Special Issue "Humanities and Healthcare"

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 31 January 2018

Special Issue Editors

Guest Editor
Dr. Ian Walsh

School of Medicine, Queen’s University Belfast, Belfast BT9 7BL, UK
Website | E-Mail
Interests: medicine and humanities; cognition and metacognition; patient safety; healthcare education
Guest Editor
Dr. Helen Noble

School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
Website | E-Mail
Interests: chronic kidney disease; palliative care; qualitative research methods; mixed methods; end of life care

Special Issue Information

Dear Colleagues,

Healthcare involves humans, with human–human and human–machine interactions. This is only one explanation for why healthcare is neither an exact science, nor an entirely artistic pursuit. Effective clinical practice demands mastery of both technical and nontechnical skills, within a complex hierarchy of human interactions. Healthcare systems have evolved in a convoluted fashion, rendering them often opaque and confusing. Central characteristics of healthcare provision, such as compassion and empathy, further complicate the picture. Cracks can appear in a façade that is increasingly (and rightly) concerned with patient safety; it is within these cracks that potential for improvement exists.

Collaboration of healthcare with the arts and humanities augments education and practice, simultaneously providing an invaluable substrate for the humanities; exemplified by humanito-centric narratives and sociomedical interactions. Immersion in arts and humanities allows for a freeing and expansion of cognitive processing for healthcare practitioners, as well as facilitating a deeper appreciation of the human condition. Creative artists can further improve healthcare provision in this way; beyond extant arts-based therapeutic interventions.

Dr. Ian Walsh
Dr. Helen Noble
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • medical humanities

  • arts and medicine

  • arts in healthcare

  • interdisciplinary learning

Published Papers (8 papers)

