Narrative Medicine and Medical Storytelling. Social technologies and science
According to ESR and the European Federation of Radiographer societies, the quality of communication affects the diagnostic process.
A recent workshop organized on the occasion of the European Radiology Congress, ECR in Vienna, highlighted the importance of empathic communication as a tool to make the information that will build the diagnostic process clearer and more useful.
Good communication, respectful of the patient's concerns and doubts, is the starting point in the journey from investigation to diagnosis and radiologists can play a big role opening the door to the patient's confidence in a path that is sometimes long and tiring. At the same time, patients can be of help to those who are undergoing the same experience, by telling their own story, so as to improve personal understanding about diagnostic practices and to enhance the safety of procedures.
In this way the emotional part has the right space for expression and the risk of unexpressed anxieties interfering with the medical procedures is limited.
The qualitative narrative method
Regarding health, we must not forget that the human body has its own ways of taking care of itself, and that the transmission of knowledge between doctor and patient is essential to finding a cure. In recent years, this idea of intelligent interaction between the organism, the environment and the various actors involved in the healthcare process has led, even in mainstream medical circles, to the integration of the narrative-qualitative method or NBM (narrative-based medicine), based on observation, as a complement to the quantitative method or EBM (evidence-based medicine), which is based on the scientific method. Narrative medicine and medical storytelling, two similar approaches with different purposes, are becoming more and more widely discussed.
Narrative Medicine. A method of communication between doctor and patient
The approach known as narrative medicine, acknowledged in 2015 by the Istituto Superiore di Sanità (Superior Institute of Healthcare) in Italy, is a "methodology of clinical-care intervention based on a specific communicative competence". When a patient is given the opportunity to tell the story of their own clinical journey, it helps them give meaning to the experience and feel acknowledged. It also helps the doctor understand the patient's needs and symptoms better, as well as identify any weak points in the therapeutic process.
Information management is handled collaboratively through one of the oldest tools of human cooperation: storytelling. The act of narration is an opportunity to explore the patient's feelings and for doctors to listen with their emotions. By asking the right questions and using empathy (whose importance is increasingly acknowledged in medical training nowadays) to tune in to the patient's perceptions, doctors are better able to understand which data to make use of for diagnoses and medical history – all while deepening their knowledge of the patient in an environment that stimulates trust and encourages communication.
The ability to gather the opinions of all parties involved in the care process is another aspect of narrative medicine that facilitates the construction of a history of care. Among the tools doctors use to involve patients are specialised platforms where patients can share their stories with others or simply relate them confidentially, thus creating a therapeutic community that can help alleviate the sense of isolation caused by hospitalisation. As Colin Robertson and Gareth Clegg write in their book Storytelling in Medicine: How Narrative can Improve Practice, the ability to learn from the patient's story is key to establishing a therapeutic link with each individual patient.
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