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2.
Public Health ; 197: 36-38, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34298257

RESUMO

OBJECTIVE: The purpose of this article is to analyze the research concepts underlying the construction of a theatrical health intervention on Black well-being, narrative medicine and what we reference as intentional locative healing. STUDY DESIGN: Descriptive postintervention evaluation. METHODS: This short communication article provides specific examples on how to practically implement elements of narrative medicine into an artistic health intervention and in postproduction assessments. RESULTS: Creative interventions that are designed to engage wellness on both an individual and communal level yield more nuanced findings. We recommend embedding reflexive exercises in the intervention for creators, the intended audiences, and jointly within both groups. This approach is in alignment with how narrative medicine is practiced in a clinical setting. It also emphasizes multiple opportunities to integrate close readings and deepen empathetic attentiveness. In addition, in an applied theatrical context, location can be meaningfully used to: 1) address historical tensions in spatial and social communities; 2) provoke curative dialogue to ease said tensions; and 3) ascribe a more restorative meaning to that spatial or social site. CONCLUSIONS: To innovate the discourse and further inform the practice of narrative, arts-based public health interventions, it is important to audit the theoretical thinking that helped guide the creative process. Those intending to engage narrative medicine should take care to remain keenly aware of narrative humility at every step.


Assuntos
Arte , Medicina Narrativa , Humanos , Narração
3.
BMC Med Educ ; 21(1): 391, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289848

RESUMO

BACKGROUND: Narrative medicine (NM) is an approach involving narrative skills and is regarded as a model for medical humanism and effective medical practice. This study aims to explore how NM impacts medical trainees' learning of professionalism during a clerkship in a Taiwanese clinical setting. METHODS: A qualitative interview study adopting a purposive sampling method was undertaken. Thirty medical trainees participated in this study, including five fifth-year medical students (MSs), ten sixth-year MSs, nine seventh-year MSs, and six postgraduate year (PGY) trainees. Thematic framework analysis was applied, and a modified realist evaluation approach was further used to analyse the interview data. RESULTS: We identified self-exploration, reflection, and awareness of professional identity as mechanisms explaining how NM impacted professionalism learning in our participants. Furthermore, empathy, communication, doctor-patient relationship and understanding patients were identified as the outcomes of the NM intervention for trainees' learning of professionalism. CONCLUSIONS: NM facilitates medical trainees' self-exploration, reflection, and awareness of professional identity, thereby affecting their learning of professionalism in clinical settings. Adopting NM as an educational intervention in undergraduate medical education could play an important role in professionalism learning, as trainees can thereby be supported to gradually develop self-exploration and reflection capabilities and heightened awareness of professional identity reflectively through a narrative process.


Assuntos
Educação de Graduação em Medicina , Medicina Narrativa , Estudantes de Medicina , Humanos , Relações Médico-Paciente , Profissionalismo
5.
BMC Med Educ ; 21(1): 321, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090423

RESUMO

BACKGROUND: Reflection and various approaches to foster reflection have been regarded as an indispensable element in enhancing professional practice across different disciplines. With its inherent potential to engage learners in reflection and improvement, narrative medicine has been adopted in various settings. However, the relevance and effectiveness of reflection remains underexplored in the context of narrative medicine, specifically in regard to the concern about variability of learner acceptance and the way learners really make sense of these reflective activities. This study aimed to explore what medical learners experience through narrative medicine and the meanings they ascribe to the phenomenon of this narrative-based learning. METHODS: Using a transcendental phenomenology approach, twenty medical learners were interviewed about their lived experiences of taking a narrative medicine course during their internal medicine clerkship rotation. Moustakas' phenomenological analysis procedures were applied to review the interview data. RESULTS: Six themes were identified: feeling hesitation, seeking guidance, shifting roles in narratives, questioning relationships, experiencing transformation, and requesting a safe learning environment. These themes shaped the essence of the phenomenon and illustrated what and how medical learners set out on a reflective journey in narrative medicine. These findings elucidate fundamental elements for educators to consider how narrative approaches can be effectively used to engage learners in reflective learning and practice. CONCLUSION: Adopting Moustakas' transcendental phenomenology approach, a better understanding about the lived experiences of medical learners regarding learning in narrative medicine was identified. Learner hesitancy should be tackled with care by educators so as to support learners with strategies that address guidance, relationship, and learning environment. In so doing, medical learners can be facilitated to develop reflective capabilities for professional and personal growth.


