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At least 19 recordsLinked to original sources
PubMed1998

Mentoring and self-efficacy for advanced nursing practice: a philosophical approach for nurse practitioner preceptors.

Nurse practitioners (NPs), frequently called upon by graduate schools of nursing to be preceptors for NP students, are asked to play an active role in the socialization of these students as capable primary care providers. Much is expected of the preceptor in the typical short-term clinical preceptorship with little guidance available to her or him. A mentoring model of clinical education, while representing a longer-term commitment for preceptors than usual precepting arrangements, may ultimately be a more effective model for student learning and more satisfying for the preceptor than currently practiced models. Eastern philosophical principles, very much in harmony with valued nursing approaches to relationships, can provide a framework for examining mentoring as a strategy for promotion of self-efficacy for advanced practice that can be of benefit to both the NP preceptor and the NP neophyte.

Clinical Competence↗
PubMed1979

What is medicine?: towards a philosophical approach.

The failure of Western medicine to deal with many of the problems it is currently facing has led to an awareness of the need for a fundamental reappraisal. The way in which medical concepts derived from the nineteenth century have brought technical medical advances in this century and the alliances that medicine has made with statistics and more recently the social sciences, have prevented a questioning of medicine's underlying assumptions. Thus, despite a number of critical initiatives from both within and outside medicine, there has been no coherent development to seriously confront the question 'what is medicine?'. It is suggested that the basis for such a development depends on the return to a philosophical questioning of our conceptual understanding of disease, a subject which has largely been ignored during the past hundred years.

Disease↗
PubMed2003

A philosophical approach to rationing.

Rationing, the equitable allocation of medical resources, is both an economic and moral challenge--economic, because the various components of healthcare must be budgeted; moral, because the prioritisation of these resources is a value-laden decision. The moral debate about rationing pits individual choice against communal interests. The advocacy of equitable distribution of healthcare resources originates in arguments for distributive justice and a revised version of individual autonomy. If autonomy is defined strictly in terms of atomistic individuality, then the social obligations and duties of persons are subordinated to their individual rights. Alternatively, when people are defined by their relationships, "relational autonomy" balances responsibilities against the claims of individual rights to maximise distributive justice. The concept of relational autonomy provides medicine with a philosophical basis for communal rationing of healthcare resources.

Ethics, Medical↗
PubMed1997

A philosophical approach to conjoined twins.

There are increasing numbers of attempts to surgically separate conjoined twins. Almost every type of conjoined twins have been separated, with varying results. Surgeons must often make the decision as to the desirability and feasibility of separation. These decisions are complicated by ethical problems that involve patient privacy, the allocation of shared organs, and in some instances the necessity for one twin to die to save the other. Although life as a conjoined twin would appear to be intolerable, there are historical as well as current instances of conjoined twins who have progressed to adulthood as relatively well-adjusted individuals. Thus, in some situations, it may be better not to operate on these patients. At one time or another, when individual cases have been studied by theologians, all faiths have agreed that the sacrifice of one twin to save the other is ethical. When one twin is clearly stronger than the other and has the best chance for long-term survival, it also appears to be desirable to give that twin the shared organs that allow gastrointestinal and genitourinary function and ambulation. It is now possible to predict the pattern of shared organs in most cases based on an external examination. It is no longer necessary to subject these patients to prolonged, invasive tests, which may be dangerous and provide at best incomplete information. The surgeon should take great care to protect his patients' privacy and resist efforts by the media to create a "television circus"" over these patients.

Abnormalities, Multiple↗
PubMed2003

Spiritual pain and its care in patients with terminal cancer: construction of a conceptual framework by philosophical approach.

OBJECTIVE: In discussing spiritual care of patients with terminal cancer, it is important to clarify the structure of spiritual pain to be evaluated. METHODS: In this article, spiritual pain is defined as "pain caused by extinction of the being and the meaning of the self," and its structure was evaluated according to the three dimensions of the human being, that is, a being founded on temporality, a being in relationship, and a being with autonomy. RESULTS: As a result, spiritual pain of patients with terminal cancer could be described as meaninglessness of life, loss of identity, and worthlessness of living derived from loss of the future, loss of others, and loss of autonomy of a dying individual. SIGNIFICANCE OF RESULTS: On the basis of these understandings, the author deduced principles of spiritual care of terminally ill cancer patients as recovery of the future beyond death, others beyond death, and autonomy toward death in each dimension of the human being.

Adaptation, Psychological↗
PubMed1997

A philosophical approach to treatment machine maintenance and breakdown.

Planned preventative maintenance (PPM), quality control (QC) checks and breakdown all contribute to the down-time of a radiotherapy treatment machine. Low levels of machine availability are unacceptable both clinically and financially. Clinical data demonstrate that, for many tumours, interruptions to treatment will result in reduced local control. Reductions to the gaps in treatment can be achieved by patient interchange between machines. Maintaining the maximum possible machine availability will reduce the potential for errors associated with the transfer of patients between machines, and reduce the cost of treatment. Practices for routine PPM and QC vary between hospitals. In this report, a rationale for breakdown and maintenance will be described. Based on the faults experienced on a Philips SL 75-5 and a Philips SL25 over a period of 3 years, the workload associated with routine maintenance and quality control are presented and the additional work associated with breakdown discussed. Faults have been categorized on a scale between catastrophe and maintainability. A demonstration of how this analysis can be used to assess the cost-benefits of proposed changes in working patterns by the extension or reduction of maintenance periods is provided. The results indicated that no gain would be made in changing from a 1-day to a 2-day per month PPM schedule.

Cost-Benefit Analysis↗