Use of narrative medicine to identify key factors for effective doctor–patient relationships in severe asthma

I risultati del progetto Sound sono stati pubblicati sulla rivista Multidisciplinary Respiratory Medicine, con l’articolo Use of narrative medicine to identify key factors for effective doctor-patient relantioships in severe asthma.

L’articolo è il risultato dell’importante contributo di Antonietta Cappuccio di Fondazione ISTUD e project manager del progetto, e di Silvia Napolitano, Francesco Menzella, Guido Pellegrini, Alessandro Policreti, Girolamo Pelaia, Pasquale Alberto Porpiglia e Maria Giulia Marini in qualità di autori.

Background

In this project the authors use a narrative medicine (NM) approach to assess the promotion of trust in the relationship between physicians and their asthma patients.

Methods

Following a NM educational course for physicians, a research was carried out in which at least 5 written narratives (parallel charts) for each participating physician were collected and qualitatively analysed according to Bury’s classification and the Grounded Theory.

Results

The results of this study were of speculative and clinical interest. In particular, 66 participants wrote 314 narratives (246 on adult and 68 on paediatric patients). As a result of applying the NM approach, when the relationships remained problematic, many physicians wrote with a moral style about their adult (67%), and paediatric patients (33%) – especially in cases of asthmatic children’s or adolescents’ overprotective or absent families (40%) -. On the contrary, physicians who were able to listen to their patients with empathy (35%) made more shared decisions with patients, even with those they initially had a bad relationship. The used words of welcome, interest and acceptance were promoting patients’ trust that lead to restoring their activities in 45% of cases, according to physicians self-reporting.

Conclusions

These approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn’t initially good.