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The potential and pitfalls of narrative elicitation in person-centred care

Artikel i vetenskaplig tidskrift
Författare O. Naldemirci
N. Britten
H. Lloyd
Axel Wolf
Publicerad i Health Expectations
Volym 23
Nummer/häfte 1
Sidor 238-246
ISSN 1369-6513
Publiceringsår 2020
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för vårdvetenskap och hälsa
Sidor 238-246
Språk en
Länkar dx.doi.org/10.1111/hex.12998
Ämnesord admission interview, lifeworld goals, narrative elicitation, person-centred care, medicine, stories, humane, Health Care Sciences & Services, Public, Environmental & Occupational, Health
Ämneskategorier Hälsovetenskaper

Sammanfattning

Background Revitalized interest in narrative has informed some recent models of patient and person-centred care. Yet, scarce attention has been paid to how narrative elicitation is actually used in person-centred care practice and in which ways it is incorporated into clinical routine. Aim We aimed to identify facilitators and barriers for narrative elicitation and setting goals in a particular example of person-centred care practice (University of Gothenburg Centre for Person-centred Care, GPCC) where narrative elicitation is considered as a method of setting goals for the patient. Methods Observation of 14 admission interviews including narrative elicitation on an internal medicine ward in Sweden where person-centred care was implemented. Five focus group vignette-based interviews with nurses (n = 53) were conducted to assess confirmation of the emerging themes. Results The inductive analysis resulted in three themes about the strategies to elicit patients' narratives: (a) Preparing for narrative elicitation, (b) Lingering in the patient's narrative, and (c) Co-creating, that is, the practitioner's and third parties' engagement in the patient's narration. Even though there were obstacles to eliciting narratives and setting lifeworld goals in a medical setting, narrative elicitation was often useful to turn general and medical goals into more specific and personal goals. Conclusions Narrative elicitation is neither a simple transition from traditional medical history taking nor a type of structured interview. It entails skills and strategies to be practiced. On the one hand, it revitalizes ethical considerations about clinical relationship building. On the other hand, it can help patients articulate lifeworld goals that are meaningful and important for themselves.

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