Do case studies mislead about the nature of reality?
This paper attempts a partial, critical look at the construction and use of case studies in ethics education. It argues that the authors and users of case studies are often insufficiently aware of the literary nature of these artefacts: this may lead to some confusion between fiction and reality. Issues of the nature of the genre, the fictional, story-constructing aspect of case studies, the nature of authorship, and the purposes and uses of case studies as "texts" are outlined and discussed. The paper concludes with some critical questions that can be applied to the construction and use of case studies in the light of the foregoing analysis. (+info)
Power and the teaching of medical ethics.
This paper argues that ethics education needs to become more reflective about its social and political ethic as it participates in the construction and transmission of medical ethics. It argues for a critical approach to medical ethics and explores the political context in medical schools and some of the peculiar problems in medical ethics education. (+info)
That's another story: narrative methods and ethical practice.
This paper examines the use of case studies in ethics education. While not dismissing their value for specific purposes, the paper shows the limits of their use. While agreeing that case studies are narratives, although rather thin stories, the paper argues that the claim that case studies could represent reality is difficult to sustain. Instead, the paper suggests a way of using stories in ethics teaching that could be more real for students, while also giving them a way of thinking about their own professional practices. The paper shows how the method can be used to develop a more critical and reflective practice for students in the health care professions. Some immediate problems with the method are discussed. (+info)
Empowering social action through narratives of identity and culture.
Concern at widening health and wealth inequities between communities accompanying processes of globalization in recent years are reflected in contemporary definitions of health promotion, premised on the stratagem of individuals and communities increasing control over factors that determine health, thereby improving their health status. Such community empowerment practice is commonly accepted within the health promotion literature as encompassing intrapersonal, interpersonal and socio-political elements. Less articulated and understood, however, are the processes whereby the identities and cultures of marginalized communities intersect with and reverberate through these levels of action. The potential of identity and culture as important individual and community resources within social action takes on further significance within global-ized contexts, which simultaneously expose marginalized communities to dominant cultural power relations while affording members new avenues for cultural expression. In this paper we highlight culture and identity as important aspects of the empowerment process, drawing on the experiences of migrant Tongan and Samoan women throughout a social action process in Aotearoa/New Zealand. In particular, narratives of identity and culture within storytelling as an empowerment practice are explicated, as is the articulation of identity and culture within more structurally orientated power relations throughout subsequent activities related to policy advocacy. (+info)
Client narratives: a theoretical perspective.
The role of subjective client narratives in health care represents a clinical and therapeutic tool, useful in complementing objective, scientific data. Of particular interest to mental health practitioners is the role narratives play as a therapeutic tool to guide clinical practice. This paper lays a foundation for understanding the importance of narrative in the psychotherapeutic process. It provides a brief overview of narrative theory and methods of structural analysis in order to provide a theoretical approach that can be utilized by nurses to address clients' needs. (+info)
The use of narrative data to inform the psychotherapeutic group process with suicide survivors.
While bereavement is considered by many to be among one of the most stressful life events, it becomes even more distressing when it is related to the suicide of a loved one. A synopsis of psychosocial outcomes of suicide survivor bereavement is presented along with an overview of group interventions designed to help these survivors cope with their grief. The structure of an ongoing eight-week bereavement support group is described to lay a foundation for the application of narrative theory within the group process. Using narrative theory and structural analysis, the discourse of group members is presented and various themes are discussed in an effort to contribute to the task of developing effective psychotherapeutic group interventions for survivors of suicide. (+info)
Parent and child reporting of negative life events: discrepancy and agreement across pediatric samples.
OBJECTIVE: To examine the consistency in child and parent reporting of child's negative life events across child/pediatric samples. METHODS: A total of 613 child-parent dyads provided independent reports of negative life events. The pairs included three groups consisting of children who were healthy (n = 362), diagnosed with cancer (n = 130), and diagnosed with a chronic illness (juvenile rheumatoid arthritis, diabetes, or cystic fibrosis; n = 121). RESULTS: Children reported significantly more negative life events than their parents reported for them. Additionally, children in the chronically ill group self-reported significantly fewer negative life events than the other groups. However, parents of children with cancer reported significantly more negative life events than the other groups. Although discrepancies exist in all three samples, parents and children in the healthy group were significantly more discrepant than the other groups. CONCLUSIONS: These results suggest that communication of children's life events between parent and child may increase during children's experience of cancer or a chronic illness. However, significant discrepancies remain in child and parent report of negative life events. Because of this, clinicians are encouraged to recognize the strengths and limitations of using multiple reporters in assessing negative life events in children. (+info)
Critical gaps in the world's largest electronic medical record: Ad Hoc nursing narratives and invisible adverse drug events.
The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs, operates one of the largest healthcare networks in the world. Its electronic medical record (EMR) is fully integrated into clinical practice, having evolved over several decades of design, testing, trial, and error. It is unarguably the world's largest EMR, and as such it makes an important case study for a host of timely informatics issues. The VHA consistently has been at the vanguard of patient safety, especially in its provider-oriented EMR. We describe here a study of a large set of adverse drug events (ADEs) that eluded a rigorous ADE survey based on prospective EMR chart review. These numerous ADEs were undetected (and hence invisible) in the EMR, missed by an otherwise sophisticated ADE detection scheme. We speculate how these invisible nursing ADE narratives persist and what they portend for safety re-engineering. (+info)