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Værland IE, Johansen ABG, Lavik MH. "That Is What We Have Left of Her": The Significance of Transitional Objects After the Death of an Infant in a Norwegian Context. QUALITATIVE HEALTH RESEARCH 2024:10497323241271920. [PMID: 39277774 DOI: 10.1177/10497323241271920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
When an infant dies in a neonatal intensive care unit in Norway, healthcare professionals provide bereaved parents with objects intended to help them processing their loss. Such objects can be clothes, blankets, soft animal toys, hand- and footprints, hair, as well as scrapbooks where the short life is documented through text and photo. By interviewing bereaved parents in three focus groups, we investigated the parents' use of these objects. Applying the method of reflexive thematic analysis, we developed three themes from the data material: (i) the importance of preserving objects, (ii) the approach to the objects, and (iii) the ambivalence concerning the objects. Pertinent to all themes was the parents' feeling of ambivalence toward the objects. On the one hand, the parents experienced the objects to affirm parenthood and manifest that the infant existed as a family member. Further, the objects were important in ritualization while according the child its status as deceased. Also, the objects helped the bereaved establish and keep continuing bonds with the deceased and to integrate their traumatic experience of losing a child. On the other hand, the bereaved parents shared that they were ambivalent toward the objects as they stirred up both good and painful emotions. The objects reminded them of their shocking and traumatic loss and the bereaved did not want to be confronted with this all the time. Therefore, through a preference for some objects and indifference toward others as time passed, the parents worked on transforming their bonds with the lost infant.
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Affiliation(s)
- Inger Emilie Værland
- Pediatric Department, Stavanger University Hospital, Stavanger, Norway
- The Research Group for Nursing- and Healthcare Science, Stavanger University Hospital, Stavanger, Norway
- Professional Relations in Health and Welfare, University of Stavanger, Stavanger, Norway
| | | | - Marta Høyland Lavik
- The Research Group for Nursing- and Healthcare Science, Stavanger University Hospital, Stavanger, Norway
- Professional Relations in Health and Welfare, University of Stavanger, Stavanger, Norway
- Chaplaincy Department, Stavanger University Hospital, Stavanger, Norway
- Faculty of Theology, Stellenbosch University, Stellenbosch, South Africa
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Alotaibi M, Alotaibi A, Alqahtani A, Alghonaim R, Alzahrani S, Altamimi T, Aljasser D, Alqabbani S, Almuwais A. Physiotherapists Lack Knowledge in Mental Health: A Survey of Knowledge and Attitudes of Physical Therapists About Their Role in Mental Health. J Multidiscip Healthc 2024; 17:2821-2830. [PMID: 38881753 PMCID: PMC11180451 DOI: 10.2147/jmdh.s461746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose As the number of mental illnesses increases, there is a need to manage it holistically within a multidisciplinary team. The majority of patients with physical disabilities suffer from mental health problems, and physiotherapy can play a role in improving their lifestyle. This study aimed to determine physiotherapists' self-reported knowledge and attitudes regarding their role in treating patients with mental health disorders. Methods This study adopted a descriptive, cross-sectional, and prospective observational survey design. The sample consisted of 208 physical therapists. Results The majority of the participants, (48%) had a positive attitude score, with (40%) having a neutral attitude and (12%) having a negative attitude toward treating patients with mental health issues. Most respondents (86%) reported that they need more information regarding patients with mental health disorders and physiotherapists' management of their physical health issues. Conclusion Many physiotherapists lack knowledge and hold a neutral to negative attitude towards treating patients with mental disorders. This highlights the need for more training to fill the gap in knowledge and guide physiotherapists to build upon their positive attitude towards treating patients with mental disorders.
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Affiliation(s)
- Madawi Alotaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Alanoud Alotaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amani Alqahtani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rand Alghonaim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samira Alzahrani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Tala Altamimi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Doaa Aljasser
- Epidemiology and Biostatistics Section, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samiah Alqabbani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Afrah Almuwais
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Kleiner MJ, Kinsella EA, Miciak M, Teachman G, Walton DM. "Passion to do the right thing": searching for the 'good' in physiotherapist practice. Physiother Theory Pract 2024; 40:288-303. [PMID: 36097762 DOI: 10.1080/09593985.2022.2116740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 08/17/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Practitioners' perspectives of what constitutes a 'good' physiotherapist have not been explicitly examined despite their potential implications for the future practice of physiotherapy. Physiotherapists' perceptions may inform professional priorities including education curricula, professional practices, competency profiles, and patient interactions. PURPOSE The purpose of this research was to examine physiotherapists' perceptions of what constitutes a 'good' physiotherapist. The context of the study was musculoskeletal practice (MSK). METHODS A hermeneutic phenomenological investigation was undertaken. Semi-structured interviews were conducted with twelve experienced MSK physiotherapists to examine their perceptions of what constitutes a 'good' physiotherapist. FINDINGS Seven themes were identified. Good physiotherapists were depicted as: 1) oriented to care; 2) integrating knowledge sources; 3) competent; 4) responsive; 5) reflective; 6) communicative; and 7) reasoning. To deepen the understanding of these themes, we discuss the findings in relation to Joan Tronto's ethic of care theory. CONCLUSIONS Physiotherapists' perceptions of what constitutes a 'good' physiotherapist highlight practices that may underpin an ethic of care including the pivotal role of person-centered and relational dimensions of practice. The findings call into question the profession's emphasis on a technical rationalist approach to education and clinical practice and invites conversation about future directions that balance technical competence with relational dimensions of practice.
