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Ballou E, Gaufberg E. Exploring the intersection of psychiatry, art, and medical education through photographic portraits. Int Rev Psychiatry 2023; 35:555-559. [PMID: 38461392 DOI: 10.1080/09540261.2023.2268738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/05/2023] [Indexed: 03/11/2024]
Abstract
This paper describes a technique using photographic portraits in medical education to encourage close observation, cultivate empathic curiosity, explore learners' values and beliefs, and to reveal and reflect on fundamental biases. This new and evolving educational method uses the lens of psychotherapy to explore learners' experience of the portrait in a similar way we would discuss a case in psychodynamic supervision. Through close looking and small group engagement, the facilitator creates a space for deeper reflection and collaborative exploration of the therapeutic relationship, with emphasis on countertransference and the role of prior expectations. The exercise strengthens dialectical thinking through perspective-taking, challenging implicit assumptions and fostering cultural humility. Radiologists are taught to look in every corner of the X-ray and to observe each shadow, all while evaluating the entire image. Portraits can be examined in the same way, looking for subtle clues to the personality and history of the subject. Information from other sources confirms, or sometimes profoundly changes, our evaluation. In this example, we use a historical photographic portrait to demonstrate ways of engaging medical learners as they discover common psychotherapeutic approaches. The method has the potential to enhance therapeutic encounters, improve analytical skills and reduce bias.
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Affiliation(s)
- Eloise Ballou
- Instructor in Psychodynamic Psychotherapy, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Elizabeth Gaufberg
- Center for Professional and Academic Development, Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
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Liu P, Li X, Zhang XM. Healthcare professionals' and patients' assessments of listed mobile health apps in China: a qualitative study. Front Public Health 2023; 11:1220160. [PMID: 37780445 PMCID: PMC10538635 DOI: 10.3389/fpubh.2023.1220160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background In recent years, mobile health (mHealth) has gradually developed in China, and intelligent medicine has become an important research topic. However, there are still significant problems in mHealth applications (apps). Although healthcare professionals and patients are the main users, few studies have focused on their perceptions of the quality of mHealth apps. Objective This study aimed to (1) understand the respective perceptions of healthcare professionals and patients regarding mHealth apps, (2) assess what barriers exist that influence the user experience, and (3) explore how to improve the quality of mHealth apps and the development of the mHealth market in China. The study aims to promote the standardization of mHealth apps and provide effective information for the improvement and development of mHealth apps in the future. Methods Semistructured interviews with 9 patients and 14 healthcare professionals were conducted from January 2022 to April 2022 in the Affiliated Hospital of Xuzhou Medical University. The participants used mHealth apps for more than 3 months, including the "Good Mood" and "Peace and Safe Doctors" apps and apps developed by the hospital that were popular in China. Interview transcripts were analysed using thematic analysis. Results The following five themes were extracted: different concerns, hidden medical dangers, distance and insecurity, barriers for older people, and having positive perceptions of mHealth apps. Healthcare professionals prioritized simplicity in regard to mHealth apps, whereas patients rated effectiveness as the most crucial factor. The study also revealed several problems with mHealth apps, including insufficient information about physician qualifications, inaccurate medical content, nonstandard treatment processes, and unclear accountability, which led to a sense of distance and insecurity among participants. Older individuals faced additional obstacles when using mHealth apps. Despite these issues, the participants remained optimistic about the future of mHealth app development. Conclusion The utilization, advantages, and obstacles of mHealth applications for healthcare professionals and patients were explored through semistructured interviews. Despite the promising prospects for mHealth apps in China, numerous issues still need to be addressed. Enhancing the safety monitoring system and developing user-friendly mHealth apps for older adult patients are essential steps to bridge the gap between healthcare providers and patients.
