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Healthcare
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Narrative in Health and Social Care
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Narrative in Health and Social Care

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 19255

Special Issue Editor

Dr. Covelli Venusia

E-Mail Website
Guest Editor
STORIOSS Research Center, Faculty of Psychology, e-Campus University, Novedrate, Como, Italy
Interests: narrative research; narrative-based medicine; narrative medicine; disability and health; qualitative research methods; mixed methods
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the use of narrative in clinical and research practice, and on its potential to actively involve both patients and health professionals to the improvement of patient healthcare. The focus on narrative will be twofold: On one hand, it is on clinical practice and on how narrative medicine has encouraged the training of health professionals in the use of patient narratives in clinical practice over the past twenty years. On the other hand, the focus is on narrative research that, thanks to the collection and use of the patients and healthcare professionals’ narratives, is similarly placed among the objectives of improving clinical practice.

The present Special Issue intends to share the experience of various international research groups, favoring a methodological reflection between different health professionals that can bring the research procedure closer to daily medical practice, with the aim of encouraging and improving patient care.

We welcome papers (original research papers—qualitative research, quantitative research, and mixed methods research—review articles, book reviews) addressing some of the core research questions related to narrative strategies and evidence applied to several topics, such as:

  • How patients’ illness experience can be used in clinical practice;
  • The role of narrative (medicine and research) in the doctor–patient relationship;
  • Narratives in Health Education;
  • Formal and informal caregivers’ burden: using their stories to reflect on care;
  • Health professionals’ quality of life;
  • Narrative and disability: the potential of narratives on disability studies;
  • Narrative and identity: creating self in the narrative;
  • Narrative and the impact of living with a chronic or rare disease.

Dr. Covelli Venusia
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • narrative medicine
  • narrative research
  • narrative medicine and narrative research in health and social care
  • narrative tools in health and social care
  • narrative medicine and narrative research in disability studies
  • narrative in the doctor–patient relationship
  • narrative and identity
  • narrative writing and psychotherapy

Related Special Issue

Published Papers (10 papers)

