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At least 1,297 records · Page 72Linked to original sources
PubMed1994

Predicting the health-related values and preferences of geriatric patients.

BACKGROUND: Those who must make health care decisions on behalf of persons who lack decision-making capacity often have too little information. The purpose of this study was to determine whether and to what degree sociodemographic factors, social support, religious involvement, and functional status served as predictors of the health-related values and preferences of geriatric patients. METHODS: A retrospective chart review involving 178 cognitively intact patients enrolled at a geriatric clinic at a university medical center was conducted. Patient variables included age, race, sex, marital status, years of education, participation in formal religious activities, self-reported functional status, and adequacy of social and family support. These were compared with responses to a modified version of the Values History questionnaire, an established method of evaluating patient values that includes advance directives. RESULTS: Patients were likely to value quality (82%) over quantity of life (18%) and the ability to think clearly (64%) over 13 other specific health-related values. They were likely (93%) to want to be taken to a hospital emergency department on losing consciousness or becoming confused. Seventy-eight percent expressed a desire to be resuscitated using cardiopulmonary resuscitation (CPR), and 76% expressed a preference for use of a respirator, if necessary. Most (85%) considered a permanent vegetative state to be worse than death. High functional status predicted a preference for quality of life over length of life and the perception of a persistent vegetative state as worse than death (positive predictive value = 89%). Persons with better social and family support were more likely to accept treatment with CPR or a respirator and less likely to consider a permanent vegetative state to be worse than death. No single patient factor was strong enough to increase the probability of a particular value or preference by more than 17% above baseline. CONCLUSIONS: Sociodemographic and functional status variables are relatively weak predictors of personal values and directives. This reinforces the importance of routinely eliciting patient values and preferences and of updating the information, particularly following changes in functional status or family support. Baseline information regarding the health-related values and preferences of this primary care geriatric clinic population may provide valuable information about the values and preferences of decisionally impaired older patients.

Activities of Daily Living↗
PubMed2004

Child welfare versus parental autonomy: medical ethics, the law, and faith-based healing.

Over the past three decades more than 200 children have died in the U.S. of treatable illnesses as a result of their parents relying on spiritual healing rather than conventional medical treatment. Thirty-nine states have laws that protect parents from criminal prosecution when their children die as a result of not receiving medical care. As physicians and citizens, we must choose between protecting the welfare of children and maintaining respect for the rights of parents to practice the religion of their choice and to make important decisions for their children. In order to make and defend such choices, it is essential that we as health care professionals understand the history and background of such practices and the legal aspects of previous cases, as well as formulate an ethical construct by which to begin a dialogue with the religious communities and others who share similar beliefs about spiritual healing. In this paper, we provide a framework for these requirements.

Child↗
PubMed2004

Mothers' awareness about accidents among toddlers.

A study to identify the knowledge of mothers on prevention of accidents among the toddlers in a selected urban community of Mangalore was conducted in the year of 1999 at Dr. M. V. Shetty Institute of Health Sciences, Vidyanagar, Mangalore, affiliated to Rajiv Gandhi University of Health Sciences, Bangalore.

Accident Prevention↗
PubMed1989

The Jewish contribution to medicine. Part I. Biblical and Talmudic times to the end of the 18th century.

Jewish interest in medicine has a religious motivation with the preservation of health and life as religious commandments in the Holy Scriptures. Despite a basic belief that God caused disease and effected cures with physicians as agents, Jews accepted the rational medicine of ancient Greece. They assisted in the spread of these teachings in the Roman and Arab empires but carried them to the rest of Europe in their migrations. Jews were able to bridge the educational gap of a 500-year period of exclusion from universities and medical schools in the Middle Ages through the Talmud, which started as a commentary on the scriptures in the 5th century BC, but developed over the centuries into a comprehensive body of learning incorporating law, art and the sciences.

History, 15th Century↗
PubMed1998

Social construction and materiality: the limits of indeterminacy in therapeutic settings.

By drawing parallels between the courtroom testimony of a Christian Science practitioner and an intersession conversation between systemic family therapists, I critique the abstract idealism of language-centered social constructionism. I argue that social constructionist inquiry that highlights the indeterminacy of meaning without a corresponding emphasis on the responsive embodied practices of family members glosses over the material conditions shaping the politics of interaction. The implications of this problem are discussed as they relate to the setting of family therapy, where social construction theory is often used to guide practical interventions.

Adult↗
PubMed2001

[Pain--life's dreaded companion. Cultural history of algology and the most important achievements].

