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The Role of Humanity For Human Life
The Role of Humanity For Human Life
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Ben-Nun L. Humanity
CONTENTS
INTRODUCTION 4
BIBLICAL VERSES 6
VIRTUE OF HUMANITY 7
HISTORICAL PERSPECTIVES 7
HUMANISTIC MEDICINE 12
HUMANITY TYPES 20
HEALTH CARE 43
EMERGENCY SERVICES
HOSPITAL CARE
INTENSIVE CARE
NUTRITIONAL CARE
HUMANE DOCTOR 60
HUMANISTIC NURSING 65
SUMMARY 100
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INTRODUCTION
Humanity is the human race, which includes everyone on Earth.
It’s also a word for the qualities that make us human, such as the
ability to love and have compassion, be creative, and not be a robot
or alien (1).
Mackay (2) mentioned that humanism includes, among its many
contexts, the ideal of the universal perfection of health. Procedures
for alleviation of disease existed through all epochs of human history,
but efficacy was mostly lacking. The prototypic humanism of the
Renaissance (ad 1300-1600) scarcely involved the medical -sciences
other than human anatomy. The Enlightenment of the seventeenth
century included discovery of the circulation of the blood, and
applications of microscopy. Discoveries relevant to medical practice
began in the nineteenth century, ushered in by vaccination and the
germ theory of disease. This 200-year period saw a transformation of
human health according to the surrogate marker of increased life--
expectancy. This has been variously attributed to 1] increased
prosperity following the industrial revolution, 2] efforts of humanistic
social and public health reformers and, more recently, 3] advances in
medical science. Yet the beneficiaries remain a minority of the
world's population. The nexus between poverty, illness, and low life-
expectancy between and within nations is the major challenge for the
future. Contemporary science is providing ever-expanding
knowledge on means to achieve the goal of perfection of human
health, but the need for humanism is as great as at any previous age.
Fortunately, however, the targets are more clearly visible than during
the periods of poverty, plagues, and pestilence of the past (2).
de Oliveira & Kruse (3) focused on the meanings and
transformations of healthcare humanization along the time through a
literature review. The analysis is pointed out by a reading hypothesis
of Revista Brasileira de Enfermagem (REBEn) and inspired by the
ideas of Michel Focault, especially his discourse concept. It was
identified as discourse appearing condition: the nursing professional
characteristics, the association of humanization meaning to scientific
knowledge and the re-affirmation of its traditional meaning related
to the new health policies. As delimiting instance of discourse, it is
presented: nursing, government, and technology. It is also presented
the sense attributed to humanization since 1970 decade until the
present time (3).
Chan & Nimmon (4) reported that divisive, disabling, and
dangerous power has featured heavily in health professions
literature, social media, and medical education. Negative accounts of
the wielding of power have discolored the lens through which the
public sees medicine and distorted the view of a profession long
associated with healing, humanism, and heart. What has been
buried in the midst of this discourse are positive accounts of power
where the yielding of power is encouraging, empathetic and
empowering. This article offers three personal vignettes illustrating
the ability of power to positively affect lives in the practice of
medicine, for patients and doctors alike. More of these stories are
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Thus, the word humanity is from the Latin humanitas for "human
nature, kindness.” Humanity includes all the humans, but it can also
refer to the kind feelings humans often have for each other.
What is the virtue of humanity? What are the characteristics of
humanistic medicine? What are the features of the humanistic
health care? Hospital care? Nursing? How can the humanity be
promoted? What are the characteristics of education, teaching and
training to advance the humanity?
In this research the Biblical verses dealing with the human
humanity are described. Therefore, the research deals with the role
of humanity in human life.
References
1. humanity - Dictionary Definition: Vocabulary.com.
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2. Mackay IR. Humanism and the suffering of the people. Intern Med
J. 2003;33(4):195-202.
3. de Oliveira CP, Kruse MHL. Humanization and its multiple
discourses - an analysis from REBEn's content. Rev Bras Enferm.
2006;59(1):78-83.
4. Chan M, Nimmon L. Spinning the lens on physician power:
narratives of humanism and healing. Perspect Med Educ. 2019;8(5):305-8.
5. Baertschi B. Faster, higher, stronger… To go where? Transhumanism
and yearning for happiness. J Int Bioethique Ethique Sci. 2018;29(3):170-
88.
6. Hanna DR. Roy's specific life values and the philosophical
assumption of humanism. Nurs Sci Q. 2013;26(1):53-8.
BIBLICAL VERSES
"Then God said, “Let us make man in our image, after our likeness.
And let them have dominion over the fish of the sea and over the
birds of the heavens and over the cattle and over all the earth and
over every creeping thing that creeps on the earth" (Genesis 1:26).
"So God created man in his own image, in the image of God he
created him; male and female he created them" (Genesis 1:27).
"Then the Lord God formed the man of dust from the ground and
breathed into his nostrils the breath of life, and the man became a
living soul " (Genesis 2:7).
"He created them male and female; and blessed them and called
their name Adam, in the day when they were created" (Genesis 5:2).
"And when the Lord smelled a sweet savor, the Lord said in his
heart, “I will not again curse the ground any more for man's sake, for
the imagination of man's heart is evil from his youth; neither will I
ever again smite any more very thing as I have done" (Genesis 8:21).
"You shall not see your brother's ass or his ox fallen down by the
way, and hide thyself from them: you shall surely help him to lift them
up again" (Deuteronomy 22:4).
“If a stranger sojourns with thee in your land, ye shall not vex him.
But the stranger that dwelleth with you shall be unto you as one born
among you, and thou shall love him as thyself…" (Leviticus 19:33-34).
"In whose hand is the life of every living thing, And the breath of
all mankind?" (Job 12:10).
"The desire of a man is his kindness: and a poor man is better than
a liar" (Proverbs 19:22).
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"Give us help from trouble, for vain is the help of man" (Psalm
108:13).
VIRTUE OF HUMANITY
The word humanity is from the Latin humanitas for "human
nature, kindness.” Humanity includes all the humans, but it can also
refer to the kind feelings humans often have for each other. But
when you talk about humanity, you could just be talking about
people as a whole. When people do bad things, it tests his/her faith
in humanity. When people ask for money to help feed starving
children, they're appealing to his/her sense of humanity (1).
Humanity is a virtue linked with basic ethics of altruism derived
from the human condition. It also symbolizes human love and
compassion towards each other. Humanity differs from mere justice
in that there is a level of altruism towards individuals included in
humanity more so than the fairness found in justice (2). That is,
humanity, and the acts of love, altruism, and social intelligence are
typically individual strengths while fairness is generally expanded to
all. Humanity can be classed as one of six virtues that are consistent
across all cultures (3).
The concept goes back to the development of "humane" or
"humanist" philosophy during the Renaissance (with predecessors in
13th-century scholasticism stressing a concept of basic human dignity
inspired by Aristotelianism) and the concept of humanitarianism in
the early modern period, and resulted in modern notions such as
"human rights" (4).
References
1. humanity - Dictionary Definition: Vocabulary.com.
2. Peterson & Seligman 2004, p. 34. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
3. Peterson & Seligman 2004, p. 28. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
4. Humanity. Available at en.wikipedia.org/wiki/Humanity_(virtue).
HISTORICAL PERSPECTIVES
CONFUSIONAL PHILOSOPHY
Confucius said that humanity, or “Ren”, is a “love of people”
stating “if you want to make a stand, help others make a stand” (1).
That is, the Confucian theory of humanity exemplifies the golden
rule. It is so central to Confucian thought that it appears 58 times in
the Analects (2). Similar to the Christian process of seeking God,
Confucius teaches seeking Ren to a point of seemingly divine mastery
until you are equal to, or better than, your teacher (3). The
Confucian concept of Ren encompasses both love and altruism (4).
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References
1. Peterson & Seligman 2004, p. 40. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
2. 4. Chan 1955, p. 296. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
3. 5. Chan 1955, p. 298. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
4. 6. Chan. 1955, p. 312. Available at
en.wikipedia.org/wiki/Humanity_(virtue).
GREEK PHILOSOPHY
Plato and Aristotle both wrote extensively on the subject of
virtues, though neither ever wrote on humanity as a virtue, despite
highly valuing love and kindness, two of the strengths of humanity.
Plato and Aristotle considered "courage, justice, temperance" and
"generosity, wit, friendliness, truthfulness, magnificence, and
greatness of soul" to be the sole virtues, respectively (1).
Available
1. Peterson & Seligman 2004, p. 40. Available
en.wikipedia.org/wiki/Humanity_(virtue).
Reference
1. Etta D. Jackson. The three Abrahamic religions. Available at
unveiling33.wordpress.com/2011/03/24/the-three-abrahamic-religions/#
:~:text=The%20Three%20Abrahamic%20Religions…%20Judaism%2C%20
Islam%20and%20Christianity,to%20the%20Lord%20in%20exchange%20
for%20eternal%20peace.
MEDICAL HISTORY
Warner (1) mentioned that most American historians of medicine
today would be very hesitant about any claim that medical history
humanizes doctors, medical students, or the larger health care
enterprise. Yet, the idea that history can and ought to serve modern
medicine as a humanizing force has been a persistent refrain in
American medicine. This essay explores the emergence of this idea
from the end of the 19th century, precisely the moment when
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References
1. Warner JH. The humanising power of medical history: responses to
biomedicine in the 20th century United States. Med Humanit.
2011;37(2):91-6.
2. Cantor D. Between Galen, Geddes, and the Gael: Arthur Brock,
modernity, and medical humanism in early-twentieth-century Scotland. J
Hist Med Allied Sci. 2005;60(1):1-41.
3. Cordier J-F. Jean Fernel and the humanist spirit. Bull Acad Natl
Med. 2011;195(6):1399-407.
4. Kousoulis AA, Karamanou M, Androutsos G. Andrés Laguna: a great
medical humanist (1499-1559). Acta Med Port. 2011; 24(4): 671-4.
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HUMANISTIC MEDICINE
Little (1) mentioned that "Humanistic medicine" is a term
compounded, for therapeutic purposes, with the good intent of
reminding clinicians of their need to be compassionate and empathic.
Although the expression is arresting, and demands thought, it does
not go far enough. "Values-based medicine" is a stronger term,
reminding clinicians of the sustaining values that underpin the whole
health endeavor. These values include an acceptance of the value of
individual human life in quantity and quality, and of the importance
to both individuals and communities of human security and
flourishing. Values-based medicine can incorporate all the other
paradigms of medicine, including scientific and evidence-based
medicine, within it, because it can include anything that contributes
to human security and flourishing. If we are to seek a new paradigm
for a reconstructed view of health care, the term "values-based
medicine" might have more power and relevance than "humanistic
medicine" (1).
