Photovoice in Aggression Management Training for Medical and Nursing Students-A Pilot Study.

Aggression towards medical staff in the healthcare workplace is a common global concern. Measures to mitigate consequences of patient aggression include training through Aggression Management Programs (AMPs), which have been shown to increase students' self-efficacy and self-confidence. To encourage better engagement with a 30 h required AMP training, the study piloted an adapted photovoice activity with 58 students of medicine and nursing. Each student took one to three photos depicting their perceptions, feelings, and experiences of patient aggression in the workplace and discussed them in a course session. Their photos showed types of aggression in psychiatric settings, and their consequences for patients and students. Photo strategies included showing 'actors' or toy figures in aggressive encounters; tools to control aggression in psychiatric settings (e.g., mechanical restraints and syringes); and symbolic photos showing violence to the heart (emotional impact). Adding photovoice elements to the established AMP training appeared to contribute to student reflection on their individual perspectives on patient aggression in the workplace and help students to link their subjective experiences and theoretical learning. In future, incorporating pre-test and post-test questionnaires measuring empathy, attitudes, or critical thinking could help to decipher any changes in AMP effectiveness due to the use of a self-directed photovoice activity.

Involving the public through participatory visual research methods.

OBJECTIVES: To show how providing cameras to patients and community residents can be effective at involving the public in generating understanding of consumer, community, and health system problems and strengths. BACKGROUND: Health-care institutions and systems may seek to include consumer perspectives on health and health care yet be challenged to involve the most vulnerable sectors, be they persons with disabilities or persons with low socio-economic status living in societies where a top-down approach to policy is the norm. METHODS: Drawing on study examples using photo-elicitation and photovoice in Morocco and the United States, the authors explore issues of planning, data analysis, ethical concerns and action related to using participatory visual methods in different cultural and political contexts. RESULTS: Visual data generated by consumers can be surprising and can identify health system problems and strengths omitted from data gathered using other means. Statistical data may convince policy makers of the need to address a problem. Participant visual data may in turn encourage policy maker attention and action. CONCLUSION: Health system decision making may be improved by having a broader range of data available. Participant-generated visual data may support data gathered using traditional methods, or provide a reality check when compared with data generated by organizations, researchers and policy makers. The two study examples model innovative ways to surface health and health-care issues as they relate to consumers' real lives and engage vulnerable groups in systems change, even in contexts where expressing opinions might be seen as a risky thing to do.

Place as a social space: fields of encounter relating to the local sustainability process.

The paper shows how sustainability questions relate to the local space. The local place is not a static entity, but a dynamic one, undergoing constant changes, and it is the rapid social and material processes within the given local situation that is a challenge for the Chinese villages and their integrity. The following article considers the cohesion between the dwellers' emotional co-ownership of their local space and the sustainability process as a driving force in social, economic and ecological development. We bring together the classification of the seven fields of encounter, which were developed out of the empirical data of the Chinese case study villages, and sustainability oriented management considerations for all levels of this concept. We do not pretend to know the solutions, but describe a set of interrelated fields that can be anchor points for placing the solutions and show in which fields action and intervention is possible. In our concept of sustainability, every spatial field has its special meaning, needs special measures and policies and has different connotations to concepts like responsibility, family values or communication systems. We see the social sustainability process as a support for the empowerment of the local dwellers, and the SUCCESS research has encouraged the villages to find suitable sustainability oriented solutions for their natural and societal situation. Before entering the discussion about the chances and potential of a sustainability approach for the Chinese villages, it is first necessary to accept the fact that rural villages play a primordial role in Chinese society and that their potential can strengthen future pathways for China.