Cathartic narratives for chaotic thinking Hovey, Richard B
CMAJ. Canadian Medical Association journal,
2016-Dec-06, 2016-12-06, 20161206, Letnik:
188, Številka:
17-18
Journal Article
Indigenous people's engagement in health care in Canada is discussed. Mi'kmaw perspectives for care originate from Seven Sacred Teachings of love, honesty, humility, respect, truth, patience and ...wisdom, which are transferable ethical values for health care. Indigenous people may feel stigmatized because of deficit-based discourses in relation to Indigenous health inequalities. Two-Eyed Seeing expands and demystifies Indigenous knowledge with other knowledge systems, which can translate into collaborative approaches for Indigenous health and well-being. The FIRST approach empowers clinicians as agents of transformative change to enhance health care encounters with Indigenous people.
German philosopher Hans-Georg Gadamer is best known for his contribution to the development of philosophical hermeneutics, an interpretive approach to knowledge, understanding and meaning-making. It ...has become a well-established research approach in the health sciences to shed light on the lived experiences of people living with challenging chronic health conditions. Some feminist scholars have gravitated to Gadamer’s hermeneutics for its steadfast rejection of positivism and its intention to uncover preunderstandings and prejudices. However, others have critiqued the approach for its lack of focus on prescribing action for social change and its reluctance to evaluate the prejudices present in its own tradition. In this paper, the authors will demonstrate how using feminist hermeneutics can help health researchers deepen their understanding of illness narratives by examining the power structures contributing to the marginalization of chronically ill people within and outside the healthcare system. They will juxtapose a reflexive investigation of the first author’s experiences with a focused literature review of the dialogue between hermeneutics and feminism. By examining the first author’s experiences with Gadamerian hermeneutics and feminist hermeneutics through self-study, she can in turn unearth her own preunderstandings. This approach will allow the authors to leverage the depth of interpretive understanding generated by hermeneutics while exploring the power structures involved in the complex process that is patient care, particularly that of people with chronic illness. They conclude that this combined approach of feminist hermeneutics allows health researchers to deepen their understanding of illness narratives with issue-specific and effective recommendations to clinicians and public health officials, leading to better-adapted services through a more just approach to chronically ill people.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The purpose of preparing this Feature Article was to explore and share my lived experience of living with multiple layers of chronic pain, with a diagnosis of advanced, aggressive and metastasized ...prostate cancer, and COVID-19. My exploration begins with the manifestations of chronic pain from a bicycling accident, psoriatic arthritis, with cancer treatments and the pain it creates during a panademic has added to the challenges of social distancing, isolation, and medical treatments. As with many patient experiences, we the person as patient outside of health care sometimes struggle to find the right words, the proper sentence structure and as Tamas writes about the expectation of others to provide, “Clean and reasonable scholarship about messy, unreasonable experiences is an exercise in alienation.” I write this while living with extreme chronic pain, continue cancer treatments while the threat and additional anxiety of COVID-19 looms over me. This is my story.
Although many medical and dental journals publish qualitative research this does not mean they are being read by those who could directly benefit from their scholarly contributions. From clinician to ...the patient. This perspective on qualitative research for medical and dental education was written with the intention of introducing qualitative research to those who may be unaware of its possibilities and utility for clinical education. Its task is to inform others about life conditions they may not have experienced themselves other than in a biomedical context. As researchers, clinicians, and especially for students who read academic, medical, and clinical research papers which are appropriately discipline-and methodology-specific. We may find ourselves encultured to privileging one type of research methodology over others. For example, exclusively considering quantitative research methodologies as being more rigorous and trustworthy. This brief commentary may offer the opportunity for interested healthcare providers and researchers to expand their understanding of the purpose of qualitative research, its role and application in enhancing patient engagement, clinical practices, and person-centered research.
The intention of this article is to demonstrate how Indigenous and allied health promotion researchers learned to work together through a process of Two-Eyed Seeing. This process was first introduced ...as a philosophical hermeneutic research project on diabetes prevention within an Indigenous community in Quebec Canada. We, as a research team, became aware that hermeneutics and the principles of Haudenosaunee decision making were characteristic of Two-Eyed Seeing. This article describes our experiences while working with each other. Our learning from these interactions emphasized the relational aspects needed to ensure that we became a highly functional research team while working together and becoming Two-Eyed Seeing partners.
People living with chronic pain experience multiple challenges in their daily activities. Chronic pain is complex and often provokes life circumstances that create increased social isolation. Living ...with chronic pain during the pandemic may add additional layers of complexity to their daily lives. The researchers endeavored to explore the experiences of people living with chronic pain during the COVID-19 pandemic. Researchers conducted semi-structured, open-ended interviews about how the pandemic influenced participants’ lives. The interviews were recorded and analyzed using an applied philosophical hermeneutics approach. The findings were feeling socially isolated, losing their sense of livinghood, and experiencing augmented stress levels which, in most cases, aggravated their chronic pain. In addition to gaining an in-depth understanding of the needs of people living with chronic pain, these findings may guide policy decisions with the intention of improving health care access and the overall experiences of people living with chronic conditions during a pandemic.
The value of understanding patients' illness experience and social contexts for advancing medicine and clinical care is widely acknowledged. However, methodologies for rigorous and inclusive data ...gathering and integrative analysis of biomedical, cultural, and social factors are limited. In this paper, we propose a digital strategy for large-scale qualitative health research, using
(as a state of being, a communication mode or context, and a set of imaginative, expressive, and game-like activities) as a research method for recursive learning and action planning. Our proposal builds on Gregory Bateson's cybernetic approach to knowledge production. Using chronic pain as an example, we show how pragmatic, structural and cultural constraints that define the relationship of patients to the healthcare system can give rise to conflicted messaging that impedes inclusive health research. We then review existing literature to illustrate how different types of play including games, chatbots, virtual worlds, and creative art making can contribute to research in chronic pain. Inspired by Frederick Steier's application of Bateson's theory to designing a science museum, we propose DiSPORA (Digital Strategy for Play-Oriented Research and Action), a virtual citizen science laboratory which provides a framework for delivering health information, tools for play-based experimentation, and data collection capacity, but is flexible in allowing participants to choose the mode and the extent of their interaction. Combined with other data management platforms used in epidemiological studies of neuropsychiatric illness, DiSPORA offers a tool for large-scale qualitative research, digital phenotyping, and advancing personalized medicine.
The purpose of this article is to provide insight into the philosophy and practice of Applied Philosophical Hermeneutics as a unique approach for research in the health sciences. While there are ...other research approaches grounded in hermeneutics, this article focuses on Gadamer’s modern philosophical hermeneutics. During my 18 years as a hermeneutic researcher, graduate students and I have engaged with people with a wide variety of experiences such as preventable medical error, Indigenous health, adult and adolescent chronic pain, social responsibility in higher education, oral health care for autistic children, and the experiences of people living with Thalassemia. Applied Philosophical Hermeneutics offers an approach to help bring researchers, clinicians, and patients together within a community of active partnerships in research. All these projects employed Applied Philosophical Hermeneutics as an approach to gain a deeper and personal understanding of the unique experiences of these diverse groups of people. Hermeneutics remains somewhat confusing as the unmethod which may lead to a dismissive attitude toward this research approach. Therefore, the intention of this paper is to present a risk-free insight into hermeneutics, which hopefully will open-up conversations and new learning experiences among researchers, students, patients, and colleagues.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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