Rosselot (2) noticed that there is an urgent need, in our society,
to recover the real meaning of medicine as a complex of science and
humanistic values committed to person's health care. Following the
initiative of the American Board of Internal Medicine, the American
College of Physicians, and the American Society of Internal Medicine
(ACP-ASIM) and the European Federation of Internal Medicine, the
Medical Professionalism Project has launched a comprehensive
declaration to rephrase the social contract between medicine and
the society, emphasizing the principles and responsibilities that must
orient the thoughts and actions of the good physician. The
importance, soundness, and opportunity of this chart, stimulates an
ample dissemination of these concepts and to incorporate them as
moral assets, integrating the quality, as experts on a scientific
discipline, with the humanistic values provided in this era of
increasing bioethical demands (2).
According to Selzer & Charon (3), in this first article for the
feature Humanism and Medicine, Rita Charon introduces an excerpt
from Richard Selzer's introduction to his latest book, The Doctor
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References
1. Little JM. Humanistic medicine or values-based medicine. what's in
a name? Med J Aust. 2002;177(6):319-21.
2. Rosselot E. Restoring medicine as a scientific and humanist
profession. Rev Med Chil. 2003;131(4):454-6.
3. Selzer R, Charon R. Stories for a humanistic medicine. Acad Med.
1999;74(1):42-4.
4. Forest MI, Olmari-Ebbing M, Bizon M, et al. Medicine and
humanism: clinical ethics and the community dimension of geriatrics. Rev
Med Suisse Romande. 1998;118(12):1013-7.
5. Gordon J. Medical humanities: to cure sometimes, to relieve often,
to comfort always. Med J Aust. 2005;182(1):5-8.
6. Ferry-Danini J. A new path for humanistic medicine. Theor Med
Bioeth. 2018;39(1):57-77.
7. Bernardin J. Medical humanism: pragmatic or personalist? Health
Prog. 1985;66(3):46-9.
8. Miles A. Science, humanism, judgement, ethics: person-centered
medicine as an emergent model of modern clinical practice. Folia Med
(Plovdiv). 2013;55(1):5-24.
9. Marcum JA. Reflections on humanizing biomedicine. Perspect Biol
Med. 2008;51(3):392-405.
10. Thibault GE. Humanism in medicine: what does it mean and why is
it more important than ever? Acad Med. 2019;94(8):1074-7.
11. Figueroa G. At last a humanistic medicine?. Rev Med Chil.
1999;127(1):94-100.
12. Vaes J, Bain PG, Bastian B. Embracing humanity in the face of
death: why do existential concerns moderate ingroup humanization? J Soc
Psychol. 2014;154(6):537-45.
Ben-Nun L. Humanity
professionalism, not only for individual physicians but also for the
medical profession, practicing physicians must incorporate into
practice settings activities that are explicitly designed to exemplify
those values, not only with students and patients, but also within
their communities. The Author cites a number of examples of ways
in which professionalism and humanism can be fostered by individual
physicians as well as professional organizations (1).
According to Cohen (2), the terms professionalism and humanism
are sometimes confused as being synonymous; even more confusing,
each is sometimes regarded as a component feature of the other.
The Author argues that, in the context of medicine, the two terms
describe distinctly different, albeit intimately linked attributes of the
good doctor. Professionalism denotes a way of behaving in
accordance with certain normative values, whereas humanism
denotes an intrinsic set of deep-seated convictions about one's
obligations toward others. Viewed in this way, humanism is seen as
the passion that animates professionalism. Nurturing the humanistic
predispositions of entering medical students is key to ensuring that
future physicians manifest the attributes of professionalism. Medical
educators are encouraged to recognize the role of humanism in
professional development and to incorporate into their curricula and
learning environments explicit means to reinforce whatever
inclinations their students have to be caring human beings. Chief
among those means are respected role models who unfailingly
provide humanistic care, ceremonies that celebrate the attributes of
humanism, awards that honor exemplars of the caring physician, and
serious engagement with the medical humanities to provide vivid
insights into what a humanistic professional is (2).
Hoga (3) reflected upon the humanization of health care, the
demand for which is growing. It involves several complex and
interdependent dimensions. The professional's subjective
perspective and the interpersonal relationship are discussed and
shown to be important factors in the humanization of health care.
The necessity of professional's self-awareness and the awareness of
their defenses are emphasized since they are considered to be
important for the creation of a real encounter between professionals
and patients. These topics are essential for the humanization and
promotion of health care (3).
Chin-Yee & al. (4) reported that medicine in the twenty-first
century faces an 'identity crisis,' as it grapples with the emergence of
various 'ways of knowing,' from evidence-based and translational
medicine to narrative-based and personalized medicine. While each
of these approaches has uniquely contributed to the advancement of
patient care, this pluralism is not without tension. Evidence-based
medicine is not necessarily individualized; personalized medicine may
be individualized but is not necessarily person-centered. As novel
technologies and big data continue to proliferate today, the focus of
medical practice is shifting away from the dialogic encounter
between doctor and patient, threatening the loss of humanism that
many view as integral to medicine's identity. As medical trainees, we
struggle to synthesize medicine's diverse and evolving 'ways of
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References
1. Swick HM. Viewpoint: professionalism and humanism beyond the
academic health center. Acad Med. 2007;82(11):1022-8.
2. Cohen JJ. Viewpoint: linking professionalism to humanism: what it
means, why it matters. Acad Med. 2007;82(11):1029-32.
3. Hoga LAK. Subjective dimension of the professional in the
humanization of health care: a thought. Rev Esc Enferm USP. 2004;
38(1):13-20.
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HUMANITY TYPES
This section deals with various types of humanity, including
preserving humanity, public humanization policies, human
dimensions of care in ambulatory settings, the beginning of human
life, humanization of birth: delivery care, humanized obstetrics, the
problem of spontaneous abortion, childbirth practices, medicalization
and prenatal care, a neonatal and pediatric intensive care unit,
HIV/AIDS children living in shelters under the perspective of nursing,
the family living with Down syndrome, the care interventions in
patients with lower extremity arteriosclerosis obliterans, the effect of
pustulosis, the care of surgery patients, dentistry practices,
homeopathy, the humanization and the formation of the professional
in physiotherapy, rehabilitation, homeless men, sexual relationships
with patients, communicating bad news, the approach between
caregivers and the elderly, palliative care the end of life, planetary
health respond to COVID pandemic, and bias in humanizing negative
characteristics.
PRESERVING HUMANITY
Mann (1) mentioned that preserving humanity in the present
technological age can be a challenge for all health care workers, but
perhaps particularly for staff working within an intensive care
environment. This article highlights some of the potential effects of
such technology on staff, patients, and relatives, particularly bringing
to light some of the disadvantages brought about by the use of such
technology. Areas considered include the role of nurses within a
technological environment, patients' and relatives' reactions to
technology, the potential effect on autonomy and responsibility for
both patients and nurses, economic issues, and finally ethical and
moral issues raised by the advent of further technology. Despite
many positive contributions to nursing care which arise from the use
of technology, there are disadvantages attributed to technology
which have only been mentioned superficially in previous literature
on this subject. The question arises as to whether nurses are able to
balance preserving the humanity of patients with the extensive use
of technology in an intensive care environment today (1).
Reference
1. Mann RE. Preserving humanity in an age of technology. Intensive
Crit Care Nurs. 1992;8(1):54-9.
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Reference
1. Moreira MADM, Lustosa AM, Dutra F, et al. Public humanization
policies: integrative literature review. Cien Saude Colet. 2015;20(10):
3231-42.
Ben-Nun L. Humanity
Reference
1. Gracey CF, Haidet P, Branch WT, et al. Precepting humanism:
strategies for fostering the human dimensions of care in ambulatory
settings. Acad Med. 2005;80(1):21-8.
Reference
1. Schenker JG. The beginning of human life: status of embryo.
Perspectives in Halakha (Jewish Religious Law). J Assist Reprod Genet.
2008;25(6):271-6.
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DELIVERY CARE
de Souza & al. (1) mentioned that this was a qualitative
exploratory study, which aimed to investigate how health
professionals working in delivery care perceive the humanization of
the birth process. Seventeen professionals who work in the area
were interviewed. The data were obtained through semi-structured
interviews and processed through thematic analysis. During the data
analysis three categories emerged: the meaning of humanization of
birth; the humanization practice in the studied services; and
difficulties of the humanization process. The results show that the
humanization of birth care is not yet a common practice in most of
the studied hospitals and that the staff is not prepared to provide a
humanized and qualified service for mothers and newborns. The
data show that it is essential to change the biomedical model from a
mainly technical approach to an approach that values the social and
cultural aspects of pregnancy and delivery (1).
Kruno (2) mentioned that in this paper is a descriptive exploratory
study developed with the objective of getting acquainted with life
experiences, preparation, feelings, and motivations of women who
have chosen home childbirth. The subjects of the research
comprised ten women who had at least one experience of home
childbirth in Porto Alegre, in the last five years. The data was
gathered through semi-structured interviews, which were analyzed
according to Minayo's proposal. It indicates that the women who
opted for home childbirth don't accept what the hospital system
offers to women in labor at present time, but they do recognize that,
for a few women, hospital delivery is the best choice, whether for
reasons that involve personal decisions or health ones (2).
Goer (3) described a survey of a convenience sample of 24
grassroots birth activist groups based in several countries that
revealed remarkable similarities despite differences in culture and
maternity care systems. With few exceptions, they began with a few
individuals, generally women, who were dissatisfied or angry with an
obstetric management system that failed to provide safe, effective,
humane maternity care, that suppressed alternative models of care
and nonconforming practitioners, or both. Responses indicated that
organizational structures tend to fall into a limited number of
categories, and strategies intended to accomplish reform overlap
considerably. All groups have experienced difficulties resulting from
the hegemony of conventional obstetric management and active
opposition of practitioners within that model. Most groups are
volunteer based, and all struggle under the handicap of limited
resources compared with the forces arrayed against them and the
scope of what they hope to accomplish (3).
Neves & al. (4) mentioned that breastfeeding is one of the key
practices which promote health, being associated with a reduction of
diseases and mortality in childhood. Thus, from the course
conclusive work, the present article was structured, which aimed to
recognize the perceptions of mothers in the face of the use of the
mother kangaroo method. With a qualitative, descriptive, and field
approach, it was held at the Philanthropic Hospital of Ponta Grossa,
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References
1. de Souza TG, Gaíva MAM, dos Anjos Modes PSS. The humanization
of birth: how health professionals working in delivery care perceive it. Rev
Gaucha Enferm. 2011;32(3):479-86.
2. Kruno RB, de Lourenzi Bonilha AL. Home delivery as voiced by
women: a perspective at the light of humanization. Rev Gaucha Enferm.
2004;25(3):396-407.
3. Goer H. Humanizing birth: a global grassroots movement. Birth.
2004;31(4):308-14.
