Narrative medicine: feasibility of a digital narrative diary application in oncology
A preliminary, open, uncontrolled, real-life study in the oncology and radiotherapy departments of Istituto di Ricovero e Cura a Carattere Scientifico National Cancer Institute Regina Elena, Rome, (Italy), recruiting adult Italian-speaking patients who then completed the DNM diary from the start of treatment, showed that the use of the DNM in oncology patients assisted clinicians with understanding their patients experience. The results published on Journal of International Medical Research
Understanding the causes of a patient’s doubts and fears may help clinicians to provide more detailed explanations, psychological advice, or to be more attentive to scheduling to improve patients’ awareness, empowerment, and treatment adherence. However, for this, appropriate interaction with each patient is needed. If adequately oriented, narrative medicine may help to improve personal relationships, therapeutic alliance, and promote adherence to treatment while fostering the professional growth of clinicians. This approach may provide clinicians with a deeper knowledge of the patient and help them to obtain information that is difficult for patients to communicate during chemo- or radiotherapy sessions and follow-up visits.
Approximately 30 years ago, narrative medicine was first described as a new approach to improving the patient–clinician relationship. Kleinman introduced the use of narratives as a tool to collect and interpret information on the patient’s experience of illness, not only to enrich knowledge about their physical and psychological condition but also to formulate a correct diagnosis. Narratives may have therapeutic potential and may be applied in a way that provides health care professionals with information that can be used for diagnosis or the personalization of treatment. Although the Italian Istituto Superiore di Sanità published recommendations in 2014 for the implementation of narrative medicine in the management of rare and chronic degenerative diseases, no standard method is currently available in Italy for the management of oncology patients.
A specific digital platform has been developed to obtain guided narratives from patients during chemotherapy or radiotherapy for solid tumors. The tool was designed to obtain information about barriers to treatment adherence and to facilitate the relationship between health care professionals and patients. Herein, we report a preliminary study aimed to evaluate the feasibility, practicability, and self-assessed utility of the digital narrative medicine approach from the perspective of both patients and health care professionals.
