Stephen Buetow

• Professor (Associate) at University of Auckland

Compliance and regulatory bodies often encourage health care providers’ disclosure of and apologies for wrongdoing. Patients may perceive that forgiveness is expected and feel pressure to grant it. However, forgiveness carries consequences, which can bring limits to forgiveness. Understanding these limits is crucial for understanding when forgivene...

Purpose: Medication often falls short in controlling tremors in Parkinson's disease. While physical activities suggest potential benefits, current exercise regimes have limitations. This paper explores the concept of deliberate shaking as an intervention to aid exercise uptake and potentially leverage synergies between medication and physical acti...

This paper questions the conventional wisdom that physicians must suppress anger in response to patient misbehaviour. It distinguishes the emotion of anger from its expression, which leans toward concerned frustration and disappointment for the sake of professionalism in patient care. Drawing on the framework of person-centred health care as a virt...

This paper examines the concept of centredness in health care, with a particular focus on person‐centred care. While the principle of centring care is widely accepted, the concept of a ‘centre’ remains ambiguous, complicating its implementation. The paper defines centredness, questions the necessity of a central focus and explores alternative model...

Introduction Globally, yoga has gained popularity as a health-promoting and disease-prevention discipline. The common health conditions prompting yoga use include musculoskeletal disorders, mental health conditions, asthma, fibromyalgia, arthritis, diabetes, and cancers. Although the therapeutic benefits of using yoga are well documented, little is...

Bias is an ambiguous term, defined in different ways. In conventional usage, it indicates unwarranted prejudice. However, in health research, the notion that bias is invariably bad is biased. Although research bias is an error that is always harmful, researcher bias is a tendency to think in a particular way that may obscure or illuminate attempts...

For Pacific peoples, health promotion, community nursing and community development initiative over many years, has often been conducted within a framework of one-sided decision-making. There is always an imbalance between the power relationships of the community being studied and those of the researchers or health practitioners. As a result, there...

Objective: This study investigated whether previously identified modifiable risk factors for dementia were associated with cognitive change in Māori (indigenous people of New Zealand) and non-Māori octogenarians of LiLACS NZ (Life and Living in Advanced Age; a Cohort Study in New Zealand), a longitudinal study. Method: Multivariable repeated-mea...

Background Austria has high health resource use compared to similar countries. Reclassifying (switching) medicines from prescription to non-prescription can reduce pressure on health resources and aid timely access to medicines. Since Austria is less progressive in this area than many other countries, this research aimed to elucidate enablers and b...

Emergency responders (police, fire, ambulance and defence force personnel) risk exposure to dangerous and traumatic events, and the possible subsequent development of post-traumatic stress disorder. Consequently, partners of these emergency responders risk developing secondary traumatic stress (STS) from vicarious exposure to the trauma through com...

Body image research focuses almost exclusively on women or overweight and obesity or both. Yet, body image concerns among thin men are common and can result, at least in part, from mixed messages in society around how men qua men should dress and behave in order to look good and feel good. Stand-alone interventions to meet these different messages...

Stable, healthy families are the loto or heart of strong Pacific communities. This paper addresses the problem of a decline in the strength of Pacific families. It introduces and discusses the Tongan concept of O'ofaki, as the way in which shared, core relational commitments can bring Pasifika peoples together to support one another for health and...

There is now broad agreement that ideas like person-centred care, patient expertise and shared decision-making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to...

Objective: A systematic review with a meta-analysis explored effects of cognitively loaded physical activity interventions on global cognition in community-dwelling older adults (≥65 years of age) experiencing mild cognitive impairment (MCI), compared to any control. Methods: A literature search was conducted in 4 databases (MEDLINE [OvidSP], Pu...

Modern technologies sanction a new plasticity of physical form. However, the increasing global popularity of aesthetic procedures (re)produces normative beauty ideals in terms of perfection and symmetry. These conditions limit the semblance of freedom by people to control their own bodies. Cultural emancipation may come from principles in Eastern p...

