Use of narrative medicine to identify key factors for effective doctor–patient relationships in severe asthma

Multidisciplinary Respiratory Medicine

SOUND GROUP¹  Francesco Menzella²  Girolamo Pelaia³  Silvia Napolitano⁴  Maria Giulia Marini⁴  Antonietta Cappuccio⁴  Guido Pellegrini⁵  Alessandro Policreti⁶  Pasquale Alberto Porpiglia⁶ 

[1] ;Department of Medical Specialties Pneumology Unit, Arcispedale Santa Maria Nuova- IRCCS, Azienda USL di Reggio Emilia;Department of Medicine and Surgery Section of Respiratory Diseases, University “Magna Graecia” of Catanzaro;Fondazione ISTUD;Hospital “Città di Sesto San Giovanni” and “E. Bassini”, SC of Paediatric and Neonatology, ASST NordMilano;Medical Department Novartis Italia;

关键词: Narrative medicine;    Severe asthma;    Medical education and training;    Qualitative research;   

DOI  :  10.1186/s40248-019-0190-7

来源: DOAJ

【 摘 要 】

Abstract Background In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients. Methods Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury’s classification and the Grounded Theory. Results The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) - especially in cases of asthmatic children’s or adolescents’ overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients’ trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting. Conclusions These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn’t initially good.

【 授权许可】

Unknown