Assuntos
Medicina Narrativa , Compreensão , Humanos , Aprendizagem , Narração
6.
Rev. Hosp. Ital. B. Aires (2004) ; 41(2): 97-102, jun. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1254583

RESUMO

Introducción: la pandemia de COVID-19 impone a los profesionales de la salud: altas exigencias y modificaciones en el modo de vincularse con pacientes, pares y familiares. Estos cambios implican consecuencias emocionales tales como el incremento del nivel de estrés y síntomas de ansiedad y de depresión. Objetivo: describir un proyecto interdisciplinario creado bajo el modelo de la Medicina Narrativa dirigido a habilitar el relato de la experiencia de profesionales de la salud pertenecientes a un hospital general privado de alta complejidad de la ciudad de Buenos Aires durante la pandemia de COVID-19. Metodología: se creó una lista de correo y se convocó a profesionales del hospital a realizar una producción escrita, oral o gráfica que represente su experiencia durante la pandemia. Luego, el material recibido se envió a la misma lista de distribución con frecuencia semanal. En cada correo se renovó la invitación a narrar lo vivido o comentar los relatos de otros. Resultados: en el transcurso de siete semanas se recibieron diez producciones individuales: ocho textos, un audio y un gráfico. Los principales temas tratados pudieron agruparse en tres ejes: sala COVID, comunidad y telemedicina. Los autores fueron profesionales de Medicina, Enfermería, Psicología y de Puericultura. Conclusión: desarrollamos un proyecto bajo el modelo de la Medicina Narrativa que permitió a profesionales narrar su experiencia durante la pandemia de COVID-19, habilitando la posibilidad de poner en palabras lo vivido, reflexionar sobre modelos de actuación y elaborar el desgaste emocional generado por el contacto permanente con el dolor y el sufrimiento. (AU)


Introduction: the COVID-19 pandemic imposes high demands on health professionals and changes in the way they relate to patients, peers and family members. These changes involve emotional consequences such as increased stress levels, symptoms of anxiety and depression. Objective: to describe an interdisciplinary project created under the Narrative Medicine model aimed at enabling the reporting of the experience of health professionals belonging to a highly complex private general hospital in the city of Buenos Aires during the COVID-19 pandemic. Methodology: a mailing list was created and hospital professionals were invited to make a written, oral or graphic production that represents their experience during the pandemic. Then, the received material was sent to the same distribution list on a weekly basis. In each email, the invitation to narrate what was experienced or to comment on the stories of others was renewed. Results: over the course of seven weeks, ten individual productions were received: eight texts, one audio and one graphic. The main topics discussed could be grouped into three axes: COVID room, community and telemedicine. The authors were professionals from Medicine, Nursing, Psychology and Childcare. Conclusion: we developed a project under the Narrative Medicine model that allowed professionals to tell their experience during the covid 19 pandemic, enabling the possibility of putting into words what was experienced, reflecting on models of action and elaborating on the emotional exhaustion generated by permanent contact with pain and suffering. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoal de Saúde/psicologia , Medicina Narrativa , COVID-19/psicologia , Ansiedade , Dor , Estresse Psicológico , Depressão , Pandemias
7.
Postgrad Med J ; 97(1146): 271-272, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33753458
8.
J Gerontol B Psychol Sci Soc Sci ; 76(9): 1808-1816, 2021 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33786581

RESUMO

OBJECTIVES: Older adults experience higher risks of getting severely ill from coronavirus disease 2019 (COVID-19), resulting in widespread narratives of frailty and vulnerability. We test: (a) whether global aging narratives have become more negative from before to during the pandemic (October 2019 to May 2020) across 20 countries; (b) model pandemic (incidence and mortality), and cultural factors associated with the trajectory of aging narratives. METHODS: We leveraged a 10-billion-word online-media corpus, consisting of 28 million newspaper and magazine articles across 20 countries, to identify nine common synonyms of "older adults" and compiled their most frequently used descriptors (collocates) from October 2019 to May 2020-culminating in 11,504 collocates that were rated to create a Cumulative Aging Narrative Score per month. Widely used cultural dimension scores were taken from Hofstede, and pandemic variables, from the Oxford COVID-19 Government Response Tracker. RESULTS: Aging narratives became more negative as the pandemic worsened across 20 countries. Globally, scores were trending neutral from October 2019 to February 2020, and plummeted in March 2020, reflecting COVID-19's severity. Prepandemic (October 2019), the United Kingdom evidenced the most negative aging narratives; peak pandemic (May 2020), South Africa took on the dubious honor. Across the 8-month period, the Philippines experienced the steepest trend toward negativity in aging narratives. Ageism, during the pandemic, was, ironically, not predicted by COVID-19's incidence and mortality rates, but by cultural variables: Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation. DISCUSSION: The strategy to reverse this trajectory lay in the same phenomenon that promoted it: a sustained global campaign-though, it should be culturally nuanced and customized to a country's context.


