Conference Agenda

Overview and details of the sessions of this conference. Please select a date or location to show only sessions at that day or location. Please select a single session for detailed view (with abstracts and downloads if available).

 
Session Overview
Session
RN16_03b: Challenges for Health Care Organisation
Time:
Wednesday, 21/Aug/2019:
4:00pm - 5:30pm

Session Chair: Antonio Maturo, Bologna University
Location: UP.4.205
University of Manchester Building: University Place, Fourth Floor Oxford Road

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Presentations

Using A Humanist Perspective To Overcome Nurse-Patient Barriers During Hemodialysis Sessions

Matteo Antonini1, Chantal Cara2, Sylvain Brousseau3, Jean Weidmann4, Louise O'Reilly5, Tanja Bellier-Teichmann1, Evelyne Boillat1, Vanessa Brandalesi1, Mario Konishi4, Delphine Roulet Schwab1, Isabelle Ledoux5, Jerôme Pasquier6, Philippe Delmas1

1La Source School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Switzerland; 2Université de Montréal; 3Université du Québec en Outaouais; 4School of Management and Engineering Vaud; 5Université de Sherbrooke; 6Vaud University Hospital (CHUV)

In the last decades, the incidence of Chronic Kidney Disease has rapidly grown in Europe. End-stage kidney disease necessitates long-term kidney replacement therapy, the most widespread of which is hemodialysis. This is a strongly engaging therapy that obliges patients to spend three half-days per week in healthcare structures, often, for several years. Health assistance is mainly provided by specialized nurses, which professional identity implies a strong engagement in patients’ life project. Nevertheless, previous research suggests that the large presence of technology-based treatments during the hemodialysis sessions could bring to dehumanizing practices that exacerbate nurses-patients’ conflicts and have strong repercussions on both patients’ and nurses’ quality of life. To counter this tendency, preliminary research suggests that a training in humanistic nursing practices can provide the conceptual and practical instruments to efficaciously overcome nurses-patients’ barriers and reinforce nurses’ professional identity. To test this hypothesis, we have carried out a research based on an experimental design involving 10 hospitals in French-speaking Switzerland. Following a cluster randomized sample, 50 of the participating nurses have received a “educational intervention” in humanistic nursing practices while 46 have been assigned to the control group. A questionnaire on nurses-patients’ relations and quality of life has been completed by both nurses and patients (N=105) before and after the training. Using the control sample as a baseline, we observe a significative improvement in nurses’ quality of life and nurses-patients’ relations. Our results show how a humanistic approach can improve healthcare quality and nurses’ and patients’ quality of life.



Breaking Boundaries for Studying Chronic Pain in Childhood

Ana Patrícia Hilário

Instituto de Ciências Sociais da Universidade de Lisboa, Portugal

While there is some work on children’s experiences of postoperative pain or cancer-related pain, little has been said about how chronic pain in childhood is experienced and managed in the family context. Despite its worldwide prevalence, the condition is under researched and many children do not receive appropriate pain management. There is little understanding of the needs of children with chronic pain and the needs of their parents. Portugal offers an interesting context in which to explore this matter as it has been marked by a lack of knowledge on paediatric chronic pain and resources available to children with chronic pain. This study intends to provide another lens for understanding family experiences and management of chronic pain in childhood by listening to the voices of children, as well as those of their parents. The study will make an important contribution to social science research, as well as to specific knowledge on paediatric chronic pain by providing an insight into family experiences and management of chronic pain in childhood. A qualitative approach will be developed. A range of visual methods will be employed to address the research questions, and will be combined with interviewing techniques. Twenty children, aged 7-10 at the time of recruitment, who suffer from chronic pain together with their parents will participate in the study. This presentation intends to describe the challenges and opportunities of conducting research with children who suffer from chronic pain and their parents.



Class-related Inequalities in Utilisation of Health Care Services in Later Life: A Bourdieusian Approach

Ivana Paccoud1, James Nazroo2, Anja Leist1

1University of Luxembourg, Luxembourg; 2University of Manchester, UK

While studies have found inequalities in the use of health care services between different socio-economic groups, the class-related mechanisms underlying this inequality need further investigation. This paper draws on Bourdieu’s theory of economic, social and cultural capital to understand the effect of these capitals and of their structure on health care services and hospital use.

Using data from the fifth wave of the Survey of Health, Aging, and Retirement in Europe (SHARE), with a representative sample of 30,782 individuals from 15 European countries, the goal of this study is to determine how each capital, and their overall distribution, is associated with the use of health and hospital services in later age. Our results show that inequalities in the use of health care services are sensitive to immaterial, socio-cultural factors and question the idea that only economic factors affect health care and hospital utilisation. Cultural capital was strongly associated with the higher use of health care and dentist services and social capital was found to have a protective effect on hospital admissions and on the length of hospital stays. In addition, we show that inequalities are rooted in the different distribution of forms of capitals that in turn create class-based health practices.

Bourdieu’s approach to capitals offers a valuable framework for research on inequalities in health care utilisation. The results can help improve our understanding of how different forms of capital (economic, cultural and social) can serve as important class-related determinants of health care and hospital service use.



Alternative Health Practices as a Channel for Social Criticism from the Early 1900s to Present Day

Pia Vuolanto1, Johanna Nurmi2, Suvi Rytty2

1Tampere University, Finland; 2University of Turku, Finland

Alternative health practices challenge western biomedicine, but they can also offer a channel for broader social criticism. Since the early 1900s, there have been connections between medical heterodoxies and broader social, cultural and political-economic movements. Alternative health practices have the potential to influence social change, be it in the form of civilization and cultural critique, or the critique of capitalism, working life or supranational pharmaceutical companies.

This paper examines the connection between health and social criticism in alternative health practices from the early 1900s to the present day. We examine how and why alternative health practices have been and still are used as a channel for social criticism. We approach the subject through Finnish case studies placed in a larger European context of natural lifestyles and lifestyle movements where certain lifestyle practices are used to pursue changes, not just on the individual level, but also on the societal level.

Natural lifestyles incorporate a broad and varying range of different heath practices including natural remedies, alternative treatments, special diets and avoidance of pharmaceuticals such as vaccines. Advocates of a natural lifestyle in Finland have published several periodicals since 1910. We concentrate on three different periodicals during three periods: 1910–1930, 1950–1970, and 2000-2017. Analytically, we focus on the discourses of alternative health practices and the ways in which these discourses contrast with biomedical discourses and generate rhetorical boundaries of mainstream legitimate knowledge. Combining sociological and historical research, this paper is especially focused on the continuum between past and present, showing that the intertwining of health and social criticism is neither a contemporary nor historical phenomenon, but is deeply rooted in the structures of modern western societies.