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Affiliation(s)
- PeiYu Liu
- Department of Anesthesia and Operation Room, Nanjing Drum Tower Hospital, Nanjing, China
| | - XueYun Li
- Department of Anesthesia and Operation Room, Nanjing Drum Tower Hospital, Nanjing, China
| | - Xiao Man Zhang
- Department of Nursing, Xuzhou Medical University, Xuzhou, China
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张 丽, 刘 义, 杨 中, 张 芳. [Human Caring at Different Stages After Disasters]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:736-740. [PMID: 37545066 PMCID: PMC10442621 DOI: 10.12182/20230760103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 08/08/2023]
Abstract
Disasters, including natural disasters and man-made ones, occur rather frequently in recent years. Disasters bring destruction to the resources and expectations of local residents and cause varying degrees of physical and mental damage to the victims, some of whom suffered persistent post-traumatic stress disorder (PTSD). Human caring is the essence and core of nursing. Giving consideration to the needs and wishes of patients, the nursing staff respect the personal values of patients, give patients sincere attention and care, satisfy the reasonable needs of patients, protect the dignity of patients, stimulate patients' positive inner drive, alleviate their physical and mental pain, and facilitate the smooth recovery of patients. However, very few studies have been done to look into the human caring at various stages after a disaster hit and there is little relevant guidance available. Herein, we examined the characteristics and needs of victims of disasters in the post-disaster response stage and recovery stage and elaborated on specific and feasible measures for the implementation of human caring after disasters, including prehospital emergency care, which includes on-the-site emergency care and transportation of patients, in-hospital treatment, which includes an environment of human caring and human caring for patients and their families, especially for the special-needs populations, and post-hospital recovery stage, which includes post-hospital continuing and community-based human caring. We intend to provide guidance and reference for the practice of human caring when major disasters occur.
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Affiliation(s)
- 丽华 张
- 华中科技大学同济医学院附属协和医院 (武汉 430022)Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - 义兰 刘
- 华中科技大学同济医学院附属协和医院 (武汉 430022)Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - 中善 杨
- 华中科技大学同济医学院附属协和医院 (武汉 430022)Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - 芳 张
- 华中科技大学同济医学院附属协和医院 (武汉 430022)Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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Wu Z, Tian H, Xu D, Chen J, Hu Y, Wang X, Zhou S. Influencing Factors and Symbiotic Mechanism of the Integration of Medical Care and Disease Prevention during the COVID-19 Pandemic: A Cross-Sectional Survey of Public Hospital Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:241. [PMID: 36612563 PMCID: PMC9819979 DOI: 10.3390/ijerph20010241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Background: The COVID-19 outbreak has accelerated the huge difference between medical care and disease prevention in Chinese medical institutions. This study aimed to investigate the relationship between the symbiotic units, environments, models, and effects of the integration of medical care and disease prevention. Methods: This cross-sectional study involved 762 employees of public hospitals in 11 cities in Zhejiang Province by random stratified sampling. We analyzed the influence paths of elements in the mechanism of integration of medical care and disease prevention and the mediating effect of symbiotic models among symbiotic units, symbiotic environments, and effects on this integration. Results: The path coefficient of the symbiotic unit on the symbiosis model was 0.46 (p < 0.001), the path coefficient of the symbiotic environment on the symbiosis model was 0.52 (p < 0.001). The path coefficient of the symbiotic unit and the environment was 0.91 (p < 0.001). The symbiotic models exhibited a partial mediation effect between symbiotic units and the effect of this integration. Sobel test = 3.27, β = 0.152, and the mediating effect accounted for 34.6%. Conclusions: It is suggested that health policymakers and public hospital managers should provide sufficient symbiotic units, establish collaborative symbiotic models, and improve the effects of integration of medical care and disease prevention in public hospitals.
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Affiliation(s)
- Zhen Wu
- School of Public Health, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Huiyi Tian
- School of Public Health, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Dongjian Xu
- School of Public Health, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Jiaying Chen
- School of Public Administration, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Yaqi Hu
- School of Public Administration, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
| | - Siyu Zhou
- School of Public Health, Hangzhou Normal University, Yuhangtang St., Yuhang, Hangzhou 311121, China
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Veiga MG, Felizi RT, Trevisan GD, Cubero DDIG, Fernandes CE, Oliveira ED. Message applications in the doctor-patient relationship as a stressor. Rev Assoc Med Bras (1992) 2022; 68:1228-1233. [PMID: 36228253 PMCID: PMC9575017 DOI: 10.1590/1806-9282.20220253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/17/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: The aim of this study was to assess the use of smartphones’ messaging apps as a stressor affecting the well-being of gynecologists who use this tool to communicate with patients. METHODS: A cross-sectional study was conducted with gynecologists who use message applications to communicate with patients. Participants answered the WhatsApp Stress Scale, Oldenburg Burnout Inventory, and the techno-stress questionnaire. The population sample consisted of gynecologists and obstetricians selected by convenience. RESULTS: Physicians who spent more time using WhatsApp to communicate with patients had higher levels of stress (p=0.010), Burnout (p<0.001), and techno-invasion score (p<0.05). CONCLUSIONS: A positive association was found between the high frequency of WhatsApp usage for communication with patients and doctor's Burnout and stress, negatively influencing professional's well-being.
