Azienda USL-IRCCS di Reggio Emilia, Italy.
Department of Medicine and Surgery, University of Parma, Italy.
Acta Biomed. 2020 Mar 13;91(2-S):7-15. doi: 10.23750/abm.v91i2-S.9371.
To activate the participation of the person in his/her care path, the literature highlight the impact of the professional's ability to show a genuine interest in the problems brought by the patient and to recognize him/her as 'competent'. In these sense the narrative patient's agenda could be a useful relational tool, because is focused on the perception of patient experiences of his/her illness. Thus this study aims to analyze the usefulness of patient's narrative agenda during the assessment phase.
A semi-structured interview has been adopted to explore the agenda of Robert, 21 years old, suffering from osteosarcoma. A first level analysis identified the four functional areas of the agenda: ideas and beliefs; expectations and desires and context in which he lives and interacts. A second level analysis assessed the main Robert's problems.
The narrative agenda has highlighted many central problems of Robert (e.g. therapeutic adherence, quality of life, mood, body image, existential problems related to experiences, hopes and expectations). Of course these results could be integrated with other tools: qualitative, to understanding difficulties and to formulate hypotheses, and quantitative, to measure the level of severity of problems reported.
The narrative agenda has not only proved to be a valid instrument of assessment, allowing an adequate insight on the patient's problems, as we exemplified, but it can be also used for monitoring the dynamic situation of the person's history, lending itself to the re-exploration of its functional areas over time.
为了激活患者在其护理路径中的参与，文献强调了专业人员展示对患者问题真正兴趣并将其视为“有能力的”的能力的影响。在这些意义上，叙述性的患者议程可能是一种有用的关系工具，因为它侧重于患者对自身疾病的体验的感知。因此，本研究旨在分析在评估阶段使用患者叙述性议程的有用性。
采用半结构化访谈来探讨 21 岁患有骨肉瘤的罗伯特的议程。一级分析确定了议程的四个功能区域：想法和信念、期望和愿望以及他生活和互动的背景。二级分析评估了罗伯特的主要问题。
叙述性议程突出了罗伯特的许多核心问题（例如治疗依从性、生活质量、情绪、身体形象、与经历相关的存在问题、希望和期望）。当然，这些结果可以与其他工具相结合：定性的，用于理解困难并提出假设，以及定量的，用于测量报告问题的严重程度。
叙述性议程不仅被证明是一种有效的评估工具，允许对患者的问题进行充分的了解，正如我们举例说明的那样，而且还可以用于监测患者个人历史的动态情况，随着时间的推移，它可以重新探索其功能区域。
