Background: Health and social care professionals experience high-stress levels during end-of-life care. Various intervention programs have been proposed to reduce stress and prevent burnout among physicians and nurses, including arts-based activities that have shown potential. However, it is unclear how art programs can alleviate stress among healthcare professionals providing end-of-life care. This study aimed to explore the potential of Clinical Art programs to alleviate distress in professionals providing end-of-life care.Methods: Two Clinical Art workshops, held in October and November 2020, were attended by local health and social care professionals. Focus groups were conducted with those who attended and consented to participate in the study. Verbatim transcripts were made, and a qualitative analysis of the text was conducted.Results: Thirteen health and social work professionals participated in the study.Perceived difficulties in end-of-life care included the complexity and uncertainty of end-of-life care services, the approaches to patients and families, and the difficulties due to human aspects of healthcare providers. The positive effects of Clinical Art included pure enjoyment of art, empathic communication with patients and families and the application of an ontological view of human beings, which were identified as reasons for Clinical Art's effectiveness and applicability to care. Conclusions:The results suggest that the Clinical Art program has a psychosocial moderating effect on health and social work professionals and can be used for empathic communication with patients and families in end-of-life care and for applying an ontological view of human beings in caring for patients. K E Y W O R D Sart program, Clinical Art, end-of-life care, ontological view of human beings, qualitative research Health and social work professionals providing end-of-life care experience a range of distressing factors and stressors, including suicidal ideation, increased alcohol and drug use, anxiety, depression, and difficulty coping with the issue of death. 1 Hospice work is considered particularly stressful due to the inherent complexity of providing end-of-life care. 2 Patients requiring end-of-life and palliative care may experience extreme difficulties such as depression, anger, anxiety, severe physical pain, or discomfort, social isolation, financial strain, and family conflicts. [3][4][5] Health and social care professionals must be prepared to respond to the demands of patients and families undergoing such distress. These pressures also become an additional source of stress. Furthermore, health and social work professionals involved in the provision of end-of-life care may experience moral distress due to poor communication among healthcare professionals and ethical dilemmas. [6][7][8] Various studies have been conducted on the attitudes of health and social care professionals toward care of the dying. Positive attitudes of nurses engaged in end-of-life cancer care were associated with age and clinical experien...
Negative capability or tolerance for uncertainty is important for primary care physicians. The 2022 edition of the Model Core Curriculum for Medical Education also states that the content of professionalism is to “keep thinking about unanswerable questions.”
We report a case of pneumatosis intestinalis (PI) in a hemodialysis patient who presented with anorexia and nausea. Anorexia with postprandial nausea can be caused by gastrointestinal diseases, with one of the rare causes being PI. PI may occur in hemodialysis patients, but it is rarely reported. We experienced a case of benign PI in a hemodialysis patient, for whom the conservative treatment with antibiotics improved the patient's clinical symptoms. In patients with PI, it is important to rule out potentially life‐threatening complications, such as the presence of hepatic intraportal gas on CT scan.
BackgroundConsidering work styles especially of solo attending physicians, medical facilities have been required to effectively utilize sufficient human resources in many countries. Therefore, we compared cross-sectionally clinical performance of the single- and the multiple-attending physicians groups in inpatient care. Furthermore, we also qualitatively analyzed physicians’ working burden and quantitively assessed advantages / disadvantages of those attending physicians systems.MethodIn this cross-sectional study, we extract electronic health record of patients from a hospital in Japan from April 2017 to October 2018 to compare anonymous statistical data including average lengths of hospital stay and patient outcome between the single-attending and multiple-attending-physicians system. Then, we conducted a questionnaire survey for all physicians of single and multiple-attending physician systems, asking their physical and psychiatric working burden, and their reasons and comments on their working styles.ResultThe average length of hospital stay was significantly shorter in the multiple-attending physicians system than in the single-attending physicians system, while patients’ age, gender and diagnoses were similar. From the questionnaire survey, although physical burden in multiple-attending physicians system tended to be lower than that in single-attending physician system, no significant difference was found in all categories. Advantages of multiple-attending physicians system extracted from qualitative analysis are 1) Improvement of physicians ’ quality of life (QOL), 2) Lifelong-learning effect, and 3) Improving the quality of medical care, while disadvantages were 1) Risk of miscommunication, 2) Conflicting treatment policies among physicians, and 3) unfamiliar culture with multiple-attending physicians system.ConclusionMultiple-attending-physicians system in inpatient care may reduce physical burden on physicians, and not only improve QOL of physicians but lead to lifelong learning and improving the quality of medical care.
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