BACKGROUND AND OBJECTIVES Schwartz Rounds (SR) is an interdisciplinary program that focuses on co... more BACKGROUND AND OBJECTIVES Schwartz Rounds (SR) is an interdisciplinary program that focuses on compassionate care by allowing the formation of an interprofessional community around the human and emotional testimonies of caregivers. The purpose of this study was to examine the impact of implementing departmental SR on pediatric care providers at a tertiary care children’s hospital in New York. METHODS We applied the logic outcomes model for program evaluation to examine the impact of SR on pediatric providers. The standard evaluation form provided by the Schwartz Center was used to collect data after every SR. Descriptive statistics and qualitative data content analysis methods were used to analyze the evaluation data from the SR. RESULTS A total of 820 standard evaluation forms were collected from 17 of the 23 SR sessions offered (response rate: 74.8%). Most participants felt that, during the SR sessions, challenging social and emotional aspects of patient care were discussed and th...
Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at G... more Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.
The emergence of cognition-enhancing drugs in the treatment of Alzheimer disease raises questions... more The emergence of cognition-enhancing drugs in the treatment of Alzheimer disease raises questions about quality of lives for those with dementia and for their caregivers, and about the perceptions of health care professionals. This pilot study analyzes a limited data from a series of three focus groups on the experience of treatment. These groups engaged both Alzheimer disease-affected persons, their caregivers, and a multidisciplinary professional core. We conclude that therapeutic goals need to be better addressed with patients and families, as well as better monitored, with the possibility of withdrawing therapy as appropriate. We also detected, as hypothesized, considerable disparity between the perspectives of professionals and consumers regarding the benefits of therapy.
... Jan Lucas Hoving, PT, PhD Cabrini Medical Centre 3144 Victoria, Australia Bart W. Koes, PhD E... more ... Jan Lucas Hoving, PT, PhD Cabrini Medical Centre 3144 Victoria, Australia Bart W. Koes, PhD Erasmus Medical Center Rotterdam 3000 DR Rotterdam, the Netherlands Henrica CW de Vet, PhD Vrije Universiteit Medical Centre 1081 BT Amsterdam, the Netherlands ...
ddiction is a significant problem among adolescents – it reduces academic performance, increases ... more ddiction is a significant problem among adolescents – it reduces academic performance, increases the likelihood of injury or criminal behavior, and has been estimated to cost US society as much as $500 billion every year. In new research, which builds on the idea that social connection and helping others can have benefits, Byron R. Johnson, Maria E. Pagano, Matthew T. Lee, and Stephen G. Post studied the effects of social isolation on young people who were being treated for alcohol and drug addiction. They find that socially estranged juveniles were more likely to relapse into addiction post-treatment, but also that those who gave help to others as part of the program were less likely to relapse and to commit crimes.
These guidelines summarize the content of meetings of family caregivers and individuals with deme... more These guidelines summarize the content of meetings of family caregivers and individuals with dementia of the Alzheimer's type who identified and spoke on ethical issues in dementia care and who engaged in dialogue with an interdisciplinary and interprofessional group of individuals working in the field of Alzheimer's disease. This inductive method begins with attentive listening to the voices of the affected population and family members, in contrast with a theoretical and deductive approach to ethics.
Examination of the change strategies associated with successful long-term sobriety remains an und... more Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals with long-term sobriety (range 16-25 years continuous abstinence). Subjects (n = 11 were surveyed on demographic information, problem history, Alcoholics Anonymous (AA) affiliation, and helping behaviors within several life domains over the course of sobriety. General helping behaviors increased from lower levels in the month prior to getting sober, to moderate levels at 1 year of sobriety, but did not continue to increase with additional years of sobriety. Levels of general help to others at home, work, and 12-step programs were similar at varying lengths of sobriety. Whereas overall levels of general help given to others were similar across settings, helping other alcoholics, as opposed to helping others at home or work, was rated as contributing the most to staying sober. Across time, alcoholics increased ...
Journal of evaluation in clinical practice, Jan 29, 2014
Contemporary health care is increasing in complexity and lacks a unifying understanding of episte... more Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as 'patient-centred care' (PCC) typifies system-wide discordance. We contrast the fragmented descriptions of PCC and related tools to its own origins in the writings of Balint and to a subsequent construct, relationship-centred care (RCC). We identify the explicit and elaborated connection between RCC and a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments between RCC and independently developed constructs. Among these, we emphasize Schon's reflective practice, Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying conse...