4. Neves PN, Ravelli APX, Lemos JRD. Humane care for low-weight
newborns (kangaroo mother method): mother's perceptions. Rev Gaucha
Enferm. 2010;31(1):48-54.
CHILDBIRTH PRACTICES
According to Pereira & al. (1), the humanization of care in
childbirth and the choice of performing cesarean or vaginal delivery
have long been discussed in Brazil and worldwide. The complexities
of the factors surrounding this issue range from the quality of
obstetric care through to the significance of childbirth for women. A
new proposal for humanization of delivery was introduced by the
Brazilian Ministry of Health, the objectives of which were to make
changes to the current system of delivery practices regarding, access,
care, quality, and resolution, in order to make it a more human and
less technical experience. The Sofia Feldman Hospital, in Belo
Horizonte - MG, is a benchmark in the adoption of best practices in
care during childbirth, according to the Brazilian National Health
Agency. However, for the humanization to become a national reality,
there are still many challenges to be overcome within the public
health system and the private partnerships. The most important
problems are related with the current education system that
continues to prepare health professionals to act in an interventional
way, focused on the physician figure. This study aims to provide an
overview about the different humanized care practices focused on
pregnancy and childbirth, conducted in southern and southeastern
Brazil (1).
Nagahama & Santiago (2) characterized hospital care for
childbirth in two hospitals affiliated with the Unified National Health
System in Maringá, Paraná, Brazil, and identify both obstacles and
facilitating factors for the implementation of humanized care, based
on women's perception of the care received. This was an exploratory
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References
1. Pereira RM, de Oliveira Fonseca G, Pereira ACCC, et al. New
childbirth practices and the challenges for the humanization of health care
in southern and southeastern Brazil. Cien Saude Colet. 2018;23(11):3517-
24.
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HUMANIZED OBSTETRICS
Kämpf & al. (1) reported that an initial analysis is made of the way
obstetricians that defend the humanization of childbirth in Brazil
understand and analyze the practice of episiotomy, a conventional
technique included in protocols in obstetrics that they had learned in
medical training and subsequently abandoned. An initial analytical
construct is presented through the prism of the social studies of
science and technology and raise questions about the neutrality of
science and technology and the impartiality of the specialist/scientist.
The relationships were further point out that seem to exist between
political activity, the production of scientific knowledge, and
technical activities in the professional work of the aforementioned
obstetricians (1).
Busanello & al. (2) aimed to analyze the practices developed in
assisting the adolescent, from the account of health workers, in an
Obstetric Center in a teaching hospital, based on the proposal of
humanization of parturition of the Health Ministry. According to the
workers, useful practices in assisting parturition, among them,
orientations about relaxation techniques at parturition, improving
the attachment between mother and child, are being carried out.
However, the right to a companion has not been considered. The
lithotomy position and standardization of trichotomy, episiotomy e
amniotomy were registered. Medical records, among them
partogram, anamnesis and physical and obstetric exam of the
parturient, proved to the unsatisfactory. The data show that, in the
scenario investigated, are developed practices considered
appropriate and inappropriate, showing the need to further
encourage the use of procedures grounded in scientific evidence and
inserted into the proposal to the humanization of birth (2).
References
1. Kämpf C, de Brito Dias R. Episiotomy from the perspective of
humanized obstetrics: reflections based on social studies of science and
technology. Hist Cienc Saude Manguinhos. 2018;25(4):1155-60.
2. Busanello J, da Costa Kerber NP, Mendoza-Sassi RA, et al.
Humanized attention to parturition of adolescents: analysis of practices
developed in an obstetric center. Rev Bras Enferm. 2011; 64(5):824-32.
SPONTANEOUS ABORTION
Blackshaw & Rodger (1) noticed that a substantial proportion of
human embryos spontaneously abort soon after conception, and
ethicists have argued this is problematic for the pro-life view that a
human embryo has the same moral status as an adult from
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Reference
1. Blackshaw BP, Rodger D. The problem of spontaneous abortion: is
the pro-life position morally monstrous? New Bioeth. 2019;25(2):103-20.
PRENATAL CARE
Warmling & al. (1) analyzed how discourses of medicalization and
humanization reconnect in primary healthcare and shape prenatal
care for pregnant women provided by family health teams. This was
a single and integrated case study with multiple analytical units and a
qualitative approach. A total of 17 focus groups were performed, in
which 47 health professionals were heard (14 physicians, 19 nurses,
and 14 dentists), members of 17 family health teams in 16
municipalities in the South of Brazil. The empirical material was
analyzed from the perspective of Foucauldian discourse analysis. The
family health teams, adopting general practice, reported difficulties
in conducting prenatal care, evoking, and bolstering the discourse of
obstetric medicalization that their practice should supposedly offset.
The discourse officially adopted by humanization, prioritized in the
generalist model of prenatal care, continues to function as a
complementary discourse to that of medicalization and
specialization, which prevails in the practices reported by the teams.
The emphasis on humanized care for pregnant women tests the
limits of professional territories and assumes the renegotiation of
competencies. Efforts at collaboration between the family health
teams and obstetricians have not proved very successful in this
specific case (1).
Barreto & al. (2) wanted to know how the approach of public
policy humanization prerequisites and health programs proposed by
the Ministry of Health occur in the practice of prenatal of care usual
risk. This field study used exploratory descriptive qualitative
approach. The survey was conducted from February to June 2014,
with participant observation and semi-structured interviews in four
family health units where five nurses and three doctors attended.
Operative Proposal was chosen for data analysis. The categories
revealed in this study that promoted the humanization of prenatal
care were: The approach and linking of pregnant woman and their
family-to-family health units and permanent education as a facilitator
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References
1. Warmling CM, Fajardo AP, Meyer DE, Bedos C. Social practices in
the medicalization and humanization of prenatal care. Cad Saude Publica.
2018;34(4):e00009917.
2. Barreto CN, Wilhelm , da Silva SC, et al. "The Unified Health System
that works": actions of humanization of prenatal care. Rev Gaucha
Enferm. 2015;36 Spec No:168-76.
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References
1. da Silva LJ, da Silva LR, Christoffel MM. Technology and
humanization of the neonatal intensive care unit: reflections in the context
of the health-illness process. Rev Esc Enferm USP. 2009;43(3):684-9.
2. dos Reis LS, da Silva EF, Waterkemper R, et al. Humanization of
healthcare: perception of a nursing team in a neonatal and paediatric
intensive care unit. Rev Gaucha Enferm. 2013;34(2):118-24.
3. Spir EG, Soares AVN, Wei CY, et al. The companions' perception
about the humanization of assistance at a neonatal unit. Rev Esc Enferm
USP. 2011;45(5):1048-54.
4. de Souza KMO, Ferreira SD. Humanized attention in neonatal
intensive-care unit: senses and limitations identified by health
professionals. Cien Saude Colet. 2010;15(2):471-80.
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for assessing its grade. The main Humanization care programs have
been elaborated and developed both in America (Brazil, USA) and
Europe. The North American and European models specifically
concern pediatric care, while the model developed in Brazil is part of
a broader program aimed at all age groups. The first emphasis is on
the importance of the family in child care, the second emphasis is on
the child's right to be a leader, to be heard and to be able to express
its opinion on the program's own care. Several tools have been
created and used to evaluate humanization of care programs and
related aspects. None, however, had been mutually compared. The
data show that the major models of humanization care and the
related assessment tools here reviewed highlight the urgent need for
a more unifying approach, which may help in realizing health care
programs closer to the young patient's and his/her family needs (8).
Mandato & al. (9) emphasized that as the quality and quantity of
patient-centered care may be perceived differently by recipients and
independent observers, assessment of humanization of pediatric care
remains an elusive issue. Herein the aim was to analyze differences
between the degrees of verified existing vs. perceived humanization
issues of a pediatric ward. Furthermore, the study examined
whether there is concurrence between the degrees of humanization
perceived by users (parents/visitors) vs. staff members. The study
was conducted in the pediatric wards of seven medical centers of the
Campania region (Italy) categorized as general (n=4), children's (n=1),
and university (n=2) hospitals. The degree of existing humanization
was assessed by a multidisciplinary focus group for each hospital
through a pediatric care-oriented checklist specifically developed to
individuate the most critical areas (i.e., those with scores < 2.5). The
degree of perceived humanization was assessed through four
indicators: well-being, social aspects, safety and security, and health
promotion. The focus groups showed that critical areas common to
all centers were mainly concerned with welfare, mediation,
translation, and interpretation services. Specific critical issues were
care and organizational processes oriented to the respect and
specificity of the person and care of the relationship with the patient.
Perceived humanization questionnaires revealed a lack of
recreational facilities and mediation and translation services. As for
specific features investigated by both tools, it was found that
mediation and interpretation services were lacking in all facilities
while patient perceptions and observer ratings for space, comfort,
and orientation concurred only in the general hospital evaluations.
The data demonstrate that future humanization interventions to
ensure child- and family-friendly hospital care call for careful
preliminary assessments, tailored to each pediatric ward category,
which should consider possible differences between perceived and
verified characteristics (9).
According to Tripodi & al. (10), humanization of care (HOC)
interventions has rarely been evaluated and compared. The
outcomes of published interventions aimed to improve the HOC for
hospitalized children was systematically reviewed. PubMed and
Scopus were used as data sources. Studies published between
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References
1. Medeiros HMF, da Graça Corso da Motta M. HIV/AIDS children
living in shelters under the perspective of humanistic nursing. Rev Gaucha
Enferm. 2008;29(3):400-7.
2. Holyoake DD. A little lady called Pandora: an exploration of
philosophical traditions of humanism and existentialism in nursing ill
children. Child Care Health Dev. 1998;24(4):325-36.
3. França APM, Mendes ARB, Barrias MIF. OC34 - Paediatric
rehabilitation: humanizing nursing care to children and their families. Nurs
Child Young People. 2016 May 9;28(4):78.
4. Ullán AM, Fernández E, Belver MH. Humanization through the art of
environment of children's emergency in a hospital. Rev Enferm.
2011;34(9):50-9.
5. Bergan C, Bursztyn I, de Oliveira Santos MC, Tura LFR.
Humanization: social representations of a children's hospital. Rev Gaucha
Enferm. 2009;30(4):656-61.
6. Ceribelli C, Nascimento LC, Pacífico SMR, de Lima RAG. Reading
mediation as a communication resource for hospitalized children: support
for the humanization of nursing care. Rev Lat Am Enfermagem.
2009;17(1):81-7.
7. Kissoon N. Bench-to-bedside review: humanism in pediatric critical
care medicine - a leadership challenge. Crit Care. 2005;9(4): 371-5.
8. Tripodi M, Siano MA, Mandato C, et al. Humanization of pediatric
care in the world: focus and review of existing models and measurement
tools. Ital J Pediatr. 2017 Aug 30;43(1):76.
