Examining nurses' humanistic behaviour ability and empathy levels in clinical practice: A descriptive and exploratory study

BACKGROUND

It is critical for nurses to provide healthcare services to healthy/sick individuals with a humanistic approach and with empathy.

AIMS

This research aimed to determine nurses' humanistic behaviour ability, empathy levels and related factors in clinical practice.

DESIGN

A descriptive cross-sectional and exploratory study.

METHODS

Probability sampling method was used, and 337 nurses working in two public hospitals were included in the study. Data was collected using the Humanistic Practice Ability of Nursing Scale and the Empathy Level Determination Scale. Structural equation model analysis and descriptive statistics were used to evaluate the hypothesised model. This study adhered to the STROBE checklist for reporting.

RESULTS

Nurses' humanistic ability and empathy level in nursing practices were found to be above average. Both the ability to act humanely in nursing practices and their empathy levels were found to be significantly higher in nurses who were married and had children. A significant relationship was found between empathy levels and humanistic behaviours. Accordingly, nurses' empathy levels positively affected their humanistic care behaviours, and the model established between the two concepts was found to be statistically appropriate.

CONCLUSIONS

Nurses' empathy levels positively affect their ability to act humanistically. The result of the model established between the two concepts also supports this. Care strategies should be developed that consider factors that will improve empathetic and humanistic behaviours in nurses and maximise individualised care practices.

IMPLICATIONS FOR THE PROFESSION

Increasing the awareness of nurses about the factors affecting humanistic behaviours and empathic attitudes while caring for individuals in clinical practice, will contribute to improving the quality of nursing care.

Study on the validity of the theoretical paradigm of art therapy for vulnerable children

PURPOSE

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas.

MATERIALS AND METHODS

This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems.

RESULTS

Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments.

CONCLUSION

This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance.IMPLICATIONS FOR REHABILITATIONThis study mainly refers to children with difficulty in social inclusion and psychological development.The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children.The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation.

The heart of anaesthesiology: revitalising humanism in the age of technology

Technological innovation has greatly aided modern medicine, and anaesthesiology in particular, but also contributes to dehumanising influences that promote physician burnout and dissatisfaction among patients. Here we advocate for a profound reaffirmation of humanistic principles-empathy, compassion, and communication-in perioperative medicine. We propose adaptable strategies to bolster humanism in practice, such as curricular offerings, simulation training, role modelling, and recognition. As perioperative technologies continue to evolve, the threat of depersonalisation in anaesthetic care looms, making commitments to humanism a crucial precondition for healing in the communities in which we work and live.

"The Water in Which We Swim:" A Unique, Post-Clerkship Multidisciplinary Course

OBJECTIVE

To improve patient outcomes and promote health equity, medical students must be taught not only biomedicine, but also the social sciences to understand the larger contexts in which patients live and health care operates. Yet, most undergraduate medical education does not explicitly cover these topics in a required, longitudinal curriculum.

METHODS

In January 2015 at Harvard Medical School, we created a two-part sequence (pre- and post-clerkship) of required, 4-week multidisciplinary courses-"Essentials of the Profession I and II"-to fill this gap. "Essentials of the Profession II (EOP2)" is an advanced social sciences course anchored in patient narratives and the lived experiences of students and includes clinical epidemiology and population health, healthcare delivery and leadership, health policy, medical ethics and professionalism, and social medicine that engages students to conduct structural analyses to be effective healers, advocates, and leaders.

RESULTS

Per student course evaluations, the overall course rating was 1.7 (SD 0.9, 1 = excellent and 5 = poor); its overall rating has improved over time; and it has scored well even when run virtually. It was rated highly in application of critical thinking, integration of the disciplines, and relevance for clinical work. Qualitative analyses of student responses revealed the following key course strengths: breadth of topics, teaching faculty and guest speakers, and small group discussions. The weaknesses included workload, lack of diversity of opinions, repetition, and time spent in lectures.

CONCLUSIONS

We argue that EOP2 is "essential" for post-clerkship medical education. It offers an opportunity to re-ignite and enhance humanism and activism; remind students why they chose the medical profession; equip them with frameworks and toolkits to help them to overcome challenges; and devise solutions to improve health care and patient outcomes that are applicable to their future training and ongoing practice of medicine.

First patient project: Engaging pathology through the donor dissection experience and its role in professionalism

The peer-reviewed anatomical education literature thoroughly describes the benefits and drawbacks of donor dissection. Gross anatomy laboratory environments utilizing donor dissection are generally considered to be a premier environment where students foster non-traditional discipline-independent skills (NTDIS), including the acquisition of professionalism, empathy, resilience, emotional intelligence, and situational awareness. Therefore, this IRB-approved study explored the impact of a formal humanism and pathology thread, the first patient project (FPP), on the personal and professional development of pre-professional undergraduate students in a gross anatomy dissection-based course. Five reflections from each student were collected across four cohorts (n = 74 students, 370 reflections). A post-course questionnaire collected data on student perceptions of the project. The framework method was used to analyze reflection and free response data and descriptive statistics were performed on Likert-style items using Excel. Three themes were identified to encompass the impacts of the FPP on professional development and include: Socialization (through collective dissection experience and pathology), Humanistic Qualities (respect for the donor and their history, and introspection), and Content and Skills (technical and NTDIS, anatomical knowledge). The end of course FPP survey was completed by 29 students across three cohorts (65%) and their perspectives were generally favorable regarding the promotion of respect, empathy, and humanization of their donors. This study underscores the value of incorporating humanism, pathology, and reflection, facilitated through formal curriculum for pre-professional undergraduate students. It provides evidence of the positive impact on their personal and professional development, supporting the integration of NTDIS in curricula across various disciplines.

