Markey Cancer Center, University of Kentucky, Lexington, KY, 40536, USA.
Departments of Medicine, Neurosurgery, and Neurology, University of Kentucky, 800 Rose Street, CC447, Lexington, KY, 40536-0093, USA.
J Neurooncol. 2017 Sep;134(2):417-421. doi: 10.1007/s11060-017-2542-5. Epub 2017 Jul 1.
Narrative Medicine sessions can encourage patients to rediscover personal identity and meaning by telling or writing their stories. We explored this process to improve care and quality of life for brain cancer patients in an academic neuro-oncology program. Brain cancer and its treatments may threaten a patient's quality of life and sense of self in many ways, including impaired cognitive skills, loss of memory, reduced coordination, and limited capacity for self-expression. The impact of symptoms and side effects on quality of life must be evaluated in terms of each patient's identity and may be understood in terms of each patient's story. Insights from Narrative Medicine visits may also be helpful for the treatment team as they seek to assess patient needs, attitudes, and abilities. We provide case-based histories demonstrating applications of Narrative Medicine in the care of patients with brain tumors whose sense of self and quality of life are challenged. The cases include managing frontal lobe syndrome of loss of initiative and pervasive emotional apathy with his wife and young children, regaining a meaningful activity in a patient, re-establishing self-identity in a young woman with ependymoma, and improving spells with coexistent epilepsy and psychogenic non-epileptic seizures (PNES).
叙事医学可以通过讲述或书写故事来鼓励患者重新发现个人身份和意义。我们在一个学术神经肿瘤学项目中探索了这一过程，以改善脑癌患者的护理和生活质量。脑癌及其治疗方法可能会在多个方面威胁到患者的生活质量和自我意识，包括认知技能受损、记忆力丧失、协调能力降低以及自我表达能力受限。症状和副作用对生活质量的影响必须根据每个患者的身份进行评估，并且可以根据每个患者的故事来理解。叙事医学访问的见解也可能对治疗团队有帮助，因为他们试图评估患者的需求、态度和能力。我们提供了基于案例的病史，展示了叙事医学在照顾脑肿瘤患者方面的应用，这些患者的自我意识和生活质量受到了挑战。这些病例包括与患者的妻子和年幼的孩子一起管理额叶综合征导致的主动性丧失和普遍的情感冷漠，帮助患者恢复有意义的活动，帮助年轻的室管膜瘤患者重新建立自我认同，以及改善同时患有癫痫和心因性非癫痫性发作（PNES）的患者的发作情况。
