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叙事医学:理论、临床实践与教育——范围综述。

Narrative Medicine: theory, clinical practice and education - a scoping review.

机构信息

Institute of Management, Scuola Superiore Sant'Anna Pisa, Piazza Martiri della Libertà 33, Pisa, 56127, Italy.

SIMeN, Società Italiana Medicina Narrativa, Arezzo, Italy.

出版信息

BMC Health Serv Res. 2024 Sep 27;24(1):1116. doi: 10.1186/s12913-024-11530-x.

Abstract

BACKGROUND

The origin of Narrative Medicine dates back to more than 20 years ago at an international level. Narrative Medicine is not an alternative to evidence-based medicine, however these two approaches are integrated. Narrative Medicine is a methodology based on specific communication skills where storytelling is a fundamental tool to acquire, understand and integrate several points of view related to persons involving in the disease and in the healthcare process. Narrative Medicine, henceforth NM, represents a union between disease and illness between the doctor's clinical knowledge and the patient's experience. According to Byron Good, "we cannot have direct access to the experience of others' illness, not even through in-depth investigations: one of the ways in which we can learn more from the experience of others is to listen to the stories of what has happened to other people." Several studies have been published on NM; however, to the best of our knowledge, no scoping review of the literature has been performed.

OBJECTIVE

This paper aims to map and synthetize studies on NM according to theory, clinical practice and education/training.

METHOD

The scoping review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist. A search was conducted in PubMed, APA PsycNet and Jstor. Two authors independently assessed the eligibility and methodological quality of the studies and extracted the data. This review refers to the period from 1998 to 2022.

RESULTS

A total of 843 abstracts were identified of which 274 papers were selected based on the title/abstract. A total of 152 papers in full text were evaluated and 76 were included in the review. Papers were classified according to three issues: ✘ Nineteen studies focused on the definition and concept of NM (Theoretical). ✘ Thirty-eight papers focused on the collection of stories, projects and case reports (Clinical practice). ✘ Nineteen papers focused on the implementation of the Narrative Medicine approach in the education and training of medical doctors (Education and training).

CONCLUSIONS

This scoping review presents an overview of the state of the art of the Narrative Medicine. It collect studies performed mainly in Italy and in the United States as these are the countries developing the Narrative Medicine approach in three identified areas, theoretical, clinical practice and education and training. This scoping review will help to promote the power of Narrative Medicine in all three areas supporting the development of methods to evaluate and to measure the Narrative Medicine approach using key performance indicators.

摘要

背景

叙事医学的起源可以追溯到 20 多年前的国际水平。叙事医学不是循证医学的替代品,而是将这两种方法结合在一起。叙事医学是一种基于特定沟通技巧的方法,其中讲故事是获取、理解和整合与疾病和医疗过程相关的多个观点的基本工具。叙事医学(NM),是将疾病与医生的临床知识和患者的经验联系起来的一种方法。正如 Byron Good 所说,“我们无法直接了解他人疾病的体验,即使通过深入调查也无法了解:我们可以从他人的经验中学习更多的一种方式是倾听他人发生的故事。”已经发表了一些关于 NM 的研究;然而,据我们所知,还没有对文献进行范围综述。

目的

本文旨在根据理论、临床实践和教育/培训,对 NM 的研究进行映射和综合。

方法

该范围综述按照系统评价和荟萃分析扩展的首选报告项目(PRISMA-ScR)清单进行。在 PubMed、APA PsycNet 和 Jstor 中进行了搜索。两位作者独立评估了研究的合格性和方法学质量,并提取了数据。本综述涉及 1998 年至 2022 年期间。

结果

共确定了 843 篇摘要,其中 274 篇基于标题/摘要入选。共有 152 篇全文进行了评估,其中 76 篇被纳入综述。论文根据三个问题进行分类:✘19 项研究侧重于 NM 的定义和概念(理论)。✘38 篇论文侧重于故事、项目和案例报告的收集(临床实践)。✘19 项研究侧重于叙事医学方法在医生教育和培训中的实施(教育和培训)。

结论

本范围综述介绍了叙事医学的最新进展。它收集了主要在意大利和美国进行的研究,因为这两个国家正在这三个确定的领域(理论、临床实践和教育和培训)中发展叙事医学方法。本范围综述将有助于在这三个领域中促进叙事医学的力量,支持使用关键绩效指标来评估和衡量叙事医学方法的方法的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e501/11428871/08eb649c79d8/12913_2024_11530_Fig1_HTML.jpg

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