The Sun Also Rises: Tracing the evolution of humanistic values in anatomy pedagogy and research, including cadaveric acquisition practices

Anatomy has always been at the intersection of the socio-cultural and political landscape, where new ideas constantly replace older wisdom. From ancient Egyptians through the Greeks, and then the Romans, finally culminating into the European Renaissance-all the significant eras of human civilisation have left their insignia and distinct marks on the evolution of anatomical practices. Despite its utility as a tool for anatomy pedagogy and research that has proven its worth over millennia, cadaveric dissection has particularly been subject to political and social vicissitudes. A major debate about anatomical dissection lay with the ethical considerations, or its lack thereof, while acquiring corpses for demonstration in the dissection halls. From antiquity, anatomical dissection-often synonymous with medical studies-had typically been carried out on the dead bodies of executed criminals with certain laws, such as the Murder Act of 1752, facilitating such uses. Gradually, the uses of unclaimed bodies, resourced primarily from the impoverished sections of society, were also introduced. However, these body acquisition protocols often missed the crucial element of humanism and ethical considerations, while knowledge augmentation was taken as sufficient reasoning. Unfortunately, a gross disregard towards humanistic values promulgated heinous and illegal practices in acquiring corpses, including grave robbery and even murders like in the case of Burke and Hare murders of 1828. Follow-up legislation, such as the Anatomy Act of 1832, and comparable laws in other European nations were passed to curb the vile. What distils from such a historical discourse on humane values in anatomy dissection, or medical science in general, is that the growth and integration of humanism in anatomy have never been linear, but there were intermittent and, yet, significant disruptions in its timeline. For example, there were serious human rights violations in anatomical practices during the Third Reich in Germany that perpetrated the holocaust. The medical community has kept evolving and introducing new moral values and principles while using such egregious events as lessons, ultimately resulting in the Declaration of Helsinki in 1964. This article revisits the heterogeneous journey of integrating humanistic values in anatomy practice. Such humanistic traits that, like medical science, have also developed over centuries through the inputs of physicians, researchers, and philosophers-from Greece to modernity with an important stopgap at the Renaissance-are a fascinating lore that deserves to be re-envisioned through the lens of contemporary values and ethos. In parallel to human medicine, humanistic values continue to influence veterinary medicine, a welcome development, as our society condemns animal cruelty in any form. There are lessons to be learned from this historical journey of how humanism shaped many of the concepts that anatomists use now. Finally, and most importantly, it might prevent the medical community from repeating the same mistakes by cautioning against the traps that are there, and in a convoluted world where morality as such is eroding from our social fabric, will always be there. Such historical account acts as a righteous, ethical, and contextual compass to guide the existing and upcoming anatomists in discerning between light and dark, right and wrong, and roads-to be or not to be-taken.

The biopsychosocial model is lost in translation: from misrepresentation to an enactive modernization

INTRODUCTION

There are increasing recommendations to use the biopsychosocial model (BPSM) as a guide for musculoskeletal research and practice. However, there is a wide range of interpretations and applications of the model, many of which deviate from George Engel's original BPSM. These deviations have led to confusion and suboptimal patient care.

OBJECTIVES

1) To review Engel's original work; 2) outline prominent BPSM interpretations and misapplications in research and practice; and 3) present an "enactive" modernization of the BPSM.

METHODS

Critical narrative review in the context of musculoskeletal pain.

RESULTS

The BPSM has been biomedicalized, fragmented, and used in reductionist ways. Two useful versions of the BPSM have been running mostly in parallel, rarely converging. The first version is a "humanistic" interpretation based on person- and relationship-centredness. The second version is a "causation" interpretation focused on multifactorial contributors to illness and health. Recently, authors have argued that a modern enactive approach to the BPSM can accommodate both interpretations.

CONCLUSION

The BPSM is often conceptualized in narrow ways and only partially implemented in clinical care. We outline how an "enactive-BPS approach" to musculoskeletal care aligns with Engel's vision yet addresses theoretical limitations and may mitigate misapplications.

What Humans Need

Family medicine is a champion of human-focused health care in the context of lasting relationships. What do humans need-those who seek care and those who offer it? Respect, understanding, and kindness. Without it, more money, more ancillary personnel, more time-saving technology cannot lift us from the profession's doldrums. The author believes that the deep desire to be of help to others can be rekindled in an office culture where the humanity in all of us is honored.

Analysis of Student Reflections on "What Matters Most" to Palliative Care Patients: A Narrative Medicine Exercise

Background: Effective communication with ill patients requires practice, yet, the traditional history overlooks patients' personal stories. This information is vital to determining goals of care and facilitates partnership by building trust. Objective: We implemented a narrative medicine exercise for students during their palliative medicine rotation to highlight humanism. Impact was determined through thematic analysis of students' reflections. Design: Students elicited "what matters most" to patients, transcribing this plus a personal reflection. Using an inductive and iterative approach, 100 reflections were analyzed, developing codes then broader themes. Results: Four main themes (Getting to know the patient, Student Reaction, Building-blocks of patient-physician relationship, Student Personal Insights) were identified, with 15 subthemes. Conclusion: The power of uncovering patients' backgrounds and values was demonstrated, reinforcing a palliative medicine approach. Analysis showed a positive impact and the possibility of change to future practice. The intervention was feasible, well received, and encouraged reflection on the physician-patient relationship beyond the medical domain.

Mediating Effect of Humanism on the Relationship between Task Performance Competence and Holistic Nursing Competence for Clinical Nurses

This is a cross-sectional descriptive study that investigates the mediating effect of humanism on the relationship between task performance and holistic nursing competence among clinical nurses. The participants were nurses with more than one year of work experience in general hospitals in South Korea, recruited using convenience sampling. A total of 227 data samples were collected. A self-reported questionnaire including the task performance competence scale, holistic nursing competence scale, and humanism scale was used for the survey. Data were analyzed using the t-test, analysis of variance, Pearson's correlation coefficients, and hierarchical multiple regression after checking for normal distribution. The results showed that task performance competence, holistic nursing competence, and humanism differed according to characteristics such as gender, age, educational level, marital status, position, length of career, and job and salary satisfaction. Task performance competence was positively correlated with holistic nursing competence and humanism. A positive correlation was also observed between holistic nursing competence and humanism. A partial mediating effect of humanism in the relationship between task performance competence and holistic nursing competence was confirmed. Thus, to increase nurses' holistic nursing competence, it is necessary to improve task performance competence and formulate a continuous and repetitive education program that includes humanism.

Farewell to humanism? Considerations for nursing philosophy and research in posthuman times

In this paper, I argue that critical posthumanism is a crucial tool in nursing philosophy and scholarship. Posthumanism entails a reconsideration of what 'human' is and a rejection of the whole tradition founding Western life in the 2500 years of our civilization as narrated in founding texts and embodied in governments, economic formations and everyday life. Through an overview of historical periods, texts and philosophy movements, I problematize humanism, showing how it centres white, heterosexual, able-bodied Man at the top of a hierarchy of beings, and runs counter to many current aspirations in nursing and other disciplines: decolonization, antiracism, anti-sexism and Indigenous resurgence. In nursing, the term humanism is often used colloquially to mean kind and humane; yet philosophically, humanism denotes a Western philosophical tradition whose tenets underpin much of nursing scholarship. These underpinnings of Western humanism have increasingly become problematic, especially since the 1960s motivating nurse scholars to engage with antihumanist and, recently, posthumanist theory. However, even current antihumanist nursing arguments manifest deep embeddedness in humanistic methodologies. I show both the problematic underside of humanism and critical posthumanism's usefulness as a tool to fight injustice and examine the materiality of nursing practice. In doing so, I hope to persuade readers not to be afraid of understanding and employing this critical tool in nursing research and scholarship.

