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叙事医学在临床遗传学实践中的应用。

Narrative medicine in clinical genetics practice.

机构信息

Department of Pathology and Molecular Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada.

出版信息

Am J Med Genet A. 2012 Aug;158A(8):1941-7. doi: 10.1002/ajmg.a.35482. Epub 2012 Jun 29.

Abstract

Over the last 30 years medicine has undergone a significant paradigm shift. Due to the tremendous advances of modern medicine more and more people are living longer with their illnesses. These people have stories to tell, and they want these stories to be heard: They are reclaiming their voices. As clinical geneticists we need to hear what these voices are telling us, especially so in our area of clinical care where cures are rare, and disease states can be permanent. Narrative medicine is an important new skill set that hones abilities to do just that.This article highlights how integral narrative medicine is to clinical genetics practice, how geneticists already employ many of its tools and how they practice it diligently every day. I will show how geneticists can further improve their abilities to hear and honor patients' stories by writing and sharing stories with patients and with each other as doctors, counselors, and nurses, social workers and chaplains. The review presents the skills of close reading and how they improve patient care and illustrates how geneticists can, by using reflective writing, reshape their emotions in order to understand them, to let them go, and to make room for more. It presents the major types of illness narratives whose recognition allows us to hear and understand patients' stories. When used, the tools of narrative medicine can result in better patient care.

摘要

在过去的 30 年里,医学发生了重大的范式转变。由于现代医学的巨大进步,越来越多的人带病生存时间更长。这些人有故事要讲,他们希望这些故事能被听到:他们正在重新找回自己的声音。作为临床遗传学家,我们需要倾听这些声音在告诉我们什么,尤其是在我们的临床护理领域,治愈的机会很少,疾病状态可能是永久性的。叙事医学是一种重要的新技能,它能磨练我们倾听的能力。本文强调了叙事医学在临床遗传学实践中的重要性,遗传学家已经运用了其中的许多工具,以及他们如何每天勤奋地实践。我将展示遗传学家如何通过与患者以及作为医生、顾问、护士、社会工作者和牧师的同事分享故事,进一步提高倾听和尊重患者故事的能力。这篇综述介绍了仔细阅读的技巧,以及它们如何改善患者护理,并举例说明了遗传学家如何通过反思性写作来重塑自己的情绪,从而理解、释放情绪,并为更多的情绪留出空间。它介绍了主要类型的疾病叙事,这些叙事的识别使我们能够倾听和理解患者的故事。当使用叙事医学的工具时,可以改善患者的护理。

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