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一种创造性叙事干预如何改善医学生对痴呆症患者的态度:一项混合方法研究。

How a creative storytelling intervention can improve medical student attitude towards persons with dementia: a mixed methods study.

作者信息

George Daniel R, Stuckey Heather L, Whitehead Megan M

机构信息

Department of Humanities, Penn State College of Medicine, USA.

出版信息

Dementia (London). 2014 May;13(3):318-29. doi: 10.1177/1471301212468732. Epub 2012 Dec 27.

Abstract

BACKGROUND

The creative arts can integrate humanistic experiences into geriatric education. This experiential learning case study evaluated whether medical student participation in TimeSlips, a creative storytelling program with persons affected by dementia, would improve attitudes towards this patient population.

METHODS

Twenty-two fourth-year medical students participated in TimeSlips for one month. The authors analyzed pre- and post-program scores of items, sub-domains for comfort and knowledge, and overall scale from the Dementia Attitudes Scale using paired t-tests or Wilcoxon Signed-rank tests to evaluate mean change in students' self-reported attitudes towards persons with dementia. A case study approach using student reflective writing and focus group data was used to explain quantitative results.

RESULTS

Twelve of the 20 items, the two sub-domains, and the overall Dementia Attitudes Scale showed significant improvement post-intervention. Qualitative analysis identified four themes that added insight to quantitative results: (a) expressions of fear and discomfort felt before storytelling, (b) comfort experienced during storytelling, (c) creativity and openness achieved through storytelling, and (d) humanistic perspectives developed during storytelling can influence future patient care.

CONCLUSIONS

This study provides preliminary evidence that participation in a creative storytelling program improves medical student attitudes towards persons with dementia, and suggests mechanisms for why attitudinal changes occurred.

摘要

背景

创意艺术可以将人文体验融入老年医学教育。本体验式学习案例研究评估了医学生参与“时光流逝”(TimeSlips)这一与痴呆症患者开展的创意故事讲述项目,是否会改善对该患者群体的态度。

方法

22名四年级医学生参与了为期一个月的“时光流逝”项目。作者使用配对t检验或威尔科克森符号秩检验,分析了痴呆症态度量表中各项、舒适与知识子领域以及总体量表在项目前后的得分,以评估学生自我报告的对痴呆症患者态度的平均变化。采用案例研究方法,利用学生反思性写作和焦点小组数据来解释定量结果。

结果

20项中的12项、两个子领域以及痴呆症态度量表总体在干预后均有显著改善。定性分析确定了四个主题,为定量结果提供了更深入的见解:(a)故事讲述前感到的恐惧和不适;(b)故事讲述过程中体验到的舒适;(c)通过故事讲述实现的创造力和开放性;(d)故事讲述过程中形成的人文视角可影响未来的患者护理。

结论

本研究提供了初步证据,表明参与创意故事讲述项目可改善医学生对痴呆症患者的态度,并提出了态度改变发生原因的机制。

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