Abstract
Although family engagement at end of life has received attention in the literature, opportunities to better understand what different populations need from us remain. In the first article, Johnstone et al discuss ethnic minority family engagement when providing end-of-life care. Expectations and needs must be sought in all populations, not assumed. The same is true for discharge needs, which Waniga et al explore in a novel set of nurse- and physician-generated discharge instructions and their impact on patient perception. Their study suggests that when both nurses and physicians take an active role in providing well-defined discharge instructions, patient perception of care is increased. Taking it one step further to understand the impact of specific disease needs, Coffey et al provide an in-depth understanding into health information access issues affecting persons with chronic injuries.
In addition, expectations are profoundly impacted and shaped by local culture, whether across the globe or state lines. The article by Ogaji draws our attention to a study of patient-reported experiences with primary health care in Nigeria. This study will serve as a useful model for larger scale collaborations while adding to the limited literature on experiences of care in Nigerian primary health-care settings.
A contribution by Crowell helps us to better understand the process patients experience to obtain medical marijuana in the state of New Jersey. These results highlight important elements in patients’ initial steps toward seeking medical marijuana and key insights into the need to drive the incorporation of medical marijuana into the standard of care, including key barriers that may negatively influence providers’ behavior.
Rounding out this issue, we return to the topic of family engagement with a case study by Michalopoulou et al. The authors highlight the complexity of pediatric care where clinicians must attend both to the child, who is learning health management, and to the family, who is responsible for decisions and care. The authors assert that to establish effective relationships, practitioners must intentionally become more self-aware and sensitive to the family and that developing these skills is critical.
Together, our authors provide insights into relevant issues facing global health care today. We thank our authors, reviewers, and our editorial board for their contributions to this issue. I welcome your feedback at
This piece was displayed in the Art is Good Medicine 2016 Exhibit at Bond University School of Medicine (Gold Coast, Queensland, Australia; March 2016). ©2016 Salvataggio Press, Katrina A. Bramstedt.
A second-year medical student in Australia, Rafia put both heart and creativity to work in this mixed media creation. Inspiration came from an incident during high school when a classmate with a terminal illness was gifted with many handmade paper cranes for encouragement.
In 2014, she started a medical humanities program for medical students, which has several components designed to improve the observation skills of future physicians. In addition to a compulsory mixed media art assignment for second-year medical students, there is the voluntary option for students to display their artwork in an exhibition that is open to the university at large, as well as to the local community. Details about the art curriculum are located at this link: http://journalofethics.ama-assn.org/2016/08/imhl1-1608.html
When doctors provide care for their patients, they often tend to neglect their own physical, social, and mental well-being. This is an issue frequently overlooked by doctors, as they do not address these aspects of their lives and may even engage in health-deteriorating behaviors. The mannequin has its hands outstretched, offering a paper crane to the viewer. This represents a doctor offering treatment to patients and its nonspecificity highlights how this treatment is universal. Both hands were used to hold the crane to accentuate the fact that doctors attempt to put in as much effort as possible when providing care for their patients.
A paper crane was used as the symbol of treatment in my artwork, as it is said in Japanese culture that if an individual folds 1000 paper cranes, he will have one of his wishes granted. In my artwork, the doctor’s efforts to improve patient’s well-being and quality of life are symbolized by the crane. Also, however, the doctor is attempting to subtly push away a “Box of Worries.” The box was placed in this position to illustrate how doctors must set aside their own problems when working to attend to the needs of others, but also ensure that this does not affect their ability to provide treatment or the image presented to the patient. Overall, various elements of the artwork aim to show that a sustainable work–life balance is a pervasive dilemma for doctors. [Excerpt from Art is Good Medicine 2016 Exhibit Book, pages 24-26.]
The Art is Good Medicine 2016 Exhibit Book is available free at this link: https://itunes.apple.com/au/book/art-is-good-medicine/id1132472239?mt=11