst survey methods are capable of outlining espoused workplace characteristics, observation of staff interactions and perceptions gives an understanding of culture as a living entity manifested through interpersonal relationships. Attempts at changing workplace cultures should start from the clarification of values held among staff in that culture.

Cultural barriers to health care for southeast Asian refugees.

OpenAIRE

Uba, L

1992-01-01

Many Southeast Asians now living in the United States experience severe health problems, attributable to physical trauma and inadequate health care in Asia, and low socioeconomic status in this country. Evidence indicates that despite their health problems, Southeast Asian refugees underuse the American health care system. Cultural reasons for this underuse are examined. Southeast Asian cultural attitudes toward suffering, such as beliefs that suffering is inevitable or that one's life span i...

Culture-bound syndromes in Hispanic primary care patients.

Science.gov (United States)

Bayles, Bryan P; Katerndahl, David A

2009-01-01

We sought to document Hispanic primary care patients' knowledge and experience of five culture-bound syndromes (CBS), as well as the basic socio-cultural correlates of these disorders. A convenience sample of 100 adult Hispanic patients presenting in an urban South Texas primary care clinic was recruited to complete a brief cross-sectional survey, presented in an oral format. Interviews sought information concerning five culture-bound syndromes--susto, empacho, nervios, mal de ojo, and ataques de nervios. Additional demographic, socio-economic, and acculturation data was collected. Descriptive and bivariate statistics (chi square, Fisher's) were used to assess relationships among variables and experience with each CBS. A multivariate logistic analysis was conducted to determine the possible contributions of age, gender, acculturation, and education to the personal experience of a culture-bound syndrome. Results indicate that 77% of respondents had knowledge of all five syndromes, with 42% reporting having personally experienced at least one CBS. Nervios was the most commonly suffered disorder, being reported by 30 respondents. This was followed, in declining order ofprevalence, by susto, mal de ojo, empacho, and ataques de nervios. Multivariate logistic regression analysis found that higher education beyond high school was associated with a slightly decreased likelihood of reporting having suffered from any culture-bound syndrome. While co-occurrence among these disorders occurred, the patterns of predictors suggest that the co-occurrence is not a reflection of mislabeling of one common syndrome. Knowledge of and experience with culture-bound syndromes is common among Hispanic primary care patients in South Texas. Healthcare providers ought to consider discussing these illnesses in a non-judgmental manner with patients who present with symptoms that are consistent with these syndromes. Future studies, with larger sample sizes, are warranted to elucidate the nature

Desnutrição infantil no contexto familiar de mães adolescentes: visão cultural do cuidado - DOI: 10.4025/actascihealthsci.v26i1.1648 Infantile malnutrition in the familiar context of adolescent mother: culture care view - DOI: 10.4025/actascihealthsci.v26i1.1648

Directory of Open Access Journals (Sweden)

Mirna Albuquerque Frota

2004-04-01

. Results show that, in its majority, adolescent mothers are confused and anxious in the care of the undernourished child. They demonstrate attempts and forms of taking care that goes from the empirical knowledge to the search for health services. The cultural focus of the care in on the holistic attendance leading to larger satisfaction of specific segments of the population marked by sociocultural problems.

A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

Science.gov (United States)

Hanley, Mary Anne; Coppa, Denise; Shields, Deborah

2017-08-01

For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

Holistic Marketing 3.0: Menuju Organisasi Spiritual

Directory of Open Access Journals (Sweden)

Gancar Candra Premananto

2015-12-01

Full Text Available Holistic Marketing is become new mantra for marketer in this 21 century. The concept builds on 4 pillars which are integrated marketing, internal marketing, performance marketing and relationship marketing. The point of that concept is about the important things is to make relationship to everybody and to every stakeholders. The concepts still on development process by Kotler & Keller. This conceptual article proposed that Holistic Marketing proposed by Kotler & Keller still discuss about horizontal relationship. It is not include the important relationship that should be building by human, which is relationship to God. Those relationship can make organization can apply the concept of HabluminaLLAH, habluminannas dan rahmatan lil ’alamin. The concept proposed as Holistic Marketing 3.0, to make more complete and holistic relationship.

Canadian residents' perceptions of cross-cultural care training in graduate medical school.

Science.gov (United States)

Singh, Barinder; Banwell, Emma; Groll, Dianne

2017-12-01

The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine.

Canadian residents’ perceptions of cross-cultural care training in graduate medical school

Science.gov (United States)

Singh, Barinder; Banwell, Emma; Groll, Dianne

2017-01-01

Background The Royal College of Physicians and Surgeons of Canada specifies both respect for diversity as a requirement of professionalism and culturally sensitive provision of medical care. The purpose of the present study was to evaluate the perception of preparedness and attitudes of medical residents to deliver cross-cultural care. Methods The Cross Cultural Care Survey was sent via e-mail to all Faculty of Medicine residents (approx. 450) in an academic health sciences centre. Comparisons were made between psychiatry residents, family medicine residents, and other residency groups with respect to training, preparedness, and skillfulness in delivering cross-cultural care. Results Seventy-three (16%) residents responded to the survey. Residents in psychiatry and family medicine reported significantly more training and formal evaluation regarding cross-cultural care than residents in other programs. However, there were no significant differences in self-reported preparedness and skillfulness. Residents in family medicine were more likely to report needing more practical experience working with diverse groups. Psychiatry residents were less likely to report inadequate cross-cultural training. Conclusion While most residents reported feeling skillful and prepared to work with culturally diverse groups, they report receiving little additional instruction or formal evaluation on this topic, particularly in programs other than psychiatry and family medicine. PMID:29354194

Validation of holistic nursing competencies: role-delineation study, 2012.

Science.gov (United States)

Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Campbell, Joan A; Brekke, Mary E; Sandor, M Kay

2013-12-01

The American Holistic Nurses Credentialing Corporation (AHNCC), certifying body for nurses practicing within the precepts of holistic nursing, uses a systematic process to guide program development. A previous publication described their early work that distinguished basic and advanced holistic nursing and development of related examinations. A more recent publication described the work of AHNCC from 2004 to 2012, including a role-delineation study (RDS) that was undertaken to identify and validate competencies currently used by holistic nurses. A final report describes the RDS design, methods, and raw data information. This article discusses AHNCC's goals for undertaking the 2012 Holistic Nursing RDS and the implications for the certification programs.

[Neonatal palliative care and culture].

Science.gov (United States)

Bétrémieux, P; Mannoni, C

2013-09-01

The period of palliative care is a difficult time for parents and caregivers because they are all weakened by the proximity of death. First of all, because of religious and cultural differences, parents and families cannot easily express their beliefs or the rituals they are required to develop; second, this impossibility results in conflicts between the caregiver team and the family with consequences for both. Caregivers are concerned to allow the expression of religious beliefs and cultural demands because it is assumed that they may promote the work of mourning by relating the dead child to its family and roots. However, caregivers' fear not knowing the cultural context to which the family belongs and having inappropriate words or gestures, as sometimes families dare not, cannot, or do not wish to describe their cultural background. We attempt to differentiate what relates to culture and to religion and attempt to identify areas of potential disagreement between doctors, staff, and family. Everyone has to work with the parents to open a space of freedom that is not limited by cultural and religious assumptions. The appropriation of medical anthropology concepts allows caregivers to understand simply the obligations imposed on parents by their culture and/or their religion and open access to their wishes. Sometimes help from interpreters, mediators, ethnopsychologists, and religious representatives is needed to understand this reality. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Organisational culture in residential aged care facilities: a cross-sectional observational study.

Science.gov (United States)

Etherton-Beer, Christopher; Venturato, Lorraine; Horner, Barbara

2013-01-01

Organisational culture is increasingly recognised as important for provision of high-quality long-term care. We undertook this study to measure organisational culture in residential aged care facilities in two Australian states. Cross-sectional observational study in 21 residential aged care facilities in Western Australia (n = 14) and Queensland (n = 7), Australia. Staff and next-of-kin of residents participated. Measurement comprised surveys of facility staff and residents' next-of-kin, and structured observation of indicators of care quality. Staff tended to rate organisational culture positively. Some qualitative feedback from staff emphasised negative perceptions of communication, leadership and teamwork. Staffing levels were perceived as a dominant challenge, threatening care quality. Direct observation revealed variability within and between facilities but suggested that most facilities (n = 12) were in the typical range, or were quality facilities (n = 8). There was scope to strengthen organisational culture in participating aged care facilities.

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

Science.gov (United States)

Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

2014-01-30

As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

Achieving a holistic perspective in stroke rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Lund, Hans; Jones, Dorrie

2015-01-01

Background/Aims: Holistic, multidisciplinary rehabilitation is often the most appropriate for stroke patients. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a comprehensive conceptual framework and systematic terminology used...... to a holistic approach in stroke rehabilitation, including an understanding of functioning and the ability to participate in everyday life. Using this approach to rehabilitation, disability is not only perceived as a consequence of stroke but also in the context of the individual person, where interactions...... the holistic approach....

Spirit-guided care: Christian nursing for the whole person.

Science.gov (United States)

Murphy, Lyn S; Walker, Mark S

2013-01-01

Healthcare today is challenged to provide care that goes beyond the medical model of meeting physical needs. Despite a strong historical foundation in spiritual whole person care, nurses struggle with holistic caring. We propose that for the Christian nurse, holistic nursing can be described as Spirit-guided care--removing oneself as the moiatiating force and allowing Christ, in the furm of the Holy Spirit, to flow through and guide the nurse in care of patients and families.

Arts and cultural activity: A vital part of the health and care system.

