Abstract:
PURPOSE:Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms beyond the physiological processes related to curing. The objective of this study was to determine a definition of healing that operationalizes its mechanisms and thereby identifies those repeatable actions that reliably assist physicians to promote holistic healing. METHODS:This study was a qualitative inquiry consisting of in-depth, open-ended, semistructured interviews with Drs. Eric J. Cassell, Carl A. Hammerschlag, Thomas S. Inui, Elisabeth Kubler-Ross, Cicely Saunders, Bernard S. Siegel, and G. Gayle Stephens. Their perceptions regarding the definition and mechanisms of healing were subjected to grounded theory content analysis. RESULTS:Healing was associated with themes of wholeness, narrative, and spirituality. Healing is an intensely personal, subjective experience involving a reconciliation of the meaning an individual ascribes to distressing events with his or her perception of wholeness as a person. CONCLUSIONS:Healing may be operationally defined as the personal experience of the transcendence of suffering. Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Egnew TRdoi
10.1370/afm.313keywords:
subject
Has Abstractpub_date
2005-05-01 00:00:00pages
255-62issue
3eissn
1544-1709issn
1544-1717pii
3/3/255journal_volume
3pub_type
杂志文章abstract:PURPOSE:Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1053
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical func...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.722
更新日期:2007-09-01 00:00:00
abstract:PURPOSE:Despite the benefits of well-child care visits, up to one-half of these visits are missed. Little is known about why children miss them, so we undertook a qualitative study to elucidate these factors. METHODS:We interviewed 17 caregivers whose children had missed well-child visits and 6 clinicians, focusing on...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2466
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection;...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.1954
更新日期:2016-07-01 00:00:00
abstract:PURPOSE:We undertook a study to evaluate the effectiveness of corticosteroid injections in primary care patients with greater trochanteric pain syndrome (GTPS). METHODS:We evaluated the effect of corticosteroid injections compared with expectant treatment (usual care) in a pragmatic, multicenter, open-label, randomize...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1232
更新日期:2011-05-01 00:00:00
abstract:PURPOSE:We wanted to estimate excess risk of in-hospital mortality associated with medical injuries identified using an injury surveillance system, after controlling for risk of death resulting from comorbidities. METHODS:The Wisconsin Medical Injuries Prevention Program (WMIPP) screening criteria were used to identif...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.553
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:The distinction between physiologic (innocent) and pathologic (organic) heart murmurs is not always easy in routine practice, leading too often to unnecessary cardiology referrals and expensive investigations. We aimed to test the hypothesis that the complete disappearance of murmur on standing can exclude card...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2105
更新日期:2017-11-01 00:00:00
abstract::Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the conflicted physician-patient relationships that can develop even over the short tenure of residency. While residency seeks to create medically prepared and com...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2135
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. METHODS:We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impover...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.601
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:In 2004, we undertook a consultation with Canadian primary health care experts to define the attributes that should be evaluated in predominant and proposed models of primary health care in the Canadian context. METHOD:Twenty persons considered to be experts in primary health care or recommended by at least 2 ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.682
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Chronic hepatitis C, a treatable condition caused by the hepatitis C virus (HCV), can be found in almost all primary care and community practices. The rate of hepatitis C treatment is low, however. This study explores the frequency of hepatitis C treatment, documented discussions of treatment consideration, ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.62
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:Few clinical guidelines focus on how physicians can identify intimate partner violence (IPV) perpetration or victimization among male patients, and little is known of men's experiences and beliefs regarding screening in health care settings. Our objective was to determine prevalence of men's experiences with IP...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2536
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2171
更新日期:2018-01-01 00:00:00
abstract::We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2014
更新日期:2017-03-01 00:00:00
abstract::Physician narratives in family medicine have the potential to convey the vibrant spirit of our field and provide meaningful insights into disease, illness, suffering, and the nature of healing. They may also complement empirical research, education, and practice through their integrative, expressive nature. This true ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.372
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:We hypothesized that antibiotic overuse for acute cough illness (ACI) is in part due to a mismatch between patients' expectations and the natural history of ACI. METHODS:We performed a population-based random digit dialing survey of 493 adults in Georgia to determine their expectations regarding the duration o...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.1430
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Whether patients with 1 or more chronic illnesses are more or less likely to receive recommended preventive services is unclear and an important public health and health care system issue. We addressed this issue in a large national practice-based research network (PBRN) that maintains a longitudinal database d...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1502
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:Shared medical appointments (SMAs) are becoming popular, but little is known about their association with patient experience in primary care. We performed an exploratory analysis examining overall satisfaction and patient-centered care experiences across key domains of the patient-centered medical home among pa...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1660
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Adolescent mothers are at risk for rapidly becoming pregnant again and for depression, school dropout, and poor parenting. We evaluated the impact of a community-based home-visiting program on these outcomes and on linking the adolescents with primary care. METHODS:Pregnant adolescents aged 12 to 18 years, pre...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.629
更新日期:2007-05-01 00:00:00
abstract:PURPOSE:In primary care, the involvement of health care assistants (HCAs) in clinical depression management is an innovative approach. Little is known, however, about how HCAs experience their new tasks. We wanted to describe the perceptions and experiences of HCAs who provided case management to patients with depressi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1037
更新日期:2009-11-01 00:00:00
abstract::Tobacco use, lack of physical activity and poor diet, and alcohol consumption are leading causes of death in the United States. We estimated screening and counseling rates by using a nationally representative sample of adults aged 35 years and older with a preventive care supplement to the 2014 Medical Expenditure Pan...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2363
更新日期:2019-03-01 00:00:00
abstract:PURPOSE:Our goal was to monitor the progress of 3 Healthy People 2010 (HP2010) objectives encouraging self-management education and clinician counseling for weight loss and physical activity among adults with doctor-diagnosed arthritis. METHODS:Using the national 2002 and 2006 National Health Interview Survey (NHIS) a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1210
更新日期:2011-03-01 00:00:00
abstract:PURPOSE:To address doubts regarding National Lung Screening Trial (NLST) generalizability, we analyzed over 6,000 lung cancer screenings (LCSs) within a community health system. METHODS:Our LCS program included 10 sites, 7 hospitals (2 non-university tertiary care, 5 community) and 3 free-standing imaging centers. Pri...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2519
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to trans...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.130
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:We wanted to identify differences between diabetic patients who smoke and those who do not smoke to design more effective strategies to improve their diabetes care and encourage smoking cessation. METHODS:A random sample of adult health plan members with diabetes were mailed a survey questionnaire, with tel...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.36
更新日期:2004-01-01 00:00:00
abstract:PURPOSE:We wanted to understand the views of patients and clinicians on the central concept of healing and to identify major facilitators of and barriers to promoting healing in primary care. METHODS:We undertook a qualitative analysis of focus group discussions. Participants were drawn from primary care clinics of a ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.838
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:Although screening for unipolar depression is controversial, it is potentially an efficient way to find undetected cases and improve diagnostic acumen. Using a reference standard, we aimed to validate the 2- and 9-question Patient Health Questionnaires (PHQ-2 and PHQ-9) in primary care settings. The PHQ-2 compr...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1139
更新日期:2010-07-01 00:00:00
abstract::I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relatio...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1908
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). METHODS:We created recorded ...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1996
更新日期:2017-01-01 00:00:00
abstract:PURPOSE:At this second anniversary of the Annals of Family Medicine, we sought to characterize primary care research and to identify opportunities for new directions by analyzing the content of the first and second volumes of the Annals. METHODS:Using an a priori classification scheme, 2 editors independently categori...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.330
更新日期:2005-05-01 00:00:00