Problem Solving for Better Health-Nursing: Application to a Cancer Hospital in China

October 27th, 2015 in International News

by Airong Lu, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China. ISNCC Corporate and Philanthropic Development Committee Member.

The Dreyfus Health Foundation introduced the “Problem Solving for Better Health®” (PSBH®) program in 1989 in China. The principle underlying the PSBH methodology is that individuals should be empowered to take responsibility for solving health problems that they can address. Thus, the approach is a bottom-up rather than a top-down approach. The model was introduced in the Cancer Hospital of Chinese Academy of Medical Sciences in June 2012.

The PSBH methodology includes a five-step problem-solving process that leads the participant to identify a health problem that he or she can directly address. The five steps to the PSBH process are as follows:

  • Step 1: Define the problem (size, cause, and contributing factors)
  • Step 2: Prioritize the problem (focus on the most important aspect that should be addressed)
  • Step 3: Define a solution. Ask the important questions, such as: what needs to be done, with whom, where things should be implemented, and how long it will take to achieve the desired objective
  • Step 4: Develop an action plan (including why, what, how, where and a means of evaluation)
  • Step 5: Take action

A PSBH workshop was offered to 36 cancer nurses; all the participants were divided into small groups to identify a problem that they could directly address. Participants were introduced to various projects that have been implemented in other PSBH program settings. Group work was emphasized in the workshop, where participants worked together and applied the five-step problem-solving process to identify and tackle the problems. The main roles of the workshop facilitators were to identify the strengths of each group of participants and to support them during the problem solving process. At the end of the workshop, the proposed projects were submitted to the PSBH China program team to review. After revisions were completed, participants were encouraged to implement their projects using resources already available in their hospital, including personnel and equipment.

A total of 31 PSBH projects were developed at the PSBH workshop. All of these projects were approved and received small amounts of seed funding from the Dreyfus Health Foundation. The 31 projects included: a research study related to smoking cessation, the development of evidence-based practice guidelines for the administration of chemotherapeutic agents, improvement of hand hygiene compliance, various quality improvement strategies, and psychological support for oncology nurses. In September 2013, the 31 PSBH nursing projects were completed successfully. About ten articles have been published as a result of the PSBH program at the hospital and 98% of the PSBH participants were satisfied with the workshop. The application of PSBH in our cancer hospital has been successful. It really helped to strengthen the nursing workforce and improve quality of care for cancer patients.

 

Companion Animals in the Workplace

October 13th, 2015 in Reflection

by Nandini Maharaj, The University of British Columbia, Vancouver, Canada.

Many people regard their pets as family members often spending a great deal of time with them inside and outside the home. Having greater access to domestic spaces, some pets even accompany their human companions to work with some people opting for pet-friendly housing and work environments. In my own workplace at the School of Population and Public Health (SPPH), University of British Columbia, there is a Dogs in the Workplace Policy in place that allows faculty, staff, and students to bring their dogs to work with guidelines to ensure the safety and well-being of all those concerned. Along with universities and hospitals, cancer care facilities have embraced companion pets in their complementary and alternative programs. Acknowledging some differences in terminology used in the available literature, animal-assisted therapy (AAT) represents a broad term that can be used to refer to: 1) specific interventions with targeted goals and outcomes that are monitored by medical personnel, and 2) casual, non-directed encounters such as pet visitation involving lay volunteers1.

As the human companion of Dally, an easily excitable English Bulldog (even at nine years old), I would never dream of bringing him to work. Nevertheless, in our quiet moments cuddling together at home or sitting on a bench in the park, I find great solace in the ineffable bond that we share. I feel a sense of pride seeing him bring happiness to other people and appreciate the richness that he adds to my own life. These sentiments speak to a number of issues concerning the role of pets in a therapeutic capacity. First, in deciding whether to get involved in AAT, great care must be taken in choosing a therapy animal including the breed, temperament, and personal attributes. Therapy animals must also receive proper training, certification, and ongoing monitoring. Second, the benefits of pets may extend beyond the individual’s relationship with his or her pet. Pets are often considered to be social lubricants, facilitating interactions between people.

In an oncology setting, nursing staff may also benefit from having an opportunity to interact with therapy animals which in turn may lead to improved communication and engagement between staff and patients1. Finally, being able to experience love and affection through touch and eye contact without any need to communicate verbally can be a tremendous gift for someone coping with a life-altering illness such as cancer. There is some evidence that pets can reduce symptom burden by alleviating pain, fatigue, and emotional distress among cancer patients and other groups1. Thus, even in the absence of a shared language, people and pets are able to engage in a kind of reciprocal communication that, for many people, translates into a profound sense of feeling understood and valued by these cherished companions.

 

Dally taking a break on a bench at the park.

Dally taking a break on a bench at the park.

References

  1. Marcus, D. A. (2012). Therapy dogs in cancer care: A valuable complementary treatment. New York: Springer.
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