Science.gov (United States)

Cann, Paul L

2017-06-01

This article discusses how the arts and cultural activities are a vital part of a health and care system and have potential to fulfil the theme of active ageing. The changing nature of care provision in response to demographic change, fiscal pressure and increasingly consumerist attitudes on the part of care users, is considered. Selected examples of how participation in arts and cultural activities increases not only well-being but also health outcomes are then outlined. The article highlights the potential of 'cultural commissioning' and within that 'arts on prescription' - public funding of arts-related activities for people with care needs - and advocates investment in arts and cultural activities to better meet the demands of health, social care and aged care. Concluding remarks are made, and a way forward is suggested. © 2017 AJA Inc.

An anthropological approach to teach and evaluate cultural competence in medical students - the application of mini-ethnography in medical history taking.

Science.gov (United States)

Hsieh, Jyh-Gang; Hsu, Mutsu; Wang, Ying-Wei

2016-01-01

Purpose To use mini-ethnographies narrating patient illness to improve the cultural competence of the medical students. Methods Between September 2013 and June 2015, all sixth-year medical students doing their internship at a medical center in eastern Taiwan were trained to write mini-ethnographies for one of the patients in their care. The mini-ethnographies were analyzed by authors with focus on the various aspects of cultural sensitivity and a holistic care approach. Results Ninety-one students handed in mini-ethnographies, of whom 56 were male (61.5%) and 35 were female (38.5%). From the mini-ethnographies, three core aspects were derived: 1) the explanatory models and perceptions of illness, 2) culture and health care, and 3) society, resources, and health care. Based on the qualities of each aspect, nine secondary nodes were classified: expectations and attitude about illness/treatment, perceptions about their own prognosis in particular, knowledge and feelings regarding illness, cause of illness, choice of treatment method (including traditional medical treatments), prejudice and discrimination, influences of traditional culture and language, social support and resources, and inequality in health care. Conclusions Mini-ethnography is an effective teaching method that can help students to develop cultural competence. It also serves as an effective instrument to assess the cultural competence of medical students.

Viewpoint: Cultural competence and the African American experience with health care: The case for specific content in cross-cultural education.

Science.gov (United States)

Eiser, Arnold R; Ellis, Glenn

2007-02-01

Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care. The authors identify key influences, including the legacy of slavery, Jim Crow discrimination, the Tuskegee syphilis study, religion's interaction with health care, the use of home remedies, distrust, racial concordance and discordance, and health literacy. The authors propose that the awareness of specific information pertaining to ethnicity and race enhances cross-cultural communication and ways to improve the cultural competence of physicians and other health care providers by providing a historical and social context for illness in another culture. Cultural education, modular in nature, can be geared to the specific populations served by groups of physicians and provider organizations. Educational methods should include both information about relevant social group history as well as some experiential component to emotively communicate particular cultural needs. The authors describe particular techniques that help bridge the cross-cultural clinical communication gaps that are created by patients' mistrust, lack of cultural understanding, differing paradigms for illness, and health illiteracy.

Raymond Williams and local cultures

OpenAIRE

B Longhurst

1991-01-01

In this paper it is maintained that Raymond Williams's writings on culture are of great importance to current developments in cultural geography. His work is periodised into three stages and its different subject matters identified. An interpretation of Williams's theory of culture is offered which places particular emphasis on his concepts of 'structure of feeling' and 'knowable community'. The creative tension between Williams's holistic treatment of culture and his stress on cultural strug...

A survey of cultural competence of critical care nurses in KwaZulu ...

African Journals Online (AJOL)

A survey of cultural competence of critical care nurses in ... Nurses are primary caregivers and have a key role in providing care in a culturally ... relating to culture, gender or sexual orientation. ... concerning the population they work with, and although a ... lead to conflict, increased levels of anxiety, and stress among nurses,.

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study

Science.gov (United States)

2014-01-01

Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians. PMID:24479405

What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand.

Science.gov (United States)

Frey, Rosemary; Boyd, Michal; Foster, Sue; Robinson, Jackie; Gott, Merryn

2016-07-01

Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal. © 2015 John Wiley & Sons Ltd.

Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen.

Science.gov (United States)

Webair, Hana H; Al-Assani, Salwa S; Al-Haddad, Reema H; Al-Shaeeb, Wafa H; Bin Selm, Manal A; Alyamani, Abdulla S

2015-10-13

Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country. A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Survey on Patient Safety Culture was distributed to all health workers (110). Participants were physicians, nurses and administrative staff. The response rate from the participating centres was 71 %. (N = 78). The percent positive responses of the items is equal to the percentage of participants who answered positively. Composite scores were calculated by averaging the percent positive response on the items within a dimension. Positive safety culture was defined as 60 % or more positive responses on items or dimensions. Patient safety culture was perceived to be generally positive with the exception of the dimensions of 'Communication openness', 'Work pressure and pace' and 'Patient care tracking/follow-up', as the percent positive response of these dimensions were 58, 57, and 52 % respectively. Overall, positive rating on quality and patient safety were low (49 and 46 % respectively). Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care.

Culture and end of life care: a scoping exercise in seven European countries.

Directory of Open Access Journals (Sweden)

Marjolein Gysels

Full Text Available AIM: Culture is becoming increasingly important in relation to end of life (EoL care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. METHODS: We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. RESULTS: A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries. The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. CONCLUSION: This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Science.gov (United States)

Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H. Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

2012-01-01

Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of Eo

Culture and end of life care: a scoping exercise in seven European countries.

Science.gov (United States)

Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

2012-01-01

Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

Family care: an exploratory study of experience and expectations among older Chinese immigrants in Australia.

Science.gov (United States)

Lo, Meihan; Russell, Cherry

2007-01-01

Family caregiving in East Asian cultures is traditionally based on the Confucian ethic of filial piety that mandates total, holistic care for elders. While research suggests changes in 'family care' are occurring in Asian countries themselves, remarkably little is known about immigrant Asian families in Australia. The study aimed to explore the experience of 'family care' among Chinese-speaking older people who have migrated to Australia in later life. In-depth interviews were conducted in Cantonese with a convenience sample of five cases, including six older Chinese and analysed inductively for dominant themes. Although no single model of 'family care' emerged, findings reveal significant departures from the norms of filial piety and an overall 'westernisation' of care practices, both in relation to what families actually do for their parents and what the older people themselves expect. Transformation of filial culture has implications for policy, service planning and professional practice. It cannot be assumed that elderly Chinese immigrants' needs are being met through traditional family structures.

Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

Science.gov (United States)

Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

2017-08-31

The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

SELF-DIRECTED LEARNING, TEAMWORK, HOLISTIC VIEW AND ORAL HEALTH.

Science.gov (United States)

Leisnert, Leif

2014-01-01

The dental program at the Malmö Dental School, the so called Malmö-model, is guided by four linked principles: self-directed learning, teamwork, a holistic view of patient care, and oral health (Fig.1). Self-assessment ability is a critical competence for healthcare professionals, necessary for the successful adaptation to the modern life-long learning environment. Educational research seems to point out two critical factors for the development of such skills, continuous practice of self-assessment and constructive feedback. The first study presented in this thesis assessed students' self-assessment ability by means of the Interactive Examination in a cohort of senior dental students, who had gone through an identical assessment procedure during their second year of studies. The results indicated that self-assessment ability was not directly relevant to subject knowledge. Upon graduation, there were a number of students (10%) with significant self-assessment difficulties. Early detection of students with weak self-assessment abilities appears possible to achieve. The aim of the second study, concerning teamwork and holistic view, was to investigate if highlighting teamwork between dental and dental hygienist students could improve the students' holistic view on patients, as well as their knowledge of, and insight into, each other's future professions. This project showed that by initiating teamwork between dental and dental hygienist students, it was possible to increase students' knowledge on dental hygienists competence, develop students' perceived holistic view on patients, and prepare students for teamwork. The third study explored findings clinicians used when diagnosing chronic periodontitis. A questionnaire was distributed to students, dental teachers and clinical supervisors in the Public Dental Services. Within all categories of clinicians, the majority of the clinicians used deepened pocket, bone loss on x-rays, and bleeding as findings. There were

Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

Directory of Open Access Journals (Sweden)

Adel F. Almutairi

Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

Consumer views on a new holistic screening tool for supportive and palliative-care needs: Sheffield Profile for Assessment and Referral for Care (SPARC): a survey of self-help support groups in health care.

Science.gov (United States)

Hughes, Philippa; Ahmed, Nisar; Winslow, Michelle; Walters, Stephen J; Collins, Karen; Noble, Bill

2015-08-01

Sheffield Profile for Assessment and Referral for Care (SPARC) was developed in response to concerns that palliative care may not be reaching all people who could benefit from it. Acceptability of the tool is an important step in developing its future use. To elicit the views of a wide variety of members of consumer and self-help support groups concerned with health care on the relevance, acceptability and the overall perception of using SPARC as an early holistic needs assessment tool in supportive and palliative care. This study was conducted in South Yorkshire and North Derbyshire (UK). Ninety-nine consumer and self-help groups were identified from information in the public domain. Thirty-eight groups participated. Packs containing study information and self-complete postal questionnaires were distributed to groups, and they were asked to circulate these to their members. Completed questionnaires were returned in pre-paid envelopes to the research team. 135 questionnaires and feedback forms were returned. The majority of respondents found SPARC easy to understand (93% (120/129; 95% Confidence Interval 87% to 96%) and complete (94% (125/133; 95% CI: 88% to 97%). A minority, 12.2% (16/131), of respondents found questions on SPARC 'too sensitive'. Overall, respondents considered SPARC an acceptable and relevant tool for clinical assessment of supportive and palliative-care needs. Whilst a small minority of people found SPARC difficult to understand (i.e. patients with cognitive impairments), most categories of service user found it relevant. Clinical studies are necessary to establish the clinical utility of SPARC. © 2013 John Wiley & Sons Ltd.