Ahead of her time: The multidimensional impact of Marie Ussing Nylen

Marie Ussing Nylen was a trail blazing scientist and administrative leader at the US National Institutes of Health. She accomplished this when it was extremely difficult for a woman to do so. She was also a whole person - a wife, mother, and talented athlete, that is, a well-rounded person by any definition. She was a gift to dental and oral science, as well as to those fortunate enough to know and work with her.

A case study of a strategic initiative in pediatric rehabilitation transition services: An insiders' perspective on team principles and practices

Aims

The aim was to describe an innovative initiative that took place in a pediatric rehabilitation hospital. The goal of this organization-wide strategic initiative, called the Transition Strategy, was to improve service delivery to children/youth with disabilities and their families at times of life transition. The research question was: What are the key elements that have contributed to the success of the Strategy, from the perspective of team members? The objectives were to describe: (a) the guiding principles underlying team functioning and team practices, (b) key enablers of positive team functioning, (c) the nature of effective team practices, and (d) lessons learned.

Methods

A holistic descriptive case study was conducted, utilizing historical documents, tracked outcome data, and the experiences and insights of multidisciplinary team members (the authors). Reflecting an insiders' perspective, the impressions of team members were key sources of data. The perspectives of team members were used to generate key teamwork principles, enablers of team functioning, team practices, and key learnings.

Findings and Discussion

Team members identified four guiding humanistic principles (respect, support, partnership, and open communication). These principles underpinned three novel practices that contributed to team effectiveness in the eyes of team members: supportive relational practices, human-centered co-design, and solution-focused communication. Key enablers were the relational style of leadership, and a team climate of innovation, autonomy, and trust, supported by the organizational vision. This team climate fostered a sense of psychological safety, thereby encouraging both experimentation and learning from failure.

Conclusions

This article provides information for other healthcare organizations interested in understanding the Strategy's value and its implementation. It provides a practical example of how to adopt a humanistic approach to health care, leading to both innovative service development and thriving among team members.

Love, compassion and attachment in psychiatric care: perspectives for research and clinical practice

Love, compassion and related constructs have drawn to much attention from the general public due to the increased need of a better and more humanistic medical care. However, those constructs have been constantly neglected in academic benches and high impact research journals due to the 'abstract' and 'non-measurable' nature of these constructs. At the same time, medicine is claiming for a more patient-oriented and empathetic care, as care has been more disease-oriented and less life- and health-oriented, as initially proposed. This piece tries to discuss and claim for a more compassionate and altruistic care, despite technical pressure from most healthcare systems. We aim, thus, to incentive more research and clinical practice toward this very important subject.

[Participate in professional conferences from the initial training]

As part of the MAEVAS day, organized by the Paris Psychiatry & Neurosciences University Hospital Group, three nursing students from the Théodore-Simon inter-hospital training institute in Neuilly-sur-Marne (93) presented a conference entitled "Humanism & Cure at the Heart of the Care Relationship: Dare to Think!" to an audience of caregivers on May 23, 2022. They report on the essence of the reflections shared.

Psychotherapy Within Occupational Therapy Literature: A Scoping Review

Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the role and scope of occupational therapy in the provision of psychotherapy. Purpose. To document how psychotherapy has been explored in occupational therapy literature. Method. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines by searching eight databases (e.g., Medline, AMED, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Sociological Abstracts, and ProQuest Dissertations & Theses). Articles included at the full-text stage were subjected to a narrative synthesis. Findings. A total of 207 articles met the criteria for inclusion, spanning 93 years. 47.3% of these articles represented non-empirical literature, with only 14% representing effectiveness studies, suggesting that this body of literature remains in an early stage of development. Implications. Occupational therapists have been writing about and practicing psychotherapy for nearly a century, yet there remains an important opportunity to develop and evaluate occupation-based psychotherapy approaches. Effectiveness studies are needed.

Sociohumanistic Knowledge and the Future of Science

The author's understanding of the role of the social sciences and humanities in preserving and developing science as a sociocultural phenomenon is substantiated. This justification is built as an explication and critical analysis of the program of philosophical research in science and technology, the main content and results of which are presented in the monograph by I.T. Kasavin Science As a Humanistic Project (2020). This article describes how the search for new strategies for the study of science is carried out within the framework of Russian philosophy. The historicity of science is analyzed, and the complex topology of its genesis is shown, which does not fit into the linear scheme of historical continuity, reflecting the synchronous coexistence of different variations of science as a cultural phenomenon. The historicity of science makes us turn to the question of its cultural and historical agency; it is substantiated that this agency acquires a political character in the current activity. How can the political agency of science be perceived and consistently combined with the ethos of the expert community? According to the author, political agency and the range of interests that scientists defend in public are determined by understanding the essence of science as a cultural phenomenon. The existential and cultural-creative functions of science are emphasized; on this basis the author's interpretation of the humanistic project suggested by Kasavin is proposed as a program for the humanization of technoscience.

Training of neurologists for the 21st century: cultural and professional skills

Training of neurologists for the near future is a challenge due to the likely advances in neuroscientific methods, which will change much of our knowledge on diagnosis and treatment of neurological diseases.

OBJECTIVE

to comment on what may be more likely to be a constant in the very near future and to recommend how to prepare the neurologist for the 21st century.

METHODS

through a critical review of recent articles on the teaching of Neurology, to present a personal view on the subject.

RESULTS

Diagnostic methods and therapeutic resources in Neurology will be greatly improved, but the central core of teaching young neurologists will continue to be the clinical/anatomical correlation. The neurologist must be prepared to be the primary physician in the care of patients with neurological disorders, although the roles of consultant and clinical neuroscientist must also be considered. In addition to technical knowledge, the neurologist must be prepared to discuss not only distressing issues related to the specialty, such as the risks of genetic diseases for family members of their patients, the inexorable progression of some diseases and the need for palliative care, but also problems not directly related to Neurology that cause anxiety and depression in the patient or that are the main reason for the initial consultation.

