Care Ethics and the Practice of Medicine
Ruth E. Groenhout in Care Ethics and Social Structures in Medicine, 2018
Health care work, however, generally requires more than just practice in caregiving. Health care is a specialized field of knowledge, one that requires extensive education, whether one is a physician, a nurse, or a technician of one type or another. The practical wisdom developed by good caregivers is more than just wisdom developed by experience. It is grounded in highly technical understanding of human physiology and the various methods of responding to health and illness. Because of this, caring in the health care context depends crucially on the social structures that make that knowledge possible, and on the systems of health care provision developed to make the provision of care possible and effective. These social structures and systems themselves, then, are essential parts of the provision of care, and deserve careful analysis in terms of their capacity to provide the care they are intended for.
Professional Performance Situations and Narrative Importance
John D Engel, Joseph Zarconi, Lura L Pethtel, Sally A Missimi, Rita Charon in Narrative in Health Care: Healing Patients, Practitioners, Profession, and Community, 2017
The shift toward placing relationship at the center of what transpires between patient and caregiver underscores the value of narrative as a framework for understanding. It also addresses contemporary criticisms of medicine as depersonalized and non-humanistic, and shifts from what McArthur and Moore (25) characterize as a commercial culture of service provision to a more professional culture, fundamentally motivated to serve the sufferer above all else. The increasing interest in narrative is reflected in a burgeoning literature. A growing number of scholars, educators, and clinicians appear to be developing into what Rita Charon describes as a federation of like-minded individuals committed to narrative competence as essential to clinical competence.* Health professions education must attend to its relevance and value in contemporary health care.
Qualitative methods
Kay Aranda in Critical Qualitative Health Research, 2020
As a health care professional, you enter the field with a distinct set of communication skills. Active listening, consciously attending to interactions, noticing responses, situation awareness, concentrating on mindful conversation, are all proficiencies that can be channeled into the research interview. However, the boundaries associated with the interviewer–interviewee relationship are dictated by the research purpose and ethical approval. Responding to a disclosure made in an interview that requires referral to another agency because what has been made known is either illegal or represents a danger to self or others, may be more skillfully handled because of professional training. The sine qua non is the interaction is determined by the research contract with the participant (made explicit in the information sheet and signed into the consent form): therapeutic intervention (bar an immediate crisis intervention and referral) is not a part of the process.
It’s about time – Associations between working time dimensions and well-being of physicians
Published in Chronobiology International, 2022
Franziska U. Jung, Erik Bodendieck, Felix S. Hussenoeder, Melanie Luppa, Steffi G. Riedel-Heller
So far, studies investigating the relationship between these work factors and occupational health often concentrate on a variety of professions or the health care sector in general. In terms of physician wellness, studies focused on investigating the link between excessively long working hours and health or burnout (Rosta and Gerber 2007). Contrary, it has been shown that length, frequency as well as time of duty (i.e. night shift) negatively influence performance by causing sleep loss and sleep inertia as reviewed recently (Wong et al. 2018). One study investigated the association between working time characteristics (such as number of free weekends, shift work schedule) and somatic complaints in a sample of young physicians being in residency training (Fischer et al. 2016). The study concludes that shift work is related to increased somatic complaints, whereas free weekends are associated with fewer complaints. Similarly, another study – including physicians at an early career stage – found evidence for the impact of several working time arrangements (i.e. weekend on-call or number of consecutive night shifts) on psychological strain, fatigue and work-life conflict (Tucker et al. 2010).
Challenges in health professionals’ training and health care for wellness
Published in International Journal of Healthcare Management, 2021
Health care is about services for the prevention, treatment of diseases, rehabilitation of those who suffer, and health promotion. For appropriate health care, health providers need to have knowledge and skills for coordinated care across teams, professions, settings, and the time frames, responding to expectations of preventive, curative, and rehabilitative care. Critical understanding is essential, especially in the changed landscape of health delivery in the era of glittering technology. People entrusted to deliver care need to be steered by ethical commitments and social accountability which are the essence of professionalism in health care which needs to be on scientific principles, based on medical research, amalgamated with the wisdom of service providers. It should not just be diagnosis and treatment of diseases, but wellness of the patient as a whole.
Ethical aspects of the coordination of return-to-work among employees on sick leave due to common mental disorders: a qualitative study
Published in Disability and Rehabilitation, 2023
Lisa Holmlund, Lars Sandman, Therese Hellman, Lydia Kwak, Elisabeth Björk Brämberg
In Sweden, the healthcare and social insurance systems are mainly tax-funded. Responsibility for RTW is shared between the Swedish social insurance agency (SSIA), the manager, the employee, and the healthcare services. The SSIA carries overall responsibility for monitoring and coordinating RTW and decides eligibility for sick leave benefits based on a certificate issued by a physician [27]. The manager is responsible for supporting an efficient RTW-process [27] and for making adjustments for the employee [28]. The occupational health services (OHS), voluntary for Swedish employers, may assist in health promotion, preventive measures, and RTW-processes. The employee on sick leave is obliged to provide information to form the basis for sickness certification and rehabilitation measures and to actively engage in the RTW-process. With the new act on coordination measures for persons on sick leave [14], the healthcare services should—in addition to providing medical care and rehabilitation—focus on individual support for the employee on sick leave and the internal and external coordination of stakeholders. As a result, the coordination of RTW, organized by an on-site coordinator has been broadly implemented at primary health care centres (PCCs) [29]. Although no minimum qualifications are provided, having a health care professional background is common, such as being a registered occupational therapist, nurse, or physiotherapist. Because coordination of RTW in Sweden is organized within the healthcare system, the ethical values and norms of Swedish healthcare legislation are central to our study.
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