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Alternative Approaches
Published in Ruth Chambers, Paula Stather, Tackling Obesity and Overweight Matters in Health and Social Care, 2022
But for some patients, being exposed to such stigma can trigger them to change. Sometimes overweight or obese patients need to reach a ‘tipping point’ or ‘turning point’, such as when they receive a diagnosis of prediabetes to get them to realise that they must change and actually do so—with support from the clinicians they are in contact with, hopefully.
The healthcare continuum
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
Primary care evolved in the pandemic. Telehealth, healthcare provided using video, audio and diagnostic technology, was available prior to the pandemic but not widely adopted by providers and consumers. It is estimated that between 5% and 15% of all primary care encounters were being delivered prior to the pandemic. At the height of the first wave when the United States was in shutdown, there were instances where telehealth was representing upward of 80% of all clinical visits. While not sustained nationally as shutdown measures were eased, the industry has settled back to slightly higher than pre-pandemic levels estimated at approximately 22%, but this varies by system, region and specialty. For example, behavioral health utilization has maintained higher than average utilization as high as 68% nationally. It is projected that the industry will reach a tipping point where 40%–50% of all visits will be delivered using telehealth technology.10
Risk and protective factors
Published in Lorraine Bell, Helping People Overcome Suicidal Thoughts, Urges and Behaviour, 2021
When considering risk and protective factors, keep these points in mind (SPRC 2011): Not all risk and protective factors are equal. Some risk factors have been shown to significantly increase risk, whereas other risk factors do not have as strong or well-demonstrated relationships to risk. Lists mask the fact that some risk factors are much more powerful than others.High risk for suicide, whether for individuals or communities, is usually found in a combination or “constellation” of multiple risk factors.The significance of particular risk and protective factors varies among individuals and communities, so the degree of risk or protection conveyed by any one factor will differ among individuals and communities.Although risk factors generally contribute to long-term risk, immediate stressors or tipping point may create the final impetus for the suicidal act. Tipping points may include relationship problems or break-ups, financial hardships, legal difficulties, public humiliation or shame, worsening medical prognosis and other stressful events.
From hearing aids to cochlear implants: The journey for private patients in New Zealand
Published in Cochlear Implants International, 2023
Valerie Looi, Natasha de Jongh, Rebecca Kelly-Campbell
Motivation was a recurring theme through the journey with ‘Not hearing well enough’ being the most commonly reported motivation to get a CI, and ‘own motivation’ being the most common ‘facilitator’ that helped them through the whole journey. Although a range of motivating factors contributed to participants’ decision to get a CI, for many there was a tipping point that sparked them into action. The authors have defined ‘tipping point’ to be an occurrence, realization or event/circumstance that acted as a catalyst for further action. For the majority, the day-to-day struggle with HL building up over time acted as their tipping point, but for some, the tipping point was more spontaneous. Prochaska and DiClemente’s (2005). Transtheoretical Model starts at precontemplation, progressing to contemplation and then preparation prior to action. The World Health Organisation’s motivational tools textbook (Tønnesen, 2012) discusses that in the contemplation phase, pros and cons are equal, but in the preparation stage, the pros outweigh the cons with individuals progressing to act when they perceive a favourable balance. Where, how, and how fast this balance shifts depends on the individual and their circumstances; for some it may be a gradual shift, but for others, they may be a ‘trigger’ that acts as their call to action. This is demonstrated by the findings in this study where for some, it is a culmination of factors and the ongoing struggle with HL that leads to action, whereas for others, there was a single occurrence/circumstance that acted as their trigger or tipped the con/pro balance to act.
Using Life Story on the Journey to Self-Awareness with Patients in a Wellness Program at a Mental Health Care Facility
Published in Occupational Therapy in Mental Health, 2020
Fathima Fayers, Chantal Christopher, Thavanesi Gurayah
The toolbox, referred to the different techniques or strategies learned in therapy, such as documenting experiences, like recounting the life story and engaging in regular reflections to clarify one’s current stance. The spontaneity with which the skills and tools were used in interactions within the facility including therapy sessions, was evidenced by participants’ reflections on their experiences within the facility. These findings were mirrored by a recent piece by Cherry (2018), where the ongoing process of self-awareness was discussed. It was also mentioned that in clarifying one’s current stance, the person was able to draw from a wider frame of reference, thereby coping better with adaptations or changes in the environment, or any other circumstances they may face (Cherry, 2018). This supports earlier discussions on coping differently with the tipping points which previously led to their current need for therapy.
Twelve tips for applying change models to curriculum design, development and delivery
Published in Medical Teacher, 2018
Judy McKimm, Paul Kneath Jones
A major curriculum change (e.g. towards an integrated or case-based model) is a transformational change which typically stems from diffusion of innovation: it has relative advantage; it is compatible with existing values and practices; arises from peer-to-peer networks and conversations, and has observable (possibly measurable) results (Rogers 2003). It is a radical change, not only of curriculum design and structure, but may also involve shifting educational philosophies (e.g. towards a different approach such as more learner-centered) and changes to common practices (e.g. reduction in lectures, shift to small group learning). In health professions’ education, such changes typically stem from an accumulation of “Best Evidence” Medical Education (e.g. the BEME collaboration, see www.bemecollaboration.org) which leads to a “tipping point” from which a different way of seeing the world is established as the “new order”. Examples of this include the global implementation of the objective structured clinical examination (OSCE) as a key way of assessing practical clinical skills (Harden and Gleeson 1979) or the more recent introduction of the longitudinal integrated clinical clerkship (Hirsh and Walters 2017).