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超越医生视角看患者视角。

Moving Beyond the Doctor's Perspective of the Patient's Perspective.

机构信息

Division of General Internal Medicine, McMaster University, Hamilton, ON, Canada.

Department of Health Research Methods, Evidence and Impact, Hamilton, ON, Canada.

出版信息

J Gen Intern Med. 2023 Jun;38(8):1962-1965. doi: 10.1007/s11606-023-08144-0. Epub 2023 Mar 21.

Abstract

The emergence of narrative medicine has promoted reflective practices and story-telling as means of promoting compassion, building resiliency, and understanding the "patient" and "physician" as "persons." However, though some narrative medicine pieces describe patients' experiences, the narrative of the patient is usually told by physicians, producing a second-hand facsimile of the patient's lived experience. Stories written by physicians may have their roots in patient encounters, but are filtered through the physician's, rather than the patient's, understanding of the world. This focus on patient stories told by physicians replicates traditional gaps in legitimacy between the voices of physicians and patients and maintains the locus of power with physicians and the health care system. This paper explores the ways in which well-meaning physicians aiming to elevate patients' stories frequently fall short, and what we can do to better elevate patients' voices on the wards, in clinics, and in the medical literature. Stories about patients are important to help clinicians and trainees develop and practice compassionate person-centered care; stories written by patients on topics and with orientations of their choosing are currently lacking, and, we argue, even more important.

摘要

叙事医学的出现促进了反思实践和讲故事,以此来增强同情心、建立韧性,并将“患者”和“医生”理解为“人”。然而,尽管有些叙事医学作品描述了患者的经历,但患者的叙述通常是由医生讲述的,这只是患者生活经历的二手模拟。医生撰写的故事可能源于与患者的接触,但经过了医生而不是患者对世界的理解的过滤。这种对医生讲述的患者故事的关注复制了医生和患者之间在合法性方面的传统差距,并保持了医生和医疗体系的权力中心地位。本文探讨了善意的医生旨在提升患者故事的方式,以及我们可以做些什么来更好地在病房、诊所和医学文献中提升患者的声音。关于患者的故事对于帮助临床医生和实习生发展和实践富有同情心的以患者为中心的护理很重要;而患者选择主题并以自己的取向撰写的故事目前还缺乏,我们认为,这些故事甚至更为重要。

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