This article, written by a family physician and a family therapist, is designed to identify differences between these two cultures that may serve as stumbling blocks to successful meeting of occupants of these two worlds. With the differences identified and described, various notions and suggestions are offered in an effort to promote more successful bridging between these two groups. There is little question about the synergistic impact that can be engendered for recipients of their care should this bridging be successfully navigated. The present day realities in healthcare make this an idea whose time has not just come, but rather seems imperative. 相似文献
The unique profession of seafaring involves rest and sleep in a 24-h-a-day work environment that usually involves time-zone crossings, noise, heat, cold and motion. Sleep under such conditions is often difficult to obtain, and sleeping and sleep loss are often related to fatigue and contributory to accidents. This study aims to determine how accident investigators report sleep in Incident at Sea Reports and subsequently analyse the relationships between sleep, fatigue and accidents in these reports.The full text of 44 Incident at Sea Reports was coded and analysed using NUDIST software. This sample included collisions and groundings reported since 1991, where significant human factors contributed to the incident. The Incident at Sea Reports were electronically searched for reference to sleep and content was indexed against parameters such as fatigue behaviours, time of day and contributing personnel. Incident at Sea Reports incorporate three levels of reference to sleep, analysis of which may associate sleeping and sleepiness with accident causation. The highest level of reference unequivocally associates either being asleep, or being sleep deprived with accidents, but not always with fatigue. At an intermediate level, reference to the conflicting pressures of work and sleep on board fishing boats and ships suggests a work environment that is not conducive to obtaining sufficient sleep, and accident investigators are usually unable to link the watchkeeping environment with fatigue as a contributing factor. At the lowest level of association, reference is made to the integrated nature of sleeping and work on board. 相似文献