Choral singing therapy following stroke or Parkinsons disease: An exploration of participants experiences

© 2015 Informa UK Ltd. Purpose: People with stroke or Parkinsons disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use is of increasing interest. This article explores the experiences of and factors influencing participation in choral singing therapy (CST) by people with stroke or PD and their significant others. Method: Participants (eight people with stroke, six with PD) were recruited from a community music therapy choir running CST. Significant others (seven for stroke, two for PD) were also recruited. Supported communication methods were used as needed to undertake semi-structured interviews (total N = 23). Results: Thematic analysis indicated participants had many unmet needs associated with their condition, which motivated them to explore self-management options. CST participation was described as an enjoyable social activity, and participation was perceived as improving mood, language, breathing and voice. Conclusions: Choral singing was perceived by people with stroke and PD to help them self-manage some of the consequences of their condition, including social isolation, low mood and communication difficulties.Implications for RehabilitationChoral singing therapy (CST) is sought out by people with stroke and PD to help self-manage symptoms of their condition.Participation is perceived as an enjoyable activity which improves mood, voice and language symptoms.CST may enable access to specialist music therapy and speech language therapy protocols within community frameworks

Apophenia, unconscious bias and reflexivity in nursing qualitative research

From PubMed via Jisc Publications Router.History: received 2018-03-16, revised 2018-09-20, accepted 2018-09-21Item not available in this repository.Nurses routinely engage in pattern recognition and interpretation in qualitative research and clinical practice. However, they risk spontaneously perceiving patterns among things that are not meaningfully related. Although all people are prone to this cognitive bias of "apophenia", nurses may be at increased risk because they commonly produce or at least use qualitative research that can be highly interpretive. Qualitative researchers have been silent on the risk of apophenia and hence on exploring how attention to apophenia could help to indicate and manage such unconscious biases. Therefore this conceptual paper suggests how, in disciplines like nursing, researchers could attend to and use reflexivity on signs of possible apophenia to help bring unconscious biases to awareness. Within safe communities of professional practice, the researchers could cooperate with trusted peers to reflect on how and why they may each perceive patterned phenomena from different perspectives. If one reason is that the researchers, for example, appear to exhibit particular unconscious biases, then dialogue could help them to become aware of, and reflect on the biases. This expansion of researchers' consciousness of bias could inform the management of apophenia and enhance the quality of qualitative research and modern nursing practice.89pubpu

Something in Nothing: Negative Space in the Clinician-Patient Relationship

Clinicians can easily miss the importance of how what is not present gives depth, perspective, and clues to the real meaning of social action in clinical encounters. This essay addresses examples of commonly overlooked forms of this concept of negative space in the clinician-patient relationship. The examples are negative physical space, which denotes the physical distances that separate clinicians and patients during face-to-face encounters; negative communicative space, which refers to how nonverbal and verbal communication can signify information not exchanged during these visits; and negative longitudinal space, which describes pauses over time and includes what is not said between clinicians and patients between visits. Discussed is how the awareness of these different spaces helps us to let go of our preconceptions, to experience what is there rather than what we expect to find, and to use space sensitively to improve interactions with patients.sch_nur7pub4166pub

Physician kindness as sincere benevolence

Paper adds to the growing body of evidence that children can acquire phonological systems before they are able to master the phonetic skills needed to convey the contrasts in that systemsch_nur185pub4162pub1

Towards a New Understanding of Provider Continuity

Provider continuity is in need of an expanded definition that is not exclusively clinician centered. Currently, provider continuity is defined by visits over time to the same clinician. Many patients and informal caregivers, however, are co-providers of health care, not merely consumers. As a result, provider continuity will not happen if there is a lack of consistency in who attends with or for the patient during successive visits. Such fragmentation may weaken knowledge of the patient and information exchange. Consequently, there is a need to redefine provider continuity to mean that the same attendees visit the same clinician(s), service, or facility as an uninterrupted succession of events. More than semantic quibbling, the proposed reconceptualization challenges the foundation of family medicine in terms of the values and language by which the discipline defines itself in clinician-centered ways. The change required has implications for practice and research

How Can a Family Resemblances Approach Help to Typify Qualitative Research? Exploring the Complexity of Simplicity

The term qualitative research still gives meaning to a diverse array of approaches. Attributes typical of these approaches are easily oversimplified. Recognition that qualitative research requires no essential set of predefining attributes can minimize this problem. This article suggests how to typify qualitative research outputs on the basis of overlapping similarities in the uses of this research. It discusses these similarities within and across five domains of qualitative research—philosophy and theory, purpose, approach to reasoning, data collection, and use of numbers. Across these domains, qualitative research is typified as research that, without taking a unified stance on epistemological issues, can produce rich data by selecting and engaging purposefully with small samples, and analyzing these data using iterative processes of induction, abduction, and deduction. Within this network of family resemblances, no attributes of qualitative research are individually necessary or sufficient. Together, they attend simply to the complexity of coinciding attributes of this research

Person-centred Health Care: Balancing the Welfare of the Clinician and Patient

OxfordPerson-centred health care is increasingly endorsed as a key element of high-quality care, yet, in practice, it often means patient-centred health care. This book scrutinizes the principle of primacy of patient welfare, which, although deeply embedded in health professionalism, is long overdue for critical analysis and debate. It appears incontestable because patients have greater immediate health needs than clinicians and the patient-clinician encounter is often recognized as a moral enterprise as well as a service contract. However, Buetow argues that the implication that clinician welfare is secondary can harm clinicians, patients and health system performance. Revaluing participants in health care as moral equals, this book advocates an ethic of virtue to respect the clinician as a whole person whose self-care and care from patients can benefit both parties, because their moral interests intertwine and warrant equal consideration. It then considers how to move from values including moral equality in health care to practice for people in their particular situations. Developing a genuinely inclusive concept of person-centred care - accepting clinicians as moral equals - it also facilitates the coalescence of patient-centred care and evidence-based health care. This reflective and provocative work develops a constructive alternative to the taken-for-granted principle of primacy of patient welfare. It is of interest to students and academics in the health and caring sciences, philosophy, ethics, medical humanities and health management.sch_nurpub4640pu