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COVID-19大流行中的前进之路:论证叙事能力在肺科和重症医学中的重要性

A Way Forward in the COVID-19 Pandemic: Making the Case for Narrative Competence in Pulmonary and Critical Care Medicine.

作者信息

Awdish Rana Lee Adawi, Hayes Margaret M, Cooper Avraham Z, Hosey Megan M, Trainor Alison, Weatherston Rosemary, Wilcox M Elizabeth

机构信息

Wayne State University School of Medicine, Detroit, Michigan.

Henry Ford Health System, Detroit, Michigan.

出版信息

ATS Sch. 2022 May 15;3(2):188-196. doi: 10.34197/ats-scholar.2022-0021PS. eCollection 2022 Jun.

Abstract

Each surge of the coronavirus disease (COVID-19) pandemic presented new challenges to pulmonary and critical care practitioners. Although some of the initial challenges were somewhat less acute, clinicians now are left to face the physical, emotional, and mental toll of the past 2 years. The pandemic revealed a need for a more varied skillset, including space for reflection, tolerance of uncertainty, and humanism. These skills can assist clinicians who are left to heal from the difficulty of caring for patients in the absence of families who were excluded from the intensive care unit, public distrust of vaccines, and morgues overtaken by our patients. As pulmonary and critical care medicine practitioners and educators, we believe that cultivating practices, pedagogies, and institutional structures that foster narrative competence, "the ability to acknowledge, absorb, interpret, and act on the stories and plights of others," in our ourselves, our trainees, and our colleagues, may provide a productive way forward. In addition to fostering needed skills, this practice can promote necessary healing as well. This perspective introduces the practice of narrative competence, provides evidence of support for its implementation, and suggests opportunities for curricular integration.

摘要

冠状病毒病(COVID-19)大流行的每一次浪潮都给肺部和重症医学从业者带来了新的挑战。尽管一些最初的挑战不那么严峻,但临床医生现在不得不面对过去两年的身体、情感和精神创伤。大流行揭示了对更多样化技能的需求,包括反思的空间、对不确定性的容忍度和人文关怀。这些技能可以帮助临床医生从困难中恢复过来,这些困难包括在没有家属陪伴的情况下照顾患者(家属被排除在重症监护病房之外)、公众对疫苗的不信任以及太平间被我们的患者挤满。作为肺部和重症医学的从业者及教育工作者,我们认为在我们自己、我们的学员和同事中培养能够促进叙事能力的实践、教学方法和机构结构,即“承认、吸收、解读他人的故事和困境并据此采取行动的能力”,可能是一条富有成效的前进道路。除了培养所需技能外,这种实践还可以促进必要的康复。本文阐述了叙事能力的实践,提供了支持其实施的证据,并提出了课程整合的机会。

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