The mourning of the health care professional: an important element in education about death and loss

This article explores the centrality of the mourning process in the education of developing health care professionals who are the survivors of complex and manifold losses. This was discussed in an elective seminar for senior medical students and graduate nurses. Learning about clinical responsibility often occurred in the context of loss and mourning. The outcome of mourning included for some a greater sensitivity to the impact of clinical interventions and a more accurate empathy for losses incurred by patients as a result of illness. Old and unresolved loss and mourning experiences were reawakened as a result of the seminar, which led to a sorting and mastering of these experiences. This is felt to be a common result of discussions about encounters with death and loss. Courses on death and dying for the health care professional, although important, are not sufficient by themselves for mastery of these topics. Clinical teachers must be aware of the student's response to loss and provide an atmosphere that legitimizes learning about these issues. The principles of awareness and open acknowledgement of loss and mourning are applicable to all health care settings.     

Cultural and institutional restrictions on dying styles in a technological society

The starting medical advances of this century have created unparalleled opportunities for ill and suffering people, but these same forces have combined to make the experience of dying a terrifying, fearful, lonely vigil for many. Devoid of traditional myths, rituals, and family support, many patients now die in sterile institutional settings often appearing as mere appendages to life-supporting machines. This shift from the moral to the technical order manifests itself in doctors' fascination with gadgets, the emphasis upon parts of the body, and a concomitant blurring of distinctions concerning death, personhood, and individual rights. The patient is reduced to a secondary role in his or her own death, thus engendering a widespread desire for a sudden death. In light of these circumstances, health care personnel need to create circumstances that would give people more opportunities to die in styles commensurate with their life styles. Society must seriously study the implications of the unthinking treatment of people; and routines, policies, and procedures based on matters of mere efficiency and technological convenience must be replaced by those human and humane ceremonies, attitudes, and policies that must assure that technology's magnificent achievements do not obscure the human need for individuality and spiritual growth even during the dying process.     

Making death,compassion and partnership ‘part of life’ in school communities

Death can be considered a social taboo, a common source of fear and public avoidance. School communities are not immune to this, as the topic of death is constantly avoided. It is vital to understand how we can socially and culturally cultivate a positive regard for death, dying and bereavement in our school communities. Community members need to discuss these difficult issues and use strategies to enhance compassion, connectedness and support. In this literature review we reason that death is specifically not ‘part of life’ in school communities. Due to the dearth of school community-based literature on this issue and the progressive literature residing in palliative care, we aim to coalesce palliative care and school-based research, evaluate it and highlight compassion and partnership as a way forward for school communities. Essentially, our societal attitudes about death and dying have been profoundly altered and our community ownership of these normal life events has largely disappeared. This is demonstrated for example, by palliative care moving from the social grass roots ‘modern hospice movement’ formed in the 1960s and being reintegrated into the mainstream health care system by the end of the 1990s, resulting in an overall medicalised morphing of death, dying and bereavement issues. Therefore, we recommend that further research be conducted in how to develop compassionate schools to inform us how death may be continually made ‘part of life’ in school communities, for the benefit of students, teachers and families alike.     

Impediments to communication in transition to terminal illness

Viewing themselves in two hypothetical roles-as terminal patients and as family members related to a terminal patient-48 adults were surveyed on their expectations and preferences about how information should be communicated when a terminal illness is first diagnosed. Identifying with the patient role, respondents believed patients should be told the truth immediately and unconditionally. In contrast, respondents indentifying with family members perceived conditions under which the rights of patients should be abridged. In this latter role, male respondents were significantly less likely than males to imagine themselves as able to inform a loved one about a terminal illness. Nevertheless, for both sexes, early childhood experiences communicating about death and dying were found to be a better predictor of the case with which respondents can imagine communicating with a terminally ill loved one than are current adult attitudes and experiences. Regardless of personal ease in discussing death, however, most respondents thought the physician, not family members or other health care professionals, should decide when and how the terminally ill adult should be informed--a noteworthy finding in light of the fact that 83 percent of all respondents consider physicians poorly equipped for this role.     

Stimulating Intrinsic Motivation in Millennial Students: A New Generation,a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.     

HUMOR AS AN INNOVATIVE METHOD FOR TEACHING SENSITIVE TOPICS

Guidelines for including geriatric content in six health care disciplines recommend training in topics such as fear of aging, death, dying, grieving, and suicide. The psychoanalytic theory of humor provides a basis for using humor to teach these sensitive topics. Humor used in clinical settings relieves anxiety, decreases discomfort, and provides a coping mechanism for both patients and health care providers. Humor used in educational settings increases comprehension, enhances retention, and improves faculty ratings. Suggestions are provided for incorporating humor into lesson plans and assignments. The use of humor contributes to learning and to improved health care for older people.     