34
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Reference
1. Ramos AF, Caetano JA, Soares E, Rolim KMC. The family living with
Down syndrome patients in the perspective of Humanistic Theory. Rev
Bras Enferm. 2006;59(3):262-8.
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Reference
1. He Y, Xie C, Xia Y, et al. Humanistic care interventions in patients
with lower extremity arteriosclerosis obliterans. Am J Transl Res.
2021;13(9):10527-35.
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References
1. Kharawala S, Golembesky AK, Bohn RL, Esser D. The clinical,
humanistic, and economic burden of generalized pustular psoriasis: a
structured review. Expert Rev Clin Immunol. 2020;16(3):239-52.
2. Kharawala S, Golembesky AK, Bohn RL, Esser D. The clinical,
humanistic, and economic burden of palmoplantar pustulosis: a structured
review. Expert Rev Clin Immunol. 2020;16(3):253-66.
SURGERY PATIENTS
Medina & Backes (1) mentioned that the understanding and the
respect of the Human Being as an individual, the preoccupation with
his/her feelings, desires and rights, and the orientation for a qualified
care towards the humanization in the attendance of the customer
and family are the guidelines of this work, based on the Humanistic
Theory of Paterson & Zderad (1988). The study was done with fifteen
surgical patients interned in a Hospital in Santa Maria, Rio Grande do
Sul. The accompaniment in the preoperative tried to identify and to
reduce the factors responsible for anxiety, fear and discomfort
caused by the imminence of the surgical act. The key-elements used
in this humanization process regarding the client and his relatives,
were the ability to empathize and verbal and non-verbal
communication. The interaction experienced with the customers
enabled us to assemble technical knowledge (instrumental
rationality) and subjectivity (intuition and affection), developing a
differentiated nursing assistance, with a stronger support and
presence, orientation, and reflection and, safety and comfort to the
customer (the Human Being) attended (1).
Reference
1. Medina RF, Backes VM. Humanism in the care of surgery patients.
Rev Bras Enferm. 2002;55(5):522-7.
DENTISTRY PRACTICES
Nascimento & al. (1) evaluated public health dentistry practices of
two different family health models. Qualitative study conducted with
data obtained from focus groups consisting of 58 dentists working in
the Family Health Strategy for at least three years between August-
October, 2006. The Paideia Family Health Approach was used in the
city of Campinas and the Oral Health Initiative as part of the Family
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References
1. Nascimento AC, Moysés ST, Bisinelli JC, Moysés SJ. Oral health in
the family health strategy: a change of practices or semantics
diversionism. Rev Saude Publica. 2009;43(3):455-62.
2. Moimaz SAS, Lima AMC, Garbin CAS, et al. User evaluation on
dental care in the Unified Health System: an approach from the standpoint
of humanization. Cien Saude Cole. 2016;21(12):3879-87.
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CORONAVIRUS PANDEMIC
Lewis (1) emphasized that the coronavirus pandemic has
shattered our world with increased morbidity, mortality, and
personal/social sufferings. At the time of this writing, we are in a
biomedical race for protective equipment, viral testing, and vaccine
creation in an effort to respond to COVID threats. But what is the
role of health humanities in these viral times? This article works
though interdisciplinary connections between health humanities, the
planetary health movement, and environmental humanities to
conceptualize the emergence of "planetary health humanities." The
goal of this affinity linkage is to re-story health humanities toward
promotion of planetary health and community well-being. Wellbeing
is critical because the main driver of environmental destruction and
decreasing planetary health is coming from non-sustainable
definitions of wellbeing. We need the arts and humanities to help
reimagine the possibility of a sustainable community wellbeing. For
health humanities, a basic role and narrative identity starts to
emerge-we should become a planetary health (and well-being)
humanity (1).
Reference
1. Lewis B. Planetary health humanities-responding to COVID Times. J
Med Humanit. 2021;42(1):3-16.
HOMEOPATHY
Teixeira (1) mentioned that during the last decade, the traditional
medical model has endeavored to retrieve an improvement in the
patient-physician relationship by means of propositions for
humanization in the areas of education, medical care and policies. To
enhance holistic characteristics of non-conventional practices in
health, the incorporation of several aspects of humanities in
understanding the process of the individual's illness, stressing that
the physician's interest in aspects apparently not related to the
impaired organ (history of the patient's life, personality, interests,
etc.) should be added to the technical and less humanized
consultation. Since homeopathy embraces this wide semiological
approach as inherent practice, using the totality of characteristic
symptoms to evaluate organic unbalance and choose means of
treatment, homeopathic clinical practice can significantly contribute
to humanism in medicine (1).
Reference
1. Teixeira MZ. Homeopathy: a humanistic approach to medical
practice. Rev Assoc Med Bras (1992). 2007;53(6):547-9.
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PHYSIOTHERAPY
da Silva & de Fátima de Araújo Silveira (1) presented humanizing
attention and management in the health area at SUS is presented as
a way of qualification on health practices and a challenge to all the
people that work in the area. The research intended to verify the
conception of the physiotherapy graduating students about the
humanization in their formation. The study was conducted in a
qualitative, exploratory, descriptive, comparative, and analytic
approach, and its sample was composed by 24 individuals. The data
collected through semi-structured interviews were submitted to
content analysis, of the thematic kind, proposed by Bardin. The
Authors verified that the conception of the participants when it
comes to the conception about the humanization is: restricted,
superficial and with a lack of scientific knowledge; don't show a
consensus or basis related to the theoretical and even operational
aspects about the humanization in physiotherapy; and its coverage
and applicability aren't entirely demarcated, the view is only focused
on the relation worker/user. They refer to find difficulties in working
as a group and understand its insertion in the attention in health
area. The various bodies of SUS might perform a challenge maker
role in health practices, and for that, one of the necessities is on the
professional formation (1).
Reference
1. da Silva ID, de Fátima de Araújo Silveira M. The humanization and
the formation of the professional in physiotherapy. Cien Saude Colet.
2011;16 Suppl 1:1535-46.
REHABILITATION
Abrams & Gibson (1) argued that rehabilitation enacts a particular
understanding of "the human" throughout therapeutic assessment
and treatment. Following Michel Callon and Vololona Rabeharisoa's
"Gino's Lesson on Humanity," the Authors suggest that this is not
simply a top-down process but is cultivated in the application and
response to biomedical frameworks of human ability, competence,
and responsibility. The emergence of the human is at once a
materially contingent, moral, and interpersonal process. The Authors
begin the article by outlining the basics of the actor-network theory
that underpins "Gino's Lesson on Humanity." Next, we elucidate its
central thesis regarding how disabled personhood emerges through
actor-network interactions. Section "Learning Gino's lesson" draws
on two autobiographical examples, examining the emergence of
humanity through rehabilitation, particularly assessment measures
and the responses to them. The Authors conclude by thinking about
how rehabilitation and actor-network theory might take this lesson
on humanity seriously (1).
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Reference
1. Abrams T, Gibson BE. Putting Gino's lesson to work: Actor-network
theory, enacted humanity, and rehabilitation. Health (London).
2017;21(4):425-40.
HOMELESS MEN
Sumerlin & Privette (1) emphasized that the present humanistic
model for counseling homeless men assumed that counseling goals
evolve from each client's internal frame of reference and may include
a positive adaptation to his homeless experience. The model
encompasses Rogers' necessary components of psychotherapy,
Sullivan's interpersonal theory of psychiatry, Adler's use of wellness
and encouragement, and Privette's peak-performance contribution.
Factor analysis of history of homelessness, background data, ratings
of subjective health and of happiness, and scores on Jones and
Crandall's Short Index of Self-actualization yielded nine factors
relevant to counseling. Empirical support was reported for placing a
counseling services program in a multiservice facility for homeless
persons (1).
Reference
1. Sumerlin JR, Privette G. Humanistic constructs and counseling
homeless men. Psychol Rep. 1994;75(1 Pt 2):611-26.
Reference
1. Leggett A. Origins and development of the injunction prohibiting
sexual relationships with patients. Aust N Z J Psychiatry. 1995;29(4):586-
90.
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Reference
1. Luna-Solis Y. How to say bad news without compromising the
patient's humanity. Rev Peru Med Exp Salud Publica. 2019;36(1):123-7.
Reference
1. Kova P, Laham SM, Haslam N, et al. Our flaws are more human than
yours: ingroup bias in humanizing negative characteristics. Pers Soc
Psychol Bull. 2012;38(3):283-95.
THE ELDERLY
Mota & al. (1) described the use of oral life history as a strategy
for the approach between caregivers and the elderly. The aim is to
contribute to humanization of the relationship between health
professionals and patients. A qualitative descriptive study included a
sample of seven elderly individuals of both sexes and 65 years or
older. Open, semi-structured interviews were conducted, producing
narratives of the patients' life histories. The narratives were later
returned to the participants in the form of personalized booklets for
use as they saw fit. The approach contributed to the formation and
strengthening of bonds between the nursing staff and the elderly and
enhanced both the human and therapeutic aspects of this
relationship (1).
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References
1. Mota CS, Reginato V, Gallian DMC. Oral life history as a humanistic
strategy for the approach between caregivers and the elderly. Cad Saude
Publica. 2013;29(8):1681-4.
2. Rose BK, Osterud HT. Humanistic geriatric health care: an
innovation in medical education. J Med Educ. 1980;55(11):928-32.
Reference
1. Alonso JP. Palliative care: between humanization and
medicalization at the end of life. Cien Saude Colet. 2013;18(9):2541-8.
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HEALTH CARE
Rider & al. (1) emphasized that changes in the organization of
medical practice have impeded humanistic practice and resulted in
widespread physician burnout and dissatisfaction. The objective was
to identify organizational factors that promote or inhibit humanistic
practice of medicine by faculty physicians. From January 1, 2015,
through December 31, 2016, faculty from eight US medical schools
were asked to write reflectively on two open-ended questions
regarding institutional-level motivators and impediments to
humanistic practice and teaching within their organizations. Sixty
eight of the 92 (74%) study participants who received the survey
provided written responses. All subjects who were sent the survey
had participated in a year-long small-group faculty development
program to enhance humanistic practice and teaching. As humanistic
leaders, subjects should have insights into motivating and inhibiting
factors. Participants' responses were analyzed using the constant
comparative method. Motivators included an organizational culture
that enhances humanism, which we judged to be the overarching
theme. Related themes included leadership supportive of humanistic
practice, responsibility to role model humanism, organized activities
that promote humanism, and practice structures that facilitate
humanism. Impediments included top-down organizational culture
that inhibits humanism, along with related themes of non-supportive
leadership, time and bureaucratic pressures, and non-facilitative
practice structures. The data show that while healthcare has evolved
rapidly, efforts to counteract the negative effects of changes in
organizational and practice environments have largely focused on
cultivating humanistic attributes in individuals. The findings suggest
that change at the organizational level is at least equally important.
