The narrative in patient-centred care

Background: Transdisciplinary research and generalist practice both face the task of integrating and discerning the value of knowledge across disciplinary and sectoral knowledge cultures. Transdisciplinarity and generalism also both offer philosophical and practical insights into the epistemology, ontology, axiology, and logic of seeing the 'whole'. Although generalism is a skill that can be used in many settings from industry to education, the focus of this paper is the literature of the primary care setting (i.e., general practice or family medicine). Generalist philosophy and practice in the family medicine setting highly values whole person care that uses integrative and interpretive wisdom to include both biomedical and biographical forms of knowledge.Generalist researchers are often caught between reductionist (positivist) biomedical measures and social science (post-positivist) constructivist theories of knowing. Neither of these approaches, even when juxtaposed in mixed-methods research, approximate the complexity of the generalist clinical encounter. A theoretically robust research methodology is needed that acknowledges the complexity of interpreting these ways of knowing in research and clinical practice.Methods: A conceptual review of literature to define the alignment between (a) the philosophy and practice of generalism in primary care and (b) both the practical (Zurich) and philosophical or methodological (Nicolescuian) schools of transdisciplinarity.Results: The alignment between generalism and transdisciplinarity included their broad scope, relational process, complex knowledge management, humble attitude to knowing, and real-world outcome focus. Conclusion:The concurrence between these approaches to knowing is offered here as Transdisciplinary Generalisma coherent epistemology for both primary care researchers and generalist clinicians to understand, enact, and research their own sophisticated craft of managing diverse forms of knowledge.

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“…Both generalism in primary care 42,52 and transdisciplinarity 53 highly depend upon and value a shared language amongst participants.…”

Section: Collaborative Understanding and Shared Languagementioning

confidence: 99%

Transdisciplinary Generalism: Naming the epistemology and philosophy of the generalist

Lynch

Dowrick

McGregor³

et al. 2020

Evaluation Clinical Practice

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“… 25 As scheduled, medical appointments typically are constrained in time; the possibilities to discuss the medical background of patients are limited. 26 However, understanding patients’ perspectives and witnessing their narrative are crucial for gaining insight into their situation 27 motivating for investigation of the online arenas that women with infertility are turning to.…”

Section: Introductionmentioning

confidence: 99%

Social media in the infertile community—using a text analysis tool to identify the topics of discussion on the multitude of infertility blogs

Sormunen

Westerbotn

Aanesen

et al. 2021

Womens Health (Lond Engl)

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Background: Infertility affects one in six couples. New digital resources exist which enable the study of lived experience of persons with infertility. Blogging represents a forum for sharing narratives and experiences. To provide high quality care for persons with a history of infertility, it is crucial to ascertain what they value as significant in their situation. Blogs with a focus on infertility may provide this information. Objectives: The aim of this study was to gain insight into which infertility-related issues are discussed on Swedish infertility blogs. Methods: In total, 70 infertility blogs were identified on the Internet and 25 met the inclusion criteria. A quantitative–qualitative content analysis was performed with the support of the Gavagai Explorer text analysis software. Results: A total of 4508 postings were retrieved from the blogs, all of which were written by women. The outcome of the analysis resulted into the following topics: Emotions (16.8%), Relations (12.5%), Time and waiting (7.1%), Body (6.6%), Care and treatment (4.2%), Food and diet (1.4%) and Exercise (0.5%). For most topics, there was a balance between positive and negative statements, but the body topic stood out by having more negative than positive sentiment. Conclusion: By considering the topics expressed in blogs, health care personnel are provided with an opportunity to better understand the situation of individuals affected by infertility.

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“…Such a partnership recognises 'the patient's need for selfexpression and [the practitioner's] need to achieve pattern recognition, action and closure', where both the patient's narrative and the practitioner's normative style contribute to the relationship (J. Clark, 2008). This approach clearly makes the person and the therapeutic relationship the focus of care, rather than the disease (Starfield & Horder, 2007).…”

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confidence: 99%

“…This necessitates intentional management of the potential problem of the power, knowledge and influence that the therapist wields (Cattan & Tiford, 2006 Speaking in the language of the patient-consciously adapting to match the language of the sufferer, validating them and allowing them to feel heard and understood -is an acquired primary care skill (J. Clark, 2008). Language is a vital part of the commitment to being with the individual in their context .…”

mentioning

confidence: 99%

“…Treatment goals and assessment priorities that are acceptable and understandable to both patient and primary practitioner are a vital part of collaborative interaction and require a shared language (J. Clark, 2008). This necessitates intentional management of the potential problem of the power, knowledge and influence that the therapist wields (Cattan & Tiford, 2006 Speaking in the language of the patient-consciously adapting to match the language of the sufferer, validating them and allowing them to feel heard and understood -is an acquired primary care skill (J.…”

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confidence: 99%

See 1 more Smart Citation

Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process

Lynch

Askew

Mitchell

et al. 2012

Social Science & Medicine

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The narrative in patient-centred care

Cited by 8 publications

References 2 publications

Transdisciplinary Generalism: Naming the epistemology and philosophy of the generalist

Transdisciplinary Generalism: Naming the epistemology and philosophy of the generalist

Social media in the infertile community—using a text analysis tool to identify the topics of discussion on the multitude of infertility blogs

Beyond symptoms: Defining primary care mental health clinical assessment priorities, content and process

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