CONCLUSION

neurology will be an even more important area of medicine and the neurologist must be well prepared to be the primary doctor to diagnose, treat and follow the patient with neurological disorders. In addition to technical knowledge, training in doctor-patient relations should be highlighted.

Finding Meaning in Medicine: Pediatric Residents' Perspectives on Humanism

OBJECTIVES

To explore pediatric residents' perspectives on humanism and how residency impacts humanism formation.

METHODS

We conducted a qualitative study with pediatric resident focus groups at Stanford. Transcripts were analyzed by two investigators using grounded theory. Subsequent literature review led us to adapt Cruess et al. 2015's professional identity formation framework to describe development of a humanism identity in residency. Member check was done to verify themes and the adapted framework.

RESULTS

Thirty two pediatric residents participated. Five themes emerged: 1) Empathy, compassion, and respect are foundational elements of humanism. 2) Each resident had a unique view of humanism derived from personal values. 3) Residents felt that the terms excellence and resilience (Gold Foundation IECARES model) did not fit with their own definitions. 4) Residents felt that humanism is a central part of their practice and training. 5) The demands, structure, and culture of residency were often in conflict with promoting humanism in residents. Based on residents' perspectives, we modified the professional identity formation and socialization conceptual framework proposed by Cruess et al. 2015 to reflect humanism identity formation during pediatrics residency. The new framework emphasizes the increased power of the healthcare system and unconscious acquisition on humanism formation in residency as compared to medical school.

CONCLUSIONS

Residents believe that humanism is a core part of practicing medicine and should be reinforced during residency training. Cruess' professional identity and socialization framework is a tool for a better understanding of the complexity of humanism development in residency.

Artificial Intelligence in Emergency Medicine: Benefits, Risks, and Recommendations

BACKGROUND

Artificial intelligence (AI) can be described as the use of computers to perform tasks that formerly required human cognition. The American Medical Association prefers the term 'augmented intelligence' over 'artificial intelligence' to emphasize the assistive role of computers in enhancing physician skills as opposed to replacing them. The integration of AI into emergency medicine, and clinical practice at large, has increased in recent years, and that trend is likely to continue.

DISCUSSION

AI has demonstrated substantial potential benefit for physicians and patients. These benefits are transforming the therapeutic relationship from the traditional physician-patient dyad into a triadic doctor-patient-machine relationship. New AI technologies, however, require careful vetting, legal standards, patient safeguards, and provider education. Emergency physicians (EPs) should recognize the limits and risks of AI as well as its potential benefits.

CONCLUSIONS

EPs must learn to partner with, not capitulate to, AI. AI has proven to be superior to, or on a par with, certain physician skills, such as interpreting radiographs and making diagnoses based on visual cues, such as skin cancer. AI can provide cognitive assistance, but EPs must interpret AI results within the clinical context of individual patients. They must also advocate for patient confidentiality, professional liability coverage, and the essential role of specialty-trained EPs.

Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ?

Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.

Humanistic Care in Nursing: Concept Analysis Using Rodgers' Evolutionary Approach

BACKGROUND

Despite the importance and prominent role as a clinical, theoretical, and research approach in nursing practice, humanistic care nature and boundaries are not explicit and challenging for nurses to understand. This study was conducted to clarify the concept of humanistic care in nursing.

MATERIALS AND METHODS

Based on Rogers's evolutionary concept analysis, keywords such as "humanistic car *," "caring behave *," "humanistic nurs *," "humanistic model of care," were searched in PubMed, SCOPUS, Science Direct, Web of Science, WILEY, Springer, SAGE, ProQuest, SID, Iranmedex without time limit until November 2018. Sixty-five documents in nursing and ten documents in the medical discipline were finalized for thematic analysis.

RESULTS

Nine attributes of the humanistic care, including "excellence in clinical literacy," "creating a healing environment," "a comprehensive and unique viewpoint," "contribution to clients' adaptation and flourishing of their talents," "unrequited love and affection," "preservation of human dignity," "real presence," "constructive dynamic interaction," and "nurse's self-care," were recognized. Assessing the historical and evolutionary course of the concept's semantic tendency revealed three periods: The focus in first, second, and third was on the nurse-patient relationship, quantitative tendency/measurement, and metaphysics/spiritual humanism, respectively. The comparison of interdisciplinary differences indicated greater semantic comprehensiveness and depth in the nursing discipline.

CONCLUSIONS

Clear and practical definition and identification of humanistic care in nursing can be helpful in the further development of existing knowledge, instrumentation, designing guidelines, clinical interventions, knowledge translation, and correction of concept misuse. The identified antecedents and consequences can be in various aspects of clinical management.

"We Need to Talk About Empathy": Dutch Humanist Chaplains' Perspectives on Empathy's Functions, Downsides, and Limitations in Chaplaincy Care

This paper investigates the functions, downsides, and limitations of empathy in chaplaincy care. Data were collected from 20 humanist chaplains working in health care, prison, and military settings using semi-structured interviews. According to the participants, empathy is at the heart of their profession but has disadvantages as well. The analysis yields seven major functions of empathy with corresponding downsides and limitations: (1) to connect, (2) to understand, (3) to guide, (4) to acknowledge, (5) to motivate, (6) to inspire, and (7) to humanize. We argue for a need to "talk about empathy" since despite its importance and challenges, there is little professional and academic discussion about empathy in chaplaincy care. We hope that the findings of this study can function as starting points for the discussion and thus contribute to the ongoing professionalization of chaplaincy care. To that end, we propose three topics for further reflection and conversation.

Patients' Satisfaction with Humane Care in Critical Care Units

Background:

It is important to assess the provision of care in a humane framework to achieve patients' holistic needs in Critical Care Units (CCUs) and to promote health outcomes. The aim of the current study was to determine patients' satisfaction with humane care in CCUs.

Materials and Methods:

In the current descriptive–analytical study, data were collected from 225 patients admitted to the CCUs of seven teaching hospitals in Lorestan Province, Iran, in 2017. The Persian version of the Revised Humane Caring Scale (P-RHCS) was used in this study. Data were analyzed using descriptive statistics and inferential statistics (independent t-test and one-way ANOVA).

Results:

The mean (SD) overall score of the P-RHCS was 4.61 (0.53), which indicated that patients were highly satisfied with humane care. The patients were most satisfied with “professional performance” [mean (SD) 4.72 (0.60)] and “interdisciplinary collaboration” [mean (SD) 4.72 (0.65)], and the least satisfied with “awareness of and contribution to self-care” [mean (SD) 4.23 (0.78)]. The findings revealed that patients' satisfaction with humane care depends on their demographic and clinical characteristics.