The availability of education on death and dying: a survey of U.S. nursing schools

A stratified random sample of 226 U.S. nursing schools was surveyed to determine the extent and nature of current death education training for nursing students. Of the 205 responding schools, 5 percent reported offering a required death and dying course, while an additional 39.5 percent indicated that a death and dying course was available for their students on an elective basis. The authors challenge the current pedagogical approach toward death education in U.S. nursing schools. They propose the need for the development of a model that would formally link a death education course, or courses, with the clinical phase of training. It is hypothesized that such an approach would enhance the nursing students' recognition and management of their feelings regarding death and dying and therefore result in more effective means of relating to terminally ill patients.     

Caring for the dying: advocacy or paternalism

Moral dilemmas in the care of a dying person ideally should be decided in the context of that person's own freely determined understanding of death. At the philosophical, the clinical, and the personal levels, the primal question of how to understand death must be addressed before decisions are made concerning much ethical problems as euthanasia. Philosophers and practitioners who fail to do this are guilty of an a priori paternalism toward the dying, on whom their conclusions will be imposed. Until we have determined, together with the person involved, the way in which that person wants to view his or her death, any prior ethical judgment not only is presumptuous but infringes on the most basic freedom, that of determining the meaning that one's own experience shall have. The role of advocacy is an alternative to the traditional paternalism toward the dying. The essay attempts to (a) develop the distinctions among paternalism, consumerism, and advocacy; (b) propose a concept of advocacy as the assistance to the dying in freely determining how to understand their dying and death; (c) describe three of the views of death (naturalistic, religious, and existentialist) that need to be understood by those who assist the dying in exercising their freedom of self-determination.     

高校保健体育与心理健康教育相结合的教学方式探讨

普通高校对部分身体异常和病、残、弱等特殊群体的学生开设保健体育课已成为学校体育教育的组成部分。当前,学校要贯彻全面发展的教育方针,体现教育的公平性,普及体育及其健身理论,就必须把握好保健班学生体育这一环节,保障其接受体育教育的均等机会。为此,笔者从构建高校保健体育课与心理健康教育相结合的必要性、保健体育课程与《学生体质健康标准》内容的编制等几方面提出了一点思考,为完善高校保健体育课教学提供参考。     

从问题取向到人文关怀——将幸福教育融入高职学生心理健康教育

长期以来，高职院校心理健康教育一直延续着重“问题取向”轻“人文关怀”的教育模式。随着积极心理学的兴起，幸福教育逐渐引起教育界的关注，并开始融入到心理健康教育中。幸福教育主要包括树立正确幸福观念、培养体验幸福能力、塑造追求幸福品质三个方面，力求使学生真正领悟生命意义，从而更加热爱生活，保持积极乐观的心态。     

大学生健康发展教育中的人文关怀与心理疏导

基于理论和现实的判断,联合国教科文组织曾提出这样一个观点：健康的一半是心理.因而,在大学生健康发展教育中,对心理健康的关注将是必然的选择.在教育的过程中,面对学生的思想情绪和心理健康方面的问题,我们也有必要把人文关怀和心理疏导贯穿、渗透、体现于工作的各个方面,加强交流沟通,进行及时帮助.     

The effects of a course on death and grief on nurses' attitudes toward dying patients and death

The purpose of this study was to measure the effects of a course on death and grief on the attitudes toward death and toward dying patients of nurses who work in high-risk death areas of hospitals. This quasi-experimental design used four groups of subjects. One group experienced the treatment. Another group served as a waiting-list control group and then experienced the treatment. Two groups were control groups. The treatment consisted of attendance at a 6-week continuing education course entitled "Coping with Death and Dying in High-risk Areas of Hospitals." The Death Anxiety Semantic Differential, Parts I and II, was used as the dependent variable. The results indicate that the small-group counseling and education experience did have an impact on attitudes toward death and dying patients of nurses who attended. The discussion of the findings and recommendations for further study are presented.     

