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Presented at the IMANA Convention held at the
International Medical Center Jeddah on December 29, 2014 by Dr Omar Hasan
Kasule Sr. MB Ch B (MUK), MPH (Harvard), DrPH (Harvard) Faculty of Medicine King
Fahad Medical City, Riyadh
HOLISTIC APPROACH TO PATIENT CARE
·
A holistic approach to medical treatment incorporates social,
psychosomatic, spiritual, emotional dimensions.
·
It recognizes the role of the family in the providing social and
psychological support to the patient.
·
Physicians trained in the biomedical model were reluctant to acknowledge
the family’s role in care.
·
This is changing towards recognition of the family as a part of the
therapeutic process.
THE FAMILY AS PART OF HOLISTIC CARE
·
Family members are involved in medical decisions when they act as proxy
decision makers.
·
They can be donors of organs and tissues.
·
They help the patient experience a home ambience during their visits to the
hospital.
·
Family visits are a social
obligation and are encouraged.
·
The neuro-humoral-immune axis in
patient care
FAMILY AS GUESTS OF THE
HOSPITAL
·
Family visits are a social obligation and are encouraged
·
The family members are honored guests with all the shari’at rights of a guest.
·
The family members are honored
guests with all the shari’at rights
of a guest.
·
Family visits should not interrupt
routines and procedures
PROVIDING FOR THE NEEDS OF THE
FAMILY
·
While the physician understands
the role of family support for the patient, he may not realize that the family
is also in need of care and support.
·
The family needs psychological
support; they are anxious and worried.
·
They need reassurance about the
patient’s condition without breach of confidentiality.
·
Caregivers must avoid involvement
in family conflicts.
FAMILY
INVOLVEMENT IN TERMINAL CARE
·
Comfort: pain relief, communication, hygiene, wudhu all the time
·
'Ibadat-friendly hospital
·
Spiritual preparation: allay anxiety, present death as a positive event
·
Legal preparation: debts and a will
·
Prepare family for mourning
WHAT FAMILY-CENTERED CARE IN
PEDIATRIC UNITS
·
Scope
·
Family visitation;
·
Family-centered rounding;
·
Family presence during invasive
procedures and cardiopulmonary resuscitation;
·
Family conferences
·
Although challenges to successful
implementation exist, the growing body of evidence suggests that PFCC is
beneficial to patients, families, and staff. Meert KL1,
Clark J,
Eggly S.
Family-centered care in the pediatric
intensive care unit. Pediatr Clin North Am.
2013 Jun;60(3):761-72.
FUTURE CHALLENGES
·
The future of the family’s role in
care is threatened by several factors.
·
A high technology hospital
environment discourages family involvement in providing social and
psychological support.
·
There is less time for family
members to be involved in patient care because of lack of time due to their work
commitments.
·
The transition from a large
extended family to the smaller nuclear family also means that there are fewer
family members available to provide social support to the patient.
·
Rising divorce rates and family
break-up threaten the family’s role as a cohesive social support network.
THE TAUHIDI PARADIGM
- Lack of integration due to atomistic view of the cosmos: analytic but not synthetic
- Integration is not addition but is fitting according to the laws, sunan
- The tauhidi paradigm provides a conceptual basis for integration.
- Integration calls forth balance among the components integrated