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Narratives in Clinical Practice: The essence of person centered care?

James Appleyard

Abstract


From earliest times listening to a person’s story has been the essence of the patient-physician consultation. Evidence from the literature suggests that it is the core clinical skills of communication through questioning, delineating, interpreting, explaining and discerning meaning that provide a way of bringing together the very different perspectives of patients and health professionals.

These narrative skills facilitate an awareness of both health and disease and take into consideration the biological, social psychological, spiritual and pathophysiological dimensions. In this context the science of objective measurements can be successfully integrated with the art of clinical experience and judgment.


Keywords


Empathy, ethical framework, evidence based medicine, clinical skills, integration, listening, narrative competence, person centered care.

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References


. Genette G. Narrative Discourse: An Essay in Method. Lewin J, trans. Ithaca, NY: Cornell University Press; 1980.

. Greenhalgh T, Hurwitz B. "Narrative based medicine: Why study narrative?" BMJ 1999, 318:48-50.

. DeSalvo L. Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives. San Francisco, Calif: Harper; 1999.

. Laine C, Davidoff F. Patient-centered medicine: a professional evolution. JAMA.1996;275:152-156

. Charon R. Narrative medicine: form, function, and ethics. Ann Intern Med.2001;134:83-87.

. Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician: personal awareness and effective patient care. JAMA.1997;278:502-509.

. Fox R, Lief H. Training for "detached concern." In: Lief H, ed. The Psychological Basis of Medical Practice. New York, NY: Harper & Row; 1963. Pages12-35.

. Cox J Campbell AV Fulford KWM. Medicine of the Person. Jessica Kingsley Publishers, 2007

. Engel GL. The need for a new medical model: a challenge for biomedicine. Science.1977;196:129-136.

. Sackett DL,Rosenberg WMC,Gray JAM, Haynes RB, Richardson WS Evidence based medicine: what it is and what it isn't.BMJ 1996; 312: 71–72

. Tannenbaum SJ What physicians know. N Engl J Med 1993; 329: 1268–127.

. Jones AH. Literature and medicine: narrative ethics. Lancet.1997;349:1243-1246.

. Charon R. Medical interpretation: implications of literary theory of narrative for clinical work. J Narrative Life History.1993; 3:79-97.

. Greenhalgh T, Hurwitz B. Narrative Based Medicine: Dialogue and Discourse in Clinical Practice. London, England: BMJ Books, 1998.

. Hurwitz B. Narrative and the practice of medicine. Lancet.2000;356:2086-2089.

. Cassell E. The nature of suffering and the goals of medicine. N Engl J Med.1982;306:639-645.

. Balint M. The Doctor, his Patient and the Illness. London, England: Tavistock Publications; 1957

. Silva SA. Charon R. Wyer PC. The marriage of evidence and narrative: scientific nurturance within clinical practice Journal of Evaluation in Clinical Practice. 2011; 17(4):585-93.

. Mezzich JE, Salloum IM, Cloninger CR, Salvador-Carulla L, Kirmayer L, Banzato CE, Wallcraft J, Botbol M. Person-centered Integrative Diagnosis: Conceptual Bases and Structural Model. Canadian Journal of Psychiatry 2010; 55:701-708.

. Schmolke MM, Mezzich, JE. Contrasting the essentials of recovery orientation and person-centered care. The International Journal of Person Centered Medicine 2013; 3: 31-35.

. Farkas M, Gagne C, Anthony W, Chamberlin J. Implementing recovery oriented evidence based programs: identifying the critical dimension. Community Mental Health Journal 2005; 41: 141-158.




DOI: http://dx.doi.org/10.5750/ijpcm.v3i2.403

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