narrative medicine
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2022 ◽  
Vol 11 (2) ◽  
pp. 406
Maria Cecilia Cercato ◽  
Sabrina Vari ◽  
Gabriella Maggi ◽  
Wioletta Faltyn ◽  
Concetta Elisa Onesti ◽  

Background. Guidelines for the implementation of narrative medicine in clinical practice exist; however, in Italy, no standard methodology is currently available for the management of oncological patients. Since 2017, at the “Regina Elena” National Cancer Institute, studies using “digital narrative diaries” (DNMLAB platform) have been carried out; this article focuses on a pilot, uncontrolled, real-life study aiming to evaluate the utility of DNM integrated with the care pathway of patients with bone and limb soft tissue sarcomas. Methods. Adult patients completed the diary during treatment or follow-up by writing their narrative guided by a set of narrative prompts. The endpoints were: (a) patients’ opinions about therapeutic alliance, awareness, and coping ability; (b) healthcare professionals’ (HCPs’) opinions about communication, therapeutic alliance, and information collection. Open- and closed-ended questions (Likert score: 1–5) were used to assess the items. Results. At the interim analysis of data from seven patients and five HCPs, DNM was shown to improve: (a) the expression of patients’ point of view, the perception of effective taking charge, disease awareness, and self-empowerment (score: 4.8/5); (b) patients’ communication, relationships, and illness knowledge (score: 4.6–4.8/5). Conclusions. The preliminary results supported the need to integrate patients’ narratives with clinical data and encourage further research.

2022 ◽  
Vol 9 (1) ◽  
pp. 48-49
Deborah Starr ◽  
Lance Weiler

Columbia University School of the Arts’ Digital Storytelling Lab, in collaboration with Columbia’s Department of Narrative Medicine, developed Where There’s Smoke, a story and grief ritual that mixes interactive documentary, immersive theatre and online collaboration to invite healthcare providers and others into resonant conversations about life, loss and memory, and to imagine how stories can be used to create empathetic healing spaces. When Robert Weiler was diagnosed with terminal colon cancer, the complexity of healthcare and ensuing grief for the family, led his son Lance, a storytelling pioneer, to realize that a straightforward story wasn’t enough to explain and explore the experience, so he created Where There’s Smoke. Where There’s Smoke premiered in 2019 at the Tribeca Film Festival where it was hailed as an “absolute can’t miss” (Backstage). However, when COVID-19 submerged the world in loss, uncertainty, and isolation, Lance reimagined the piece as an online experience. He also combined the piece with protocols of Narrative Medicine as provided by faculty, Deborah Starr. The piece traces a heartbreaking journey through end-of-life care and grief, embracing grief as nonlinear and immersive, grief as an escape room with no escape. Participants sift through artwork, videos, and conversations and are provided with immersive moments for individuals, pairs and groups to have opportunities for self-discovery, unexpected intimacy, and ensuing healing. This is a personal yet universally relevant narrative, which gradually reveals itself to be something more…the possibility of immersive storytelling to create space for empathetic healing, grieving, and connecting.

Saeideh Daryazadeh ◽  
Payman Adibi ◽  
Nikoo Yamani

Narrative medicine (NM) is an educational tool that can be used to promote the professional competencies of medical students. This study aimed to investigate Iranian medical students’ perceptions of the first NM program offered in 2019. The study was conducted on 69 medical interns who participated in the weekly NM program that was part of the professional ethics course for two months. We used a questionnaire to determine medical interns' perceptions and personal attitudes toward NM. Three experts confirmed the validity of the questionnaire in Persian, and its reliability was verified by internal consistency (α = 0.879). The independent t-test was used to compare the differences in the total scores of students' perceptions. Data analysis was conducted using SPSS 23 software (P < 0.05). The response rate to the questionnaire was 95.65%. The results showed overall students' perceptions of the program were found to be positive. Furthermore, the scores showed a significant difference in terms of gender (P = 0.014), but none in terms of marital status (P = 0.936). According to the results, NM was effective in improving students’ reflections and their empathy with patients. Therefore, it is recommended to include NM in professional ethics education.  

2021 ◽  
pp. 152483992110654
Kathryn West ◽  
Karen R. Jackson ◽  
Tobias L. Spears ◽  
Brian Callender

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

Stroke ◽  
2021 ◽  
Emma Reford ◽  
Christopher P. Kellner

Stroke and COVID-19 are both traumatic and life-altering experiences that are marked by uncertainty, fear, and medical intervention. The devastation that stroke and COVID-19 oppress on an individual and a population is well established, and these traumas are potently magnified in the troughs of the COVID-19 pandemic. Furthermore, stroke has been shown to be a potential complication of COVID-19 infection, and while there is global controversy regarding this finding, it is undeniable that there are patients across the world presenting with both conditions concurrently. Thus, the topic of isolated stroke and the co-occurrence of stroke and COVID-19 amidst the pandemic both warrant considerable investigation on both a basic science level and a humanistic level. This opinion article advocates for a narrative medicine approach to better explicate the intertwining of stroke and COVID-19. Interviewing patients who presented with both stroke and COVID-19 as well as patients who present with stroke during the pandemic will provide the opportunity to gather and juxtapose individual illness experiences, including encounters with the health care system, relationship with care teams and care takers, recovery, and insights into the future. Creating, analyzing, and comparing such an anthology of illness narratives of the 2 patient populations will offer a unique understanding into the experience of different, yet over-lapping, medical traumas in an unprecedented time. With this deeper appreciation of patient accounts, the health care system can better recognize how to provide for future patients who present specifically with stroke or stroke and COVID-19. However, more broadly, this study can also afford insight into how the health care system can better provide for and support patients who present with complex diagnoses in the context of a complex healthcare system, which most probably will operate under the effects of the pandemic for time to come as well as other, future complicating factors.

2021 ◽  
pp. medhum-2021-012194
Yoshiko Iwai ◽  
Sarah Holdren ◽  
Leah Teresa Rosen ◽  
Nina Y Hu

While COVID-19 brings unprecedented challenges to the US healthcare system, understanding narratives of historical disasters illuminates ethical complexities shared with COVID-19. In 2005, Hurricane Katrina revealed a lack of disaster preparation and protocol, not dissimilar to the challenges faced by COVID-19 healthcare workers. A case study of Memorial Hospital during Hurricane Katrina reported by journalist-MD Sheri Fink reveals unique ethical challenges at the forefront of health crises. These challenges include disproportionate suffering in structurally vulnerable populations, as seen in COVID-19 where marginalised groups across the USA experience higher rates of disease and COVID-19-related death. Journalistic accounts of Katrina and COVID-19 offer unique perspectives on the ethical challenges present within medicine and society, and analysis of such stories reveals narrative trajectories anticipated in the aftermath of COVID-19. Through lenses of social suffering and structural violence, these narratives reinforce the need for systemic change, including legal action, ethical preparedness and physician protection to ensure high-quality care during times of crises. Narrative Medicine—as a practice of interrogating stories in medicine and re-centering the patient—offers a means to contextualise individual accounts of suffering during health crises in larger social matrices.

2021 ◽  
Ileana Scarpino ◽  
Chiara Zucco ◽  
Mario Cannataro

2021 ◽  
pp. 3-22
Alan Bleakley ◽  
Shane Neilson

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