In recent years, patient narratives have attracted increasing attention as a valuable source of insights into the subjective experience of healthcare. This paper outlines a best-practice approach to the collection, analysis, and use of patient narratives, based on current literature and on the experience of developing the Swiss Database of Individual Patient Experiences (DIPEx). The DIPEx project aims to provide a systematic and methodologically rigorous collection of patient narratives on various health situations and topics. This paper presents and details the DIPEx approach as a current standard in the field, offering a comprehensive overview and discussing the potential uses and benefits of patient narratives: improve healthcare practice, empower patients and caregivers, help structure better communication in healthcare, and contribute to medical teaching and learning.
BACKGROUND
An expectant mother faces several decisions related to pregnancy that cannot be tackled with the rational choice method or by consulting medical evidence. These choices are moral and practical prenatal decisions, which involve respectively the prospective mother’s moral and practical identities. Current genetic counselling services do not support expectant mothers in such decisions, and the mental processes employed, such as mental simulation, are prone to decision-making biases that increase the likelihood of making sub-optimal decisions.
OBJECTIVE
We show how the quality of moral and practical prenatal decisions can be improved using virtual reality (VR) and provide practical recommendations for the design and development of an effective and ethically aligned VR tool for such prenatal decisions.
METHODS
This is a theoretical study on moral and practical decisions in pregnancy, which adopts the logical-conceptual method of philosophy.
RESULTS
VR technology is a suitable decision-support tool for making moral and practical prenatal decisions. Yet, to be effective and ethically aligned, VR should comply to a set of practical recommendations for its design and development that we provide.
CONCLUSIONS
VR allows the operationalization of biopsychosocial support in the clinical encounter, facilitates the individual’s reflection on her values and beliefs, supports the contextualization of available choices to an individual’s circumstance, presents complex information in more understandable forms, and enhances the ability of mental simulation.
An effective VR tool facilitating decision-making in moral and practical prenatal decisions should consider the specific needs of its target audience and be built in consultation with the relevant stakeholders and experts in the field (e.g., social workers, therapists, clinicians). Moreover, VR scenarios that are part of this tool should be community specific, presented in an emotionally balanced manner, and based in reality. Finally, VR tools should be distributed as part of a public health program for reasons of fairness.
This study provides the theoretical basis and framework for the development of a better consulting support in pregnancy and contributes to a more inclusive patient engagement in prenatal decision-making, which has been advocated for in contemporary medical practice.
CLINICALTRIAL
Not applicable
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