Conclusions:

Generally, patients were satisfied with humane care provided in CCUs; however, it is recommended that nurses' skills be reinforced, especially regarding information provision and effective communication with patients to improve health outcomes.

The Actively Caring for People Movement: A Synergistic Integration of Behaviorism, Humanism, and Positive Psychology

This article reviews the Actively Caring for People (AC4P) Movement, initiated in 2007 to increase occurrences of interpersonal acts of kindness worldwide. Resources to support the AC4P Movement, including research-based training manuals and AC4P wristbands for adults and children, are available at www.ac4p.org. This prosocial movement incorporates principles from three diverse disciplines of psychological science: humanism, positive psychology, and applied behavioral science (ABS). With this article, I explicate seven evidence-based "life lessons" that operationalize select principles from humanism and ABS, and rejuvenate a seemingly forgotten applied psychology concept from the 1970s: humanistic behaviorism. Whenever and wherever practiced, these life lessons benefit human well-being and quality of life. Certain life lessons reflect the essence of empowerment and self-motivation and thereby illustrate critical distinctions between management and leadership. Next, I exemplify synergistic connections between positive psychology and ABS, highlighting practical techniques for promoting and supporting human welfare and personal happiness. Previous and ongoing research by my students and colleagues demonstrates how ABS can apply findings from positive psychology to promote subjective well-being on a large scale. The need for worldwide application and dissemination of practical procedures to increase occurrences of AC4P behavior is strikingly obvious, perhaps more so now than ever before in our contentious, fractured, and polarized society. This article explores evidence-based strategies for increasing occurrences of AC4P behavior in various settings, with the mission to cultivate an AC4P culture in families, educational settings, corporations, and communities throughout the world.

Transhumanism and African humanism: How to pursue the transhumanist vision without jeopardizing humanity

African humanism should be considered more in the theoretical discussion on transhumanism. Using an underexplored humanistic philosophy of Ubuntu, this article shows how the perspective from the global south provides guidelines for pursuing transhumanism without jeopardizing humanism. It argues that heuristics from African (Ubuntu) humanism can serve transhumanist goals. While transhumanism has attracted severe criticisms from bio-conservatives, this article counterargues some salient objections. Drawing on an Ubuntu understanding of humanism, this article posits that the transhumanist vision of the posthuman does not threaten our humanity. Ubuntu humanism is shown to be supportive of transhumanism and can plausibly serve as a guide to protecting transhumanist trajectories from potential abuses. This article concludes that the embedded values of African humanism deserve to be taken seriously in galvanizing global trust in transhuman futures.

Should attendance for preclinical simulation and clinical education be mandatory?

Mandatory attendance, particularly in didactic settings, is a highly debated topic in higher education, including dental education. Within dental education, a large portion of education occurs in preclinical laboratories and clinical environments. There is little to no research on attendance in these settings in dental schools. This point/counterpoint paper examines the pros and cons of mandatory attendance in these highly specialized educational settings. With the backdrop of the COVID-19 pandemic that began in March 2020 and continues to impact dental education at the time of publication, this topic has become even more relevant. Viewpoint 1 claims that attendance should be mandatory because a greater exposure to preclinical and clinical environments helps foster better clinical hand skills, critical thinking, decision-making, problem-solving skills, and an overall sense of professional identity. It goes on further to suggest that there may be a link between attendance and performance in exams and that attendance is part of the dental school's responsibility. Viewpoint 2 argues that the rationale for attendance is complex, and that creating learning environments that are psychologically safe will incentivize students to attend, even without mandatory attendance policies. Furthermore, it explains that technological advances have allowed dental schools to think creatively about asynchronous learning, which by its very nature does not require attendance at a given time. The authors of both viewpoints conclude that the preclinical and clinical education and experience are critical dental education and that dental school leaders should focus on improving the quality of these experiences.

Validity and reliability of the Korean version of the Humanism Scale Short Form: A cross-sectional study

Aim

To examine the reliability and validity of a Korean version of the Humanism Scale Short Form.

Design

A cross‐sectional descriptive design.

Methods

This study involved 191 nurses in Korea. Data were collected from 1 May to 30 June 2019. Bilingual nursing professionals translated the scale into Korean, and reverse translation was performed. Validity and reliability were assessed, and the correlation coefficients of the developed scale were compared with those of the Korean version of the Empathy Quotient Scale and Compassion Competence Scale to evaluate concurrent validity.

Results

Exploratory factor analysis with 15 items showed that two factors (human equality and respect for human beings) explained 50.86% of the variance. Cronbach's alpha for the overall scale was 0.88. Thus, the scale has acceptable reliability and validity. Humanism measures can predict a nurse's approach to holistic care and provide fundamental data for developing programs to improve integrated caring capacities.

Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School

Anatomy education provides students with opportunities to learn structure and function of the human body, to acquire professional competencies such as teamwork, interpersonal skills, self-awareness, and to reflect on and practice medical ethics. The fulfillment of this wide potential can present challenges in courses that are part of an integrated curriculum and shorter than traditional courses. This new reality, together with students' increasing concern about the stresses within medical education, led to efforts at Harvard Medical School to implement practical steps toward an optimal learning environment in anatomy. These were based on core elements of ethical anatomy education and principles of trauma-informed care. Anatomy is conceptualized here as the "first clinical discipline," with relational interactions between anatomical educators, medical students, and body donors/patients. Essential prerequisites for the implementation of this work were support by the medical school leadership, open partnership between engaged students and faculty, faculty coordination, and peer-teaching. Specific interventions included pre-course faculty development on course philosophy and invitations to students to share their thoughts on anatomy. Student responses were integrated in course introductions, combined with a pre-dissection laboratory visit, an introductory guide, and a module on the history and ethics of anatomy. During the course, team-building activities were scheduled, and self-reflection encouraged, for example, through written exercises, and elective life-body drawing. Students' responses to the interventions were overall positive, but need further evaluation. This first attempt of a systematic implementation of an optimal learning environment in anatomy led to the identification of areas in need of adjustment.

A Systematic Review of Interventions to Improve Humanism in Surgical Practice

INTRODUCTION

Humanism in surgery is an emerging priority in surgical education. Its emphasis on the patient experience is a key component of the therapeutic relationship between surgeons and their patients. However, the documented high rates of compassion fatigue and burnout among surgical trainees and staff can serve as a barrier in delivering care with empathy and compassion. As such, this systematic review seeks to characterize the outcomes regarding interventions that aim to broadly improve humanism within surgery.