Assuntos
Ageismo , Envelhecimento , COVID-19 , Carência Cultural , Medicina Narrativa , Percepção Social , Idoso , Ageismo/etnologia , Ageismo/prevenção & controle , Ageismo/psicologia , Ageismo/tendências , Envelhecimento/ética , Envelhecimento/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Mineração de Dados/métodos , Mineração de Dados/estatística & dados numéricos , Saúde Global , Disparidades nos Níveis de Saúde , Humanos , Incidência , Medicina Narrativa/ética , Medicina Narrativa/métodos , Medicina Narrativa/tendências , Psicologia , SARS-CoV-2
9.
J Med Internet Res ; 23(3): e24948, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33674257

RESUMO

During disease outbreaks or pandemics, policy makers must convey information to the public for informative purposes (eg, morbidity or mortality rates). They must also motivate members of the public to cooperate with the guidelines, specifically by changing their usual behavior. Policy makers have traditionally adopted a didactic and formalistic stance by conveying dry, statistics-based health information to the public. They have not yet considered the alternative of providing health information in the form of narrative evidence, using stories that address both cognitive and emotional aspects. The aim of this viewpoint paper is to introduce policy makers to the advantages of using narrative evidence to provide health information during a disease outbreak or pandemic such as COVID-19. Throughout human history, authorities have tended to employ apocalyptic narratives during disease outbreaks or pandemics. This viewpoint paper proposes an alternative coping narrative that includes the following components: segmentation; barrier reduction; role models; empathy and support; strengthening self-efficacy, community efficacy, and coping tools; preventing stigmatization of at-risk populations; and communicating uncertainty. It also discusses five conditions for using narrative evidence to produce an effective communication campaign on social media: (1) identifying narratives that reveal the needs, personal experiences, and questions of different subgroups to tailor messaging to produce targeted behavioral change; (2) providing separate and distinct treatment of each information unit or theory that arises on social networks; (3) identifying positive deviants who found creative solutions for stress during the COVID-19 crisis not found by other members of the community; (4) creating different stories of coping; and (5) maintaining a dialogue with population subgroups (eg, skeptical and hesitant groups). The paper concludes by proposing criteria for evaluating the effectiveness of a narrative.


Assuntos
COVID-19/epidemiologia , Informática Aplicada à Saúde dos Consumidores , Disseminação de Informação/métodos , Mídias Sociais , Rede Social , Humanos , Medicina Narrativa , Pandemias , SARS-CoV-2
10.
Rev. bras. med. esporte ; 27(spe): 31-33, Mar. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1156137

RESUMO

ABSTRACT The impact of traditional public health emergencies on the comprehensive education of medical students in colleges and universities is mainly reflected in the test of comprehensive literacy. Based on this, this paper studies the construction of a public health emergency impact analysis platform from a medical perspective and cloud computing. From the platform's database construction, event collection methods, impact evaluation rules and other aspects to achieve accurate analysis of the impact of emergencies, using the cloud computing method for comprehensive analysis and evaluation, the algorithm can analyze and intelligently classify information data on the Internet in the process of multiple input, and respond to potential public health emergencies according to cloud computing technology, in order to analyze the impact on the comprehensive quality of medical students. The experimental results show that the public health emergency analysis platform has the advantages of high feasibility and high data utilization, and can effectively improve the impact of public health emergencies on the comprehensive literacy of medical students.


RESUMO O impacto das tradicionais emergências de saúde pública sobre a formação integral de estudantes de medicina em faculdades e universidades reflete-se principalmente no teste de formação integral. Com base nisso, este documento estuda a construção da plataforma de análise de impacto de emergência de saúde pública sob a perspectiva médica e computação em nuvem. A partir da construção da base de dados da plataforma, foram desenvolvidos métodos de coleta de eventos, regras de avaliação de impacto e outros aspectos para obter uma análise precisa do impacto das emergências, usando o método de computação em nuvem para análise e avaliação. O algoritmo pode realizar a análise e classificação inteligente de dados de informação na Internet no processo de introdução múltipla, e responder a possíveis emergências de saúde pública de acordo com a tecnologia de computação em nuvem a fim de analisar o impacto sobre a qualificação dos estudantes de medicina. Os resultados experimentais mostram que a plataforma de análise de emergências de saúde pública tem as vantagens de alta viabilidade e alta utilização de dados, pode melhorar efetivamente o impacto das emergências de saúde pública na formação integral dos estudantes de medicina.