Holistic Energy Renovation of Pre- and Postwar Apartment Blocks in Denmark

DEFF Research Database (Denmark)

Eriksen, Marlene Stenberg Hagen; Rode, Carsten; Bjarløv, Søren Peter

of today. This paper presents the Danish research project Holistic Energy Renovation, which aims at performing a holistic energy renovation of two case buildings. As part of the project nine parameters for a holistic renovation have been defined, a method for developing and assessing a holistic building...... of the assessment method and an evaluation of how the holistic perspective has influenced the project process and product development....

Impact of holistic review on student interview pool diversity.

Science.gov (United States)

Grabowski, Christina J

2017-12-29

Diversity in the physician workforce lags behind the rapidly changing US population. Since the gateway to becoming a physician is medical school, diversity must be addressed in the admissions process. The Association of American Medical Colleges has implemented a Holistic Review Initiative aimed at assisting medical schools with broadening admission criteria to include relevant, mission-driven attributes and experiences in addition to academic preparation to identify applicants poised to meet the needs of a diverse patient population. More evidence is needed to determine whether holistic review results in a more diverse selection process. One of the keys to holistic review is to apply holistic principles in all stages of the selection process to ensure qualified applicants are not overlooked. This study examines whether the use of holistic review during application screening at a new medical school increased the diversity of applicants selected for interview. Using retrospective data from the first five application cycles at the Oakland University William Beaumont School of Medicine (OUWB), the author compared demographic and experiential differences between the applicants selected using holistic review, including experiences, attributes and academic metrics, to a test sample selected solely using academic metrics. The dataset consisted of the total group of applicants selected for interview in 2011 through 2015 using holistic review (n = 2773) and the same number of applicants who would have been selected for an interview using an academic-only selection model (n = 2773), which included 1204 applicants who were selected using both methods (final n = 4342). The author used a combination of cross-tabulation and analysis of variance to identify differences between applicants selected using holistic review and applicants in the test sample selected using only academics. The holistic review process yielded a significantly higher than expected percent of female

A survey of cultural competence of critical care nurses in KwaZuluNatal

Directory of Open Access Journals (Sweden)

Jennifer de Beer

2014-11-01

Full Text Available Background. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA. Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities.Objective. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA.Methods. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R cultural competence questionnaire. Results. The overall cultural competence score for the respondents was 70.2 (standard deviation 7.2 out of a possible 100, with 77 (74% of the respondents scoring in the awareness range, 26 (25% in the competent range, and only 1 in the proficient range. Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses.Conclusion. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.

The application of holistic risk management in the banking industry

Directory of Open Access Journals (Sweden)

J. Chibayambuya

2007-12-01

Full Text Available Purpose: The application of holistic risk management is fast becoming a standard measure of good governance in the business arena. What role can holistic risk management play in the management of risk in the financial services industry? The aim of this paper is to propose a holistic risk management framework for the management of risk. Design/Methodology/Approach: A comprehensive framework that covers the holistic view risk management is proposed/developed out of an extensive literature review. Findings: Given the deliberations of various frameworks, a holistic risk management is proposed. The proposed framework ensures that all components of risk management are taken into account when strategizing for risk management in general and holistic risk management in particular; thereby improving the management of risk in the banking industry. Implications: The article proposes a holistic approach to risk management which takes into account all the facets of risk management, e.g. analyzing, planning, strategy, communication, implementation, motivation, systems review and plan modification. This holistic approach, when implemented in the banking industry, can have a significant impact on the improved management of risk. Originality/Value: The new proposed holistic risk management framework offers a fresh perspective of strategizing for risk management in terms of risk analysis, risk planning, risk strategy, risk communication, risk implementation, risk motivation, risk review and risk plan modification.

What is the key to culturally competent care: Reducing bias or cultural tailoring?

Science.gov (United States)

Cuevas, Adolfo G; O'Brien, Kerth; Saha, Somnath

2017-04-01

To gain a better understanding as to whether disparities in patient-provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently. African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10. Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients' needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians. Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians' patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.

Developing Cultural Differences in Face Processing

Science.gov (United States)

Kelly, David J.; Liu, Shaoying; Rodger, Helen; Miellet, Sebastien; Ge, Liezhong; Caldara, Roberto

2011-01-01

Perception and eye movements are affected by culture. Adults from Eastern societies (e.g. China) display a disposition to process information "holistically," whereas individuals from Western societies (e.g. Britain) process information "analytically." Recently, this pattern of cultural differences has been extended to face…

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

Science.gov (United States)

Goodwin, Miki; Candela, Lori

2013-06-01

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prenatal care of African American women in selected USA urban and rural cultural contexts.

Science.gov (United States)

Morgan, M

1996-01-01

The purpose of this ethnonursing research was to systematically discover, describe, and analyze the beliefs, practices, and values of African American women related to prenatal care. The domain of inquiry was prenatal care of African American women within their familiar cultural contexts. The study was conceptualized within Leininger's Theory of Culture Care Diversity and Universality which enabled the researcher to study professional and generic care as influenced by the worldview, social structural factors, cultural values and beliefs, ethnohistory, and environmental context. The goal of the study was to discover knowledge that could be used by health professionals to provide culturally congruent prenatal care that would increase the health and well being of the people. The rationale for the study was based on studies that showed the lack of prenatal care in the African American cultural group leads to low birth weights and high infant mortality rates. Four major themes that focused on the domain of inquiry were identified: 1) Cultural care meant protection, presence, and sharing; 2) social structural factors that greatly influenced the health and well being were spirituality, kinship, and economics; 3) professional prenatal care was seen by the women as necessary and essential but there was distrust of noncaring professionals, and barriers to such care; and 4) folk health beliefs, practices, and indigenous health care providers were widely used by women in the African American community.

The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities.

Science.gov (United States)

Ascoli, Micol; Palinski, Andrea; Owiti, John Arianda; De Jongh, Bertine; Bhui, Kamaldeep S

2012-09-28

Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS) that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering "culture" in the presentation and expression of mental distress. The narratives reveal an overall "culture of understanding cultural issues" and specific "cultures of care". These emerged as necessary foci of intervention to improve service user outcomes. Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery.

Integrating Cultural Humility into Health Care Professional Education and Training

Science.gov (United States)

Chang, E-shien; Simon, Melissa; Dong, XinQi

2012-01-01

As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article…

Primary School Teachers' Views on a Holistic Approach to Facilitating the Acquisition of Musical Cultural Values

Science.gov (United States)

Badjanova, Jelena

2013-01-01

Recent tendencies in education highlight the need to align the system of general education in Latvia with the tenets of sustainability. In keeping with this broad target orientation, this paper re-examines international and Latvian experiences and perspectives on the application of a holistic approach to the content of primary education. This…

Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance.

Science.gov (United States)

Dupuis, Sherry; McAiney, Carrie A; Fortune, Darla; Ploeg, Jenny; Witt, Lorna de

2016-01-01

Longstanding concerns about quality care provision, specifically in the area of long-term care, have prompted calls for changing the culture of care to reflect more client-driven and relationship-centred models. Despite an increase in culture change initiatives in both Canada and the United States, there is insufficient information about the theories and approaches that guide culture change. The purpose of this paper is to describe a culture change initiative currently underway in Canada, the Partnerships in Dementia Care Alliance, and the theoretical foundations informing our work. More specifically, we describe how the theoretical and philosophical underpinnings of the Alzheimer Disease and Related Dementias framework, the authentic partnership approach, participatory action research and Appreciative Inquiry have been integrated to guide a culture change process that encourages working collaboratively, thinking and doing differently and re-imagining new possibilities for changing the culture of dementia care. © The Author(s) 2014.

Generalist palliative care in hospital: cultural and organisational interactions

DEFF Research Database (Denmark)

Bergenholtz, Heidi; Jarlbaek, Lene; Hølge-Hazelton, Bibi

2016-01-01

: a quantitative study, in which three independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative, ethnographic study exploring the culture of generalist palliative nursing care in medical departments. SETTING/PARTICIPANTS: A Danish regional...

Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: a systematic review.

Science.gov (United States)

Coast, Ernestina; Jones, Eleri; Lattof, Samantha R; Portela, Anayda

2016-12-01

Addressing cultural factors that affect uptake of skilled maternity care is recognized as an important step in improving maternal and newborn health. This article describes a systematic review to examine the evidence available on the effects of interventions to provide culturally appropriate maternity care on the use of skilled maternity care during pregnancy, for birth or in the postpartum period. Items published in English, French and/or Spanish between 1 January 1990 and 31 March 2014 were considered. Fifteen studies describing a range of interventions met the inclusion criteria. Data were extracted on population and intervention characteristics; study design; definitions and data for relevant outcomes; and the contexts and conditions in which interventions occurred. Because most of the included studies focus on antenatal care outcomes, evidence of impact is particularly limited for care seeking for birth and after birth. Evidence in this review is clustered within a small number of countries, and evidence from low- and middle-income countries is notably lacking. Interventions largely had positive effects on uptake of skilled maternity care. Cultural factors are often not the sole factor affecting populations' use of maternity care services. Broader social, economic, geographical and political factors interacted with cultural factors to affect targeted populations' access to services in included studies. Programmes and policies should seek to establish an enabling environment and support respectful dialogue with communities to improve use of skilled maternity care. Whilst issues of culture are being recognized by programmes and researchers as being important, interventions that explicitly incorporate issues of culture are rarely evaluated. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care.

Science.gov (United States)

Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric

2012-12-01

Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Evaluation of Learning Materials: A Holistic Framework

Science.gov (United States)

Bundsgaard, Jeppe; Hansen, Thomas Illum

2011-01-01

This paper presents a holistic framework for evaluating learning materials and designs for learning. A holistic evaluation comprises investigations of the potential learning potential, the actualised learning potential, and the actual learning. Each aspect is explained and exemplified through theoretical models and definitions. (Contains 3 figures…

Traditional acupuncturists and higher education in Britain: the dual, paradoxical impact of biomedical alignment on the holistic view.

