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

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.

The role of patients’ stories in medicine: a systematic scoping review

“…• Enhanced relationship building [ 19 , 30 , 111 , 125 , 136 , 146 , 148 , 153 , 155 , 161 , 192 , 201 , 205 , 212 , 271 , 277 – 280 , 292 – 294 ],…”

“…• Enhanced shared perspectives [114,135,169,171,172,197,[203][204][205][206][207][208][209][210][211][212][213][214][215][216][217] • Enhanced contextualization and personalization of care [151,169,194,204,206,210,[212][213][214][215][217][218][219][220][221][222][223] Better physician emotional wellbeing through:…”

Perspectives on decisions for treatment and care in severe asthma

“… 19 However, to ensure improvement in communication globally, it is essential that primary care physicians (PCPs) have training to ensure that they refer individuals with severe asthma to pulmonologists in secondary care, for example, 8 and that they communicate with patients effectively to ensure understanding of their treatment pathway. 13 , 20 …”

Using mixed methods to evaluate and design the learning of narrative medicine among medical bachelor’s students in China: A design-based study

“…Although narrative medicine has been applied abroad, it has recently been addressed in China. Previously, institutions outside of China have applied narrative medicine to clinical practice using parallel charts, which are narratives of experiences with patients [17][18][19]. Educational activities of narrative medicine, especially parallel charts, have been used in clinical practice among a small number of institutions in China, but no Chinese universities or institutions have designed and applied systematic and formal programmes for medical students.…”