Physicians in the study described the characteristics of an
organizational culture that supports and embraces humanism.
Suggestions were offered for organizational change that keep
humanistic and compassionate patient care as its central focus (1).
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Costa & al. (9) are concerned a practice of assistance built and
implemented with the health team members of an Oncology and
Radiotherapy Service in a large general hospital in the east part of the
state of Rio Grande do Sul, attempting to make the assistance more
humane. It was a possibility of reflecting with the work team about
the assistance provided to the patients in light of the proposals of
SUS (New Public Health System) and with the perspective of the
humanistic approach and its methodological proposals (9).
References
1. Rider EA, Gilligan MC, Osterberg LG, et al. Healthcare at the
crossroads: the need to shape an organizational culture of humanistic
teaching and practice. J Gen Intern Med. 2018;33(7):1092-9.
2. Kilpatrick AO. The health care leader as humanist. J Health Hum
Serv Adm. 2009;31(4):451-65.
3. Ferreira LR, Artmann E. Pronouncements on humanization:
professionals and users in a complex health institution. Cien Saude Colet.
2018;23(5):1437-50.
4. Gilmartin MJ. Humanism in health care service: the role of
stakeholder management. Nurs Adm Q. 2001;25(3):24-36.
5. de Tarso Puccini P, de Oliveira Cecílio LC. Humanization of
healthcare services and the right to healthcare. Cad Saude Publica. 2004;
20(5):1342-53.
6. Franco NM, Medeiros GF, Silva EA, et al. A model-driven approach
to customize the vocabulary of communication boards: towards more
humanization of health care. Stud Health Technol Inform. 2015;216:800-4.
7. Cheraghi MA, Esmaeili M, Salsali M. Seeking humanizing care in
patient-centered care process: a grounded theory study. Holist Nurs Pract.
2017;31(6):359-68.
8 . Fontaine DK, Briggs LP, Pope-Smith B. Designing humanistic critical
care environments. Crit Care Nurs Q. 2001;24(3):21-34.
9. Busch IM, Moretti F, Travaini G, et al. Humanization of care: key
elements identified by patients, caregivers, and healthcare providers. A
systematic review. Patient. 2019;12(5):461-74.
9. Costa CA, Filho WDL, Soares NV. Humanized care for the oncologic
patient: reflections with the health team. Rev Bras Enferm. 2003;
56(3):310-4.
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References
1. Kogstad RE, Ekeland T-J, Hummelvoll JK. In defence of a humanistic
approach to mental health care: recovery processes investigated with the
help of clients' narratives on turning points and processes of gradual
change. J Psychiatr Ment Health Nurs. 2011;18(6):479-86.
2. Fink EB. Psychiatry's role in the dehumanization of health care. J
Clin Psychiatry. 1982;43(4):137-8.
3. Szasz T. Secular humanism and "scientific psychiatry". Philos Ethics
Humanit Med. 2006 Apr 25;1(1):E5.
4. Allen JG. Psychotherapy is an ethical endeavor: Balancing science
and humanism in clinical practice. Bull Menninger Clin. 2013;77(2):103-
31.
5. Fink EB. Psychiatry's role in the dehumanization of health care. J
Clin Psychiatry. 1982;43(4):137-8.
6. Amieva AN. Psychiatry and humanism in Argentina. Int Rev
Psychiatry. 2016;28(2):133-53.
7. Thifault M-C, Kirouac L. Psychiatric nurses experiences of the
humanization movement during the first and second waves of
deinstitutionalization in Quebec (1960-1990). Rech Soins Infirm. 2019;
(139):99-108.
8. Beltrán-Salazar OA. Healthcare institutions do not favor care.
Meaning of humanized care for people directly participating in it. Invest
Educ Enferm. 2014;32(2):194-205.
9. Kirkpatrick JN, Nash K, Duffy TP. Well rounded. Arch Intern Med.
2005;165(6):613-6.
10. Soberón-Acevedo G, García-Viveros M, Narro-Robles J. New
challenges for humanism in medical practice. Salud Publica Mex. 1994;
36(5):541-51.
11. Kvesić A, Galić K, Vukojević M. Humanism influencing the
organization of the health care system and the ethics of medical relations
in the society of Bosnia-Herzegovina. Philos Ethics Humanit Med. 2019
Sep 14;14(1):12.
EMERGENCY SERVICES
Sousa & al. (1) analyzed the evidence of research carried out on
humanization in urgent and emergency care, considering their
contributions to nursing care. Integrative review of LILACS, CINAHL,
SciELO, Web of Science, SCOPUS, and BDENF databases, was
conducted using the keywords: humanization of care, urgencies,
emergencies, emergency medical services, and nursing. The search
resulted in a total of 133 publications, of which 17 were included in
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the scope of this review. The analysis enabled the elaboration of the
evidence units: 'Reception with Risk Classification: a device with good
results' and 'Barriers and difficulties to use the guidelines of the
National Humanization Policy'. The data indicate that the Reception
with Risk Classification was evidenced as the main device for the
effective implementation of the National Humanization Policy and
there are barriers to its effectiveness related to the organization of
health care networks, structural problems, and multi-professional
work (1).
Viotti & al. (2) examined whether humanity of care and
environmental comfort played a role in moderating the relationship
between waiting time and patient satisfaction in an emergency
department (ED). The study used a cross-sectional and non-
randomized design. A total of 260 ED patients in two hospitals in
Italy completed a self-report questionnaire. Moderated regression
showed that after adjusting for control variables, waiting time was
significantly and inversely associated with patient satisfaction.
Humanity of care and environmental comfort showed a positive and
significant association with patient satisfaction. Finally, the
interaction term between waiting time and humanity of care was
found to be significant, whereas the interaction effect between
waiting time and environmental comfort was not significant. The
conditional effect showed that when humanity of care was low,
waiting time was negatively and significantly related to patient
satisfaction. By contrast, when humanity of care was medium and
high, the relationship between waiting time and patient satisfaction
was not significant. These findings shed light on the key role of
humanity of care in moderating the relationship between waiting
time and patient satisfaction. The complex interrelations emerged
should be carefully considered when interventions to foster patient
satisfaction in an ED context are planned (2).
References
1. Sousa KHJF, Damasceno CKCS, Almeida CAPL, et al. Humanization in
urgent and emergency services: contributions to nursing care. Rev Gaucha
Enferm. 2019 Jun 10;40:e20180263.
2. Viotti S, Cortese CG, Garlasco J, et al. The buffering effect of
humanity of care in the relationship between patient satisfaction and
waiting time: a cross-sectional study in an emergency department. Int J
Environ Res Public Health. 2020 Apr 24;17(8):2939.
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HOSPITAL CARE
Graber (1) noticed that caring and humanism in hospitals exist on
both the organizational and the individual levels. This paper
identifies key organizations and foundations that have succeeded in
promoting or fostering caring environments in hospitals. These
include the Picker Institute, the Baptist Healing Trust, Sage
Consulting, and the Caritas Consortium. Exemplary, caring clinicians
in hospitals are also described. These clinicians developed positive
relationships with patients and in interviews communicated a
number of approaches to express caring to patients. Health and
human services managers can take a number of steps to promote
caring among their clinicians. However, they must implement a
culture and a reward system that encourages humanism (1).
Lima & al. (2) aimed at evaluating the professionals' satisfaction
of a municipal pediatric hospital of Fortaleza with relationship to the
humanization of the attendance in the hospital, as National Program
of Humanization of the Hospital Assistance extolled by ministry of
Health. The descriptive study had as sample 38 professionals. The
data collection was carried out by a questionnaire, being the data
presented in tables. Interaction was detected between the
administration of the hospital and the professionals by internal
discussions to evaluate the service. They consider the work
environment is comfortable for their work practice, therefore some
improvement was indicated. The support for the professionals was
suggested as an improvement point. The professionals suggested
trainings, improvement of the atmosphere of the hospital and quality
of the attendance. It is expected that this study supplies subsidies for
the planning of actions favorable for the humanization of hospital
assistance (2).
Nogueira-Martins & al. (3) analyzed the profile of volunteers and
their work process in hospital humanization. The following
instruments were used: a sociodemographic questionnaire and a
semi-structured interview, applied to 26 volunteer coordinators and
26 volunteers, who belong to 25 hospitals in the metropolitan area of
São Paulo, Southeastern Brazil, between 2008 and 2009. Interviews
were analyzed according to thematic analysis principles. Five main
themes were identified: volunteer profile (age, sex, level of income);
volunteer work organization (volunteer agreement, training);
volunteer-hospital relationship (relationship with hospital
management and employees); motivation (solidarity, previous
experience with family members' or one's own diseases, personal
satisfaction, conflict resolution) and benefits (individual, dual,
collective); and humanization and volunteer activities (patient care,
logistic support, emotional support, development of patients'
abilities, leisure, organization of commemorative events). The data
demonstrate that in the activity developed by volunteers, there are
positive aspects (such as the contribution to hospital humanization)
and negative aspects (such as volunteers performing activities
assigned to employees). Attention should be paid to the regulation
of volunteer activities, especially patient care, and actions that value
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References
1. Graber DR. Organizational and individual perspectives on caring in
hospitals. J Health Hum Serv Adm. 2009;31(4):517-37.
2. Lima FET, Jorge MSB, Moreira TMM. Hospital humanization:
professional satisfaction in a pediatric hospital. Rev Bras Enferm. 2006;
59(3):291-6.
3. Nogueira-Martins MCF, Bersusa AAS, Siqueira SR. Humanization and
volunteering: a qualitative study in public hospitals. Rev Saude Publica.
2010;44(5):942-9.
4. Buffoli M, Bellini E, Bellagarda A, et al. Listening to people to cure
people: the LpCp - tool, an instrument to evaluate hospital humanization.
Ann Ig. 2014;26(5):447-55.
5. de Amorim Gomes AM, Moura ERF, Nations MK, do Socorro Costa
Feitosa Alves M. Ethnic evaluation of hospital humanization by the users
of the Brazilian Unified Health System and their mediators. Rev Esc
Enferm USP. 2008;42(4):635-42.
6. Lemos L. The aspects of humanizing in hospitals for adults. We
learn from pediatric experience!. Acta Med Port. 1996;9(10-12): 383-5.
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INTENSIVE CARE
Luiz & al. (1) aimed to understanding perceptions of family
members and healthcare professionals about humanization at the
Intensive Care Unit (ICU) to direct it to an educational action.
Exploratory descriptive and qualitative study conducted in an ICU
level 3 of a public hospital in Porto Alegre, RS, Brazil, with fourteen
subjects, eight family members and six healthcare professionals.