Introduction: To estimate the cognitive-load of self-reported physical and cognitive activities by New Zealand’s (NZ) indigenous population (Māori) and non‑Māori from the Life and Living in Advanced Age‑Cohort Study New Zealand (LiLACS NZ). Methods: Three-round panel Delphi exercise in NZ involving six panellists across an expert rater group and a...

https://www.tandfonline.com/doi/full/10.1080/09638288.2019.1620873

When investigating the etiology of diseases, epidemiological observational studies traditionally deemphasize psychosomatic associations. Exploring cognitive behavior provides an insight into how psychosomatic associations affect disease. Yoga philosophy identifies the kleshas (mental afflictions) of ignorance, ego, desire, hatred, and fear of death...

Purpose: Rehabilitation is commonly portrayed as care that seeks to enable persons who are disabled to recover as normal a state of well-being as their personal and social circumstances allow. In contrast, this article frames psychological preconditions for persons living with disabilities to flourish toward, around or even beyond recovery through...

Introduction: We assessed the sensitivity and specificity of the Modified Mini-Mental State Examination (3MS) in predicting dementia and cognitive impairment in Māori (indigenous people of New Zealand) and non-Māori octogenarians. Methods: A subsample of participants from Life and Living in Advanced Age: a Cohort Study in New Zealand were recrui...

Nurses routinely engage in pattern recognition and interpretation in qualitative research and clinical practice. However, they risk spontaneously perceiving patterns among things that are not meaningfully related. Although all people are prone to this cognitive bias of “apophenia”, nurses may be at increased risk because they commonly produce or at...

Something important is happening in applied, interdisciplinary research, particularly in the field of applied health research. The vast array of papers in this edition are evidence of a broad change in thinking across an impressive range of practice and academic areas. The problems of complexity, the rise of chronic conditions, overdiagnosis, co‐mo...

Background: Widening access to medicines through reclassification ('switching') of medicines from prescription to non-prescription is an international trend generally welcomed by community pharmacists. Research has focused on scheduling and committee deliberations affecting reclassification, rather than industry aspects, despite industry's role in...

Person-centered care offers a promising way to manage clinicians' conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of othe...

Falls can injure, even kill. No one with Parkinson’s disease (PD) wants to fall by accident. However, the potential nastiness of falls does not preclude a more nuanced understanding of the personal meaning that falls can have. Rather than view falls as a problem to fear and manage solely by preventing and repairing harm, people with PD and those wh...

Purpose: Current rehabilitation models emphasize therapy that attempts to return to “normal” the lives of persons who are disabled. An opportunity is available to scrutinize whether this recovery orientation of rehabilitation is necessarily optimal. Method: This conceptual article uses reasoning, informed by experience and a nonsystematic review of...

When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical pr...

Background In 2012, New Zealand reclassified trimethoprim to allow specially trained pharmacists to supply it without a prescription to women with symptoms suggesting uncomplicated cystitis, under strict criteria for supply. Objective To assess how this policy change allowing pharmacist supply of trimethoprim affected overall antibiotic supply. Set...

Interest has grown in centering Parkinson's disease (PD) care provision on the welfare of the patient with PD. By putting the welfare of patients first, this patient-centric focus tends to subordinate the welfare of others including clinicians and carers. A possible solution is person-centered care. Rather than remove the spotlight from the patient...

Despite its potential hazards, the activity of questioning theoretical frameworks and proposing solutions is necessary if progress is even to be possible. Intellectual history has by no means ended, so we cannot expect to have all the answers, and from time to time the activity of critical questioning will be frustrating. But intellectual progress...

Aims: To describe prescribing for women with suspected urinary tract infections, including suspected uncomplicated cystitis, in New Zealand. Methods: Randomly selected community pharmacies participated in the study. Women attending the pharmacy in a 2-week period in 2012 for prescribed or non-prescription treatment of symptoms suggesting a urina...

The University of Auckland, like many tertiary educational institutions, expects undergraduates and postgraduates to leave the institution equipped not only with specialist knowledge, but with a set of intellectual skills, capacities and personal attributes. Included in this suite of transferable skills is academic and information literacy (AIL).Th...

People with stroke or Parkinson's disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use...

To identify factors associated with differences between developed countries in reclassifying (switching) medicines from prescription to non-prescription availability. Cross-national qualitative research using a heuristic approach in the US, UK, Japan, Australia and New Zealand, supplemented by data from Canada, Denmark, the Netherlands and Singapor...

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy 'at the bedside'? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a...

