Narrative Medicine And Community Based Health Care And Planning

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.

This salient reference grounds readers in the theoretical basis and day-to-day practice of community-based health care programs, and their potential as a transformative force in public health. Centering around concepts of self-determination, empowerment, and inclusiveness, the book details the roles of physicians, research, and residents in the transition to self-directed initiatives and greater community control. Community-focused interventions and methods, starting with genuine dialogue between practitioners and residents, are discussed as keys to understanding local voice and worldview, and recognizing residents as active participants and not simply targets of service delivery. And coverage pays careful attention to training issues, including how clinicians can become involved in community-based care without neglecting individual patient needs. Among the topics covered are: Narrative medicine in the context of community-based practice. Qualitative and participatory action research. Health committees as a community-based strategy. Dialogue, world entry, and community-based intervention. Politics of knowledge in community-based work. Training physicians with communities. Dimensions of Community-Based Projects in Health Care challenges sociologists, social workers, and public health administrators to look beyond traditional biomedical concepts of care and naturalistic methods of research, and toward more democratic programs, planning, and policy. The partnerships described in these pages reflect a deep commitment to patients’ lives, and to the future of public health.p>

Narrative medicine has developed an identity already. Clinicians of many disciplines are being summoned to a practice that recognizes patients by receiving their accounts of self. Starting from different positions, the four authors have converged in a strong and shared commitment to narrative health care. They conceptualize narrative health care practices within frameworks derived from the social sciences and psychology, and, to a lesser degree, phenomenology and autobiographical theory. They relate the development of narrative medicine to relationship-centered care, patient-centered care, and complex responsive process of relating theory, positing that narrative medicine can help clinicians to develop the skills required to practice relationship-centered care. The book details - with exercises, resource texts, and abundant scholarly apparatus - how these skills can be developed and strengthened. This work will change health care. Because of its scholarly rigor, its multi-voiced sources, and its highly practical features (lists, activities, key ideas and key references, primary texts written by health care professionals and patients), this work will be a guide in the field for those who practice medicine or nursing or social work. The book establishes that there is a field to be practised, a need to practise it, and a means to develop the wherewithal to do so.

This book takes up the challenge of the failure of most initiatives in community-based service delivery to address the significant philosophical shift that is necessary to create, implement, and evaluate appropriately these sorts of projects. Challenging the tendency to focus entirely on practicalities, the authors emphasize the centrality of philosophy to any successful community-based undertaking. While fully acknowledging the importance of local knowledge and the guidance of projects by local people, this volume shows that these principles are often at odds with the ‘Cartesian’ mindset that underpins much project planning, with its emphasis on objectivity in science and knowledge. Since all knowledge is mediated by human activity and embedded in language and other modes of expression, this dualist approach must be reconsidered. A thorough rethinking of traditional service delivery, which takes into account issues of data, methodology, and bias together with questions of generalizability, community, power, and communication, this book will appeal to scholars of sociology, social policy, and social work with interests in community-based service delivery.

Community-Based Health Interventions in an Institutional Context examines challenges of "institutionalizing" community-based health care. While the community-based or localized model is growing in popularity and importance in the United States, in practice it must often be brought in to larger institutions in order to grow to scale. The typical goals of an institution—standardization, formalization, and control—may be seen as antithetical to those of a community-based healthcare provider, such as spontaneity, customization, and flexibility. The contributions to this work raise questions about how the community-based model can be scaled up through institutions, and how "institutionalization" can be rethought from a bottom-up approach. They provide not only an overview of community-based organizations, but also delve into practical topics such as establishing budgets, training workers, incorporating technology, as well as more theoretical topics like goal-setting, policy effects (like the ACA), and relationships between patient and community. This work will be of interest for researchers interested in exploring the community-based health care model, as well as practitioners in health care and health policy.

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

This book explains how narrative medicine can improve evidence based medicine (EBM), making it more effective and efficient, giving patients better quality of life and offering more satisfaction to all health care providers. It discusses not only the disease experienced by the person who is ill, but also focuses on the context and the culture, and investigates how narrative medicine can make other disciplines around the globe more applicable, less manipulative, and more “scientific”. Only by integrating the narrative aspects, can EBM become more effective and efficient, with fewer uncured patients, more satisfied patients with a better quality of life, and satisfaction for all health care providers. Every chapter is divided into two main sections: the first presents the latest research in the field, with comments and interviews with experts, while the second section provides a list of practical exercises and tasks. The book is intended for anyone with an interest in caring for and curing patients: all care providers of care, physicians, general practitioners, specialists nurses, psychotherapists, counselors, social workers, providers of aid, healthcare managers, scientific societies, academics and researchers.

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 thos