METHODS

A systematic search of 4 electronic databases (EMBASE, MEDLINE, PsycINFO, and Cochrane CENTRAL) was conducted through an independent double selection and extraction process from database inception to March 20, 2020. The inclusion criteria consisted of interventional studies aiming to improve humanism in surgery at all levels of training. A qualitative synthesis and thematic analysis were performed.

RESULTS

A total of 19 studies (1 RCT, 14 prospective cohort, and 4 cross-sectional studies), with 20 intervention arms, were included from the initial 745 studies that were eligible for title screening. Studies included a total of 1763 surgical trainees at varying levels of training. Two major strategies for improving humanism were identified: (1) directly through the development of empathetic communication skills (n = 11) and (2) indirectly through programs aimed at reducing levels of compassion fatigue and emotional exhaustion by addressing trainee burnout (n = 9). A total of 70% (14/20) of the studied interventions were successful in improving empathy in surgical trainees.

CONCLUSION

Interactive workshops around the principles of empathetic communication with patient simulations and small group learning were effective at improving empathy in surgical trainees. Furthermore, mindfulness-based training and the provision of physical resources to support trainee well-being consistently improved rates of burnout among surgical trainees. Overall, further investigation is necessary to better understand methods of improving empathy in surgery.

Delivering Personalized Care at a Distance: How Telemedicine Can Foster Getting to Know the Patient as a Person

The promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient's individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic. Patients and clinicians report high satisfaction with telemedicine, and the quality of communication and patient-centeredness experienced in this setting are both rated highly. In this article, we explore the benefits offered by telemedicine in facilitating personalized care with particular focus on telemedicine delivered by video platforms. We propose strategies and skills specific to the effective implementation of personalized telemedicine, drawing on literature in patient-centered communication and home visits. While traditional in-person office visits continue to offer important opportunities such as thorough physical examination and the potential for enhanced non-verbal communication, telemedicine offers many important advantages that can facilitate the process of getting to know the patient as a person.

Development and Validation of the Humanistic Practice Ability of Nursing Scale

PURPOSE

The purpose of this study was to develop a Humanistic Practice Ability of Nursing (HPAN) scale adapted to China and validate its psychometric properties.

METHODS

The original HPAN scale was revised through a literature review. Sixteen experts who met the inclusion criteria were consulted 2 rounds by the Delphi method. According to their suggestions and opinions, the structure, content, and semantics of each item of HPAN were modified, and a HPAN scale was preliminarily developed. The HPAN scale was validated through item analysis, exploratory factor analysis, convergent validity, and reliability. The data came from 406 first-class hospital nurses.

RESULTS

A 5-dimension, 29-item HPAN scale demonstrated satisfactory fit with significant factor loadings. The split-half reliability coefficient of the scale was .98, the split-half reliability coefficient of each dimension was .86-.99, Cronbach's α coefficient was .96, and the Cronbach's α coefficient of each dimension was .87-.98. The model fit of the scale was good, and the items of the scale showed convergent and discriminant validity.

CONCLUSION

The HPAN scale indicated that the reliability and validity were good. It is easy to imply factors of HPAN. This scale can be used to assess the HPAN.

Comparing feeling of competence regarding humanistic caring in Belgian nurses and nursing students: A comparative cross-sectional study conducted in a French Belgian teaching hospital

Aim

The aim of the study was to describe and compare feeling of competence regarding humanistic caring in Registered Nurses (RN) and nursing students (NS).

Design

A quantitative comparative cross-sectional research design was used.

Methods

A convenience sample of 196 RN and 47 NS in a teaching hospital in Belgium completed a self-administered questionnaire composed of a sociodemographic survey and the Caring Nurse-Patient Interactions Scale (CNPI-23) developed by Cossette et al.

Results

The four dimensions of the CNPI-23 were compared using the Skillings-Mack test. Both groups scored higher on "humanistic" and "comforting" than on "clinical" and "relational" care and both scored lowest on this last dimension. Linear regressions showed that none of the variables had a statistically significant influence on the CNPI-23 scores, except for NS "state of health," which influenced their feeling of competence regarding "relational care."

Humanism and professionalism training for pediatric hematology-oncology fellows: Results of a multicenter randomized trial

PURPOSE

Although humanism and professionalism are central tenets to the practice of medicine, few formal curricula exist for medical trainees. Following a national needs assessment among pediatric hematology-oncology (PHO) fellows, we created a novel curriculum entitled "Humanism and Professionalism for Pediatric Hematology-Oncology" (HP-PHO). In this study, we measure outcomes of this curricular intervention.

METHOD

We cluster-randomized 20 PHO fellowship programs to deliver usual training in humanism and professionalism (UT) or the novel curriculum (intervention) during the 2016-2017 academic year. The primary outcome measure was the Pediatric Hematology-Oncology Self-Assessment in Humanism (PHOSAH). Secondary measures included the Maslach Burnout Inventory, Patient-Provider Orientation Scale, Empowerment at Work Scale, and a 5-point satisfaction scale. Participating fellows completed pre- and posttests at the beginning and end of the academic year, respectively, and we calculated change scores for each study instrument.

RESULTS

Cluster randomization yielded 59 intervention and 41 UT fellows. The nine intervention sites administered 33 of 36 modules. Change scores on the PHOSAH were not significantly different between the UT and intervention arms. However, fellows on the intervention arm gave significantly higher ratings on several items within the satisfaction scale related to physician burnout, physician depression, balancing professional duties and personal life, and humanism overall.

CONCLUSIONS

Exposure to the HP-PHO curriculum did not alter fellows' self-assessed humanism and professionalism skills. However, intervention fellows expressed significantly higher levels of satisfaction in their humanism training, indicating the curriculum's potential for positive impact on the fellows' perceived learning environment.

[Creating a desirable future by restoring value to care]

Violent behaviour against caregivers is becoming increasingly frequent in the health system. Several solutions have been put forward to move towards a model which would enable professionals to continue delivering care and practising their profession while advocating values of humanity. However, they are not always implemented.

Facilitating and hindering experiences to the development of humanistic caring in the academic and clinical settings: an interpretive phenomenological study with nursing students and nurses

Objectives This paper reports on nursing students' and nurses' lived experiences mediating their development of humanistic caring. Methods Using interpretive phenomenology, 26 participants were individually interviewed. A five-stage phenomenological analysis based on Benner's (Benner, P. (1994). Interpretive phenomenology: Embodiment, caring, and ethics in health and illness. Thousand Oaks, CA: SAGE) method occurred simultaneously. Results The analysis highlighted that the development of humanistic caring is affected by role models and counterexamples, environments in which humanistic caring is exalted or trivialized, communication-related courses, patient storytelling, and work overload. Conclusions It might be valuable to raise the awareness of nurse educators about their opportunity in shaping the development of students' humanistic caring.