BACKGROUND AND OBJECTIVES Schwartz Rounds (SR) is an interdisciplinary program that focuses on co... more BACKGROUND AND OBJECTIVES Schwartz Rounds (SR) is an interdisciplinary program that focuses on compassionate care by allowing the formation of an interprofessional community around the human and emotional testimonies of caregivers. The purpose of this study was to examine the impact of implementing departmental SR on pediatric care providers at a tertiary care children’s hospital in New York. METHODS We applied the logic outcomes model for program evaluation to examine the impact of SR on pediatric providers. The standard evaluation form provided by the Schwartz Center was used to collect data after every SR. Descriptive statistics and qualitative data content analysis methods were used to analyze the evaluation data from the SR. RESULTS A total of 820 standard evaluation forms were collected from 17 of the 23 SR sessions offered (response rate: 74.8%). Most participants felt that, during the SR sessions, challenging social and emotional aspects of patient care were discussed and th...
Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at G... more Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.
The emergence of cognition-enhancing drugs in the treatment of Alzheimer disease raises questions... more The emergence of cognition-enhancing drugs in the treatment of Alzheimer disease raises questions about quality of lives for those with dementia and for their caregivers, and about the perceptions of health care professionals. This pilot study analyzes a limited data from a series of three focus groups on the experience of treatment. These groups engaged both Alzheimer disease-affected persons, their caregivers, and a multidisciplinary professional core. We conclude that therapeutic goals need to be better addressed with patients and families, as well as better monitored, with the possibility of withdrawing therapy as appropriate. We also detected, as hypothesized, considerable disparity between the perspectives of professionals and consumers regarding the benefits of therapy.
... Jan Lucas Hoving, PT, PhD Cabrini Medical Centre 3144 Victoria, Australia Bart W. Koes, PhD E... more ... Jan Lucas Hoving, PT, PhD Cabrini Medical Centre 3144 Victoria, Australia Bart W. Koes, PhD Erasmus Medical Center Rotterdam 3000 DR Rotterdam, the Netherlands Henrica CW de Vet, PhD Vrije Universiteit Medical Centre 1081 BT Amsterdam, the Netherlands ...
ddiction is a significant problem among adolescents – it reduces academic performance, increases ... more ddiction is a significant problem among adolescents – it reduces academic performance, increases the likelihood of injury or criminal behavior, and has been estimated to cost US society as much as $500 billion every year. In new research, which builds on the idea that social connection and helping others can have benefits, Byron R. Johnson, Maria E. Pagano, Matthew T. Lee, and Stephen G. Post studied the effects of social isolation on young people who were being treated for alcohol and drug addiction. They find that socially estranged juveniles were more likely to relapse into addiction post-treatment, but also that those who gave help to others as part of the program were less likely to relapse and to commit crimes.
These guidelines summarize the content of meetings of family caregivers and individuals with deme... more These guidelines summarize the content of meetings of family caregivers and individuals with dementia of the Alzheimer's type who identified and spoke on ethical issues in dementia care and who engaged in dialogue with an interdisciplinary and interprofessional group of individuals working in the field of Alzheimer's disease. This inductive method begins with attentive listening to the voices of the affected population and family members, in contrast with a theoretical and deductive approach to ethics.
Examination of the change strategies associated with successful long-term sobriety remains an und... more Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals with long-term sobriety (range 16-25 years continuous abstinence). Subjects (n = 11 were surveyed on demographic information, problem history, Alcoholics Anonymous (AA) affiliation, and helping behaviors within several life domains over the course of sobriety. General helping behaviors increased from lower levels in the month prior to getting sober, to moderate levels at 1 year of sobriety, but did not continue to increase with additional years of sobriety. Levels of general help to others at home, work, and 12-step programs were similar at varying lengths of sobriety. Whereas overall levels of general help given to others were similar across settings, helping other alcoholics, as opposed to helping others at home or work, was rated as contributing the most to staying sober. Across time, alcoholics increased ...
Journal of evaluation in clinical practice, Jan 29, 2014
Contemporary health care is increasing in complexity and lacks a unifying understanding of episte... more Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as 'patient-centred care' (PCC) typifies system-wide discordance. We contrast the fragmented descriptions of PCC and related tools to its own origins in the writings of Balint and to a subsequent construct, relationship-centred care (RCC). We identify the explicit and elaborated connection between RCC and a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments between RCC and independently developed constructs. Among these, we emphasize Schon's reflective practice, Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying conse...
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Papers by Stephen Post