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Research

16 pages, 276 KiB  
Article
Fear God, Not COVID-19: Is Conservative Protestantism Associated with Risky Pandemic Lifestyles?
by John P. Bartkowski, Katherine Klee, Terrence D. Hill, Ginny Garcia-Alexander, Christopher G. Ellison and Amy M. Burdette
Healthcare 2023, 11(4), 582; https://doi.org/10.3390/healthcare11040582 - 15 Feb 2023
Cited by 2 | Viewed by 1586
Abstract
Previous research has established attitudinal and behavioral health variations in relation to the COVID-19 pandemic, but scholarship on the religious antecedents associated with these outcomes has only recently gained momentum. Rhetoric from some leading conservative Protestants in the U.S. has underplayed the threat [...] Read more.
Previous research has established attitudinal and behavioral health variations in relation to the COVID-19 pandemic, but scholarship on the religious antecedents associated with these outcomes has only recently gained momentum. Rhetoric from some leading conservative Protestants in the U.S. has underplayed the threat of the pandemic and may have contributed to unhealthy pandemic behaviors within this faith tradition. Moreover, previous inquiries have revealed that conservative Protestantism’s otherworldly focus can thwart personal and community health. We use nationally representative data to test the hypotheses that, compared with other religious groups and the non-religious, conservative Protestants will tend to (1) perceive the pandemic as less threatening and (2) engage in riskier pandemic lifestyles. These hypotheses are generally supported net of confounding factors. We conclude that affiliation with a conservative Protestant denomination can undermine public health among this faith tradition’s adherents and may therefore compromise general health and well-being during a pandemic. We discuss the implications of these findings, offer recommendations for pandemic health promotion among conservative Protestants, and delineate promising avenues for future research on this important topic. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
11 pages, 674 KiB  
Article
Understanding Patient Experience with Outpatient Cancer Rehabilitation Care
by Kelley C. Wood, Jessica J. Bertram, Tiffany D. Kendig and Mackenzi Pergolotti
Healthcare 2023, 11(3), 348; https://doi.org/10.3390/healthcare11030348 - 25 Jan 2023
Cited by 2 | Viewed by 1879
Abstract
Background: Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services. Methods: We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that [...] Read more.
Background: Understanding patient experience is key to optimize access and quality of outpatient cancer rehabilitation (physical or occupational therapy, PT/OT) services. Methods: We performed a retrospective mixed-method analysis of rehabilitation medical record data to better understand patient experience and aspects of care that influenced experience. From the medical record, we extracted case characteristics, patient experience data (Net Promoter Survey®, NPS) and patient-reported outcome (PRO) data. We categorized cases as ‘promoters’ (i.e., highly likely to recommend rehabilitation) or ‘detractors’, then calculated NPS score (−100 [worst] to 100 [best]). We identified key themes from NPS free-text comments using inductive content analysis, then used Pearson [r] or Spearman [ρ] correlation to explore relationships between NPS, characteristics, and PRO improvement. Results: Patients (n = 383) were 60.51 ± 12.02 years old, predominantly women with breast cancer (69.2%), and attended 14.23 ± 12.37 visits. Most were ‘promoters’ (92%); NPS score was 91.4. Patients described two experiences (themes) that influenced their likelihood to recommend rehabilitation: (1) feeling comfortable with the process and (2) observable improvement in health/functioning, and described attributes of clinic staff, environment and clinical care that influenced themes. Likelihood to recommend rehabilitation was associated with achieving the minimal clinical important difference on a PRO (ρ = 0.21, p < 0.001) and cancer type (ρ = 0.10, p < 0.001). Conclusion: Patients who received specialized cancer PT/OT were highly likely to recommend rehabilitation. Feeling comfortable with the rehabilitation process and making observable improvements in health and/or functioning influenced likelihood to recommend. Rehabilitation providers should leverage the findings of this study optimize access to and quality of cancer rehab services. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
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15 pages, 295 KiB  
Article
Narratives about Negative Healthcare Service Experiences: Reported Events, Positioning, and Normative Discourse of an Active Client
by Elina Weiste, Nanette Ranta, Melisa Stevanovic, Henri Nevalainen, Annika Valtonen and Minna Leinonen
Healthcare 2022, 10(12), 2511; https://doi.org/10.3390/healthcare10122511 - 12 Dec 2022
Viewed by 1221
Abstract
Narratives about clients’ service experiences in healthcare organizations constitute a crucial way for clients to make sense of their illness, its treatment, and their role in the service process. This is important because the client’s role has recently changed from that of a [...] Read more.