Science.gov (United States)

Givati, Assaf; Hatton, Kieron

2015-04-01

Traditional acupuncturists' quest for external legitimacy in Britain involves the standardization of their knowledge bases through the development of training schools and syllabi, formal educational structures, and, since the 1990s, the teaching of undergraduate courses within (or validated by) Higher Education Institutions (HEIs), a process which entails biomedical alignment of the curriculum. However, as holistic discourses were commonly used as a rhetorical strategy by CAM practitioners to distance themselves from biomedicine and as a source of public appeal, this 'mainstreaming' process evoked practitioners' concerns that their holistic claims are being compromised. An additional challenge is being posed by a group of academics and scientists in Britain who launched an attack on CAM courses taught in HEIs, accusing them of being 'unscientific' and 'non-academic' in nature. This paper explores the negotiation of all these challenges during the formalization of traditional acupuncture education in Britain, with a particular focus on the role of HEIs. The in-depth qualitative investigation draws on several data sets: participant observation in a university validated acupuncture course; in-depth interviews; and documentary analysis. The findings show how, as part of the formalization process, acupuncturists in Britain (re)negotiate their holistic, anti-reductionist discourses and claims in relation to contemporary societal, political and cultural forces. Moreover, the teaching and validation of acupuncture courses by HEIs may contribute to broadening acupuncturists' 'holistic awareness' of societal and cultural influences on individuals' and communities' ill-health. This investigation emphasises the dynamic and context-specific (rather than fixed and essentialized) nature of acupuncture practice and knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ethnonursing: A Qualitative Research Method for Studying Culturally Competent Care across Disciplines

Directory of Open Access Journals (Sweden)

Marilyn R. McFarland PhD, RN, FNP-BC, CTN

2012-07-01

Full Text Available Nurse anthropologist, Madeleine Leininger, developed the culture care theory and ethnonursing research method to help researchers study transcultural human care phenomena and discover the knowledge nurses need to provide care in an increasingly multicultural world. The authors propose that the ethnonursing method can be useful for research that addresses providing care in other disciplines, including education, administration, physical, occupational, and speech therapy, social work, pharmacy, medicine, and other disciplines in which research findings have implications for human care and health. The authors discuss the culture care theory and describe the ethnonursing research method's enablers, data analysis phases, and qualitative evaluation criteria. The theory is presented as a guide for using research findings to design culturally competent and congruent care to promote well-being among diverse people, groups, communities, and institutions. Resources include a reference list of key source publications, a discussion of exemplar studies, and samples of a theory-based, open-ended interview guide and data coding system.

Conceptual framework for holistic dialysis management based on key performance indicators.

Science.gov (United States)

Liu, Hu-Chen; Itoh, Kenji

2013-10-01

This paper develops a theoretical framework of holistic hospital management based on performance indicators that can be applied to dialysis hospitals, clinics or departments in Japan. Selection of a key indicator set and its validity tests were performed primarily by a questionnaire survey to dialysis experts as well as their statements obtained through interviews. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale (19 responses collected). Applying the theoretical framework, we selected a minimum set of key performance indicators for dialysis management that can be used in the Japanese context. The indicator set comprised 27 indicators and items that will be collected through three surveys: patient satisfaction, employee satisfaction, and safety culture. The indicators were confirmed by expert judgment from viewpoints of face, content and construct validity as well as their usefulness. This paper established a theoretical framework of performance measurement for holistic dialysis management from primary healthcare stakeholders' perspectives. In this framework, performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators of the former type may be applied for the detection of operational problems or weaknesses in a dialysis hospital, clinic or department, while latent causes of each problem can be more effectively addressed by the latter type of indicators in terms of process, structure and culture/climate within the organization. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

Care dependency of hospitalized children: testing the Care Dependency Scale for Paediatrics in a cross-cultural comparison.

Science.gov (United States)

Tork, Hanan; Dassen, Theo; Lohrmann, Christa

2009-02-01

This paper is a report of a study to examine the psychometric properties of the Care Dependency Scale for Paediatrics in Germany and Egypt and to compare the care dependency of school-age children in both countries. Cross-cultural differences in care dependency of older adults have been documented in the literature, but little is known about the differences and similarities with regard to children's care dependency in different cultures. A convenience sample of 258 school-aged children from Germany and Egypt participated in the study in 2005. The reliability of the Care Dependency Scale for Paediatrics was assessed in terms of internal consistency and interrater reliability. Factor analysis (principal component analysis) was employed to verify the construct validity. A Visual Analogue Scale was used to investigate the criterion-related validity. Good internal consistency was detected both for the Arabic and German versions. Factor analysis revealed one factor for both versions. A Pearson's correlation between the Care Dependency Scale for Paediatrics and Visual Analogue Scale was statistically significant for both versions indicating criterion-related validity. Statistically significant differences between the participants were detected regarding the mean sum score on the Care Dependency Scale for Paediatrics. The Care Dependency Scale for Paediatrics is a reliable and valid tool for assessing the care dependency of children and is recommended for assessing the care dependency of children from different ethnic origins. Differences in care dependency between German and Egyptian children were detected, which might be due to cultural differences.

Effectiveness of holistic interventions for people with severe chronic obstructive pulmonary disease: systematic review of controlled clinical trials.

Directory of Open Access Journals (Sweden)

Ulugbek Nurmatov

Full Text Available Despite a well-recognised burden of disabling physical symptoms compounded by co-morbidities, psychological distress and social isolation, the needs of people with severe chronic obstructive pulmonary disease (COPD are typically poorly addressed.To assess the effectiveness of interventions designed to deliver holistic care for people with severe COPD.We searched 11 biomedical databases, three trial repositories (January 1990-March 2012; no language restrictions and contacted international experts to locate published, unpublished and in-progress randomised controlled trials (RCTs, quasi-RCTs and controlled clinical trials (CCTs that investigated holistic interventions to support patients with severe COPD in any healthcare context. The primary outcome was health-related quality of life (HRQoL. Quality assessment and data extraction followed Cochrane Collaboration methodology. We used a piloted data extraction sheet and undertook narrative synthesis.From 2,866 potentially relevant papers, we identified three trials: two RCTs (from United States and Australia, and one CCT (from Thailand: total 216 patients. Risk of bias was assessed as moderate in two studies and high in the third. All the interventions were led by nurses acting in a co-ordinating role (e.g. facilitating community support in Thailand, providing case-management in the USA, or co-ordinating inpatient care in Australia. HRQoL improved significantly in the Thai CCT compared to the (very limited usual care (p<0.001, in two sub-domains in the American trial, but showed no significant changes in the Australian trial. Exercise tolerance, dyspnoea, and satisfaction with care also improved in the Thai trial.Some 15 years after reports first highlighted the unmet needs of people with severe COPD, we have been unable to find robust trial evidence about interventions that can address those needs. There is an urgent need to develop and evaluate holistic care interventions designed improve HRQo

The Assessment of Athletic Training Students' Knowledge and Behavior to Provide Culturally Competent Care

Science.gov (United States)

Nynas, Suzette Marie

2015-01-01

Context: Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients. Objective: To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care,…

A holistic approach to corporate social responsibility as a prerequisite for sustainable development: Empirical evidence

Directory of Open Access Journals (Sweden)

Zlatanović Dejana

2015-01-01

Full Text Available The growing importance of sustainable development and corporate social responsibility (CSR for contemporary organizations demands appropriate holistic tools. The paper highlights how Soft Systems Methodology (SSM, a relevant holistic, i.e., soft systems approach, supports the conceptualization and management of the complex issues of CSR and sustainable development. The SSM’s key methodological tools are used: rich picture, root definitions, and conceptual models. Empirical research compares a selected sample of enterprises in the automotive industry in the Republic of Serbia, to identify possible systemically desirable and culturally feasible changes to improve their CSR behaviour through promoting their sustainable development. Some limitations of this research and of SSM application are discussed. Combining SSM with some other systems approaches, such as System Dynamics or Critical Systems Heuristics, is recommended for future research.

Effectiveness of cross-cultural education for medical residents caring for burmese refugees.

Science.gov (United States)

McHenry, Megan Song; Nutakki, Kavitha; Swigonski, Nancy L

2016-01-01

Limited resources are available to educate health professionals on cultural considerations and specific healthcare needs of Burmese refugees. The objective of this study was to determine the effectiveness of a module focused on cross-cultural considerations when caring for Burmese refugees. A brief educational module using anonymously tracked pre- and post-intervention, self-administered surveys was developed and studied. The surveys measured pediatric and family medicine residents' knowledge, attitudes, and comfort in caring for Burmese refugees. Paired t-tests for continuous variables and Fisher's exact tests for categorical variables were used to test pre- and post-intervention differences. We included open-ended questions for residents to describe their experiences with the Burmese population. The survey was available to 173 residents. Forty-four pre- and post-intervention surveys were completed (response rate of 25%). Resident comfort in caring for Burmese increased significantly after the module (P = 0.04). Resident knowledge of population-specific cultural information increased regarding ethnic groups (P = 0.004), appropriate laboratory use (P = 0.04), and history gathering (P = 0.001). Areas of improved resident attitudes included comprehension of information from families (P = 0.03) and length of time required with interpreter (P = 0.01). Thematic evaluation of qualitative data highlighted four themes: access to interpreter and resources, verbal communication, nonverbal communication, and relationship building with cultural considerations. A brief intervention for residents has the potential to improve knowledge, attitudes, and comfort in caring for Burmese patients. Interventions focused on cultural considerations in medical care may improve cultural competency when caring for vulnerable patient populations.

Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making.