Nurses' Self-Assessment of Caring Behaviors in Nurse-Patient Interactions: A Cross-Sectional Study

Nurse-patient interactions based on caring behaviors ensure better working conditions and better-quality healthcare. The aim of this quantitative study is to examine how nurses self-assess the frequency of applying caring behaviors in nurse-patient interactions and to identify the differences in the application frequency of caring behaviors in relation to work experience and education level. The respondents were Bachelor of Science (BSc) nurses and nurses with basic training (VET) employed in different clinical departments of the Clinical Hospital Center in Croatia. The survey used the "Caring Nurse-Patient Interactions Scale (Nurse Version)". The respondents assessed the caring behaviors from the subscale "needs" as the most frequently applied (median (Me): 4.7; interquartile range (IQR): 4.4-4.9), while the least frequently applied were the procedures from the subscale "sensitivity" (Me: 3.8; IQR: 3.2-4.3). The VET nurses reported applying caring behaviors to the subscales "hope" (p < 0.001), "problem-solving" (p = 0.003), and "environment" (p = 0.021) more frequently than BSc nurses did. Compared with less experienced respondents, the respondents with more than 30 years of work experience applied the caring behaviors on the subscales "sensitivity" (p = 0.009), "expression of emotions" (p = 0.001), "problem-solving" (p = 0.008), and especially "humanism" and "spirituality" (p < 0.001) more frequently. The results indicate that respondents are more focused on applying skills or carrying out a task than on caring behaviors which is about demonstrating compassion, loving kindness, and relationships.

Peruvian psychiatry in America and the world: its journey in search of an identity

Throughout history, Latin American psychiatry has followed a variety of routes as its mythic-religious origins experienced the various influences of European and North American ideas of the last three centuries. In its modern trajectory, a post-colonial subordination was followed by a more selective import of ideas and a critical approach to their application in the New Continent. At one point, the identity of Latin American psychiatry was essentially considered mestiza, social and critical, reflecting a search for autonomy and originality. In this journey, Peruvian psychiatry has been considered one of the most representative versions of the history and position of the discipline. This article attempts to detail the identity-seeking process of Peruvian and Latin American Psychiatry through the life and work of three notable Peruvian figures: Honorio Delgado, Carlos Alberto Seguín and Humberto Rotondo. Delgado fostered the need for scientific evidence in support of any piece of knowledge, as well as humanism as essential component of best service and optimal patient care. Seguín led studies on folkloric and ethnic psychiatry, stimulated integrated approaches to care, and advocated in favour of a regional identity for psychiatry.

The long-term impact of an interprofessional humanistic faculty development programme: A qualitative investigation

RATIONALE, AIMS, AND OBJECTIVES

While it has long been supported that faculty development programmes serve as a means to improving practical knowledge, professional skills, and identity formation for faculty, significantly less research is focused on how learning that occurs in faculty development programmes is actually employed in the workplace and ingrained in day-to-day activities. The present study qualitatively explored the long-term impact of the Mentoring and Professionalism in Training (MAP-IT) programme, a longitudinal, interprofessional faculty development curriculum designed to enhance clinicians' humanistic mentoring skills, specifically nurses and physicians.

METHOD

Participants included 21 former high-potential mentors and facilitator leaders who had graduated from the MAP-IT programme from 2014 to 2016. Semi-structured focus groups and interviews were conducted between August and September of 2017 to collect participant experiences of the impact of MAP-IT skills on their professional roles (with colleagues and patients) in their clinical environments. Qualitative data were analysed using content analysis methodology.

RESULTS

Qualitative analyses using an editing analysis style resulted in nine major themes, including incorporation into clinical practice, self-care, team building and conflict resolution, mindfulness, mentorship, professionalism, interprofessional collaboration, humanism, and appreciative inquiry.

CONCLUSION

The personal and professional development instilled through the MAP-IT programme was found to remain important over time, years after participation in the programme had concluded, supporting its "durability." Implications are also discussed.

Impact of simulated patients on students' self-assessment of competency in practice of geriatric dentistry

PURPOSE

The evaluation of the effectiveness of simulation training in dentistry has previously been focused primarily on psychomotor hand skills. This study explored the impact of simulated patient (SP) encounters in simulation on students' self-assessment of competency in their clinical and communication abilities with geriatric patients.

METHODS

Students from 2 cohorts were recruited for this study. Cohort 1 (n = 30) participated in the standard curriculum with no simulation training and served as the control group. Cohort 2 (n = 34) participated in a SP experience, simulating the initial stages of a care visit for 2 nursing home patients. Students' perceptions of competency to perform these clinical and communication tasks were assessed. A group debriefing session was held 5 weeks post-simulation where Cohort 2 completed a student feedback form.

RESULTS

A statistically significant change (P < 0.00001) was noted for both cohorts in their self-reported competence to perform clinical tasks following exposure to an independent clinical experience. In addition to this gain, individuals in Cohort 2 demonstrated improvements following simulation and expressed different responses of impact to questions related to treatment, pharmacology, and managing a complex medical history.

CONCLUSIONS

This study suggests that simulation of patient interactions using SPs can strengthen students' self-assessment of competency in their abilities, leading to more genuine interactions with actual patients. These findings will help inform the design of future SP encounters as a component of an evolving humanistic curriculum.

[Can empathy be taught to caregivers?]

The concepts of empathy and care are the subject of numerous publications that testify to a surge in interest in the subject. What are the possibilities of teaching empathy to medical and nursing students? A proposed definition and a literature review can be developed to identify the effects of empathy in care and the opportunities for teaching empathy to students and practicing professionals.

Meaningful shared decision-making: complex process demanding cognitive and emotional skills

BACKGROUND

Shared decision-making (SDM) takes place when clinicians help patient identify best course of action in the context of their preferences.

METHODS

The aim of this paper is a narrative review of the literature with special focus on the humanistic dimensions of SDM.

RESULTS

We show that SDM is largely underused in practice, because of many barriers such as time constraints and poor skills.

CONCLUSIONS

We suggest that listening and empathy are key challenges in communicating uncertainty, which require emotional intelligence and trust building skills. To promote implementation, we propose the development of tools, simulation-based training and the design of improved measures for SDM quality. While essential for patients, we believe that SDM may restore meaning in healthcare.