RESUMEN El impacto de las emergencias de salud pública tradicionales en la educación integral de los estudiantes de medicina en los colegios y universidades se refleja principalmente en la prueba de comprensión de textos. Con base en esto, este trabajo estudia la construcción de una plataforma de análisis de impacto de emergencias en salud pública desde una perspectiva médica y de computación en la nube. A partir de la construcción de la base de datos de la plataforma, los métodos de recolección de eventos, las reglas de evaluación de impacto y otros aspectos para lograr un análisis preciso del impacto de las emergencias, utilizando el método de computación en la nube para un análisis y evaluación integral, el algoritmo puede analizar y clasificar de manera inteligente los datos de información en Internet en el proceso de entrada múltiple. También puede responder a potenciales emergencias de salud pública de acuerdo con la tecnología de computación en la nube, con el fin de analizar el impacto en la calidad integral de los estudiantes de medicina. Los resultados experimentales muestran que la plataforma de análisis de emergencias de salud pública tiene las ventajas de alta viabilidad y alta utilización de datos, y puede mejorar de manera efectiva el impacto de las emergencias de salud pública en la comprensión de textos de los estudiantes de medicina.


Assuntos
Humanos , Informática Médica , Tecnologia Biomédica , Educação Médica , Medicina de Emergência/educação , Medicina Narrativa , Algoritmos
12.
Lupus ; 30(4): 549-553, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33596714

RESUMO

Jane Austen died 200 years ago at the age of 41 and authors have attributed her premature death to a wide variety of causes, which include Addison's disease and lymphoma.We have reviewed all of her available letters and extricated relevant medical information which reveal rheumatism, facial skin lesions, fever and marked fluctuation of these symptoms. The severity of these symptoms increased, leading to her death within a year.This range of clinical features fulfils the most recent classification criteria for systemic lupus erythematosus.


Assuntos
Exantema/diagnóstico , Dermatoses Faciais/patologia , Lúpus Eritematoso Sistêmico/diagnóstico , Medicina Narrativa/história , Adulto , Causas de Morte , Cor , Diagnóstico Diferencial , Progressão da Doença , Fadiga/diagnóstico , Feminino , Febre/diagnóstico , História do Século XVIII , História do Século XIX , Humanos , Remissão Espontânea , Doenças Reumáticas/diagnóstico
13.
Seizure ; 86: 96-101, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33582585

RESUMO

Narrative Medicine (NM) sessions draw out the patient's narrative of illness or injury and treatment in the context of the patient's whole life story. The focus is to discover topics and areas in the patient's narrative that the patient needs to explore. PNES may be understood in many cases as a communication disorder in which distress is expressed somatically in a pathological way instead of an adaptive and verbal manner. Patients with PNES are frequently misdiagnosed, and accurate diagnosis may be delayed for many years. PNES may cause severe disruption of the patient's quality of life in terms of employment or schooling as well as relationships and activities of daily living. NM sessions encourage patients to communicate more effectively about their unspeakable distress and reclaim their lives from the communication disorder of PNES. Narrative writing exercises have also proven helpful for patients facing a variety of traumas and major stresses in situations similar to those faced by patients with PNES. This paper is a narrative review with an illustrative case report indicating NM applications to help a patient with PNES to communicate about a traumatic past that has been avoided and address psychogenic symptoms.