Science.gov (United States)

Tingsvik, Catarina; Johansson, Karin; Mårtensson, Jan

2015-01-01

The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation. Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation. A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis. One theme emerged: 'A complex nursing situation where the patient receives attention and which is influenced by the current care culture'. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present. The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process. © 2014 British Association of Critical Care Nurses.

Culture care theory: a framework for expanding awareness of diversity and racism in nursing education.

Science.gov (United States)

Lancellotti, Katherine

2008-01-01

As American society becomes increasingly diverse, and the nursing profession does not, there has been a focus on promoting both cultural competence and diversity within the profession. Although culture and diversity are widely discussed in nursing education, the issue of racism may be avoided or suppressed. Institutionalized racism within nursing education must be acknowledged and discussed before nursing education may be transformed. Madeleine Leininger's Culture Care Theory is an established nursing theory that emphasizes culture and care as essential concepts in nursing. Theoretical frameworks abound in nursing, and Culture Care Theory may be underutilized and misunderstood within nursing education. This article examines the issue of racism in nursing education and recommends Culture Care Theory as a relevant framework for enhancing both cultural competence and diversity.

Truth Telling as an Element of Culturally Competent Care at End of Life.

Science.gov (United States)

Rising, Margaret L

2017-01-01

Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultural humility can show that revealing and withholding prognostic information are two equally valid paths to the goal of protecting the patient from harm. Assumptions and history giving rise to the preference for truth telling in the United States(US) are examined. Principles of biomedical ethics are described within the context of US, Chinese, and Latin American cultures. The process of cultural competence in the delivery of health care services is explained and introduces the concept of cultural humility. By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness. © The Author(s) 2015.

Holistic Processing of Static and Moving Faces

Science.gov (United States)

Zhao, Mintao; Bülthoff, Isabelle

2017-01-01

Humans' face ability develops and matures with extensive experience in perceiving, recognizing, and interacting with faces that move most of the time. However, how facial movements affect 1 core aspect of face ability--holistic face processing--remains unclear. Here we investigated the influence of rigid facial motion on holistic and part-based…

Holistic Processing in the Composite Task Depends on Face Size.

Science.gov (United States)

Ross, David A; Gauthier, Isabel

Holistic processing is a hallmark of face processing. There is evidence that holistic processing is strongest for faces at identification distance, 2 - 10 meters from the observer. However, this evidence is based on tasks that have been little used in the literature and that are indirect measures of holistic processing. We use the composite task- a well validated and frequently used paradigm - to measure the effect of viewing distance on holistic processing. In line with previous work, we find a congruency x alignment effect that is strongest for faces that are close (2m equivalent distance) than for faces that are further away (24m equivalent distance). In contrast, the alignment effect for same trials, used by several authors to measure holistic processing, produced results that are difficult to interpret. We conclude that our results converge with previous findings providing more direct evidence for an effect of size on holistic processing.

[The cultural history of palliative care in primitive societies: an integrative review].

Science.gov (United States)

Siles González, José; Solano Ruiz, Maria Del Carmen

2012-08-01

The objective of this study is to describe the evolution of palliative care in order to reflect on the possibility of its origin in primitive cultures and their relationship with the beginnings of the cult of the dead. It describes the change in the symbolic structures and social interactions involved in palliative care during prehistory: functional unit, functional framework and functional element. The theoretical framework is based on cultural history, the dialectical structural model and symbolic interactionism. Categorization techniques, cultural history and dialectic structuralism analyses were performed. Palliative care existed in primitive societies, mostly associated with the rites of passage with a high symbolic content. The social structures - functional unit, functional framework and functional element - are the pillars that supported palliative care in prehistory societies.

Palliative care - managing pain

Science.gov (United States)

... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... stressful for you and your family. But with treatment, pain can be managed. How Pain is Measured ...

Demystifying and improving organizational culture in health-care.

Science.gov (United States)

Pellegrin, Karen L; Currey, Hal S

2011-01-01

Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

Improving socially constructed cross-cultural communication in aged care homes: A critical perspective.

Science.gov (United States)

Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

2018-01-01

Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross-cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross-cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens' Structuration Theory was applied to the study. Data were collected by interviews with residents or their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents' experiences in cross-cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross-cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross-cultural communication capabilities. © 2017 John Wiley & Sons Ltd.

Using research evidence to inform staff learning needs in cross-cultural communication in aged care homes.

Science.gov (United States)

Gillham, David; De Bellis, Anita; Xiao, Lily; Willis, Eileen; Harrington, Ann; Morey, Wendy; Jeffers, Lesley

2018-04-01

Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches. An interpretive qualitative study utilising focus group and interview data informed the development of an education resource. Fifty six care workers from four residential aged care facilities participated in either focus groups or interviews conducted in private meeting rooms within the care facilities. Participants included personal care attendants, registered and clinical nurses, managers, hospitality staff and allied health professionals. Focus group and interview data were categorised and thematically analysed. Data relevant to cross-cultural care, team cohesion and preferred learning approaches informed education resource development, including case studies. Major themes identified the need to promote cultural awareness and understanding, and strategies for cross-cultural care and communication. Themes related to team cohesion demonstrated that staff were already sympathetic and sensitive to cross-cultural issues, and that culturally and linguistically diverse staff add value to the workforce and are supported by the organisation. Staff required clear, uncomplicated education resources to equip them with skills to address problematic cultural situations. Preferred learning approaches varied and highlighted the need for varied educational materials and approaches, as well as time efficient, opportunistic education strategies for the busy workplace. An education

The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

Directory of Open Access Journals (Sweden)

Ascoli Micol

2012-09-01

Full Text Available Abstract Introduction Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery.

Chapter 7. Creating and Sustaining a Culture of Group Care

Science.gov (United States)

Ainsworth, Frank; Fulcher, Leon C.

2006-01-01

Group care centers are established to provide a range of living, learning, treatment, and supervisory opportunities for children and young people who, for a variety of reasons, need alternative, supplementary, or substitute care. It is important, therefore, that group care centres establish an organizational climate, ethos, or culture of caring…

Holistic Education from a Humanist Perspective

OpenAIRE

López Arrillaga, César Enrique

2018-01-01

This essay intends to approach the basic concepts of Holistic Education (Barrera, 2013) and a brief conceptual journey and main postulates of the humanist theory considered by the author on personality, (Carl, 1961), to establish the possible link of holistic education from a humanist perspective in the meeting of the postulates of Humanism in the teaching practice that allows the humanization of education, centered on human beings taking into account their abilities, abilities and skills, in...

Are we bridging the gap? A review of cultural diversity within stoma care.

Science.gov (United States)

Cooper-Gamson, Louise

2017-09-28

The aim of this article is to highlight the aspects of how religion, ethnic grouping, age, gender, and learning disabilities affect how stoma care is approached and supported. It will try to highlight the positive and negative approaches documented so far and how this has affected the quality of stoma care given. By following guidelines set out by the Nursing and Midwifery Council (NMC) (2015) and the Association of Stoma Care Nurses (ASCN) (2015) the aim of the article will be to expand cultural awareness in stoma care nursing. By learning about the multifaceted aspects of culture as it applies to stoma care and then being able to apply that knowledge, usefully and skilfully, expands the SCN's ability to provide services for any cultural diverse client group.

A Holistic Approach to Bit Preservation

DEFF Research Database (Denmark)

Zierau, Eld Maj-Britt Olmütz

2011-01-01

This thesis presents three main results for a holistic approach to bit preservation, where the ultimate goal is to find the optimal bit preservation strategy for specific digital material that must be digitally preserved. Digital material consists of sequences of bits, where a bit is a binary digit...... which can have the value 0 or 1. Bit preservation must ensure that the bits remain intact and readable in the future, but bit preservation is not concerned with how bits can be interpreted as e.g. an image. A holistic approach to bit preservation includes aspects that influence the final choice of a bit...... a holistic approach and include aspects of digital representation, confidentiality, availability, bit safety and costs when defining requirements for the bit preservation. Analysis of such requirements and choice of the final bit preservation solution can be supported by the three main results presented...

Developmental changes in analytic and holistic processes in face perception.

Science.gov (United States)

Joseph, Jane E; DiBartolo, Michelle D; Bhatt, Ramesh S

2015-01-01

Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2(nd) order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses [i.e., increased reaction time (RT), as more features or spacing relations were shared between stimuli]. Analytical processing was operationalized as the degree of parallel processing (or no change in RT as a function of greater similarity of features or spatial relations). Adults showed the most evidence for holistic processing (most strongly for 2(nd) order faces) and holistic processing was weaker for inverted faces and houses. Younger children (6-8 years), in contrast, showed analytical processing across all experimental manipulations. Older children (9-11 years) showed an intermediate pattern with a trend toward holistic processing of 2(nd) order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2(nd) order and featural information are incorporated into holistic representations, whereas older children only incorporate 2(nd) order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2(nd) order processing initially then incorporates featural information by adulthood.

Developmental changes in analytic and holistic processes in face perception

Directory of Open Access Journals (Sweden)

Jane Elizabeth Joseph

2015-08-01

Full Text Available Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2nd order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses (i.e., increased reaction time, RT, as more features or spacing relations were shared between stimuli. Analytical processing was operationalized as the degree of parallel processing (or no change in reaction time as a function of greater similarity of features or spatial relations. Adults showed the most evidence for holistic processing (most strongly for 2nd order faces and holistic processing was weaker for inverted faces and houses. Younger children (6-8 years, in contrast, showed analytical processing across all experimental manipulations. Older children (9-11 years showed an intermediate pattern with a trend toward holistic processing of 2nd order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2nd order and featural information are incorporated into holistic representations, whereas older children only incorporate 2nd order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2nd order processing initially then incorporates featural information by adulthood.

Developmental changes in analytic and holistic processes in face perception

Science.gov (United States)

Joseph, Jane E.; DiBartolo, Michelle D.; Bhatt, Ramesh S.

2015-01-01

Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2nd order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses [i.e., increased reaction time (RT), as more features or spacing relations were shared between stimuli]. Analytical processing was operationalized as the degree of parallel processing (or no change in RT as a function of greater similarity of features or spatial relations). Adults showed the most evidence for holistic processing (most strongly for 2nd order faces) and holistic processing was weaker for inverted faces and houses. Younger children (6–8 years), in contrast, showed analytical processing across all experimental manipulations. Older children (9–11 years) showed an intermediate pattern with a trend toward holistic processing of 2nd order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2nd order and featural information are incorporated into holistic representations, whereas older children only incorporate 2nd order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2nd order processing initially then incorporates featural information by adulthood. PMID:26300838

Developing a culturally appropriate mental health care service for Samoa.

Science.gov (United States)

Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

2013-06-01

Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Patient's dignity in intensive care unit: A critical ethnography.

Science.gov (United States)

Bidabadi, Farimah Shirani; Yazdannik, Ahmadreza; Zargham-Boroujeni, Ali

2017-01-01

Maintaining patient's dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units. The aim of this study was to uncover the cultural factors that impeded maintaining patients' dignity in the cardiac surgery intensive care unit. The study was conducted using a critical ethnographic method proposed by Carspecken. Participants and research context: Participants included all physicians, nurses and staffs working in the study setting (two cardiac surgery intensive care units). Data collection methods included participant observations, formal and informal interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace. Ethical Consideration: Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained. The findings of the study fell into the following main themes: "Presence: the guarantee for giving enough attention to patients' self-esteem", "Instrumental and objectified attitudes", "Adherence to the human equality principle: value-action gap", "Paternalistic conduct", "Improper language", and "Non-interactive communication". The final assertion was "Reductionism as a major barrier to the maintaining of patient's dignity". The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches. Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships.

LGBT Cultural Competence and Interventions to Help Oncology Nurses and Other Health Care Providers.

Science.gov (United States)

Radix, Asa; Maingi, Shail

2018-02-01

To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

Linking Cultural Competence to Functional Life Outcomes in Mental Health Care Settings.

Science.gov (United States)

Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia

2014-01-01

Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.

Family members' expectations regarding nurses' competence in care homes: a qualitative interview study.

Science.gov (United States)

Kiljunen, Outi; Kankkunen, Päivi; Partanen, Pirjo; Välimäki, Tarja

2017-11-22

Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members' can provide valuable information about competence requirements. To explore the expectations of the care home residents' family members regarding the competence of nurses in care homes for older people. A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 care home residents' family members between March and September 2016. Participants were recruited with help from regional associations and member associations of The Central Association of Carers in Finland and from regional associations of The Alzheimer's Society of Finland. The snowball technique was also used. The data were analysed using inductive content analysis. Ethics committee approval was obtained from the university committee on research ethics, and written informed consent was obtained from participants. The care home residents' family members expected that nurses would be able to interact with and treat people respectfully. Reflective collaboration between the nurse and a family member was also emphasised. Family members expected nurses to provide high-quality basic care and nursing and support residents' well-being individually and holistically. Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being. © 2017 Nordic College of Caring Science.

Creation of an American Holistic Nurses Association research consultation program.

Science.gov (United States)

Robertson, Sue; Clingerman, Evelyn; Zahourek, Rothlyn P; Mariano, Carla; Lange, Bernadette

2012-12-01

A goal of the American Holistic Nurses Association (AHNA) Research Committee is to prepare holistic nurses to conduct holistic nursing research. This article describes the creation of a Research Consultation Program and how the knowledge gained from the program will contribute to the development of a formal research mentor program.

Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

Science.gov (United States)

Ahn, Jung-Won

2017-03-01

This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.

Cultural democracy: the way forward for primary care of hard to reach New Zealanders.

Science.gov (United States)

Finau, Sitaleki A; Finau, Eseta

2007-09-01

The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System

Science.gov (United States)

Durant, Anne Foss; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California’s Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes. PMID:26828076

Caring Science: Transforming the Ethic of Caring-Healing Practice, Environment, and Culture within an Integrated Care Delivery System.

Science.gov (United States)

Foss Durant, Anne; McDermott, Shawna; Kinney, Gwendolyn; Triner, Trudy

2015-01-01

In early 2010, leaders within Kaiser Permanente (KP) Northern California's Patient Care Services division embarked on a journey to embrace and embed core tenets of Caring Science into the practice, environment, and culture of the organization. Caring Science is based on the philosophy of Human Caring, a theory articulated by Jean Watson, PhD, RN, AHN-BC, FAAN, as a foundational covenant to guide nursing as a discipline and a profession. Since 2010, Caring Science has enabled KP Northern California to demonstrate its commitment to being an authentic person- and family-centric organization that promotes and advocates for total health. This commitment empowers KP caregivers to balance the art and science of clinical judgment by considering the needs of the whole person, honoring the unique perception of health and healing that each member or patient holds, and engaging with them to make decisions that nurture their well-being. The intent of this article is two-fold: 1) to provide context and background on how a professional practice framework was used to transform the ethic of caring-healing practice, environment, and culture across multiple hospitals within an integrated delivery system; and 2) to provide evidence on how integration of Caring Science across administrative, operational, and clinical areas appears to contribute to meaningful patient quality and health outcomes.

Self-care essential extras: an integration of holistic nursing, functional medicine, and health coaching to promote therapeutic lifestyle change and decrease chronic disease.

Science.gov (United States)

Scattergood, Donna M

2010-01-01

The Essential Vitality Program blends holistic nursing, functional medicine, and health coaching to promote lifestyle changes that modify risk factors of costly chronic disease. Karl is a client who experienced enhanced vitality, decreased chronic pain and medications use, and improved meaningful functioning, by partnering with a holistic nurse coach.

Holistic face perception is modulated by experience-dependent perceptual grouping.

Science.gov (United States)

Curby, Kim M; Entenman, Robert J; Fleming, Justin T

2016-07-01

What role do general-purpose, experience-sensitive perceptual mechanisms play in producing characteristic features of face perception? We previously demonstrated that different-colored, misaligned framing backgrounds, designed to disrupt perceptual grouping of face parts appearing upon them, disrupt holistic face perception. In the current experiments, a similar part-judgment task with composite faces was performed: face parts appeared in either misaligned, different-colored rectangles or aligned, same-colored rectangles. To investigate whether experience can shape impacts of perceptual grouping on holistic face perception, a pre-task fostered the perception of either (a) the misaligned, differently colored rectangle frames as parts of a single, multicolored polygon or (b) the aligned, same-colored rectangle frames as a single square shape. Faces appearing in the misaligned, differently colored rectangles were processed more holistically by those in the polygon-, compared with the square-, pre-task group. Holistic effects for faces appearing in aligned, same-colored rectangles showed the opposite pattern. Experiment 2, which included a pre-task condition fostering the perception of the aligned, same-colored frames as pairs of independent rectangles, provided converging evidence that experience can modulate impacts of perceptual grouping on holistic face perception. These results are surprising given the proposed impenetrability of holistic face perception and provide insights into the elusive mechanisms underlying holistic perception.

Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women's national football team coaches' practice experiences.

Science.gov (United States)

Lindgren, Eva-Carin; Barker-Ruchti, Natalie

2017-12-01

The purpose of this study was to explore how an exclusive sample of women's national football team coaches described how they implement careful coaching while facing social and organizational pressure to win medals. To consider coaches' negotiations, we drew on Noddings' concept of caring. Using an interpretive research paradigm, we conducted in-depth interviews with five Swedish women's national football team coaches. An abductive approach was used to simultaneously process the theoretical framework of "ethics of care" and the empirical data. The coaches unanimously adopted a holistic perspective to coaching. The coaching strategies they described included promoting players' development, well-being, and sustainable elite performance; listening to the players' voices and engaging in dialogue; and creating a positive environment and promoting fair play. These findings demonstrate that the women coaches, despite performance pressure, adopt caring coaching in the form of Noddings' pedagogical modelling, dialogue, and confirmation strategies, and provide an example of how coaches can adopt caring, holistic, and athlete-centred coaching while working at the highest level of competitive sport and achieving competitive success.

Towards a Holistic Approach in EU Biomass Regulation

NARCIS (Netherlands)

Giljam, Renske

The energy transition requires a legal system that promotes the most sustainable forms of energy. This requires a holistic approach that accounts for all effects of energy production throughout the energy chain. This article analyses the presence of holistic elements in the current legal framework

Understanding care in the past to develop caring science of the future: a historical methodological approach.

Science.gov (United States)

Nyborg, Vibeke N; Hvalvik, Sigrun; McCormack, Brendan

2018-05-31

In this paper, we explore how the development of historical research methodologies during the last centuries can contribute to more diverse and interdisciplinary research in future caring science, especially towards a care focus that is more person-centred. The adding of a historical approach by professional historians to the theory of person-centredness and person-centred care can develop knowledge that enables a more holistic understanding of the patient and the development of the patient perspective from the past until today. Thus, the aim was to show how developments within historical methodology can help us to understand elements of care in the past to further develop caring science in future. Historical research methodologies have advocated a "history from below" perspective, and this has enabled the evolution of systematic approaches to historical research that can be explored and critically analysed. Linked with this, the development of a more social and cultural oriented understanding of historical research has enabled historians to explore and add knowledge from a broader societal perspective. By focusing on the life of ordinary people and taking social and cultural aspects into account when trying to reconstruct the past, we can get a deeper understanding of health, care and medical development. However, an interdisciplinary research focus on person-centredness and person-centred care that includes professional historians can be challenging. In this paper, we argue that a historical perspective is necessary to meet the challenges we face in future delivery of health care to all people, in all parts of society in an ever more global world. © 2018 Nordic College of Caring Science.

