Narrative Based Medicine

Edited by two leading general practitioners and with contributions from over 20 authors, this book covers a wide range of topics to do with narrative in medicine. It includes a wealth of real examples of patients narratives and addresses theoretical and practical issues including the use of narrative as a therapeutic tool, teaching narrative to students, philosophical issues, narrative in legal and ethical decisions, narrative in nursing, and the narrative medical record.

The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.

Publisher description

This book examines all aspects of narrative medicine and its value in ensuring that, in an age of evidence-based medicine defined by clinical trials, numbers, and probabilities, clinical science is firmly embedded in the medical humanities in order to foster the understanding of clinical cases and the delivery of excellent patient care. The medical humanities address what happens to us when we are affected by a disease and narrative medicine is an interdisciplinary approach that emphasizes the importance of patient narratives in bridging various divides, including those between health care professionals and patients. The book covers the genesis of the medical humanities and of narrative medicine and explores all aspects of their role in improving healthcare. It describes how narrative medicine is therapeutic for the patient, enhances the patient–doctor relationship, and allows the identification, via patients' stories, of the feelings and experiences that are characteristic for each disease. Furthermore, it explains how to use narrative medicine as a real scientific tool. Narrative Medicine will be of value for all caregivers: physicians, nurses, healthcare managers, psychotherapists, counselors, and social workers. “Maria Giulia Marini takes a unique and innovative approach to narrative medicine. She sees it as offering a bridge – indeed a variety of different bridges – between clinical care and ‘humanitas’. With a sensitive use of mythology, literature and metaphor on the one hand, and scientific studies on the other, she shows how the guiding concept of narrative might bring together the fragmented parts of the medical enterprise”. John Launer, Honorary Consultant, Tavistock Clinic, London UK

Scientific, evidence-based medicine is increasingly seen as fundamental to providing effective healthcare, but narrative-based medicine sheds light on social and interpersonal aspects of the practitioner-patient interaction which can also greatly affect healthcare outcomes. The philosophies underlying these two approaches seem to contrast, yet those who can integrate both into their practice are among the most successful medical professionals. Integrating Narrative Medicine and Evidence-based Medicine provides answers to the key question of how medical practitioners can best put both approaches into practice. It anticipates a future where evidence-based practice will be expected of all medical professionals, but contends that the integration of a narrative-based approach will also be crucial, presenting a unique perspective on structuring the patient-professional encounter for optimum results. It develops a cultural analysis and socio-cultural theory of the science of healing, and describes an efficient method by which medical practitioners can find and use medical research at the point of care with current technology and skills. This addresses the need for translational science - moving research into practice - identified by the National Institutes of Health. This book will be essential reading for educators of medical students and postgraduate trainees, behavioral scientists, psychologists, social scientists working in medical settings, and health managers and administrators. Medical students and postgraduate trainees will also find it useful in their learning.

This progressive resource brings the innovative power of narrative medicine to the forefront of community public health care. Chapters describe community involvement across a continuum of control, from health consultants describing problems and suggesting solutions to health committees designing programs and evaluating results. Narrative strategies to this end, including authentic dialogue and community mapping, are examined in the context of public health and fleshed out with examples of different levels of participation by community members. From the respectful collaboration modeled here, the principles of community public health care can potentially expand beyond the immediate community into other social domains on a greater scale. Included in the coverage: · Narratives, local knowledge, and world entry. · Community and narratives. · What is dialogue? · Storylines, causes, and locus of interventions. · Community mapping tells a story. · The politics of storytelling. Narrative Medicine and Community-Based Health Care and Planning gives health psychologists, sociologists, social workers, and public health administrators realistic practical insights for tapping into the unique resources communities and clients have to offer. This is the next step in the evolution of public health, toward large-scale improvements in care delivery, access to and relevance of services, and patient and community outcomes.

Narrative-Based Practice in Health and Social Care outlines a vision of how witnessing narratives, paying attention to them, and developing an ability to question them creatively, can make the person’s emerging story the central focus of health and social care, and of healing. This text gives an account of the practical application of ideas and skills from contemporary narrative studies to health and social care. Promoting narrative-based practice in everyday encounters with patients and clients, and in supervision, teaching, teamwork and management, it presents "Conversations Inviting Change," an established narrative-based model of interactional skills. Underpinned by an account of theory from narrative studies and related fields, including communication theory and systems thinking, it is written for students and practitioners across a broad range of professions in primary and secondary health care and social care. More information about "Conversations Inviting Change" is available at www.conversationsinvitingchange.com. This website includes podcasts, presentations and further teaching material as well as details of forthcoming courses, and is continually updated with information about the approach described in this book.

This book provides an important contribution to the new and growing field of ‘narrative-based medicine’. It specifically addresses the largest area of medical activity, primary care. It provides both a theoretical framework and practical skills for dealing with individual consultations, family work, clinical supervision and teamwork, and offers a comprehensive approach to the whole range of work in primary care. Using a wide range of clinical examples, it shows how professionals in primary care can help clarify patients’ existing stories, and elucidate new stories. It can be used as a training resource and includes exercises and summaries of key points to consider. It is based on, and describes, an established evaluated training method, and is of immediate and significant practical use to readers. It is essential reading for general practitioners, practice nurses and others in the primary care team, psychologists, family therapists, counsellors and other professionals attached to primary care. GP trainers, tutors and course organisers will find it a valuable educational tool. Professionals elsewhere in primary care such as pharmacists, dentists and optometrists, and academics in medical sociology and medical anthropology will also find it very useful.