Narratives about clients’ service experiences in healthcare organizations constitute a crucial way for clients to make sense of their illness, its treatment, and their role in the service process. This is important because the client’s role has recently changed from that of a passive object of care into an active responsible agent. Utilizing Bamberg’s narrative positioning analysis as a method, and 14 thematic interviews of healthcare clients with multiple health-related problems as data, we investigated the expectations of the client’s role in their narratives about negative service experiences. All the narratives addressed the question of the clients’ “activeness” in some way. We identified three narrative types. In the first, the clients actively sought help, but did not receive it; in the second, the clients positioned themselves as helpless and inactive, left without the care they needed; and in the third, the clients argued against having to fight for their care. In all these narrative types, the clients either demonstrated their own activeness or justified their lack of it, which—despite attempts to resist the ideal of an “active client”—ultimately just reinforced it. Attempts to improve service experiences of clients with considerable service needs require a heightened awareness of clients’ moral struggles. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
10 pages, 227 KiB  
Article
Storytelling of Young Adults with Chronic Rheumatologic Illnesses: A Pilot Study
by Aviya Lanis, Emilee Tu, Malki Peskin, Maryann Melendez, Gabriel Tarshish, Alisha Akinsete, Alicia Hoffman, Kathleen Kenney-Riley, Tamar Rubinstein and Dawn Wahezi
Healthcare 2022, 10(10), 1979; https://doi.org/10.3390/healthcare10101979 - 09 Oct 2022
Cited by 1 | Viewed by 1379
Abstract
Background: Narrative medicine allows patients to reconstruct medical experiences through written portrayals of perspectives, building a mutual depiction of illness while creating a sense of belonging. This modality has not been previously studied in youth with rheumatologic illnesses, a population with high mental [...] Read more.
Background: Narrative medicine allows patients to reconstruct medical experiences through written portrayals of perspectives, building a mutual depiction of illness while creating a sense of belonging. This modality has not been previously studied in youth with rheumatologic illnesses, a population with high mental health burden and worse health-related quality of life. We aimed to assess the feasibility of a storytelling intervention in this patient population. Methods: This is a mixed-methods study of 14–21-year-olds with rheumatologic diseases followed in the Bronx, NY. Participants completed an hour-long creative writing session focused on patient experience with chronic disease. Pre- and post-questionnaires assessed patient-reported outcomes, and post-participation video interviews assessed personal experiences through the storytelling session. Results: Thirteen female patients were divided amongst four creative writing sessions. Twelve patients completed pre-study questionnaires and 10 completed post-study questionnaires, with 100% completion of the post-participation interviews. PedsQL surveys showed statistically significant improvement in physical health (p < 0.02), and there was no significant difference between pre- and post-scores for any other questionnaires. Interview thematic domains included writing motivation, prior writing experience, illness experience, relating to others, relationship with providers, and support. Conclusion: Creative writing is a feasible and acceptable intervention for youth with rheumatologic illnesses. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
7 pages, 198 KiB  
Article
What Does It Mean to Truly Empathize with a Patient? An Analysis of Japanese Cases Employing the Narrative Approach Perspective
by Akira Akabayashi and Eisuke Nakazawa
Healthcare 2022, 10(10), 1884; https://doi.org/10.3390/healthcare10101884 - 27 Sep 2022
Viewed by 1012
Abstract
What does it mean to truly empathize with a patient? The authors (a psychiatrist and a philosopher) explore this topic from the unique perspectives gained from decades of experience. We discuss how some approaches that may be criticized are necessary if we are [...] Read more.
What does it mean to truly empathize with a patient? The authors (a psychiatrist and a philosopher) explore this topic from the unique perspectives gained from decades of experience. We discuss how some approaches that may be criticized are necessary if we are to empathize with a patient. We also touch on the current situation surrounding personnel involved in the restoration of the Fukushima Daiichi Nuclear Power Plant (the so-called Fukushima 50) after the nuclear meltdown caused by the Great East Japan Earthquake in 2011. We conclude with what we have learned to truly emphasize with patients from these cases: (1) small deviations seem to be useful sometimes; (2) healthcare professionals do not have to be too hard on themselves to empathize with patients, and a natural, narrative approach-based attitude is sometimes more than enough; and (3) physical stance, in addition to psychological stance, might also be a factor. Moreover, we look at the idea of the “village society” and argue that it is necessary for medical professionals to be fully aware of the negative connotations of village societies. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
11 pages, 246 KiB  
Article
Exploring Women’s Experiences of Maternity Service Delivery in Regional Tasmania: A Descriptive Qualitative Study
by Sally Hargreaves, Sarah Young, Sarah J. Prior and Jennifer Ayton
Healthcare 2022, 10(10), 1883; https://doi.org/10.3390/healthcare10101883 - 27 Sep 2022
Viewed by 1428
Abstract