Despite similarities in health systems and Trans-Tasman Harmonization of medicines scheduling, New Zealand is more active than Australia in 'switching' (reclassifying) medicines from prescription to non-prescription. To identify and compare enablers and barriers to switch in New Zealand and Australia. We conducted and analyzed 27 in-depth personal...

Not required because the manuscript is an invited commentary.

Abstract Introduction Nutrition care refers to any practice conducted by health professionals to support patients improve their dietary intake. New Zealand General Practitioners (GPs) are expected to provide nutrition care to patients for prevention and management of chronic disease. This study explores New Zealand GPs opinions regarding provision...

Patients could help to improve the hand hygiene (HH) compliance of healthcare professionals (HCPs) by reminding them to sanitize their hands. To review the effectiveness of strategies aimed at increasing patient involvement in reminding HCPs about their HH. A systematic review was conducted across Medline, EMBASE and PsycINFO between 1980 and 2013....

Editors' introduction to 5th philosophy of medicine thematic issue of Journal of Evaluation in Clinical Practice

The term qualitative research still gives meaning to a diverse array of approaches. Attributes typical of these approaches are easily oversimplified. Recognition that qualitative research requires no essential set of predefining attributes can minimize this problem. This article suggests how to typify qualitative research outputs on the basis of ov...

This paper suggests how a patient may be able to give and receive the caring he/she wants with respect to a clinician whose (in)action he/she perceives to be uncaring. The approach suggested draws on the philosophy and psychology of framing and adopting Hans Vaihinger's 'as if' theory. I draw on my own experience as a patient to apply this approach...

Background: Switching or reclassifying medicines with established safety profiles from prescription to non-prescription aims to increase timely consumer access to medicines, reduce under-treatment and enhance self-management. However, risks include suboptimal therapy and adverse effects. With a long-standing government policy supporting switching...

Deeply embedded in medical professionalism, the principle of primacy of patient welfare puts patient interests first. Despite the greater inherent dependence of patients on physicians than of physicians on patients, this principle acts against the right of physicians to be viewed as moral equals and can harm physicians, patients and health system p...

Medical school is typically stressful for students. It introduces serious financial, academic and workload challenges in the complex and rapidly changing environments of modern medicine and education. Regulatory requirements and technological advances are threatening students’ ability to care for themselves and their patients, as people. However, m...

Progress is being made in transitioning from clinicians who are torn between caring for patients and populations, to clinicians who are partnering with patients to care for patients as people. However, the focus is still on what patients and others can do for patients, however defined. For clinicians whose interests must be similarly respected for...

While theory plays a variety of roles in forming the central argument of an academic work, it is often assigned a secondary status to that of research methods. The following paper focuses specifically on the benefits for psychology research students in engaging with the capacity of theory to enhance the coherence and originality of their academic w...

This paper draws lessons from the use of an emic–etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information. The technique was used to heighten theoretical sensitivity in this study. As a nurse practitioner, I (the lead author) could not step out of my emic perspective to provide an etic perspective...

Little is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders. Delphi study involving indirect group interaction through a structured two-round survey. International electronic survey. 11 (65%) of...

Unlabelled: Abstract Purpose: Group singing could be a promising component of neurorehabilitative care. This article aims to conceptualize how group singing may enable people with Parkinson's disease (PD) to synchronize their movement patterns to musical rhythm and enhance quality of life. Method: Spanning the medical and social sciences, the ar...

Background Despite the risk of 'method slurring', researchers have triangulated within a single qualitative study methods that are philosophically incongruent or in a limited context, are congruent, as with hermeneutic phenomenology and constructivist grounded theory. Methods/ MaterialsWe aimed to make the case that what works best can be to mix tw...

Qualitative researchers commonly receive simplistic advice on pitfalls to avoid when conducting interviews. The pitfalls include saying too much and saying too little, yet their cogency depends on the role of the qualitative interviewer. This paper distinguishes between the roles of the miner, traveller, cleaner, and conductor. These roles are 'ide...

Few would dispute the claim that sound reasoning in clinical practice is worth cultivating. That is, of course, because the claim is a platitude: it is hard to see how anyone could seriously maintain a contrary view.We might explain sound reasoning with reference to a number of evidently desirable qualities: we want practitioners who think critical...

