Narrative in Health Care: Healing Patients, Practitioners, Profession, and Community

Description

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. Cover......Page 1 Half Title......Page 2 Title Page......Page 4 Copyright Page......Page 5 Contents......Page 6 Foreword......Page 10 About the Authors......Page 14 Acknowledgements......Page 16 Dedication......Page 17 Introduction......Page 18 PART 1 Historical Context, Genealogy, and Current Viewpoints......Page 28 CHAPTER 1 Medicine, Medical Practice, and Knowledge......Page 30 A Clinical Story......Page 31 The Making of Modern Medicine......Page 33 Science, Paradigms, and Medicine......Page 39 The Legacy of Biomedical Medicine......Page 42 Biomedicine: Competing Viewpoints......Page 45 Further Activities......Page 52 References......Page 54 CHAPTER 2 Transdisciplinary Narrative Turns and Narrative Health Care......Page 57 The Nature of Narrative in Discipline and Profession......Page 58 Narrative Naturalists......Page 60 Narrative Constructivists......Page 62 Narrative Identity......Page 64 The Temporality of Action......Page 66 The Temporality of Selfhood and Life......Page 68 Narrative and Health Care......Page 69 Sickness, Life Stories, and Narrative Identity......Page 72 Patient–Physician Encounters......Page 73 Barriers Between Patients and Physicians......Page 74 Narrative Features of Care and Caring......Page 77 Narrative Competence......Page 81 Narrative Contexts......Page 82 Further Activities......Page 83 References......Page 84 CHAPTER 3 The Patient–Practitioner Relationship......Page 89 Introduction......Page 90 Factors That Separate Patients and Practitioners......Page 91 Patient-Centered and Relationship-Centered Care......Page 92 Complex Responsive Processes of Relating......Page 97 References......Page 102 PART 2 Professional Performance Situations and Narrative Importance......Page 106 CHAPTER 4 Narrative Contexts of Care......Page 108 Introduction......Page 109 The Patient......Page 111 The Practitioner......Page 114 The Patient–Practitioner Relationship......Page 117 Narrative Matters......Page 121 The Landscapes of Illness Narratives......Page 123 Narrative Medicine and Moral Imagination......Page 125 The Altruism Struggle......Page 126 Narrative in the Practitioner–Self Dimension......Page 128 Self-Awareness, Reflective Learning, and Practice......Page 132 References......Page 136 CHAPTER 5 Narrative Contexts of Profession and Community......Page 139 Introduction......Page 140 The Narrative of Medicine as Profession......Page 141 Contemporary Narratives of Professionalism......Page 143 Implications for Medical Education......Page 148 The Narrative of Medicine as Community......Page 154 Narrative in a Broader Social Context......Page 160 References......Page 162 INTERLUDE: The Death of Ivan Ilyich......Page 166 PART 3 Narrative Competence and Its Outcomes......Page 182 CHAPTER 6 Skills for the Practice of Narrative Medicine......Page 184 Why Focus on Narrative Skills?......Page 185 Compassionate Presence......Page 188 Mindful Listening......Page 191 Exercising Moral Imagination and Practicing Empathy......Page 194 The Character of Moral Imagination......Page 195 Developing Moral Imagination Using Readers’ Theater and Film......Page 196 Developing Moral Imagination Using Photographs......Page 198 Developing and Practicing Empathy......Page 200 Witnessing Personal Narratives......Page 204 Reading and Interpreting Complex Texts......Page 206 Reading and Interpreting Literature......Page 208 Reading and Interpreting Poetry......Page 209 Writing Reflectively......Page 213 Listening to and Telling Stories in a Group......Page 220 Reasoning with Stories......Page 222 Engaging in Narrative Ethics......Page 226 A Transformation......Page 230 References......Page 231 CHAPTER 7 Narrative Success and Risks of Non-Narrative Practice......Page 235 Introduction......Page 236 Potential Benefits: Narrative Evidence......Page 237 Potential Benefits: Quantitative Evidence......Page 245 Potential Risks: Narrative Evidence......Page 246 Barriers to Narrative Practice, and Cautionary Tales......Page 248 Further Activities......Page 251 References......Page 252 PART 4 Personal Perspectives on Narrative in Health Care......Page 254 CHAPTER 8 Conversations with Practitioners......Page 256 Important Characteristics of Narrative Medicine......Page 257 Conditions That Have Prompted a Narrative Movement......Page 265 The Relationship Between Narrative Medicine and Other Related Movements......Page 268 Reactions to Some Frequently Mentioned Issues Associated with Narrative Practice......Page 270 Afterword......Page 275 Glossary......Page 278 Author index......Page 280 Subject index......Page 283