The objective of this study is to explore and understand the experiences of women who receive antenatal, birthing, and postnatal care from an integrated maternity services model in a regional area in Tasmania, Australia. This descriptive qualitative study included semi-structured, one-on-one interviews with [...] Read more.
The objective of this study is to explore and understand the experiences of women who receive antenatal, birthing, and postnatal care from an integrated maternity services model in a regional area in Tasmania, Australia. This descriptive qualitative study included semi-structured, one-on-one interviews with 14 mothers aged >18 years, who were living in a regional area of Tasmania and had accessed maternity health services. Thematic analysis revealed three key themes: (i) talking about me, (ii) is this normal? and (iii) care practices. Overall, women cited mostly negative experiences from a poorly implemented fragmented service. These experiences included feelings of isolation, frustration over receiving conflicting advice, feeling ignored, and minimal to no continuity of care. In contrast, women also experienced the euphoric feelings of birth, immense support, guidance, and encouragement. Regional women’s experiences of maternity care may be improved if health services work towards place-based continuity of care models. These models should be informed by the local women’s experiences and needs in order to achieve better communication, reduce feelings of isolation, and promote positive breastfeeding experiences. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
15 pages, 897 KiB  
Article
Narratives on the Current Medical Situation in Japan According to Highly Specialized Foreign Professionals
by Tomoari Mori, Yoko Deasy, Eri Kanemoto, Eisuke Nakazawa and Akira Akabayashi
Healthcare 2022, 10(9), 1694; https://doi.org/10.3390/healthcare10091694 - 05 Sep 2022
Cited by 2 | Viewed by 1606
Abstract
In order to understand the difficulties faced by highly skilled foreign professionals when dealing with the Japanese healthcare system and to identify the support they require therein, university health center staff members of the Okinawa Institute of Science and Technology Graduate University conducted [...] Read more.
In order to understand the difficulties faced by highly skilled foreign professionals when dealing with the Japanese healthcare system and to identify the support they require therein, university health center staff members of the Okinawa Institute of Science and Technology Graduate University conducted semi-structured interviews with faculty, staff, and students from the Institute. Data from the interviews were analyzed by subject matter analysis using a narrative-oriented approach. In total, 13 participants were interviewed, and five themes and 15 subthemes were generated from the 40 codes extracted. Although participants considered themselves to be accepting of other cultures and made little mention of the need for cultural and religious considerations that previous studies have identified as important, they reported that their experiences receiving healthcare in Japan were fraught with many difficulties. They felt that the capacity to communicate in Japanese was a prerequisite for receiving appropriate healthcare and that hospitals should assume the responsibility of providing language support. While they reported satisfaction with the easy and inexpensive access to advanced medical equipment and specialists in Japan, they also noted challenges in selecting medical institutions and departments, the flow and procedures in the hospital, and building open and direct relationships with doctors. In addition, based on the present study, people with chronic illnesses felt isolated from the community, worried about a lack of privacy, and wanted a primary care physician they could trust. In order to provide appropriate healthcare to foreigners, we require an accurate understanding of their needs, how to address these comprehensively and in a multifaceted manner, and how the communication responsibilities should be shared among the involved parties (i.e., foreign care recipients and Japanese medical professionals). Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
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16 pages, 2333 KiB  
Article
Towards an Open Medical School without Checkerboards during the COVID-19 Pandemic: How to Flexibly Self-Manage General Surgery Practices in Hospitals?
by Héctor Guadalajara, Álvaro Palazón, Olatz Lopez-Fernandez, Pilar Esteban-Flores, José Miguel Garcia, Alicia Gutiérrez-Misis, Enrique Baca-García and Damián Garcia-Olmo
Healthcare 2021, 9(6), 743; https://doi.org/10.3390/healthcare9060743 - 17 Jun 2021
Cited by 6 | Viewed by 2708
Abstract
Background: Can we create a technological solution to flexibly self-manage undergraduate General Surgery practices within hospitals? Before the pandemic, the management of clerkships was starting to depend less on checkerboards. This study aims to explore undergraduates’ perceptions of doing rotations in teaching hospitals [...] Read more.