Cross-cultural communication and use of the family meeting in palliative care.

Science.gov (United States)

Sharma, Rashmi K; Dy, Sydney M

2011-09-01

Terminally-ill patients and their families often report poor communication and limited understanding of the patient's diagnosis, prognosis, and treatment plan; these deficits can be exacerbated by cross-cultural issues. Although family meetings are frequently recommended to facilitate provider-family communication, a more structured, evidence-based approach to their use may improve outcomes. Drawing on research and guidelines from critical care, palliative care, and cross-cultural communication, we propose a framework for conducting family meetings with consideration for cross-cultural issues.

A comparison of surgery and family medicine residents' perceptions of cross-cultural care training.

Science.gov (United States)

Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R

2010-12-01

The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area. Hawaii Medical Journal Copyright 2010.

Principle-based concept analysis: intentionality in holistic nursing theories.

Science.gov (United States)

Aghebati, Nahid; Mohammadi, Eesa; Ahmadi, Fazlollah; Noaparast, Khosrow Bagheri

2015-03-01

This is a report of a principle-based concept analysis of intentionality in holistic nursing theories. A principle-based concept analysis method was used to analyze seven holistic theories. The data included eight books and 31 articles (1998-2011), which were retrieved through MEDLINE and CINAHL. Erickson, Kriger, Parse, Watson, and Zahourek define intentionality as a capacity, a focused consciousness, and a pattern of human being. Rogers and Newman do not explicitly mention intentionality; however, they do explain pattern and consciousness (epistemology). Intentionality has been operationalized as a core concept of nurse-client relationships (pragmatic). The theories are consistent on intentionality as a noun and as an attribute of the person-intentionality is different from intent and intention (linguistic). There is ambiguity concerning the boundaries between intentionality and consciousness (logic). Theoretically, intentionality is an evolutionary capacity to integrate human awareness and experience. Because intentionality is an individualized concept, we introduced it as "a matrix of continuous known changes" that emerges in two forms: as a capacity of human being and as a capacity of transpersonal caring. This study has produced a theoretical definition of intentionality and provides a foundation for future research to further investigate intentionality to better delineate its boundaries. © The Author(s) 2014.

The Culture of General Palliative Nursing Care in Medical Departments

DEFF Research Database (Denmark)

Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi

2015-01-01

in medical departments. Methods: An ethnographic study, using Spradley's 12-step method, with observational field studies and interviews with nurses from three medical departments in a Danish regional hospital. Findings: Three cultural themes emerged from the analysis, focusing on the setting, the practice...... and the nurses' reflections on GPNC: (1) GPNC provided in a treatment setting, (2) transition to loving care and the licence to perform palliative care (PC) and (3) potential for team improvement. Conclusions: GPNC as a culture in medical departments seemed to be embedded in a setting not suited for dying...

A holistic approach to marketing in Montenegrin banks

Directory of Open Access Journals (Sweden)

Žugić Jelena

2016-01-01

Full Text Available In modern conditions of market globalization and strong competition, it is necessary to improve a holistic approach to marketing in banks. This paper is based on the research conducted in the banks in Montenegro. The goal of this study was to determine whether the Montenegrin banks have clearly redefined the concept of marketing, recognized the specific nature of marketing in banking and adopted a holistic marketing concept in modern banking. The main purpose of marketing in banking is to attract, retain and develop long-term relationships with customers and other stakeholders. Also, the marketing concept in banking includes the achievement of full cooperation with customers through relationship marketing, customer relationship management (CRM, alternative distribution channels in modern banking and, in general, a holistic approach to marketing. Holistic marketing analysis will help identify the strengths and weaknesses in marketing in the banking sector of Montenegro and give platform for strategic planning for its further development.

Developmental differences in holistic interference of facial part recognition.

Directory of Open Access Journals (Sweden)

Kazuyo Nakabayashi

Full Text Available Research has shown that adults' recognition of a facial part can be disrupted if the part is learnt without a face context but tested in a whole face. This has been interpreted as the holistic interference effect. The present study investigated whether children of 6- and 9-10-year-olds would show a similar effect. Participants were asked to judge whether a probe part was the same as or different from a test part whereby the part was presented either in isolation or in a whole face. The results showed that while all the groups were susceptible to a holistic interference, the youngest group was most severely affected. Contrary to the view that piecemeal processing precedes holistic processing in the cognitive development, our findings demonstrate that holistic processing is already present at 6 years of age. It is the ability to inhibit the influence of holistic information on piecemeal processing that seems to require a longer period of development into at an older and adult age.

Developmental Differences in Holistic Interference of Facial Part Recognition

Science.gov (United States)

Nakabayashi, Kazuyo; Liu, Chang Hong

2013-01-01

Research has shown that adults’ recognition of a facial part can be disrupted if the part is learnt without a face context but tested in a whole face. This has been interpreted as the holistic interference effect. The present study investigated whether children of 6- and 9–10-year-olds would show a similar effect. Participants were asked to judge whether a probe part was the same as or different from a test part whereby the part was presented either in isolation or in a whole face. The results showed that while all the groups were susceptible to a holistic interference, the youngest group was most severely affected. Contrary to the view that piecemeal processing precedes holistic processing in the cognitive development, our findings demonstrate that holistic processing is already present at 6 years of age. It is the ability to inhibit the influence of holistic information on piecemeal processing that seems to require a longer period of development into at an older and adult age. PMID:24204847

Organizational culture influences health care workers' influenza immunization behavior.

Science.gov (United States)

Isaacson, Nicole; Roemheld-Hamm, Beatrix; Crosson, Jesse C; Dicicco-Bloom, Barbara; Winston, Carla A

2009-03-01

Low rates of influenza immunization among health care workers (HCWs) pose a potential health risk to patients in primary care practices. Despite previous educational efforts and programs to reduce financial barriers, HCW influenza immunization rates remain low. Variation in practice-level organizational culture may affect immunization rates. To explore this relationship, we examined organizational cultures and HCWs' influenza immunization behaviors in three family medicine practices. We used a multi-method comparative case study. A field researcher used participant observation, in-depth interviews, and key informant interviews to collect data in each practice in November-December 2003. A diverse team used grounded theory to analyze text data. Organizational culture varied among practices and differing HCW immunization rates were observed. The most structured and business-like practice achieved immunization of all HCWs, while the other two practices exhibited greater variation in HCW immunization rates. Physicians in the practices characterized as chaotic/disorganized or divided were immunized at higher rates than other members of the practices. In these practices, organizational culture was associated with varying rates of influenza immunization for HCWs, especially among nonphysicians. Addressing elements of organizational culture such as beliefs regarding influenza immunization and office policies may facilitate the immunization of all staff members.

The Design of Holistic Innovation Policy

DEFF Research Database (Denmark)

Borrás, Susana; Edquist, Charles

looks into a series of issues related to the design of holistic innovation policy. With this purpose in mind, this chapter summarizes previous chapters’ identification of the problems, bottlenecks and deficiencies that can afflict innovation systems. Taken together, they provide the theoretical...... foundations for the design of holistic innovation policy, which includes not only framing the problems in the innovation system, but also considerations about policy instruments for the tasks at hand, as well as the problems generated by policy itself (unintended consequences of inefficient of incomplete...

Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives.

Science.gov (United States)

McIlfatrick, Sonja; Connolly, Michael; Collins, Rita; Murphy, Tara; Johnston, Bridget; Larkin, Philip

2017-12-01

To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care. © 2017 John Wiley & Sons Ltd.

Is psychotropic medication use related to organisational and treatment culture in residential care.

Science.gov (United States)

Peri, Kathryn; Kerse, Ngaire; Moyes, Simon; Scahill, Shane; Chen, Charlotte; Hong, Jae Beom; Hughes, Carmel M

2015-01-01

The purpose of this paper is to establish the relationship between organisational culture and psychotropic medication use in residential care. Cross-sectional analyses of staff and resident's record survey in residential aged care facilities in Auckland, New Zealand (NZ). The competing values framework categorised organisational culture as clan, hierarchical, market driven or adhocracy and was completed by all staff. The treatment culture tool categorised facilities as having resident centred or traditional culture and was completed by registered nursing staff and general practitioners (GP). Functional and behavioural characteristics of residents were established by staff report and health characteristics and medications used were ascertained from the health record. Multiple regression was used to test for associations between measures of culture with psychotropic medication use (anxiolytics, sedatives, major tranquillisers). In total 199 staff, 27 GP and 527 residents participated from 14 facilities. On average 8.5 medications per resident were prescribed and 42 per cent of residents received psychotropic medication. Having a diagnosis of anxiety or depression (odds ratio (OR) 3.18, 95 per cent confidence interval (CI) 1.71, 5.91), followed by persistent wandering (OR 2.53, 95 per cent CI 1.59, 4.01) and being in a dementia unit (OR 2.45, 95 per cent CI 1.17, 5.12) were most strongly associated with psychotropic use. Controlling for resident- and facility-level factors, health care assistants' assignation of hierarchical organisational culture type was independently associated with psychotropic medication use, (OR 1.29, CI 1.08, 1.53) and a higher treatment culture score from the GP was associated with lower use of psychotropic medication (OR 0.95, CI 0.92, 0.98). Psychotropic medication use remains prevalent in residential care facilities in NZ. Interventions aimed at changing organisational culture towards a less hierarchical and more resident-centred culture

The Happy Antics programme: Holistic exercise for people with dementia.