Data collection carried out through semi-structured interviews and
focus group. Content Analysis was used. Emerged categories were
welcoming; communication; ethical and sensible professionalism;
unfavorable aspects; perception on humanization; and
religiosity/spirituality. Although the subjects have expressed their
perceptions about humanization in different ways, both groups
pointed out the same needs and priorities to improve humanization
in Intensive Care. From the results, a reflective manual of
humanizing assistance practices was created for professionals, a
board to facilitate communication of these professionals with
patients and a guideline book for family members (1).
Mongiovi & al. (2) mentioned that The National Policy of Care
Humanization and Health System Management are configured as a
complex public policy which encompasses the structural, technical,
and relational aspects of the health service. However, this policy has
failed at establishing the boundaries of its activities and the
conceptual aspects of the humanization term. This study aimed to
perform a reflection about the humanization of health through a
conceptual analysis of the term itself and in the interpretation of
speeches of nurses working in Intensive Care Units, collected in
qualitative research. It was concluded that nurses have an intuitive
insight of the definition of humanization, understanding the necessity
of conducting a holistic assistance beyond mere technique and also
covering the physiological, psychological, social, and spiritual aspects
of care. At the same time, they demonstrate the lack of preparation
in professional education for the implementation of this humanized
assistance (2).
Evangelista & al. (3) mentioned that the aim was to understand
the meaning of humanized care in intensive care units considering
the experience of the multidisciplinary team. This was a descriptive
and exploratory qualitative research. For this purpose, semi-
structured interviews were conducted with 24 professionals of the
heath-care team, and, after transcription, the qualitative data were
organized according to content analysis. From two main categories,
the Authors were able to understand that humanized care is
characterized in the actions of healthcare: effective communication,
team work, empathy, singularity, and integrality; and
mischaracterized in the management processes, specifically in the
fragmentation of the work process and health care, in the precarious
work conditions, and in differing conceptual aspects of the political
proposal of humanization. The data show that care activities in
intensive therapy are guided by the humanization of care and
corroborate the hospital management as a challenge to be overcome
to boost advances in the operationalization of this Brazilian policy (3).
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Rico & al. (4) analyzed those aspects of the relationship between
the health care team of an ICU that may be decisive in the
construction of humanized care. This was phenomenology:
descriptive and exploratory study. Analysis and observation unit
included Polyvalent 23-bed adult ICU. Nine extensive interviews
were collected. Healthcare professionals in interaction in the ICU
were studied. Analysis included assigning of data to emergent
categories. Contrasting with existing theories. Identification of
guideline values circumspect to the humanistic paradigm. The value
of professional role is accepted as emergency factor of certain
attitudes. All the professional groups detect lack of independence
situations, which are not always attributable to hierarchical reasons.
Systematic interdisciplinary communication is evaluated positively.
Humanization requires time, resources, and intergroup relationships
and explicit commitment by the institution. The data demonstrate
that relief of great suffering situations is the main reason for
interdisciplinary disagreement. Construction of a tolerant setting and
institutional recognition as factors favoring humanized care. Lack of
time and resources as obstacles to the humanization of care (4).
Harvey (5) mentioned that when the pregnant woman becomes
critically ill, it is essential that she and her fetus receive the care that
a specialized ICU provides. This unit is the setting for an expert
medical, nursing, and technical staff to use sophisticated, state-of-
the-art equipment for intensive monitoring and the immediate life-
saving interventions that may be necessary. However, care in an ICU
sometimes becomes focused on the machinery, rather than on the
patient. It is imperative that the humanizing aspects of critical care
be addressed in caring for a pregnant patient and her family.
Obstetric critical care can benefit from the data in the critical care
literature that addresses family and patient needs in an ICU.
Obstetric literature and past experiences in implementing family-
centered maternity care also can be used to identify the need for
humane care and to enhance the ICU experience (5).
Ashworth (6) mentioned that at surface level it is obvious that
high technology and humanity are involved in intensive care, since
many sophisticated biomedical techniques and machines are used,
and all varieties of humankind may pass through ICUs. But it is
important to consider the title topic, and it is proposed here to
consider first high technology, then human aspects of intensive care,
and the context which affects both (6).
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References
1. Luiz FF, Caregnato RCA, da Costa MR. Humanization in the intensive
care: perception of family and healthcare professionals. Rev Bras Enferm.
2017;70(5):1040-7.
2. Mongiovi VG, de Cássia Cordeiro Bastos Leite dos Anjos R, Soares
SBH, Lago-Falcão TM. Conceptual reflections on health humanization:
conception of nurses from intensive care units. Rev Bras Enferm.
2014;67(2):306-11.
3. Evangelista VC, da Silva Domingos T, Siqueira FPC, Mara Braga EM.
Multidisciplinary team of intensive therapy: humanization and
fragmentation of the work process. Rev Bras Enferm 2016; 69(6):1099-107.
4. Rico LR, Marsans MC, Márquez CM, et al. Interdisciplinary
relationships and humanization in intensive care units. Enferm Intensiva.
2006;17(4):141-53.
5. Harvey MG. Humanizing the intensive care unit experience.
NAACOGS Clin Issu Perinat Womens Health Nurs. 1992;3(3):369-76.
6. Ashworth P. High technology and humanity for intensive care.
Intensive Care Nurs. 1990;6(3):150-60.
NUTRITIONAL CARE
Pedroso & al. (1) analyzed the actions of alimentary and
nutritional care considering the perspectives of the nutritionists in a
hospital reference for the National Politics of Humanization (PNH).
From a qualitative approach, a focal group technique was used. The
nutritionists were divided in two groups by working time, following
homogeneity criteria. The interviews were developed for analysis of
the category: Being a nutritionist for a humanized assistance, seeking
to understand these professionals' following actions: nutritional
evaluation of the patient; planning, implementation, and evaluation
of the nutritional and alimentary care. The analysis of the content
was used as a technique for the systematization of the collected
information grouped in units of meaning. The study disclosed that
there is prioritization of the individualized assistance in function of
the number of beds and bureaucratic activities, lack of autonomy in
relation to the prescription of diets, difficulties of interaction with
other health professionals and between the nutritionists of the
clinical and meal production areas. The results will provide the
professional subsidies that substantiate actions for the construction
of a model of humanized alimentary and nutritional care on hospitals
(1).
Demário & al. (2) mentioned that the objective of the study was
to know the perception of patients about feeding in a reference
hospital for the National Humanization Politics. It is qualitative
research with twenty-six in depth and half-structuralized interviews
had been carried through. The interviews were applied to internee
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patients (adults and elders) with four or more days in health clinic.
The study revealed that the patients approved the good attendance
and the humanized health team care. The feeding is perceived as
part of the institution rules, relating it with the disease and the
health recovery. Also, the companion presence, the hospital
environment, medicines, and sensorial aspects are considered to
influence the feeding acceptance. The meal time was considered a
model to be followed. The patients had demonstrated difficulty in
revealing opinions about changes in the feeding or routines. The
meal time is an interaction moment among the patients,
companions, and health team. The study concluded that in order to
eat well in a hospital depends on what the patients is allowed to
because of their diseases, showing that, there is no hospital food
identification with their feeding history, preferences, or habits in life
(2).
References
1. Pedroso CGT, de Sousa AA, de Salles RK. Hospital nutritional care:
perception of the nutritionist for humanized attendance. Cien Saude
Colet. 2011;16 Suppl 1:1155-62.
2 . Demário RL, de Sousa AA, de Salles RK. Hospital food: perceptions
of patients in a public hospital with a proposal of humanized care. Cien
Saude Colet. 2010;15 Suppl 1:1275-82.
HUMANE DOCTOR
Charlton (1) mentioned that the holistic doctor is sometimes
proposed as an ideal. However, holism involves an expansion of
medical categories to encompass most of 'normal' life as well as
sickness. The humane doctor is suggested as a better ideal. He or
she is wise, compassionate, and liberally educated; and knows that
there is more to life than medicine-both for doctors and their
patients. Humane practice is promoted by a broad and rigorous
education but inhibited by excessive busyness and pressurized
conditions of work. This has implications for medical training and
work practices (1).
Chou & al. (2) emphasized that humanism is fundamental to
excellent patient care and is therefore an essential concept for
physicians to teach to learners. However, the factors that help
attending physicians to maintain their own humanistic attitudes over
time are not well understood. The Authors attempted to identify
attitudes and habits that highly humanistic physicians perceive allow
them to sustain their humanistic approach to patient care. In 2011,
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approach to the patient and the root causes of health problems that
can be reconciled with the concept of the patient as a person, which
is an essential theoretical element in humanistic medicine. This
question was answered through a comparative analysis of the
theories of primary care doctor Eric Cassell and systems biologist
Denis Noble. The Authors argue that, although systems biological
concepts, notably Noble's theory of biological relativity and
downward causation, are highly relevant for understanding human
beings and health problems, they are nevertheless insufficient in fully
bridging the gap to humanistic medicine. Systems biologists are
currently unable to conceptualize living wholes, and seem unable to
account for meaning, value and symbolic interaction, which are
central concepts in humanistic medicine, as constraints on human
health. Accordingly, systems medicine as currently envisioned
cannot be said to be integrative, holistic, personalized, or patient-
centered in a humanistic medical sense (4).
Sevilla-Godínez & Sevilla (5) presented a critical analysis of
current society making emphasis on the human needs to generate
domain among equals, as well as the sense of competition and
division that this creates. It addresses the process of dehumanization
that the same civilization has generated focusing on Laboral
paradigm of our days and the weak social justice that unequal wealth
distribution has generated. It has been seen that health
professionals involved in such context, have not escaped socio-
cultural pressure and postmodern neo-liberal position. The paper
discusses about the humanizing role health professionals have in
society, and the relevance of the philosophical exercise in their acts
above human frailty. Finally, it is suggested an alternative for
repositioning to himself and society (5).
Abbott (6) examined humanism as exhibited in physicians and to
develop and standardize an instrument measuring humanism in
physicians. This study had four specific objectives: 1] to determine
whether family practice residents are more humanistic than internal
medicine and surgery residents, 2] to determine whether there is a
difference in the level of humanism in residents in different years of
training, 3] to determine the relationship of demographic
characteristics to level of humanism, and 4] to determine the
relationship of family practice residency characteristics to level of
humanism. The Physician Humanism Scale was developed,
pretested, modified, and then administered to a sample (600) of
family practice, internal medicine, and surgery residents. The study
identified that family practice residents are significantly more
humanistic than internal medicine and surgery residents, although no
difference in level of humanism was identified according to year in
residency. Significant relationships were identified between
humanism and sex, race, age, marital status, and college major.
Residency characteristics significantly related to humanism were
numbers of residents, full-time faculty, nonphysician faculty, and
associated residencies; hospital size; and moonlighting policy (6).
Linn & al. (7) mentioned that in an extensive survey of
postgraduate physicians in two teaching hospitals (n=141) for their
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Fourteen students completed the elective, seven for each year it was
given. Students submitted 86 written pieces. Qualitative analysis
demonstrated the presence of nine themes: students' role confusion,
developing a professional identity, medicine as a calling, physician
privilege and power, humanizing the teacher, the limits of medicine,
death and dying, anticipating future challenges, and identification
with the patient. Students evaluated this creative writing course
favorably, indicating value in writing and reflection. Themes covered
are of concern to second-year medical students as well as other
trainees and practicing physicians. Writing may aid in the
professional development of physicians (9).
References
1. Charlton BG. Holistic medicine or the humane doctor? Br J Gen
Pract. 1993;43(376):475-7.
2. Chou CM, Kellom K, Shea JA. Attitudes and habits of highly
humanistic physicians. Acad Med. 2014;89(9):1252-8.
3. Arnold RM, Povar GJ, Howell JD. The humanities, humanistic
behavior, and the humane physician: a cautionary note. Ann Intern.
1987;106(2):313-8. Erratum in Ann Intern Med. 1987;106(5):784.
4. Vogt H, Ulvestad E, Eriksen TE, Getz L. Getting personal: can systems
medicine integrate scientific and humanistic conceptions of the patient? J
Eval Clin Pract. 2014;20(6):942-52.
5. Sevilla-Godínez HT, Sevilla E. The physician's humanizing role.
Philosophical view of socio-anthropological work in medicine. Rev Med
Inst Mex Seguro Soc. 2010;48(1):87-90.
6. Abbott LC. A study of humanism in family physicians. J Fam Pract.
1983;16(6):1141-6.
7. Linn LS, Cope DW, Robbins A. Sociodemographic and premedical
school factors related to postgraduate physicians' humanistic
performance. West J Med. 1987;147(1):99-103.
8. Weaver MJ, Ow CL, Walker DJ, Degenhardt EF. A questionnaire for
patients' evaluations of their physicians' humanistic behaviors. J Gen
Intern Med. 1993;8(3):135-9.
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HUMANISTIC NURSING
Watson (1) offered a new view of old and timeless values: the
essential ethic of love, informed by contemporary European
philosophies, and caring theory, as well as ancient poetry and
wisdom traditions. It integrates some of the philosophical views of
Levinas and Logstrup with Watson's Transpersonal Caring Theory.
The metaphysics, metaphors, and meanings associated with "ethics
of face," the "infinity of the human soul," and "holding another's life
in our hands" are tied to a deeply ethical foundation for the timeless
practice of love and caring, as a means to sustain, not only our shared
humanity, but the profession of nursing itself (1).
Wu & Volker (2) presented a discussion of the relevance of
Humanistic Nursing Theory to hospice and palliative care nursing.
The World Health Organization has characterized the need for expert,
palliative, and end-of-life care as a top priority for global health care.
The specialty of hospice and palliative care nursing embraces a
humanistic caring and holistic approach to patient care. As this
resonates with Paterson and Zderad's Humanistic Nursing Theory, an
understanding of hospice nurses' experiences can be investigated by
application of relevant constructs in the theory. This article is based
on Paterson and Zderad's publications and other theoretical and
research articles and books focused on Humanistic Nursing Theory
(1976-2009), and data from a phenomenological study of the lived
experience of Taiwanese hospice nurses conducted in 2007.
Theoretical concepts relevant to hospice and palliative nursing
included moreness-choice, call-and-response, intersubjective
transaction, uniqueness-otherness, being and doing and community.
The philosophical perspectives of Humanistic Nursing Theory are
relevant to the practice of hospice and palliative care nursing. By
'being with and doing with', hospice and palliative nurses can work
with patients to achieve their final goals in the last phase of life. The
data demonstrate that use of core concepts from Humanistic Nursing
Theory can provide a unifying language for planning care and
describing interventions. Future research efforts in hospice and
palliative nursing should define and evaluate these concepts for
efficacy in practice settings (2).
Silva (3) represented the integration of a reflected nursing
experience, an organizing theoretical framework, and the
illumination from selected literature. The genesis of this work came
with an invitation to recall a treasured story of caring in nursing
practice. The story is situated within the nursing theoretical
framework of Paterson and Zderad's humanistic work. Relevant
selections from the literature provide thematic insights into the
meaning of caring as lived in nursing practice (3).
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for patients facing death, pain and suffering are a constant concern
for a head nurse who desires both the personal and professional
development for her staff, and the best possible recovery for the
patients in their care (21).
Del Mar Molero Jurado & al. (22) mentioned that healthcare
professionals may have certain psychological characteristics which
contribute to increasing the quality of their professional
performance. Study the effect that humanization of care and
communication have on the burnout syndrome in nursing personal.
The sample included a total of 330 Spanish nurses. Analytical
instruments used were the Health Professional's Humanization Scale
(HUMAS), Communication Styles Inventory Revised (CSI-R) and Brief
Burnout Questionnaire Revised (CBB-R). Two broad nursing profiles
could be differentiated by their level of humanization (those with
scores over the mean and those with scores below it in optimistic
disposition, openness to sociability, emotional understanding, self-
efficacy, and affection), where the largest group had the high scores.
A communication repertoire based on verbal aggressiveness
impacted indirectly on the effect of humanization on burnout, mainly
in the personal impact component. The relation of humanization
profiles was observed in nursing staff with the job dissatisfaction and
burnout components. Besides that, some communication styles,
verbal aggressiveness and questioningness, have an indirect effect on
the relationship between humanization profiles and job
dissatisfaction. The results on the relationship between
communication styles and burnout, and the mediator effect of
communication styles on the relationship between humanization of
care and burnout in nursing personnel are discussed (22).
Pott & al. (23) carried out descriptive, quantitative study at a
University Hospital in Curitiba-PR, Brazil. The objective was to analyze
the caring actions performed at a semi-intensive care unit, from the
perspective of the caring humanization, and also to evaluate the
presence of comfort and communication measures in performing
these actions. The data collection occurred under a systematic non-
participant observation. The caring actions were grouped, according
to its frequency, and presented in graphs. The comfort measures
were present at 45% of the caring actions performed, and
communication establishment was present at 40% of these actions.
Even today, the comfort and communication measures, as reflected
in the process of caring humanization, remain as an ideal speech.
However, they are too far from reality of the health care system's
users and workers (23).
Walsh (24) based this paper on a phenomenological study of the
nurse-patient encounter, the purpose of which was to uncover
meaning and generate understandings of being a psychiatric nurse.
The study was informed by the phenomenology of Martin Heidegger
(1962) and the philosophical hermeneutics of Hans-Georg Gadamer
(1975). Drawing upon this phenomenological study it is the Author's
intention to discuss three of the existential elements to emerge from
an interpretative analysis of these encounters; 'Being-with' as
understanding, 'Being-with' as possibility, and 'Being-with' as 'care-
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References
1. Watson J. Love and caring. Ethics of face and hand - an invitation to
return to the heart and soul of nursing and our deep humanity. Nurs Adm
Q. 2003;27(3):197-202.
2. Wu HL, Volker DL. Humanistic Nursing Theory: application to
hospice and palliative care. J Adv Nurs. 2012;68(2):471-9.
3. Silva TN. Paterson and Zderad's humanistic theory: entering the
between through being when called upon. Nurs Sci Q. 2013;26(2):132-5.
4. Mulholland J. Nursing, humanism and transcultural theory: the
'bracketing-out' of reality. J Adv Nurs. 1995;22(3):442-9.
5. Betran Salazar OAB. Humanized care: a relationship of familiarity
and affectivity. Invest Educ Enferm. 2015;33(1):17-27.
6. Collet N, Rozendo CA. Humanization and nursing work. Rev Bras
Enferm. 2003;56(2):189-92.
7. Casate JC, Corrêa AK. Humanization in health care: knowledge
disseminated in Brazilian nursing literature. Rev Lat Am Enfermagem.
2005;13(1):105-11.
8. Braun JL, Baines SL, Olson NG, et al. The future of nursing:
combining humanistic and technological values. Health Values. 1984;
8(3):12-5.
9. de Azevedo Michelan VC, Spiri WC. Perception of nursing workers
humanization under intensive therapy. Rev Bras Enferm. 2018;71(2):372-8.
10. McCaffrey G. A humanism for nursing? Nurs Inq. 2019;26(2):
e12281.
11. Yeh M-Y, Lee S. The spirit of humanism should be cultivated in the
nursing profession. Hu Li Za Zhi. 2011;58(5):12-6.
12. Nelson S. Humanism in nursing: the emergence of the light. Nurs
Inq. 1995;2(1):36-43.
13. de Medeiros AC, de Siqueira HCH, Zamberlan C, et al.
Comprehensiveness and humanization of nursing care management in the
Intensive Care Unit. Rev Esc Enferm USP. 2016;50(5):816-22.
14. Khademi M, Mohammadi E, Vanaki Z. A grounded theory of
humanistic nursing in acute care work environments. Nurs Ethics. 2017;
24(8):908-21.
15. Mendes IA, Trevizan MA, Nogueira MS, Hayashida M. Humanistic
approach to nursing communication: the case of a hospitalized adolescent
female. Rev Bras Enferm. 2000;53(1):7-13.
16. Mendes IA, Trevizan MA, Nogueira MS, Sawada NO. Humanizing
nurse-patient communication: a challenge and a commitment. Med Law.
1999;18(4):639-44.
17. Betran Salazr OA. The meaning of humanized nursing care for
those participating in it: importance of efforts of nurses and healthcare
institutions. Invest Educ Enferm. 2016;34(1):18-28.
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Barbosa & al. (10) mentioned that the NPH aims at innovations in
health production, management, and care with emphasis on
permanent education for workers in the Unified Public Health System
and training of university students in the health care field. This study
aimed to know, through an integrative review of the literature, the
scientific production about the NPH and education of health care
professionals, from 2002 to 2010. Ten articles were analyzed in
thematic strand through three axes: humanization and users caring,
humanization and the work process, humanization, and training. The
articles point to the need to overcome the biological conception,
valuing cultural aspects of users. The work process is marked by the
devaluation of workers and by users deprived of their rights. The
training of health professionals is grounded in health services where
the prevailing standards are practices that hinder innovative
attitudes (10).
References
1. Zanfolim LC, de Fáccio Azevedo AC, de Almeida Santos L, Buriola AA.
Comprehension of community healthcare agents on the National
Humanization Policy. Rev Gaucha Enferm. 2015;36(3):36-41.
2. de Moraes Chernicharo I, da Silva de Freitas FD, de Assunção
Ferreira M. Humanization in nursing care: contribution to the discussion
about the National Humanization Policy. Rev Bras Enferm.
2013;66(4):564-70.
3. da Silva RN, da S de Freitas FD, de Araújo FP, de A Ferreira M. A
policy analysis of teamwork as a proposal for healthcare humanization:
implications for nursing. Int Nurs Rev. 2016;63(4): 572-9.
