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

  • Antonietta Cappuccio Fondazione ISTUD, Milan, Italy.
  • Silvia Napolitano | snapolitano@istud.it Fondazione ISTUD, Milan, Italy.
  • Francesco Menzella Department of Medical Specialties Pneumology Unit, Arcispedale Santa Maria Nuova- IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy.
  • Guido Pellegrini Hospital “Città di Sesto San Giovanni” and “E. Bassini”, SC of Paediatric and Neonatology, ASST Nord Milano, Sesto San Giovanni, Milan, Italy.
  • Alessandro Policreti Medical Department Novartis Italia, Origgio, VA, Italy.
  • Girolamo Pelaia Department of Medicine and Surgery Section of Respiratory Diseases, University “Magna Graecia” of Catanzaro, Catanzaro, Italy.
  • Pasquale Alberto Porpiglia Medical Department Novartis Italia, Origgio, VA, Italy.
  • Maria Giulia Marini Fondazione ISTUD, Milan, Italy.

Abstract

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.

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Published
2019-09-02
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Original Research Articles
Keywords:
Narrative medicine, Severe asthma, Medical education and training, Qualitative research
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How to Cite
Cappuccio, A., Napolitano, S., Menzella, F., Pellegrini, G., Policreti, A., Pelaia, G., Porpiglia, P. A., & Marini, M. G. (2019). Use of narrative medicine to identify key factors for effective doctor–patient relationships in severe asthma. Multidisciplinary Respiratory Medicine, 14(1). https://doi.org/10.4081/mrm.2019.27