Assuntos
Transtornos Mentais , Medicina Narrativa , Atividades Cotidianas , Eletroencefalografia , Humanos , Qualidade de Vida , Convulsões/diagnóstico , Convulsões/terapia
14.
Medicine (Baltimore) ; 100(5): e23056, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592815

RESUMO

ABSTRACT: This study aimed to evaluate the effect of reminiscence therapy-based care (RTBC) program on anxiety, depression, patients satisfaction, and survival benefit in glioma patients after tumor resection.A total of 150 eligible glioma patients were randomized into the RTBC group (N = 75, receiving RTBC) and the control care (CC) group (N = 75, receiving CC). Interventions were performed twice a month for 12 months. Anxiety was evaluated by Hospital Anxiety and Depression Scale (HADS) for anxiety score and Zung self-rating anxiety scale (SAS) score; meanwhile, depression was evaluated by HADS for depression score and Zung self-rating depression scale (SDS) score; additionally, patients satisfaction was scored. A 36-month follow-up was performed, and accumulating overall survival (OS) were calculated.Both anxiety level and depression level were reduced in the RTBC group compared with the CC group at month 9 and month 12 (all P < .05); meanwhile, the proportion of anxious patients and depressed patients were decreased in the RTBC group compared with the CC group at month 12 (all P < .05). Moreover, patients satisfaction scores were increased in the RTBC group compared to the CC group at month 6, month 9, and month 12 (all P < .05). Additionally, accumulating OS showed an increasing tendency in the RTBC group compared to the CC group, but no statistical significance was observed (P = .186).RTBC program ameliorates anxiety, depression, and promotes patients satisfaction in glioma patients after tumor resection.


Assuntos
Ansiedade/terapia , Neoplasias Encefálicas/reabilitação , Depressão/terapia , Glioma/reabilitação , Medicina Narrativa/métodos , Adulto , Fatores Etários , Idoso , Ansiedade/etiologia , Neoplasias Encefálicas/complicações , Comorbidade , Depressão/etiologia , Feminino , Glioma/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Fatores Sexuais , Fatores Socioeconômicos
15.
Support Care Cancer ; 29(8): 4381-4388, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33420531

RESUMO

BACKGROUND: Cancer is a disease that disrupts not only the patient's life, but that of the entire family as well, from a care, organizational, and emotional perspective. Patients share their experience of illness frequently with their informal caregiver (IC), a partner, son/daughter, friend, volunteer, or any other person in the family or social network who offers to support them during their clinical journey. The purpose of this study was to investigate ICs' still unknown cancer experiences through the stories of IC participants in a Literary Artistic Competition the Centro di Riferimento Oncologico di Aviano (CRO) IRCSS organized, and understand the themes that emerged from their texts and hence, the power of expressive writing. MATERIALS AND METHODS: A qualitative study was carried out on literary texts using Mishler's three levels of narrative analysis: thematic (to detect themes and subthemes); structural (to support the thematic level), and performative (to understand the narratives' meaning). In addition, the narratives were classified based on Kleinman and Frank's models. A particular focus was placed on the language of the narratives to identify figures of speech, e.g., metaphors related to cancer. RESULTS: Seven main themes emerged from the 40 stories' thematic analysis: perceptions of the disease; biographical breakdown; relationships; transformation of the sick body; IC's role; encounter with death; and strength of memory. The ICs' stories also highlighted the strengths and weaknesses of the patient's clinical pathway. ICs are a resource not only for the patient, who, thanks to them, is assured of continuous assistance but also for the healthcare organization, above all because they serve a relational role as a "bridge" between patients and healthcare workers. ICs have important messages to offer to healthcare organizations. If involved adequately, they can provide a strategic strength in supporting patients and healthcare workers themselves. The in-depth analysis of the themes and subthemes in this study led the authors to hypothesize that expressive writing benefit ICs with respect to the possibility of sharing their experiences with others and giving evidence of their role. Their stories are a testimony that can help those who face a similar experience.


Assuntos
Cuidadores/psicologia , Medicina Narrativa/métodos , Neoplasias/psicologia , Feminino , Humanos , Masculino , Redação
17.
J Med Humanit ; 42(3): 325-336, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32048123

RESUMO

Medicine and the humanities have been exploring new ways to improve the quality of healthcare. One such collaboration is the practice of narrative medicine which uses literature to teach physicians to better meet their patients' needs. Narrative medicine, however, draws primarily from Anglophone literature, yet post-war French literature, philosophy and criticism have much to add to the theoretical and practical underpinnings of narrative medicine. As well, such scholarship provokes a number of questions that expose certain weaknesses in narrative medicine as it is practiced currently. As this paper demonstrates, drawing post-war French literature into narrative medicine opens new ways to think about life, narrative and the place of the patient in the modern healthcare system.