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Affiliation(s)
- Melissa Gonzalez Veiga
- Centro Universitário Faculdade de Medicina do ABC, Department of Gynecology - Santo André (SP), Brazil
| | - Rogério Tadeu Felizi
- Centro Universitário Faculdade de Medicina do ABC, Department of Gynecology - Santo André (SP), Brazil
| | - Gislayne Darly Trevisan
- Centro Universitário Faculdade de Medicina do ABC, Department of Gynecology - Santo André (SP), Brazil
| | | | - César Eduardo Fernandes
- Centro Universitário Faculdade de Medicina do ABC, Department of Gynecology - Santo André (SP), Brazil
| | - Emerson de Oliveira
- Centro Universitário Faculdade de Medicina do ABC, Department of Gynecology - Santo André (SP), Brazil
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Wang X, Hu Y, Tao J, Hu F, Li P, Shao D, Pan HF, Xu T. Design and Initial Validation of a Humanistic Care Evaluation Tool. J Multidiscip Healthc 2021; 14:2307-2313. [PMID: 34471358 PMCID: PMC8403570 DOI: 10.2147/jmdh.s309104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed at developing and validating a humanistic care tool in Anhui province that could be used across Chinese public hospitals, and to reflect the humanistic care from patients’ perspective. Participants A cross-sectional survey was conducted in three public hospitals of Anhui Province, China by adopting simple random sampling, which included 312 outpatients and 323 inpatients. Methods The dimensions of the tool were set according to “Further Improve Medical Service Action Plan” in China and Patient-Doctor Relationship Questionnaire. Cronbach’s alpha values were calculated and used to evaluate the reliability of this tool. Construct validity was tested by the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The associations between characteristics and humanistic care were analyzed by binary logistic regression. Results These initial findings showed that about two-thirds of the respondents experienced humanistic care. Both the reliability and construct validity of the humanistic care evaluation tool were suitable Social aspects (location and yearly income), treatment style and having a regular doctor were significantly associated with better humanistic care (all P<0.05). Conclusion The humanistic care tool can directly reflect the humanistic care from patients’ perspective, and can be popularized and applied across Chinese public hospitals. These findings have important implications to further improve medical service in Chinese public hospitals.
