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患者故事在医学中的作用:系统范围综述。

The role of patients' stories in medicine: a systematic scoping review.

机构信息

Yong Loo Lin School of Medicine, National University Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.

Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.

出版信息

BMC Palliat Care. 2023 Dec 12;22(1):199. doi: 10.1186/s12904-023-01319-w.

Abstract

BACKGROUND

Patients' stories provide Palliative Care physicians with a glimpse into the former's lives and their psycho-emotional, sociocultural, and contextual considerations. Yet, few physicians are trained to interpret and apply patients' stories in their practice. Inherent variability in how stories are transmitted and interpreted raises questions over their potential effects on care. Amidst a dearth of accounts in Palliative Care, we map current use of patient stories to guide the training, assessment, and oversight of this 'care influencing' practice in medicine.

METHODS

This systematic scoping review was guided by the Systematic Evidence-Based Approach (SEBA) to ensure a reproducible and structured approach. The themes and categories identified through the Split Approach's concurrent and independent thematic and directed content analyses provided a comprehensive sketch of the included articles. The Jigsaw Perspective combined the themes and categories identified. The last stage of SEBA compared these results with two recent reviews of storytelling to ensure consistency of the domains created that guided the discussion.

RESULTS

Ten thousand two hundred seven articles were reviewed, 963 full text articles were evaluated, and 199 articles were included. The four domains identified were study characteristics, benefits, approaches, and positive effects and concerns.

CONCLUSION

Stories support patient-centered, personalized, and holistic clinical care. However, variability in the stories, their interpretations and use in care decisions underscore the need for further study on the structuring, teaching, assessing, and delivery of this 'care influencing' practice.

摘要

背景

患者的故事为姑息治疗医生提供了一个窥探患者生活的机会,让他们了解患者的心理-情感、社会文化和背景方面的考虑因素。然而,很少有医生接受过解读和应用患者故事的培训。由于故事的传递和解释方式存在固有差异,因此人们对其对护理的潜在影响存在疑问。在姑息治疗领域缺乏相关报道的情况下,我们描述了当前使用患者故事的情况,以指导对这种“影响护理”实践的培训、评估和监督。

方法

本系统范围审查遵循系统循证方法(SEBA),以确保可重现和结构化的方法。通过 Split 方法的并发和独立主题和定向内容分析确定的主题和类别为纳入的文章提供了全面的概述。拼图视角将确定的主题和类别结合在一起。SEBA 的最后一个阶段将这些结果与最近对讲故事的两项评论进行了比较,以确保创建的指导讨论的域具有一致性。

结果

共审查了 12070 篇文章,评估了 963 篇全文文章,最终纳入了 199 篇文章。确定的四个领域分别是研究特征、益处、方法以及积极影响和关注点。

结论

故事支持以患者为中心、个性化和全面的临床护理。然而,故事的变异性、对故事的解释以及在护理决策中的使用,突显了进一步研究这种“影响护理”实践的结构、教学、评估和实施的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5558/10714554/eeea0d7b6fbd/12904_2023_1319_Fig1_HTML.jpg

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