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Why Narrative?
Published in John Launer, Reflective Practice in Medicine and Multi-Professional Healthcare, 2022
My own view is that there are at least two concepts that distinguish narrative medicine and that hold it together coherently in all its different forms. One of these is the way in which narrative medicine claims legitimacy for individual stories as a counterpoise to evidence-based medicine, and as an essential complement to evidence. Narrative medicine, in other words, reasserts the importance of lived experience, and the expression of that experience, in the face of the dominant intellectual voice in modern medicine—a voice that often creates the impression that only collectivised, abstract measurements can convey truths or carry meaning. At the same time, everyone writing about narrative medicine has emphasised that narrative is not a substitute for evidence, nor does it stand in opposition to it. Instead, as the American scholar Rita Charon argues, it calls upon us to recognise ‘the narrative features of all data and the evidentiary status of all clinical text’.
A life-course perspective on migrant health
Published in Bernadette N. Kumar, Esperanza Diaz, Migrant Health, 2019
Yoav Ben-Shlomo, Loubaba Mamluk, Sabi Redwood
The development of ‘narrative medicine’ (13) refers to the practice of respectful health care by clinicians who have the capacity to ‘recognise, absorb, metabolize, interpret, and be moved by stories of illness. Put simply, it is medicine practiced by someone who knows what to do with stories’. Listening to patients’ stories is a key element of medical practice, yet even if encounters take place within a shared cultural context, narratives can be ‘chaotic’ (14), disjointed, or fragmented. Stories told by refugees may be very hard to listen to, but they provide some access to the way they understand health and illness and the values nested within the wider narratives of their society and culture (15).
Rita Charon
Published in John D Engel, Lura L Pethtel, Joseph Zarconi, Mark Savickas, Developing Clinicians’ Career Pathways in Narrative and Relationship-Centered Care, 2018
John D Engel, Lura L Pethtel, Joseph Zarconi, Mark Savickas
I also realized that narrative medicine did not spring from nowhere. Its lineage includes biopsychosocial medicine, primary care, medical humanities, and patient-centered medicine. What narrative medicine offers that the others may not be in a position to offer is a disciplined and deep set of conceptual frameworks – mostly from literary studies, and especially from narratology – that give us the theoretical means to understand why acts of doctoring are not unlike acts of reading, interpreting, and writing and how such things as reading fiction and writing ordinary narrative prose about our patients help to make us better doctors. By examining medical practices in the light of robust narrative theories, we begin to make sense of the genres of medicine, the telling situations that obtain, say, at attending rounds, the ethics that bind the teller to the listener in the office, and of the events of illness themselves. It helps us make sense of all that occurs between doctor and patient, between medicine and its public.
Comparing Narrative-Informed Occupational Therapy in Adult Outpatient Mental Health to Treatment as Usual: A Quasi-Experimental Feasibility Study with Preliminary Treatment Outcomes
Published in Occupational Therapy in Mental Health, 2021
Sally Wasmuth, Victoria G. Wilburn, Jay A. Hamm, Anthony Chase
Narrative Medicine is an evidence-based practice that emerged from Columbia University in New York, NY, USA and has received much attention over the past decade, especially regarding its impact on enhancing providers’ abilities to truly hear, understand, and respect their clients (Charon et. al., 2016). Literature suggests that involving clients in their own care planning dramatically improves treatment engagement and compliance, although the majority of psychiatric services do not utilize such a collaborative approach (McGuire et al., 2015). Some research has suggested good interpersonal and listening skills to be the only predictor of positive clinical outcomes for patients with psychosocial needs (Charon et al., 2016; Najavits & Weiss, 1994). Clinician narrative medicine activities help prepare the clinician to be an effective, therapeutic listener. In a complementary fashion, narrative-informed treatment planning allows clients to tell their stories and have them heard by a trained clinician—both, evidence suggests, are highly therapeutic (Pennebaker, 2000).
Patient perspectives on managing uncertainty living with multiple sclerosis
Published in Journal of Communication in Healthcare, 2020
Alex R. Pearce, Samantha B. Meyer
The results of the present research are shared through the lens of narrative medicine, which aims to present experiences as patients express them and allow clinicians to understand the values and meaning behind their experiences [19]. Patient perspectives about living with MS have been explored in the previous research [10,20,21], but there remains a gap in terms of understanding patient experiences of uncertainty and the role of communication with their providers in managing their uncertainty. Our data, drawing on interviews with patients living with MS about these topics, allow us to better understand how both parties – patients and physicians – might improve their communications to better manage uncertainty and help people living with MS move through uncertainty to adaptation, as proposed in Mishel’s revised TUI [5].
Narrative medicine as a medical education tool: A systematic review
Published in Medical Teacher, 2019
M. M. Milota, G. J. M. W. van Thiel, J. J. M. van Delden
Narrative medicine, or narrative-based medicine, constitutes “an approach to medicine that employs narrative skills to augment scientific understandings of illness” (Lewis 2011) and can thus be seen as one means of preventing this narrative schism. Those who teach and practice narrative-based medicine claim that it is not intended to be an alternative to modern, technologically enhanced, medicine. Rather, it is seen as a means of revealing to medical professionals that evidence-based practices can and should be paired with the personal evidence that emerges in a dialogic clinical encounter between a doctor and patient (Holmgren 2011; Chin-Yee 2018). Proponents claim that better attention to and appreciation of narratives in the clinical setting can help doctors bridge the gap between their mediopathological knowledge and the experiential knowledge contained in their patients’ stories (Greenhalgh 1999; Greenhalgh and Hurwitz 1999; Launer 1999; Hurwitz 2000).