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叙事医学在临终关怀和姑息治疗中的应用:纵向研究员课程试点。

Narrative Medicine in Hospice and Palliative Care: A Longitudinal Fellowship Curriculum Pilot.

机构信息

St. Jude Children's Research Hospital, Memphis, TN, USA.

Connecticut Children's Medical Center, Hartford, CT, USA.

出版信息

Am J Hosp Palliat Care. 2024 Oct;41(10):1161-1165. doi: 10.1177/10499091231223717. Epub 2023 Dec 21.

Abstract

INTRODUCTION

Growing evidence suggests that clinician exposure to narrative medicine (NM) may help bolster resilience and mitigate burnout. The value of formal longitudinal training in NM for hospice and palliative medicine (HPM) trainees remains understudied.

METHODS

A 1-year longitudinal NM curriculum for HPM fellows was pilot-tested for feasibility, acceptability, and exploratory impact. Six monthly 45-minute sessions included reading literature, reflective writing, and sharing creative work. Quantitative and qualitative data were collected through a pre-intervention survey and post-intervention survey administered immediately upon completion of the curriculum. Longitudinal impact was assessed with a post-intervention survey administered three months after completion of the curriculum.

RESULTS

All HPM fellows (n = 6) attended at least 5/6 sessions during the 1-year pilot, suggesting intervention feasibility. Participant engagement and self-reported comfort with NM exercises supported intervention acceptability. Post-intervention, participants described the positive influence of NM practice on their clinical practice and stated an intention to integrate NM skills in their future HPM careers. Three months following the intervention, participants had a sustained increase in their comfort level with NM. All participants felt that the NM sessions had been relevant to their life as HPM fellows and anticipated using NM moving forward in their practice of HPM.

DISCUSSION

This novel NM curriculum was feasible and acceptable to implement in a 1-year HPM fellowship. Longitudinal impact showed sustained increase in trainee comfort and interest in using NM in their future clinical practice.

摘要

简介

越来越多的证据表明,临床医生接触叙事医学(NM)可能有助于增强韧性并减轻倦怠。对于临终关怀和姑息医学(HPM)培训生来说,正式的 NM 纵向培训的价值仍有待研究。

方法

对 HPM 研究员进行为期 1 年的 NM 课程进行了试点测试,以评估其可行性、可接受性和探索性影响。六次为期 45 分钟的课程包括阅读文献、反思性写作和分享创意作品。通过干预前调查和干预后调查收集定量和定性数据,后者在课程结束后立即进行。通过课程结束后三个月进行的干预后调查评估纵向影响。

结果

所有 HPM 研究员(n = 6)都参加了为期 1 年的试点研究中的至少 5/6 次课程,表明干预具有可行性。参与者的参与度和对 NM 练习的自我报告舒适度支持了干预的可接受性。干预后,参与者描述了 NM 实践对他们临床实践的积极影响,并表示打算将 NM 技能整合到他们未来的 HPM 职业生涯中。干预三个月后,参与者对 NM 的舒适度持续增加。所有参与者都认为 NM 课程与他们作为 HPM 研究员的生活相关,并期望在未来的 HPM 实践中继续使用 NM。

讨论

这个新颖的 NM 课程在为期 1 年的 HPM 奖学金中具有可行性和可接受性。纵向影响显示,培训生对 NM 的舒适度和在未来临床实践中使用 NM 的兴趣持续增加。

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