Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
Department of English, The Ohio State University, Columbus, OH, USA.
Ann Med. 2023 Dec;55(1):849-859. doi: 10.1080/07853890.2023.2185674.
Burnout in pediatric residents is widespread. Certain factors are associated with decreased burnout, such as empathy, self-compassion, mindfulness, and resilience, while perceived stress is associated with increased burnout. Narrative medicine may reduce burnout by its impact on protective and exacerbating factors and can be an active tool to promote wellness. The objective of this pilot study was to evaluate immediate and delayed benefits of a longitudinal narrative medicine intervention for pediatric residents using qualitative and quantitative measures.
We designed a voluntary longitudinal narrative medicine intervention implemented Zoom teleconferencing software over five months for pediatric residents at Nationwide Children's Hospital. It consisted of six one-hour long sessions where residents engaged with literature, responded to a writing prompt, and shared their reflections. It was evaluated using open-ended survey questions and established quantitative assessment tools of well-being with validity evidence. Results were compared before the intervention, immediately after, and six months later using one-way ANOVA and multiple linear regression. Qualitative data was analyzed using thematic analysis.
Twenty-two (14% of eligible) residents participated in at least one session. After the intervention, the following themes emerged for benefits to resident well-being: the ability to , have an , reap , and work on . Benefits were sustained even six months later, which has not been shown previously. While there were significant qualitative findings, between all three time points, there was no change in any quantitative well-being measures.
Our longitudinal narrative medicine pilot study showed meaningful sustained qualitative benefits, though no quantitative changes, in measured well-being outcomes that have been previously associated with lower resident burnout. While not a panacea, narrative medicine can be a useful strategy for residency programs to improve pediatric resident well-being even after completion of planned interventions.Key MessageWe used a mixed-methods approach to assess the effects of a longitudinal narrative medicine intervention on well-being in pediatric residents.Open-ended responses indicated that residents found utility in and appreciated the intervention and experienced sustained improvements in their mental and emotional health, though the sample size was likely too small to show quantitative changes in well-being measures.Narrative medicine is not a panacea, but it can be a useful tool to provide to pediatric residents to promote sustained improvements in their well-being through the framework of relationship-centered care.
儿科住院医师的倦怠现象普遍存在。某些因素与倦怠程度降低有关，例如同理心、自我同情、正念和适应力，而感知到的压力则与倦怠程度增加有关。叙事医学可以通过对保护因素和加剧因素的影响来减少倦怠，并且可以作为促进健康的积极工具。本研究旨在使用定性和定量方法评估儿科住院医师进行纵向叙事医学干预的即时和延迟效益。
我们设计了一项自愿的纵向叙事医学干预措施，通过 Zoom 视频会议软件在五个月内对全国儿童医院的儿科住院医师进行实施。该干预措施由六次为时一小时的会议组成，住院医师在会议中接触文学作品、对写作提示做出回应并分享自己的感悟。使用开放式调查问题和经过验证的既定幸福感定量评估工具进行评估。使用单向方差分析和多元线性回归在干预前、干预后即刻和六个月后进行比较。使用主题分析对定性数据进行分析。
共有 22 名（符合条件的 14%）住院医师参加了至少一次会议。干预后，对居民幸福感的益处出现了以下主题：能够、拥有、收获和致力于。即使在六个月后，这些益处仍持续存在，这在以前是没有显示过的。虽然有显著的定性发现，但在所有三个时间点之间，幸福感的任何定量衡量标准都没有变化。
我们的纵向叙事医学试点研究表明，与较低的住院医师倦怠相关的幸福感测量结果有意义的、持续的定性改善，尽管没有定量变化。虽然不是万能的，但叙事医学可以成为住院医师计划的有用策略，即使在干预计划完成后，也可以改善儿科住院医师的幸福感。
我们采用混合方法评估纵向叙事医学干预对儿科住院医师幸福感的影响。
开放性回复表明，住院医师认为干预具有实用性并对此表示赞赏，并且他们的精神和情绪健康得到了持续改善，尽管样本量可能太小，无法显示幸福感测量的定量变化。
叙事医学不是万能的，但它可以作为一种有用的工具提供给儿科住院医师，通过以关系为中心的护理框架促进他们的幸福感持续改善。