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Research

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Open AccessArticle “Found Performance”: Towards a Musical Methodology for Exploring the Aesthetics of Care
Healthcare 2017, 5(3), 59; doi:10.3390/healthcare5030059
Received: 30 July 2017 / Revised: 17 August 2017 / Accepted: 24 August 2017 / Published: 18 September 2017
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Abstract
Concepts of performance in fine art reflect key processes in music therapy. Music therapy enables practitioners to reframe patients as performers, producing new meanings around the clinical knowledge attached to medical histories and constructs. In this paper, music therapy practices are considered in
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Concepts of performance in fine art reflect key processes in music therapy. Music therapy enables practitioners to reframe patients as performers, producing new meanings around the clinical knowledge attached to medical histories and constructs. In this paper, music therapy practices are considered in the wider context of art history, with reference to allied theories from social research. Tracing a century in art that has revised the performativity of found objects (starting with Duchamp’s “Fountain”), and of found sound (crystallised by Cage’s 4′ 33) this paper proposes that music therapy might be a pioneer methodology of “found performance”. Examples from music therapy and contemporary socially engaged art practices are brought as potential links between artistic methodologies and medical humanities research, with specific reference to notions of Aesthetics of Care. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
Open AccessArticle Paint it Black: Using Change-Point Analysis to Investigate Increasing Vulnerability to Depression towards the End of Vincent van Gogh’s Life
Healthcare 2017, 5(3), 53; doi:10.3390/healthcare5030053
Received: 24 July 2017 / Revised: 22 August 2017 / Accepted: 23 August 2017 / Published: 4 September 2017
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Abstract
This study investigated whether Vincent van Gogh became increasingly self-focused—and thus vulnerable to depression—towards the end of his life, through a quantitative analysis of his written pronoun use over time. A change-point analysis was conducted on the time series formed by the pronoun
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This study investigated whether Vincent van Gogh became increasingly self-focused—and thus vulnerable to depression—towards the end of his life, through a quantitative analysis of his written pronoun use over time. A change-point analysis was conducted on the time series formed by the pronoun use in Van Gogh’s letters. We used time as a predictor to see whether there was evidence for increased self-focus towards the end of Van Gogh’s life, and we compared this to the pattern in the letters written before his move to Arles. Specifically, we examined Van Gogh’s use of first person singular pronouns (FPSP) and first person plural pronouns (FPPP) in the 415 letters he wrote while working as an artist before his move to Arles, and in the next 248 letters he wrote after his move to Arles until his death in Auvers-sur-Oise. During the latter period, Van Gogh’s use of FPSP showed an annual increase of 0.68% (SE = 0.15, p < 0.001) and his use of FPPP showed an annual decrease of 0.23% (SE = 0.04, p < 0.001), indicating increasing self-focus and vulnerability to depression. This trend differed from Van Gogh’s pronoun use in the former period (which showed no significant trend in FPSP, and an annual increase of FPPP of 0.03%, SE = 0.02, p = 0.04). This study suggests that Van Gogh’s death was preceded by a gradually increasing self-focus and vulnerability to depression. It also illustrates how existing methods (i.e., quantitative linguistic analysis and change-point analysis) can be combined to study specific research questions in innovative ways. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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Open AccessArticle Nurse Perceptions of Artists as Collaborators in Interprofessional Care Teams
Healthcare 2017, 5(3), 50; doi:10.3390/healthcare5030050
Received: 31 July 2017 / Revised: 21 August 2017 / Accepted: 23 August 2017 / Published: 30 August 2017
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Abstract
Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists
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Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists are contributing to interprofessional care teams. A secondary directed content analysis of interviews with 31 nurses on a medical-surgical care unit investigated the roles and impacts of professional artists on the interprofessional care team. The investigation utilized established domains of interprofessional care, including values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork, and created the domain of quality of care. Findings suggest that artists are valued by nurses as members of the interprofessional care team, that they enhance the provision of patient-centered care, and that they improve quality of care by providing holistic dimensions of caring, including cognitive and social engagement, and meaningful interaction. The presence of artists on interprofessional teams provides a cost-effective and welcome resource for clinical staff and builds a culture in which creativity and interdisciplinary collaboration are more highly valued and activated. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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Open AccessArticle Using Jazz as a Metaphor to Teach Improvisational Communication Skills
Healthcare 2017, 5(3), 41; doi:10.3390/healthcare5030041
Received: 16 May 2017 / Revised: 28 July 2017 / Accepted: 31 July 2017 / Published: 4 August 2017
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Abstract
Metaphor helps humans understand complex concepts by “mapping” them onto accessible concepts. The purpose of this study was to investigate the effects of using jazz as a metaphor to teach senior medical students improvisational communication skills, and to understand student learning experiences. The
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Metaphor helps humans understand complex concepts by “mapping” them onto accessible concepts. The purpose of this study was to investigate the effects of using jazz as a metaphor to teach senior medical students improvisational communication skills, and to understand student learning experiences. The authors designed a month-long course that used jazz to teach improvisational communication. A sample of fourth-year medical students (N = 30) completed the course between 2011 and 2014. Evaluation consisted of quantitative and qualitative data collected pre- and post-course, with comparison to a concurrent control group on some measures. Measures included: (a) Student self-reports of knowledge and ability performing communicative tasks; (b) blinded standardized patient assessment of students’ adaptability and quality of listening; and (c) qualitative course evaluation data and open-ended interviews with course students. Compared to control students, course students demonstrated statistically significant and educationally meaningful gains in adaptability and listening behaviors. Students’ course experiences suggested that the jazz components led to high engagement and creativity, and provided a model to guide application of improvisational concepts to their own communication behaviors. Metaphor proved to be a powerful tool in this study, partly through enabling increased reflection and decreased resistance to behaviors that, on the surface, tended to run counter to generally accepted norms. The use of jazz as a metaphor to teach improvisational communication warrants further refinement and investigation. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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Open AccessArticle Healtheatre: Drama and Medicine in Concert
Healthcare 2017, 5(3), 37; doi:10.3390/healthcare5030037
Received: 28 June 2017 / Revised: 20 July 2017 / Accepted: 24 July 2017 / Published: 28 July 2017
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Abstract
Introduction: Clinical practice includes expressing empathy and understanding key features of humanity, such as mortality and illness. The Stanislavski “System” of actor training negotiates a journey from the unconscious via feeling, will and intellect to a proposed supertask. This study explored these areas
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Introduction: Clinical practice includes expressing empathy and understanding key features of humanity, such as mortality and illness. The Stanislavski “System” of actor training negotiates a journey from the unconscious via feeling, will and intellect to a proposed supertask. This study explored these areas during collaborative learning amongst undergraduate medical and drama students. Materials and Methods: Each of two interactive sessions involved teams of final year medical students rotating through challenging simulated clinical scenarios, enacted by undergraduate drama students, deploying key techniques from the Stanslavski system of actor training. Team assessment of performance was via a ratified global scoring system and dynamic debriefing techniques. Results: Medical students reported an enhanced immersive experience within simulated clinical scenarios. Drama students reported increased challenge and immersion within their roles. Medical faculty and standardised patients reported positive utility and value for the approach. Clinical team assessment scores increased by 47% (p < 0.05) with this intervention. Discussion: Qualitative and quantitative data demonstrated the merit and utility of such interdisciplinary learning. All students and faculty appreciated the value of the activity and described enhanced learning. Collaborative dynamic debriefing allowed for a continuation of the immersive experience and allowed for an exploration of arenas such as empathy. Conclusions: The deployment of drama students trained in the Stanislavski system significantly enriched medical and drama student experience and performance. Team assessment scores further demonstrated the effectiveness of this approach. Feedback from students, faculty and standardised patients was uniformly positive. The approach facilitated exploration of empathy. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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Review