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Affiliation(s)
- Xiaohu Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Yuqian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Jie Tao
- Anhui Provincial Hospital, Hefei, People's Republic of China
| | - Fuyong Hu
- School of Public Health, Bengbu Medical College, Bengbu, People's Republic of China
| | - Peng Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Donghua Shao
- Public Anhui Provincial Health and Family Planning Commission, Hefei, People's Republic of China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Tao Xu
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei, People's Republic of China
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Gao S, He L, Chen Y, Li D, Lai K. Public Perception of Artificial Intelligence in Medical Care: Content Analysis of Social Media. J Med Internet Res 2020; 22:e16649. [PMID: 32673231 PMCID: PMC7385634 DOI: 10.2196/16649] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/02/2020] [Accepted: 05/31/2020] [Indexed: 01/22/2023] Open
Abstract
Background High-quality medical resources are in high demand worldwide, and the application of artificial intelligence (AI) in medical care may help alleviate the crisis related to this shortage. The development of the medical AI industry depends to a certain extent on whether industry experts have a comprehensive understanding of the public’s views on medical AI. Currently, the opinions of the general public on this matter remain unclear. Objective The purpose of this study is to explore the public perception of AI in medical care through a content analysis of social media data, including specific topics that the public is concerned about; public attitudes toward AI in medical care and the reasons for them; and public opinion on whether AI can replace human doctors. Methods Through an application programming interface, we collected a data set from the Sina Weibo platform comprising more than 16 million users throughout China by crawling all public posts from January to December 2017. Based on this data set, we identified 2315 posts related to AI in medical care and classified them through content analysis. Results Among the 2315 identified posts, we found three types of AI topics discussed on the platform: (1) technology and application (n=987, 42.63%), (2) industry development (n=706, 30.50%), and (3) impact on society (n=622, 26.87%). Out of 956 posts where public attitudes were expressed, 59.4% (n=568), 34.4% (n=329), and 6.2% (n=59) of the posts expressed positive, neutral, and negative attitudes, respectively. The immaturity of AI technology (27/59, 46%) and a distrust of related companies (n=15, 25%) were the two main reasons for the negative attitudes. Across 200 posts that mentioned public attitudes toward replacing human doctors with AI, 47.5% (n=95) and 32.5% (n=65) of the posts expressed that AI would completely or partially replace human doctors, respectively. In comparison, 20.0% (n=40) of the posts expressed that AI would not replace human doctors. Conclusions Our findings indicate that people are most concerned about AI technology and applications. Generally, the majority of people held positive attitudes and believed that AI doctors would completely or partially replace human ones. Compared with previous studies on medical doctors, the general public has a more positive attitude toward medical AI. Lack of trust in AI and the absence of the humanistic care factor are essential reasons why some people still have a negative attitude toward medical AI. We suggest that practitioners may need to pay more attention to promoting the credibility of technology companies and meeting patients’ emotional needs instead of focusing merely on technical issues.
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Affiliation(s)
- Shuqing Gao
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Lingnan He
- School of Communication and Design, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Big Data Analysis and Simulation of Public Opinion, Guangzhou, China
| | - Yue Chen
- School of Communication and Design, Sun Yat-Sen University, Guangzhou, China
| | - Dan Li
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Kaisheng Lai
- School of Journalism and Communication, Jinan University, Guangzhou, China
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Warraich HJ, Califf RM, Krumholz HM. The digital transformation of medicine can revitalize the patient-clinician relationship. NPJ Digit Med 2018; 1:49. [PMID: 31304328 PMCID: PMC6550259 DOI: 10.1038/s41746-018-0060-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 11/09/2022] Open
Abstract
Health professionals within the medical community feel that the principles of humanism in medicine have not been a point of emphasis for information and computer technology in healthcare. There is concern that the electronic health record is eroding the patient-clinician relationship and distancing clinicians from their patients. New analytic technologies, on the contrary, by taking over repetitive and mundane tasks, can provide an avenue to make medical care more patient-centered by freeing clinicians' time, and the time of the whole clinical care team, to engage with patients. Technology such as advanced speech recognition that optimizes clinicians' workflow could revitalize the patient-clinician relationship and perhaps also improve clinician well-being. Digital phenotyping can gain invaluable additional data from patients using technology that is already used for personal reasons by the majority of patients. The digital transformation of healthcare has the potential to make healthcare more humane and personalized, however, several important steps are needed to avoid the pitfalls that have come with prior iterations of information technology in medicine such as a heightened emphasis on data security and transparency. Both patients and clinicians should be involved from the early stages of development of medical technologies to ensure that they are person-centric. Technologists and engineers developing healthcare technologies should have experiences with the delivery of healthcare and the lives of patients and clinicians. These steps are necessary to develop a common commitment to the design concept that technology and humane care are not mutually exclusive, and in fact, can be symbiotic.
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Affiliation(s)
- Haider J Warraich
- 1Department of Medicine, Cardiology Division, Duke University School of Medicine, Durham, NC USA.,2Duke Clinical Research Institute, Durham, NC USA
| | - Robert M Califf
- Duke Forge, Durham, NC USA.,4Department of Medicine, Stanford University, Palo Alto, CA USA.,Verily Life Sciences, South San Francisco, CA USA
| | - Harlan M Krumholz
- 6Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT USA
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