END-OF-LIFE CARE FOR SENIORS: PUBLIC AND PROFESSIONAL AWARENESS

Seniors living with disease or dying should be able to receive competent, comprehensive, and compassionate end-of-life care that offers dignity, self-determination, and relief from pain and suffering. Such care is predicated on an informed public and health and social service providers who are in end-of-life issues and appropriate approaches. There is, however, little evidence that seniors and their families are about end-of-life issues or about their treatment and care options. Furthermore, health and social service providers do not predictably receive the education and training necessary to ensure a high quality of end-of-life care for seniors. This paper discusses public and professional awareness and offers strategies aimed at increasing awareness of end-of-life issues. These strategies also support the development of an approach to end-of-life care for seniors that is caring, compassionate, and ethically, spiritually, and culturally appropriate. The article contributes to an emerging agenda directed at ensuring that all seniors receive end-of-life care that allows a positive conclusion to their lives.     

Death Education and Counseling: A Survey

A survey of counselors and counselor educators was conducted to assess information and attitudes with regard to death education, training in death and dying, and the appropriateness of dealing with death in the schools. Results showed that an overwhelming majority of both the responding counselors and the counselor educators felt that school counselors should work in this area (both counseling and death education). Although both these groups recognize the need for training in death and dying, little is presently being done to help counselors acquire the necessary skills and awareness to work in the area of death and grief. Recommendations for changes are included.     

The viability of pediatric hospices: a case study

This paper identifies the special characteristics needed by hospices caring for terminally ill children. It is based on a feasibility study conducted in 1979 for a pediatric hospital in New York City. From the analysis of statistical data and confidential interviews with health care professionals in the hospital and in the community, the study concludes that the needs of terminally ill children and their families are not being met currently and that the hospice is as appropriate for children as for adults. Three major differences in emphasis are noted, however. First, support of the family suffering the death of a child is of prime importance, because the grief is devastating and long lasting and because the number of family members affected is usually large. Second, the hospice emphasis on home care is even more imperative for children than for adults as it more significantly benefits both child and family; home care can be facilitated through supplementary care components such as day care. Third, there is a major need for both professional and public education in caring for terminally ill children and their families and in coping with childhood death. The author concludes that further research is needed in all aspects of pediatric terminal care.     

学生运动性猝死频发的原因及预防对策探析

目的：探析近年来学生运动性猝死频发的原因及预防对策。方法：主要采用文献资料法对其原因及预防对策进行分析。结果：学生运动性猝死频发的原因主要有以下方面：生活条件和医疗条件的改善,使得存在潜在疾病隐患的学生增多,成为运动性猝死的高危人群;缺乏锻炼,身体虚弱,承受运动负荷的能力越来越差;忽视准备活动和整理活动,缺乏运动过程的完整性;滥用药物和盲目补充功能性饮料;参与各种大型赛事的机会增多,超负荷的运动极易造成心肌损伤;生活不规律。结论：学生运动性猝死的预防主要应注意以下方面：加强体育卫生保健知识的宣传教育,提高学生自我监督和临场急救的能力;改进学生体检的内容,严禁高危学生参加剧烈运动和比赛;重视运动性心脏损伤的预防和排查;切实加强学校体育工作,提高学生对运动负荷的承受能力;注意识别运动性猝死的前驱症状;养成良好的生活方式。     

高职学前教育专业课程开发探究——以学前儿童卫生与保育课程为例

随着职业教育的发展,校企合作的程度不断深化。在这样的背景下,如何对高职学前教育专业的课程进行改革问题日益凸显。以学前儿童卫生与保育课程为例,从三个方面进行分析。首先分析高职学前儿童卫生与保育课程现状,主要从存在的问题入手。其次分析学前儿童卫生与保育课程开发的原则。最后通过梳理学前儿童卫生与保育课程开发的思路,为学前教育学专业课程开发抛砖引玉。     

卫生高职院校化学教学中加强德育的重要作用

德育是教育的灵魂,尤其是卫生高职院校应把大学生的德育放在比较突出的位置。卫生高职院校化学教材中含有丰富的德育内容,化学教师应充分对这些素材进行挖掘,并在教学中适时把德育寓于化学教育之中,对卫生高职大学生养成良好的思想道德素质,树立正确的人生观、价值观和世界观,提高全心全意为人民服务、救死扶伤的思想认识具有重要作用。     

Evolution of a community program for the dying and their families

A direct outcome of the death and dying movement has been the establishment of community programs designed to provide intervention services, support and education for the dying and their families and for the community at large. This paper discusses the evolution of such a program. Included in the discussion is a brief history, the nature of the program that evolved, problems related to community acceptance, and the current status and future of the program. Although the experiences of this program are to a degree unique, issues are raised that are likely to be common to many such community programs.