Pain is a comprehensive phenomenon which concerns not only physiology, biochemistry and molecular biology but also music, art, religion, philosophy and everyday life. The early contributions to the development of the specificity theory is described, as are some of the important discoveries in the history of algology, such as Baillou's description of rheumatism, Heberden's description of angina pectoris and the development of the gate control theory. Despite a number of important discoveries and a much improved knowledge in basic science pain is still the dreaded companion of mankind.

Analgesia↗
PubMed1995

Nightingale's spiritual philosophy and its significance for modern nursing.

In her manuscript, Suggestions for Thought, Nightingale attempted to integrate science and mysticism. She wrote that the universe is the incarnation of a divine intelligence that regulates all things through law. For Nightingale, the laws of science are the "Thoughts of God." Because of her deep conviction about universal law, she did not believe in miraculous intervention as an answer to prayer. Human beings must discover the laws of God and apply them for health and wholeness. Prayer is attuning or joining one's personal self with the consciousness of God, which is found in the deepest recesses of one's own being. Nightingale's idea of spirituality as intrinsic to human nature and compatible with science can guide the development of future nursing practice and inquiry.

England↗
PubMed2002

Customer service vs patient care.

Though hospital administrators may impose a customer satisfaction mandate, it need not alter the status of "patients" redefined as "customers." It is the duty of all health care providers to remember that the practice of medicine is not chiefly a business and is not purely a science. In its mission is the art of encouraging the individuality of each provider of medical care to interact with the individuality of his/her patients. The medical profession in antiquity was linked with religion and the treating physician with special acquired knowledge and clinical experience was often able to accomplish a "miracle" when TLC (tender loving care) was the essential element of medical practice. If TLC is reintroduced into 21st century medical practice, "customer satisfaction" will be the result rather than the goal of medical care.

Consumer Behavior↗
PubMed1996

Values in psychotherapy.

There is a tension between those who hold that psychotherapy is a scientific discipline and therefore "value-free," and those who believe that values are inherent in the nature of psychotherapy. Psychoanalysis has moved from a science-based ideology, through the ethical concerns of Melanie Klein, to a recognition of the "aesthetic" dimension--the creation of suitable forms that can contain psychological distress. From this latter perspective, the antagonism between religion and psychotherapy, initiated by Freud, becomes less acute. Action-based ethical systems, which ignore the inner world, are critically scrutinized. The evidence suggesting there is a relationship between good outcome in psychotherapy and shared values between therapist and client is reviewed. It is posited that through examination of the "ethical countertransference," therapists should become aware of their own value systems and how they influence practice.

Freudian Theory↗
PubMed2005

[Covenant or contract? A reflection on two paradigms of the nursing relationship].

This article contains a critical reflexion about two paradigms upon which nurse-patient relationships can be based: the traditional covenant, rooting in religion and ethics and the business-orientated contract. The motive for this reflexion lies in the present economic, scientific and societal context of nursing practice, which threatens traditional nursing values. It leads to an inflation of the covenant paradigm in favour of the contract paradigm, which implies greater efficiency. Following the description of the two paradigms the way they determine nursing relationships is being compared. On the basis of this confrontation the contract as basis of the nursing relationship is discarded. Finally, questions concerning the future positioning of nursing and of nursing science in terms of the foundation and of the profile of the nurse-patient relationship are asked.

Clinical Nursing Research↗
PubMed2001

[Gods, women and pharmacy in Greek Mythology].

The study of Greek Mythology fully justifies Herophilus's phrase: "Medicines are the hands of Gods" (third cent. B.C.). A number of Gods are said to be the inventors of the drugs which are useful to men. Their names are still alive in the scholarly or popular appellations of a great many medicinal herbs. However, insofar as the action of a drug (of a Pharmakon) remains mysterious, one finds it in essentially female practices as well as in medicine. The study of these ancient beliefs, which have survived in spite of the progress of twentieth century science, can develop the history of epistemology of pharmacy by stimulating interdisciplinary research.

Greece, Ancient↗
PubMed1983

[Eisleben and the Mansfeld area in the medical history aspect. A contribution to Luther year 1983].

The homeland of the reformer Martin Luther which since the middle ages has been acting as the centre of a mining industry is at the same time also one of the starting points for the organisation of a mining medicine with its medical measures directed to the treatment of the miners. On the occasion of the Luther memorial year 1983 is reported on several physicians and pharmaceutists of the Eisleben-Mansfeld district who distinguished themselves by particular activities and thus for ever stay in the history of science.

Copper↗