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Affiliation(s)
- Michelle J Kleiner
- QuinnRehab, Barrie, ON, Canada
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Elizabeth Anne Kinsella
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, ON, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Gail Teachman
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Occupational Therapy, Faculty of Health Sciences, Western University, Elborn College, London, ON, Canada
| | - David M Walton
- Health and Rehabilitation Sciences Graduate Program, Faculty of Health Sciences, Western University, London, ON, Canada
- School of Physical Therapy, Faculty of Health Sciences, Western University, Elborn College, London, ON, Canada
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Johnsson L, Höglund AT, Nordgren L. The voice of the profession: how the ethical demand is professionally refracted in the work of general practitioners. BMC Med Ethics 2023; 24:75. [PMID: 37752505 PMCID: PMC10523728 DOI: 10.1186/s12910-023-00958-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Among the myriad voices advocating diverging ideas of what general practice ought to be, none seem to adequately capture its ethical core. There is a paucity of attempts to integrate moral theory with empirical accounts of the embodied moral knowledge of GPs in order to inform a general normative theory of good general practice. In this article, we present an empirically grounded model of the professional morality of GPs, and discuss its implications in relation to ethical theories to see whether it might be sustainable as a general practice ethic. METHODS We observed and interviewed sixteen GPs and GP residents working in health care centres in four Swedish regions between 2015-2017. In keeping with Straussian Grounded Theory, sampling was initially purposeful and later theoretically guided, and data generation, analysis and theoretical integration proceeded in parallel. The focal concept of this article was refined through multidimensional property supplementation. RESULTS The voice of the profession is one of four concepts in our emerging theory that attempt to capture various motives that affect GPs' everyday moral decisionmaking. It reflects how GPs appreciate the situation by passing three professional-moral judgments: Shall I see what is before me, or take a bird's-eye view? Shall I intervene, or stay my hand? And do I need to speak up, or should I rather shut up? By thus framing the problem, the GP narrows down the range of considerations, allowing them to focus on its morally most pertinent aspects. This process is best understood as a way of heeding Løgstrup's ethical demand. Refracted through the lens of the GP's professional understanding of life, the ethical demand gives rise to specific moral imperatives that may stand in opposition to the express wishes of the other, social norms, or the GP's self-interest. CONCLUSIONS The voice of the profession makes sense of how GPs frame problematic situations in moral terms. It is coherent enough to be sustainable as a general practice ethic, and might be helpful in explaining why ethical decisions that GPs intuitively understand as justified, but for which social support is lacking, can nevertheless be legitimate.
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Affiliation(s)
- Linus Johnsson
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, BMC, Box 564, 751 22, Uppsala, Sweden.
| | - Anna T Höglund
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, BMC, Box 564, 751 22, Uppsala, Sweden
| | - Lena Nordgren
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Box 564, 751 22, Uppsala, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Kungsgatan 41, 631 88, Eskilstuna, Sweden
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Perner S, Danielsson L. Exploring clinical reasoning in Austrian mental health physiotherapy: the physiotherapist´s perspective. Physiother Theory Pract 2021; 38:2827-2840. [PMID: 34607511 DOI: 10.1080/09593985.2021.1986872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION In mental health physiotherapy, there is a lack of research investigating the assumptions and clinical reasoning strategies of the professionals. A critical view on what is taken for granted within physiotherapy promotes professional development. PURPOSE The purpose of this study was to explore and describe the essence of clinical reasoning of Austrian mental health physiotherapists, and to illuminate the meaning of their experiences. METHOD Ten semi-structured individual interviews were conducted with Austrian mental health physiotherapists. The transcripts were analyzed using a phenomenological hermeneutical method. RESULTS The informants' clinical reasoning emerged as a process of three perspectives: 1) a relational and interactional perspective; 2) a perspective of wholeness; and 3) a perspective of symptoms. The results were then further interpreted using the theories of intercorporeality and bodily resonance. CONCLUSION To bring the different clinical reasoning perspectives together to one clinical reasoning process, a discourse of reconciliation is suggested as a favorable strategy, which may be useful both in clinical practice and education.
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Affiliation(s)
- Stefan Perner
- Department of Health Sciences, Physiotherapy, FH Campus Wien, Vienna, Vienna, Austria.,Faculty of Medicine, Lund University, Lund, Sweden
| | - Louise Danielsson
- Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
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Maric F, Nicholls DA. Environmental physiotherapy and the case for multispecies justice in planetary health. Physiother Theory Pract 2021; 38:2295-2306. [PMID: 34365892 DOI: 10.1080/09593985.2021.1964659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background:Global environmental change is fundamentally altering the composition and functioning of our planetary ecosystem. Effectively presenting the largest threat to the health of present and future generations, these changes and their health impacts are forcing us to think and practice healthcare in much broader terms than ever before. Objective:In this article, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy developed through a succession of carefully developed arguments. Discussion:We show how an underpinning belief in human exceptionalism has engendered an exploitative relationship with our natural planetary environment that has both shaped Western science and healthcare and led to our current environmental health crisis. Building on the dependence of human health on our planetary ecosystem, approaches like planetary health hold great promise for a corresponding, paradigmatic turn in healthcare. They fall short of this however, where they perpetuate anthropocentric interests and interventionist practices that have underpinned healthcare to date. Drawing on ethical and post-human philosophies we argue against human exceptionalism and for a solidarity that includes other-than-humans as the primary characteristic of planetary existence. Conclusion:Building on this foundation, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy, grounded in ecological awareness, multispecies justice, and a range of consonant practices of passivity and accompaniment, conceived as an alternative to the commonplace interventionism of healthcare.
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Affiliation(s)
- Filip Maric
- Institute for Health and Care Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - David A Nicholls
- School Of Clinical Sciences, Auckland University Of Technology, Northcote, Auckland, New Zealand
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