Chen Po-Yi, Fu Chung-Pei, Wang Chih-Chia
Center for Medical Humanities Education, School of Medicine, National Defense Medical Center, Taiwan.
Department of Occupational Therapy, College of Medicine, Fu-Jen Catholic University, Taiwan.
Heliyon. 2023 Feb 13;9(2):e13716. doi: 10.1016/j.heliyon.2023.e13716. eCollection 2023 Feb.
Medical treatment and narratives are interrelated. We examined this interrelation by evaluating the medical dispute mediation system in Taiwan. We conducted 16 semi-structured interviews with legal and administrative specialists in medical mediation and physicians involved in mediation meetings. The interview data were reproduced into almost verbatim text for coding and analysis. We examined how narratives were discussed in the field of medicine and identified two approaches to narratives. One was the narrative from a patient's storytelling, that is, narrative-based medicine. The other was the narrative of medical staff, which included shared decision-making and decision aids. Discussions of these approaches revolved around the avoidance of conflicts during medical treatment. However, knowing how to handle unsuccessful medical treatment is crucial. By applying polyphony in narratives, physicians can comprehend the role of narratives in unsuccessful medical treatment, helping themselves to practice how to develop narratives to communicate with patients and their surrogates when encountering any difficulty in different stages of medical treatment.
医疗治疗与叙事是相互关联的。我们通过评估台湾的医疗纠纷调解系统来研究这种相互关系。我们对医疗调解方面的法律和行政专家以及参与调解会议的医生进行了16次半结构化访谈。访谈数据被整理成几乎逐字逐句的文本用于编码和分析。我们研究了医学领域中叙事是如何被讨论的，并确定了两种叙事方式。一种是患者讲述的叙事，即叙事医学。另一种是医务人员的叙事，包括共同决策和决策辅助工具。对这些方式的讨论围绕着避免医疗过程中的冲突展开。然而，了解如何应对治疗失败至关重要。通过在叙事中运用复调，医生可以理解叙事在治疗失败中的作用，帮助自己练习如何在医疗治疗的不同阶段遇到困难时，构建叙事与患者及其代理人进行沟通。