Science.gov (United States)

Khoo, Yvonne J-Lyn; van Schaik, Paul; McKenna, Jackie

2014-10-01

Holistic exercise for people with dementia could have psychological and physical benefits, but there is a lack of research on the experience of this type of exercise. Therefore, the objective of this study was to determine the feasibility and acceptance of holistic exercise among people with dementia. A holistic exercise programme for people with dementia was designed and implemented. Semi-structured interviews were undertaken to explore participants' experience of holistic exercise, transcribed verbatim and analyzed. Seven themes were generated from the data. They were enjoyment, relaxation, keeping active, social interaction, pain relief, learning something new and intention to continue, respectively. The results of the current small-scale study provide evidence for the feasibility and acceptance of holistic exercise for people with dementia. In addition, participants appeared to benefit in terms of psychological and physical wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Culture care of Iranian immigrants in New South Wales, Australia: sharing transcultural nursing knowledge.

Science.gov (United States)

Omeri, A

1997-01-01

Discovery and analysis of care meanings, expressions, and practices of Iranian Immigrants in New South Wales, Australia was the focus of this ethnonursing qualitative research. The purpose of the study was to systematically discover, describe and analyse the values, beliefs, and practices of Iranian immigrants in New South Wales, Australia. The aim of the investigation was to discover transcultural nursing knowledge to guide nurses and health professionals to provide culturally congruent nursing and health care to Iranians. Leininger's theory of Culture Care Diversity and Universality (Leininger, 1991) was used as the conceptual framework for the study. It was predicted that care meanings and expressions of Iranian immigrants would be influenced by their worldview, social structure features, language, and cultural values rooted in their long ethnohistorical past and reflected in their lifeways in Australia. Using the ethnonursing qualitative research method, key and general informants were purposefully selected among Iranian immigrants residing in New South Wales. Three care themes supported by a number of universal and some diverse patterns were identified for Iranian immigrants. The three themes were: (1) Care meant family and kinship ties (hambastegie) as expressed in daily lifeways and interactions with family, friends, and community; (2) Care as expressed in carrying out traditional urban gender roles (role-zan-o-mard) (Azadie zan) as well as in fulfilling emerging new role responsibilities related to equality for female Iranian immigrants; and (3) Care as preservation of Iranian identity (inhamoni, hamonandi) as expressed in traditional cultural events and health care practices. Leininger's (1991) three modes of actions and decisions were used to develop appropriate and culturally meaningful nursing care actions and decisions which were in harmony with the cultural beliefs of Iranian immigrants.

Palliative care - shortness of breath

Science.gov (United States)

... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... the cause will help the team decide the treatment. The nurse may check how much oxygen is ...

Cross-Cultural Validation of the Patient Perception of Integrated Care Survey.

Science.gov (United States)

Tietschert, Maike V; Angeli, Federica; van Raak, Arno J A; Ruwaard, Dirk; Singer, Sara J

2017-07-20

To test the cross-cultural validity of the U.S. Patient Perception of Integrated Care (PPIC) Survey in a Dutch sample using a standardized procedure. Primary data collected from patients of five primary care centers in the south of the Netherlands, through survey research from 2014 to 2015. Cross-sectional data collected from patients who saw multiple health care providers during 6 months preceding data collection. The PPIC survey includes 59 questions that measure patient perceived care integration across providers, settings, and time. Data analysis followed a standardized procedure guiding data preparation, psychometric analysis, and included invariance testing with the U.S. dataset. Latent scale structures of the Dutch and U.S. survey were highly comparable. Factor "Integration with specialist" had lower reliability scores and noninvariance. For the remaining factors, internal consistency and invariance estimates were strong. The standardized cross-cultural validation procedure produced strong support for comparable psychometric characteristics of the Dutch and U.S. surveys. Future research should examine the usability of the proposed procedure for contexts with greater cultural differences. © Health Research and Educational Trust.

1024-Pixel CMOS Multimodality Joint Cellular Sensor/Stimulator Array for Real-Time Holistic Cellular Characterization and Cell-Based Drug Screening.

Science.gov (United States)

Park, Jong Seok; Aziz, Moez Karim; Li, Sensen; Chi, Taiyun; Grijalva, Sandra Ivonne; Sung, Jung Hoon; Cho, Hee Cheol; Wang, Hua

2018-02-01

This paper presents a fully integrated CMOS multimodality joint sensor/stimulator array with 1024 pixels for real-time holistic cellular characterization and drug screening. The proposed system consists of four pixel groups and four parallel signal-conditioning blocks. Every pixel group contains 16 × 16 pixels, and each pixel includes one gold-plated electrode, four photodiodes, and in-pixel circuits, within a pixel footprint. Each pixel supports real-time extracellular potential recording, optical detection, charge-balanced biphasic current stimulation, and cellular impedance measurement for the same cellular sample. The proposed system is fabricated in a standard 130-nm CMOS process. Rat cardiomyocytes are successfully cultured on-chip. Measured high-resolution optical opacity images, extracellular potential recordings, biphasic current stimulations, and cellular impedance images demonstrate the unique advantages of the system for holistic cell characterization and drug screening. Furthermore, this paper demonstrates the use of optical detection on the on-chip cultured cardiomyocytes to real-time track their cyclic beating pattern and beating rate.

Development of an Inventory for Health-Care Office Staff to Self-Assess Their Patient-Centered Cultural Sensitivity

Directory of Open Access Journals (Sweden)

Carolyn M. Tucker

2016-02-01

Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.

[Reiki--Japanese art of curing and its position in schemes of holistic therapeutics in Poland].

Science.gov (United States)

Kosakowska, Aleksandra

2005-01-01

Reiki is a healing practice, rised in Japan in the mid XI'th century. The philosophy of this art of cure assumes that human health depends on the level and harmonious flow of the vital energy, called "ki". Therefore the main aim of this practice is to remove all energetic blockades in individual's body. Owing to that process the natural, in the practicioners' opinion, human's ability of healing by transfer the ki is restored. Certain steps of initiations increase practitioners skills. In the contemporary euroamerican culture, Reiki has begun to unfold since the beginning of 1970's. Expanding in those days New Age philosophy has supported its adaptation in our society. In Poland this method appeard in the late 1980's and is still rather unknown as a culture occurrence. Author's research, conducted among practicioners' from Olsztyn and Poznań, was to broaden the knowledge about the method and people, who are involved in it. The results show that Reiki is one of the holistic treatment's practices but it has also its unique character. For instance, it assumes the particular role of healer, who is a guide for his patient, helping him to understand and cure himself. According to the practitioners Reiki is the way of comprehensive development, identified with the drift towards holistic health.

Culture and end of life care: a scoping exercise in seven European countries

NARCIS (Netherlands)

Gysels, M.; Evans, N.; Meñaca, A.; Andrew, E.; Toscani, F.; Finetti, S.; Pasman, H.R.; Higginson, I.; Harding, R.; Pool, R.

2012-01-01

Aim: Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

NARCIS (Netherlands)

Gysels, M.; Evans, N.C.; Menaca, A.; Andrew, E.; Toscani, F.; Finetti, S.; Pasman, H.R.W.; Higginson, I.; Harding, R.; Pool, R.

2012-01-01

Aim: Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence

The nexus of nursing leadership and a culture of safer patient care.

Science.gov (United States)

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-03-01

To explore the connection between +6 nursing leadership and enhanced patient safety. Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes. © 2017 John Wiley & Sons Ltd.

Culture care meanings, beliefs, and practices in Rural Dominican Republic.

Science.gov (United States)

Schumacher, Gretchen

2010-04-01

This ethnonursing study explored the meanings, beliefs, and practices of care for rural Dominicans in the Dominican Republic. Leininger's culture care diversity and universality theory, ethnonursing, and four-phase analysis method guided the study. Interviews were conducted with 19 general and 10 key informants. Analysis of interviews revealed three main themes: (a) family presence is essential for meaningful care experiences and care practices, (b) respect and attention are central to the meaning of care and care practices, and (c) rural Dominicans value and use both generic (folk) and professional care practices. Implications and recommendations for nursing practice, education, and research are described.

Clinically applied medical ethnography: relevance to cultural competence in patient care.

Science.gov (United States)

Engebretson, Joan

2011-06-01

Medical anthropology provides an excellent resource for nursing research that is relevant to clinical nursing. By expanding the understanding of ethnographic research beyond ethnicity, nurses can conduct research that explores patient's constructions and explanatory models of health and healing and how they make meaning out of chronic conditions and negotiate daily life. These findings can have applicability to culturally competent care at both the organizational or systems level, as well as in the patient/provider encounter. Individual patient care can be improved by applying ethnographic research findings to build provider expertise and then using a cultural negotiation process for individualized patient care. Copyright © 2011. Published by Elsevier Inc.

The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain

Directory of Open Access Journals (Sweden)

Isabel Morales-Moreno

2015-10-01

Full Text Available Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain.Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied.Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation.Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health.

"Physician, Heal Thyself": How Teaching Holistic Medicine Differs from Teaching CAM.

Science.gov (United States)

Graham-Pole, John

2001-01-01

Describes the fundamental difference between complementary and alternative medicine (CAM) and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. Asserts that offering physicians-to-be more course work in holistic medicine could lay the groundwork for future…

The role of values-based leadership in sustaining a culture of caring.

Science.gov (United States)

Faith, Karen E

2013-01-01

At the heart of healthcare are fundamental values like caring and compassion as well as the duty shared by healthcare organizations to address the care needs of those in their communities who are vulnerable, injured, or ill. A concern being raised by some political analysts in Canada is that fundamental values are being challenged by current economic and political influences that are reshaping the landscape of healthcare in this country. Influences from industry, technology, and business have significantly shifted healthcare from its moral foundations. A culture of caring is also challenged by the values and behaviours of individuals that negatively impact staff morale and inter-professional collaboration in many work settings. If a "culture of caring" is to survive the canons of cost containment, the impact of recurrent political wrangling, and other substantive influences, then healthcare must be guided by committed values-based leadership. Using case illustrations, this article attempts to explain the characteristics and role of values-based leaders in promoting those values that inspire a culture of caring.

Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

Science.gov (United States)

Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2010-10-01

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.