Background: Can we create a technological solution to flexibly self-manage undergraduate General Surgery practices within hospitals? Before the pandemic, the management of clerkships was starting to depend less on checkerboards. This study aims to explore undergraduates’ perceptions of doing rotations in teaching hospitals using different teaching styles and elicit their views regarding the options of managing practices to design a mobile app that substitutes for checkerboards. Methods: In this sequential exploratory mixed methods study, 38 semi-structured interviews at a teaching hospital were conducted. The data was used to survey 124 students doing their rotations in four teaching hospitals during the first wave of COVID-19. Results: 21 themes highlighted concerns related to the practices, the teacher involvement in the students’ education, and the students’ adaptation to clinical culture. The students reported positive perceptions concerning self-managing and organizing practices via a mobile application. However, problems emerged regarding transparency, the lack of feedback, and the need for new tools. Regarding the teaching styles, the facilitator and personal models were perceived as optimal, but the personal style had no effect on using or not using a tool. Conclusions: A mobile-learning application designed like an educational opportunities’ manager tool can probably promote self-directed learning, flexible teaching, and bidirectional assessments. However, teachers who employ a personal teaching style may not need either checkerboards or a tool. This solution supports teaching at hospitals in pandemic times without checkerboards. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
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6 pages, 215 KiB  
Article
Systemic Lupus Erythematosus before and after COVID-19 Lockdown: How the Perception of Disease Changes through the Lenses of Narrative Medicine
by Fulvia Ceccarelli, Venusia Covelli, Giulio Olivieri, Francesco Natalucci and Fabrizio Conti
Healthcare 2021, 9(6), 726; https://doi.org/10.3390/healthcare9060726 - 12 Jun 2021
Cited by 5 | Viewed by 2008
Abstract
Background: The COVID-19 pandemic contributes to the burden of living with different diseases, including Systemic Lupus Erythematosus (SLE). We described, from a narrative point of view, the experiences and perspectives of Italian SLE adults during the COVID-19 emergency, by distinguishing the illness experience [...] Read more.
Background: The COVID-19 pandemic contributes to the burden of living with different diseases, including Systemic Lupus Erythematosus (SLE). We described, from a narrative point of view, the experiences and perspectives of Italian SLE adults during the COVID-19 emergency, by distinguishing the illness experience before and after the lockdown. Methods: Fifteen patients were invited to participate. Illness narratives were collected between 22 and 29 March 2020 using a written modality to capture patients’ perspectives before and after the COVID-19 lockdown. We performed a two-fold analysis of collected data by distinguishing three narrative types and a qualitative analysis of content to identify the relevant themes and sub-themes reported. Results: Eight narratives included in the final analysis (mean length 436.9 words) have been written by eight females (mean age 43.3 ± 9.9 years, mean disease duration 13.1 ± 7.4 years). Six patients provided a quest narrative, one a chaos and the remaining one a restitution narrative. By text content analysis, we identified specific themes, temporally distinct before and after the lockdown. Before COVID-19, all the patients referred to a good control of disease, however the unexpected arrival of the COVID-19 emergency broke a balance, and patients perceived the loss of health status control, with anxiety and stress. Conclusions: We provided unique insight into the experiences of people with SLE at the time of COVID-19, underlining the perspective of patients in relation to the pandemic. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
15 pages, 299 KiB  
Article
Breaking Up and a New Beginning When One’s Partner Goes into a Nursing Home: An Interview Study
by Gerd Ahlström, Nina Stååhl Markeling, Ulrika Liljenberg and Helena Rosén
Healthcare 2021, 9(6), 672; https://doi.org/10.3390/healthcare9060672 - 04 Jun 2021
Cited by 6 | Viewed by 2332
Abstract
In aging societies worldwide, spouses take on great responsibility for care when their partner continues to live at home. Nursing home placement occurs when the partner becomes too frail due to multimorbidity, and this will cause a change in the spouse’s life. This [...] Read more.
In aging societies worldwide, spouses take on great responsibility for care when their partner continues to live at home. Nursing home placement occurs when the partner becomes too frail due to multimorbidity, and this will cause a change in the spouse’s life. This study aimed to explore the spouse’s experience of their partner’s move to a nursing home. Two interviews were conducted at 9-month intervals within the project entitled “Implementation of Knowledge-Based Palliative Care in Nursing Homes”. Thirteen spouses from both urban and rural areas were included, with an age-range of 60–86 years (median 72). Qualitative content analysis was performed. The main findings were captured in two themes: Breaking up of close coexistence and Towards a new form of daily life. The first encompassed processing loneliness, separation and grief, exhaustion, increased burden, and a sense of guilt. The second encompassed a sense of freedom, relief, acceptance, support and comfort. Professionals in both home care and nursing home care need to develop and provide a support programme conveying knowledge of the transition process to prevent poor quality of life and depression among the spouses. Such a programme should be adaptable to individual needs and should ideally be drawn up in consultation with both partners. Full article
(This article belongs to the Special Issue Narrative in Health and Social Care)
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