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Open AccessReview Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review
Healthcare 2017, 5(2), 19; doi:10.3390/healthcare5020019
Received: 9 March 2017 / Revised: 21 March 2017 / Accepted: 24 March 2017 / Published: 5 April 2017
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Abstract
Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress.
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Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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Other

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Open AccessPerspective Force and Presence in the World of Medicine
Healthcare 2017, 5(3), 58; doi:10.3390/healthcare5030058
Received: 25 July 2017 / Revised: 31 August 2017 / Accepted: 3 September 2017 / Published: 13 September 2017
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Abstract
Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between ‘Force’ and ‘Presence’—the former can be read as combative, the latter as pacific. Modern
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Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between ‘Force’ and ‘Presence’—the former can be read as combative, the latter as pacific. Modern medicine has been shaped historically by the combative metaphor of a ‘war against disease’, turning medicine into a quasi-militaristic culture fond of hierarchy. This is supplemented by the metaphor of the ‘body as machine’, reducing the complex and unpredictable body to a linear, if complicated, apparatus. The two metaphors align medicine with the modern industrial–military complex that is masculine, heroic, and controlling in character. In an era in which medicine is feminising and expected to be patient-centred, collaborative (inter-professional) and transparent to the public as a democratic gesture, the industrial–military metaphor complex should no longer be shaping medicine—yet its influence is still keenly felt, especially in surgery. This continuing dominance of Force over Presence matters because it is a style running counter to the collaborative, team-based medicine needed for high levels of patient safety. Medicine will authentically democratise only as new, pacific shaping metaphors emerge: those of ‘Presence’, such as ‘hospitality’. Hospitals can once again become places of hospitality. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
Open AccessConcept Paper Performable Case Studies in Ethics Education
Healthcare 2017, 5(3), 57; doi:10.3390/healthcare5030057
Received: 2 August 2017 / Revised: 3 September 2017 / Accepted: 8 September 2017 / Published: 12 September 2017
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Abstract
Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the
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Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. Full article
(This article belongs to the Special Issue Humanities and Healthcare)
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