Sanches Marsal, Karnes Brandi, Actor Amanda, Helminiak Amanda, John Vineeth P
UT Health McGovern Medical School, Houston, TX, USA.
Vanderbilt University Medical Center, Nashville, TN, USA.
Acad Psychiatry. 2025 Jun;49(3):254-257. doi: 10.1007/s40596-024-02106-2. Epub 2024 Dec 19.
Stigma toward mental illness has been extensively described among health care professionals and has important implications with respect to quality of care. Narrative medicine has the potential to bring about positive impacts on the practitioner-patient relationship and on patient outcomes. The authors carried out a pilot study investigating the impact of narrative medicine on residents' stigma toward bipolar disorder.
Psychiatry residents attended four narrative medicine workshops. During the encounters, the residents watched a video vignette displaying stigma-related experiences and life challenges faced by a standardized patient with bipolar disorder and were encouraged to discuss their personal reactions, opinions, and other reflections prompted by the video vignette, as well as to write reflective pieces on the content mobilized by the discussion. Stigma toward mental illnesses was measured through the Mental Illness: Clinicians' Attitudes Scale-Version 4 (MICA v4).
A total of 22 psychiatry residents attended the four narrative medicine workshops. Overall, the activity was well received by the residents. There was a small, non-significant decline in the pre- and post-activity MICA v4 scores among residents.
The findings demonstrate the feasibility of implementing narrative medicine workshops for psychiatry residents and highlight the need for further studies with larger samples and a control group to evaluate its impact on stigma.
医护人员中对精神疾病的污名化现象已被广泛描述,且对医疗质量有重要影响。叙事医学有可能对医患关系和患者治疗结果产生积极影响。作者开展了一项试点研究,调查叙事医学对住院医师对双相情感障碍污名化的影响。
精神科住院医师参加了四个叙事医学工作坊。在交流过程中,住院医师观看了一段视频短片,展示了一名双相情感障碍标准化患者所面临的与污名化相关的经历和生活挑战,并被鼓励讨论他们的个人反应、观点以及视频短片引发的其他思考,同时就讨论中涉及的内容撰写反思文章。通过《精神疾病:临床医生态度量表第4版》(MICA v4)来衡量对精神疾病的污名化程度。
共有22名精神科住院医师参加了这四个叙事医学工作坊。总体而言,该活动受到住院医师的好评。住院医师在活动前后的MICA v4评分有小幅下降,但无统计学意义。
研究结果证明了为精神科住院医师开展叙事医学工作坊的可行性,并强调需要进行更大样本且有对照组的进一步研究,以评估其对污名化的影响。