Assuntos
Medicina , Medicina Narrativa , Ciências Humanas , Humanos , Narração , Filosofia
18.
J Clin Neurosci ; 83: 8-12, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33341368

RESUMO

BACKGROUND: We explore the applications of Narrative Medicine (NM) in the clinical care of brain cancer patients whose self-identity and quality of life are challenged by their disease and treatment. This paper considers how NM may help patients retain and rediscover self-identity during treatment. METHODS: We performed a retrospective review of NM sessions at our institution in 2016 with focus on life perspectives and priorities along with outlook or attitude and any changes in their symptoms and possible impact on their lives. RESULTS: The narratives shared by four brain cancer patients provided examples of loss of self-identity during illness and treatment, along with ways that NM sessions encouraged patient resilience and discovery of meaning. CONCLUSIONS: NM sessions made visible contributions for the patients mentioned in these case studies. Understanding the patient's story is critical for evaluating the significance of impairments due to brain cancer and treatment relative to the patient's unique sense of self and quality of life. NM is at the nexus of clinical management and quality of life concerns for brain cancer patients. Insights from NM sessions may also help the treatment team as they assess patient needs, attitudes, and abilities.


Assuntos
Neoplasias Encefálicas/psicologia , Medicina Narrativa , Qualidade de Vida , Adulto , Feminino , Humanos , Estudos Retrospectivos
19.
BMC Cardiovasc Disord ; 20(1): 522, 2020 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-33308152

RESUMO

BACKGROUND: The The Roadmap Using Story Telling project used a narrative medicine (NM) framework to assess the perspectives of people with heart failure (HF), their informal caregivers and HF specialists of the impact of HF on the daily life of patients and their carers. METHODS: Italian HF specialists participated on a voluntary basis, completing their own narratives, and inviting patients and their caregivers to write anonymously about their experiences, all on a dedicated online platform. The narratives were analyzed according to standard NM methodology. RESULTS: 82 narratives were collected from patients, 61 from caregivers, and 104 from HF specialists. Analysis of the three points of view revealed the extent of the burden of illness on the entire family, particularly that of the caregiver. The impact was mainly experienced as emotional and social limitations in patients' and their caregivers' daily lives. The analysis of all three points of view highlighted a strong difference between how HF is perceived by patients, caregivers, and HF specialists. CONCLUSIONS: This NM project illustrates the complex issues of living with HF and gave insights to integrate three different perspectives into the HF pathway of care.


Assuntos
Atitude do Pessoal de Saúde , Cardiologistas/psicologia , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Emoções , Insuficiência Cardíaca/psicologia , Medicina Narrativa , Pacientes/psicologia , Comportamento Social , Atividades Cotidianas , Idoso , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Qualidade de Vida
20.
BMC Med Educ ; 20(1): 412, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33167952

RESUMO

BACKGROUND: The perceived importance of clinical empathy may decline among students during medical training. Several interventions have been shown to be effective in promoting or preserving medical students' empathic abilities, such as empathy skills training or Balint groups. Although narrative medicine training shares some features with these interventions, no randomized study to date examined the efficacy of narrative medicine training. This study aimed to assess the effects of Balint groups and narrative medicine training on clinical empathy measured by the self-rated Jefferson's School Empathy Scale - Medical Student (JSPE-MS©) among fourth-year medical students. METHODS: Students who gave their consent to participate were randomly allocated in equal proportion to Balint groups, narrative medicine training or to the control group. Participants in the intervention groups received either seven sessions of 1.5-h Balint groups or a 2-h lecture and five sessions of 1.5-h narrative medicine training from October 2015 to December 2015. The main outcome was the change in JSPE-MS© score from baseline to one week after the last session. RESULTS: Data from 362 out of 392 participants were analyzed: 117 in the control group, 125 in the Balint group and 120 in the narrative medicine group. The change in JSPE-MS© score from baseline to follow-up was significantly higher in the Balint group than in the control group [mean (SD): 0.27 (8.00) vs. -2,36 (11.41), t = 2.086, P = 0.038]. The change in JSPE-MS© score in the narrative medicine group [mean (SD): - 0.57 (8.76)] did not significantly differ from the changes in the control group (t = 1.355, P = 0.18) or the Balint group (t = 0.784, P = 0.43). Adjusting for participants' characteristics at baseline, Balint groups remained associated with better outcomes compared to the control group (ß = 2.673, P = 0.030). CONCLUSIONS: Balint groups may promote clinical empathy to some extent among medical students, at least in the short run.


Assuntos
Educação de Graduação em Medicina , Medicina Narrativa , Estudantes de Medicina , Empatia , Humanos , Relações Médico-Paciente
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