4. Ribeiro JP, Gomes GC, Thofehrn MB. Health facility environment as
humanization strategy care in the pediatric unit: systematic review. Rev
Esc Enferm USP. 2014;48(3):530-9.
5. Santos-Filho SB. Perspectives of the evaluation of Brazil's National
Health Humanization Policy: conceptual and methodological aspects. Cien
Saude Colet. 2007;12(4):999-1010.
6. Nora CRD, Junges JR. Humanization policy in primary health care: a
systematic review. Rev Saude Publica. 2013;47(6):1186-200.
7. de Oliveira BRG, Collet N, Viera VS. Humanization in health care.
Rev Lat Am Enfermagem. 2006;14(2):277-84.
8. Pasche DF, Passos E, Hennington EA. Five years of the National
Policy of Humanization: the trajectory of a public policy. Cien Saude Colet.
2011;16(11):4541-8.
9. Serruya SJ, Cecatti JG, di Giacomo do Lago T. The Brazilian Ministry
of Health's Program for Humanization of Prenatal and Childbirth Care:
preliminary results. Cad Saude Publica. 2004; 20(5):1281-9.
10. Barbosa GC, Meneguim S, Lima SAM, Moreno V. National policy of
humanization and education of health care professionals: integrative
review, Rev Bras Enferm. 2013;66(1):123-7.
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EDUCATION
Beaudoin & al. (1) mentioned that the acquisition and nurturing
of humanistic skills and attitudes constitute an important aim of
medical education. In order to assess how conducive, the physician-
learning environment is to the acquisition of these skills, the Authors
determined the extent to which clinical teachers are perceived by
their trainees as humanistic with patients and students, and they
explored whether undergraduate and graduate students share the
same perceptions. A mail survey was conducted in 1994/95 of all
senior clerks and second-year residents at Laval University, University
of Montreal, and University of Sherbrooke medical schools. Of 774
trainees, 259 senior clerks and 238 second-year residents returned
the questionnaire, for an overall response rate of 64%. Students'
perceptions of their teachers were measured on a 6-point Likert scale
applied to statements about teachers' attitudes toward the patient (5
items) and toward the student (5 items). On average, only 46% of
the senior clerks agreed that their teachers displayed the humanistic
characteristics of interest. They were especially critical of their
teachers' apparent lack of sensitivity, with as many as 3 out of 4
declaring that their teachers seemed to be unconcerned about how
patients adapt psychologically to their illnesses (75% of clerks) and
that their teachers did not try to understand students' difficulties
(78%) or to support students who have difficulties (77%). Compared
with the clerks, the second-year residents were significantly less
critical, those with negative perceptions varying from 27% to 58%,
40% on average. Except for this difference, their pattern of
responses from one item to another was similar. This study suggests
the existence of a substantial gap between what medical trainees are
expected to learn and what they actually experience over the course
of their training. Because such a gap could represent a significant
barrier to the acquisition of important skills, more and urgent
research is needed to understand better the factors influencing
students' perceptions (1).
Casate & Corrêa (2) performed this literature review was for the
purpose of surveying and analyzing the scientific production in health
in Brazilian journals regarding the teaching of health care
humanization in undergraduate programs. The bibliographic survey
was performed on the LILACS database using the term humanization,
including texts published between 2000 and 2010 and examining 42
articles. The analysis of these articles revealed the following central
themes: Humanization: some thoughts on its concepts; University
and the National Curriculum Guidelines for Undergraduate Programs
in Healthcare: relations with the teaching of humanization; Curricular
changes, contents, and teaching-learning strategies regarding
humanized care; and Subjects of the teaching-learning process:
students and faculty learning the humanization of care. Some
theoretical and practical elements have been created about the
teaching of humanization in the context of health; however, it is
essential to make greater investments to effectively develop new
ways of providing care (2).
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References
1. Beaudoin C, Maheux B, Côté L, et al. Clinical teachers as humanistic
caregivers and educators: perceptions of senior clerks and second-year
residents. CMAJ. 1998;159(7):765-9.
2. Casate JC, Corrêa AK. The humanization of care in the education of
health professionals in undergraduate courses. Rev Esc Enferm USP.
2012;46(1):219-26.
3. Gerard N. Healthcare management and the humanities: an
invitation to dialogue. Int J Environ Res Public Health. 2021 Jun 24;
18(13):6771.
4. Dellasega C, Milone-Nuzzo P, Curci KM, et al. The humanities
interface of nursing and medicine. J Prof Nurs. 2007;23(3):174-9.
5. Coscrato G, Bueno SMV. Spirituality and humanization according to
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6. Scanlon A. Humanistic principles in relation to psychiatric nurse
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7. Shapiro J, Coulehan J, Wear D, Martha Montello M. Medical
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8. Qian Y, Han Q, Yuan W, Fan C. Insights into medical humanities
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hematology-oncology fellows' skills in humanism and professionalism: A
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TEACHING
Block & Billings (1) mentioned that after many years of neglect by
the medical establishment, the discipline of palliative medicine is
finally moving into academic health centers (AHCs). While hospice
programs have cared for dying patients in the community for years
with little input from mainstream medicine, palliative care is gaining
a foothold in AHCs, challenging these centers to integrate the hospice
approach with biomedicine. The discipline of palliative care promises
to be a rich source of learning and growth for physicians-in-training.
Teaching about palliative care affirms two essential but vulnerable
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References
1. Block S, Billings JA. Nurturing humanism through teaching palliative
care. Acad Med. 1998;73(7):763-5.
2. Stern DT, Cohen JJ, Bruder A, et al. Teaching humanism. Perspect
Biol Med. 2008;51(4):495-507.
3. Branch Jr WT, Chou CL, Farber NJ, et al. Faculty development to
enhance humanistic teaching and role modeling: a collaborative study at
eight institutions. J Gen Intern Med. 2014;29(9):1250-5.
4. Cohen LG, Sherif YA. Twelve tips on teaching and learning
humanism in medical education. Med Teach. 2014;36(8):680-4.
TRAINING
Beckman & al. (1) mentioned that the American Board of Internal
Medicine (ABIM) has emphasized the development of humanistic
skills in trainees. Using video technology, transition outpatient visits
of first-year house officers in a primary care training program were
evaluated for the presence or absence of nine humanistic skills
before and after the initiation of an instructional program to
reinforce the skills. Thirteen videotaped PGY-1 encounters
constituted the preintervention group and 16 videotaped PGY-1
encounters constituted the postintervention group. The
preintervention group performed a mean of 1.38 skills while the
postintervention group performed a mean of 3.56 skills, a statistically
significant improvement (p<0.05). The Authors conclude that an
educational approach that focuses on specific elements of
interactions facilitates the incorporation of skills associated with
humane medical care (1).
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Andrade & al. (2) presented the results of a study of the type
before and after training in Shelter with Risk classification compared
to the humanization of social representations of health among 111
health professionals in an emergency hospital. Data collection was
performed using the technique of free evocation and analysis was
done using the EVOC software. The results showed changes in the
symbolic meaning attributed to terms inducers towards
incorporation of the right perspective in the representation of the
Unified Health System, the translation of Humanization in health as
Shelter, and the progression of understanding the Shelter, the
humanistic focus to the qualification of processes of care of the users
demand at emergencies. The results indicate that the differences
found in the core before and after training were due to an
apprenticeship, which based in peripheral elements, was able to
question the core elements and interchange between the central and
peripheral system, recognizing the functional complementarity
between these two systems and the relationships between
representations and practices. However, the method does not assert
the persistence of such changes in the social representations of the
objects studied in depth or measure the changes in daily practices
(2).
Misch (3) mentioned that physicians' professionalism and
humanism have become central foci of the efforts of medical
educators as the public, various accrediting and licensing agencies,
and the profession itself have expressed concerns about the
apparent erosion of physicians' competency in these aspects of the
art, rather than the science, of medicine. Of the many obstacles to
enhancing trainees' skills in these domains, one of the most
significant is the difficulty in assessing competency in physicians'
professionalism and humanism. The Author suggests that the
assessment of these aspects of the art of medicine has more in
common with the approaches used in criticism of the arts than with
the quantitative assessment tools appropriate to the scientific
method and the medical model. Quantitative and semi-quantitative
tools, so effective in elucidating the etiology, pathophysiology, and
treatment of disease, are often in-appropriate and invalid when
applied to evaluation of professional and humanistic competencies.
The Author proposes that humanism "connoisseurs" be employed to
qualitatively evaluate medical trainees' professionalism and
humanism. Such connoisseurs would possess expert knowledge,
training, and experience in the interpersonal aspects of the art of
medicine, allowing them to deconstruct concepts such as empathy,
compassion, integrity, and respect into their respective key elements
while evaluating physicians' behaviors as an integrated, cohesive
whole. Through the use of a rich descriptive vocabulary, humanism
connoisseurs would provide valid formative and summative feedback
regarding competency in medical professionalism and humanism. In
the process, they would serve to counteract the relative
marginalization of professionalism and humanism in the informal and
lived curricula of medical trainees (3).
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References
1. Beckman H, Frankel R, Kihm J, et al. Measurement and
improvement of humanistic skills in first-year trainees. J Gen Intern Med.
1990;5(1):42-5.
2. Andrade MAC, Artmann E, Trindade ZA. Humanization health at
emergency service in a public hospital: comparison on social
representation of professional before and after training. Cien Saude Colet.
2011;16 Suppl 1:1115-24.
3. Misch DA. Evaluating physicians' professionalism and humanism:
the case for humanism "connoisseurs". Acad Med. 2002;7(6):489-95.
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SUMMARY
Humanity is the human race, which includes everyone on Earth. It
is also a word for the qualities that make us human, such as the
ability to love and have compassion, be creative, and not be a robot
or alien. The word humanity is from the Latin humanitas for "human
nature, kindness.” Humanity includes all the humans, but it can also
refer to the kind feelings humans often have for each other.
In this research, the Biblical verses dealing with the human
humanity are described. Therefore, the research evaluated the
virtue of humanity, the characteristics of humanistic medicine, the
features of the humanistic health care, the hospital care, the humane
doctor, nursing, and the strategies to promote humanity such as
National Humanization Policies, education, teaching and training.
"Humanistic medicine" is a term compounded, for therapeutic
purposes, with the good intent of reminding clinicians of their need
to be compassionate and empathic.
The medical humanities are concerned with "the science of the
human", and bring the perspectives of disciplines such as history,
philosophy, literature, art, and music to understanding health, illness,
and medicine.
Medical professionalism and humanism have long been integral to
the practice of medicine. Professionalism and humanism share
common values and that each can enrich the other.
Humanism in healthcare management should entail serving of
patients and their families, organizational members, and the
community.
This research indicates that humanity has accompanied humans
during the long our existence. With years, the scientific study
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