Purpose: People with stroke or Parkinson's disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therape...

The widely-observed behavior of holding losing stocks longer than winning ones, is known as the disposition effect. This failure to realise paper losses is a major cause of eventual loss in investing. There is increasing evidence that financial choices, particularly those where there is threat of loss, such as the disposition effect, could be relat...

Cooperation and conversation in the public sphere may overcome historical and other barriers to rational argumentation. As an alternative to evidence-based medicine (EBM) and patient-centered care (PCC), the recent development of a modern version of person-centered medicine (PCM) signals an opportunity for a conversational pluralogue to replace par...

This paper draws lessons from the use of an emic-etic ethnographical technique in a grounded theory study of how New Zealand practice nurses use information. The technique was used to heighten theoretical sensitivity in this study. As a nurse practitioner, I (the lead author) could not step out of my emic perspective to provide an etic perspective...

Medicines reclassification from prescription to nonprescription (switch) has slowed in some countries, including the United States. New thinking may be necessary to drive this area, including third-party reclassification and better use of the pharmacist, collaborative care, or innovative technologies. The goal of this study was to describe a recent...

The experiences and perspectives of New Zealanders with fetal alcohol spectrum disorder (FASD) need to be heard since no research to date has been performed. FASD, a neuro-developmental disability with life-lasting effects, is irreversible. The condition is caused by prenatal exposure to alcohol. This study aimed to explore and understand the daily...

The widely-observed behavior of holding losing stocks longer than winning ones, is known as the disposition effect. This failure to realise paper losses is a major cause of eventual loss in investing. There is increasing evidence that financial choices, particularly those where there is threat of loss, such as the disposition effect, could be relat...

To determine whether a diabetes annual review, independently of other care processes, is followed by improved patient clinical measurements. Audits conducted independently of the diabetes annual review were analysed for a time-trend in patient clinical measures. An interaction variable between the review and the year of audit was used to test for a...

Safety events indicating medication-related errors in Parkinson's disease (PD) are common but seldom studied, particularly from lay perspectives. Our objective was to study the meaning and significance to people living with PD of their experience of safety events. Twenty qualitative interviews were conducted by telephone with purposively sampled in...

A decade ago I called for a medicine of meaning (MOM) but incorrectly deduced that MOM always depends on healing and helping. I now wish to suggest that the practice of medicine need not promote the healing or health of individual patients in order for them to find or create meaning in their lives. Personal meaning can be enhanced by medicine in th...

The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man. (G.B. Shaw) [1] There are questions so resistant to easy resolution that we tend to ignore them for as long as we can, but so fundamental that they keep returning whenever w...

Uncertainty is unavoidable in health care, yet frequently tacit. When uncertainty is acknowledged, it tends to be defined in terms of the unpredictable nature of the care, and limits to human knowledge. It is cast as a problem that evidence-based health care can minimize. Challenging that simplistic perspective, this paper reconstructs uncertainty...

Pay-for-performance schemes reward standardized professional behaviours associated with effective care. However, they neglect the significance of virtue and devalue and erode professional motivation based on virtue. Pay for training to cultivate virtue, and/or pay-for-virtue, may mitigate these dangers. Although virtue is typically considered its o...

Andrew Miles and Juan Mezzich have called for immediate action in the design, development and implementation of research methodologies to translate the philosophy of person‑centred medicine into routine health practice. This paper responds to that clarion call by taking the first step of sketching an integrated conceptual framework for evaluating t...

Conceptualising the doctor-patient relationship as a 'window mirror' exposes care delivery from doctor to self, doctor to patient, patient to self, and patient to doctor. These directions have not been measured concurrently. We aimed to develop and validate a patient questionnaire informed by this model. A modified-Delphi exercise was conducted to...

Modern medicine threatens the ability of the clinician and the patient to care, and be cared about as whole, human individuals in health care. However, the interests of patients are put behind those of the population and, on the authority of professionalism and patient-centred care, ahead of those of clinicians. This situation has prompted the deve...

To compare Māori and non-Māori experiences in relation to access to general practice care. A semi-structured personal questionnaire was administered in telephone surveys of random samples of 651 Māori and 400 non-Māori consumers. Differences in these groups of consumers' experiences of accessing general practice care were compared statistically. Co...