Humanism in global oncology curricula: an emerging priority

Introduction

Training in humanism provides skills important for improving the quality of care received by patients, achieving shared decision-making with patients, and navigating systems-level challenges. However, because of the dominance of the biomedical model, there is potentially a lack of attention to humanistic competencies in global oncology curricula. In the present study, we aimed to explore the incorporation of humanistic competencies into global oncology curricula.

Methods

This analysis considered 17 global oncology curricula. A curricular item was coded as either humanistic (as defined by the iecares framework) or non-humanistic. If identified as humanistic, the item was coded using an aspect of humanism, such as Altruism, from the iecares framework. All items, humanistic and not, were coded under the canmeds framework using 1 of the 7 canmeds competency domains: Medical Expert, Communicator, Collaborator, Leader, Scholar, Professional, or Health Advocate.

Results

Of 7792 identified curricular items in 17 curricula, 780 (10%) aligned with the iecares humanism framework. The proportion of humanistic items in individual curricula ranged from 2% to 26%, and the proportion increased from 3% in the oldest curricula to 11% in the most recent curricula. Of the humanistic items, 35% were coded under Respect, 31% under Compassion, 24% under Empathy, 5% under Integrity, 2% under Excellence, 1% under Altruism, and 1% under Service. Within the canmeds domains, the humanistic items aligned mostly with Professional (35%), Medical Expert (31%), or Communicator (25%).

Conclusions

The proportion of humanistic competencies has been increasing in global oncology curricula over time, but the overall proportion remains low and represents a largely Western perspective on what constitutes humanism in health care. The representation of humanism focuses primarily on the iecares attributes of Respect, Compassion, and Empathy.

Humanistic caring, a nursing competency: modelling a metamorphosis from students to accomplished nurses

BACKGROUND

Most nursing regulatory bodies expect nurses to learn to be humanistic and caring. However, the learning process and the developmental stages of this competency remain poorly documented in the nursing literature.

METHODS

The study used interpretive phenomenology, and 26 participants (students and nurses) were individually interviewed. Benner's (1994) method was adapted and concretised into a five-phase phenomenological analysis to assist with intergroup comparisons.

RESULTS

Critical milestones and developmental indicators were identified for each of the five stages of the 'humanistic caring' competency. Satisfaction and meaning at work seemed closely connected to the development of 'humanistic caring'. Links emerged between the development of 'humanistic caring' and three other competencies.

CONCLUSIONS

Nurse educators might insist on the fact that 'humanistic caring' goes beyond nurse-patient communication and that it is integrated in nursing care. The findings highlight that nurses' working conditions should be improved in order to uphold humanistic caring after graduation.

[Therapeutic relationship and care with the person with severe cognitive impairment]

The inevitable evolution of cognitive disorders in neurodegenerative diseases, such as Alzheimer's disease, raises questions about the modalities and objectives of care provided to people with these diseases. It justifies the acquisition of a holistic and humanistic perspective to maintain the person as a whole at the core of our priorities. Person-centered care meets this requirement by being rooted in a supportive relationship.

'It's not a part of me, but it is what it is': the struggle of becoming en-wheeled after spinal cord injury

PURPOSE

Many people who experience spinal cord injury become long-term wheelchair users. This article addresses the process of becoming en-wheeled through the case example of a disabled man called Patrick.

DESIGN

An intrinsic case study informed by posthumanist developments was used. Within this design, Patrick and his manual wheelchair were the entangled participants of the inquiry.

METHODS

Interviews and fieldwork observation with Patrick were conducted. Qualitative data were analysed using the posthumanist notion of 'assemblages'.

RESULTS

The results illuminate Patrick's struggle of negotiating a new embodied selfhood that includes the wheelchair. Patrick engaged in ableist rehabilitation after spinal cord injury to recuperate the capacity to walk and break his connection with the wheelchair. After extensive treatment of his body, he reluctantly assumed his cyborg or posthuman condition.

CONCLUSION

The analysis and discussion resulted in a theoretical frame that presents the notions of humanist and posthumanist enwheelment as two directions of a continuum. The paper offers a useful tool for understanding and addressing enwheelment plus other cyborgification processes. We advocate for its acceptance into the disability studies and rehabilitation practice repertoire.IMPLICATIONS FOR REHABILITATIONEnwheelment -the process of becoming one with the wheelchair - is relevant to people after SCI (or other impairments).The notions of humanist and posthumanist enwheelment are developed and presented as two ends of a continuum.Rehabilitation workers should be mindful of the complexities of cyborgification to avoid ableism and help people flourishing within and beyond recovery.

Humanistic medicine in anaesthesiology: development and assessment of a curriculum in humanism for postgraduate anaesthesiology trainees

BACKGROUND

An unintended consequence of medical technologies is loss of personal interactions and humanism between patients and their healthcare providers, leading to depersonalisation of medicine. As humanism is not integrated as part of formal postgraduate anaesthesiology education curricula, our goal was to design, introduce, and evaluate a comprehensive humanism curriculum into anaesthesiology training.

METHODS

Subject-matter experts developed and delivered the humanism curriculum, which included interactive workshops, simulation sessions, formal feedback, and patient immersion experience. The effectiveness of the programme was evaluated using pre- and post-curriculum assessments in first-year postgraduate trainee doctors (residents).

RESULTS

The anaesthesiology residents reported high satisfaction scores. Pre-/post-Jefferson Scale of Patient Perceptions of Physician Empathy showed an increase in empathy ratings with a median improvement of 12 points (range; P=0.013). After training, patients rated the residents as more empathetic (31 [4] vs 22 [5]; P<0.001; 95% confidence interval [CI]: 7-12) and professional (47 [3] vs 35 [8]; P<0.001; 95% CI: 9-16). Patient overall satisfaction with their anaesthesia provider improved after training (51 [6] vs 37 [10]; P<0.001; 95% CI: 10-18). Patients rated their anxiety lower in the post-training period compared with pretraining (1.8 [2.3] vs 3.6 [1.6]; P=0.001; 95% CI: 0.8-2.9). Patient-reported pain scores decreased after training (2.3 [2.5] vs 3.8 [2.1]; P=0.010; 95% CI: 0.4-2.8).

CONCLUSIONS

Implementation of a humanism curriculum during postgraduate anaesthesiology training was well accepted, and can result in increased physician empathy and professionalism. This may improve patient pain, anxiety, and overall satisfaction with perioperative care.