Recovered or Not Recovered? A First Person Narrative Case for Non-Abstinent Recovery.

PURPOSE: The purpose of this paper was to explore interlocking questions relating to how we deal with drugs and medication in crisis residential mental health settings. In particular, it examines issues related to overly medical and simplistic explanations of the relationship between cannabis and psychosis, the positive effects of drugs, the effects of having standard rules for diverse groups of people and the concept of non-abstinent recovery. BACKGROUND: I have used mental health and addiction services for 25 years and I have 6 years' experience as a peer worker, working with many people who use drugs. METHOD: This is an opinion piece built around a first-person narrative. KEYPOINTS: Drugs can have positive effects and an appreciation and understanding of these effects is essential to understanding persistent drug use. How can we integrate non-abstinent recovery as a valid and positive choice of recovery pathway?

Raising patient voices in medical education: an assessment of patient perceived effect of social determinants of health conversations and the patient-physician relationship on quality of obstetric care, to inform the development of patient driven medical education curricula.

Background: Conventional medical education lacks the lived experiences of patients which may authentically convey the social determinants of health (SDOH) and resulting health disparities. Videos of first-person patient narratives may prove a valuable education tool in this regard. The objective of this study is to investigate how patient demographics, satisfaction with care, and patient-physician relationships influence obstetric patient interest and willingness to contribute to a SDOH video curriculum by sharing their lived experiences through first-person narratives. Methods: Study design included an anonymous, cross-sectional survey and an optional semi-structured telephone interview. Participants were 18 years old with a live-birth delivery <8 weeks prior to recruitment and received care during their pregnancy at Los Angeles General Medical Center (LAGMC). Variables surveyed included demographics, satisfaction with care, aspects of the patient-physician relationship, perceived utility, and personal interest in contributing to an educational SDOH video. A bivariate analysis was conducted to compare participants' characteristics and responses on interest in contributing and perceived helpfulness of first-person patient SDOH videos. Results: 72.43% of participants (N = 70) believed a patient's first-person video on SDOH would be "Helpful" in preparing physicians to provide competent medical care; however, 71.43% responded "No" to "Interest" in sharing with physicians their experiences with SDOH. English preference and being U.S. born were factors significantly associated with viewing first-person SDOH video as "Helpful" (P > 0.001). Major themes from telephone interviews reflected enthusiasm for first-person patient narratives and perceived benefits of using patient experiences to educate physicians on SDOH. However, participants cited barriers to disclosing SDOH including brief and strictly clinical interactions with physicians, lack of continuity of care, and fear of being judged by physicians. Conclusion: While most participants recognized the utility of addressing social needs in medical education and reported satisfaction with their obstetricians and care, these factors did not uniformly translate into willingness to contribute first-person patient narratives. To improve the representation of patients from racial, ethnic, gender, linguistic, and sexual minorities into medical curricula, further research and strategies are needed to overcome the barriers discouraging patient disclosure of social needs to physicians.

Enhancing the effects of a narrative message through experiential information processing: An experimental study.

First-person narratives are becoming a popular means to communicate health risk information. Although studies show they can increase risk perception and motivate health behaviours compared to statistical messages, more research on the conditions in which they are particularly likely to have effects is needed. In this study, we tested a moderator related to how information is processed. Specifically, we hypothesised that thinking in terms of emotions and personal experiences - known as experiential information processing - would increase people's responsiveness to a narrative. Female college students (N = 138) who reported indoor tanning were randomly assigned to read a first-person narrative message or a statistical message about the risks of skin cancer. Prior to reading the message, the women received instructions that would activate either experiential or rational information processing. Participants then reported their risk perceptions of skin cancer, worry about skin cancer and behaviour intentions related to skin cancer. Analyses showed that message type and information processing interacted to influence risk perceptions and worry. Consistent with hypotheses, participants reported the highest risk perception and worry when they used an experiential information system prior to reading the narrative message. There were no effects on behaviour intentions. Implications of these findings are discussed.

The composite first person narrative: Texture, structure, and meaning in writing phenomenological descriptions.

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method's applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or "contextual" human qualities of the phenomena are often not visible. The "what is it like" or the "unsaid" aspects of such human phenomena are not clear to the reader when proxies are used to "account for" a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the "we" among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry.