Exploring the Impact of Narrative Medicine on Holistic Health Care: a Programme Theory Study

Background: Narrative Medicine is an offspring of literature, medicine and patient centered care, addressing the relational and psychological dimensions that occur in tandem with physical illness. Narrative Medicine is thought to enhance the attributes of healthcare providers to facilitate the delivery of holistic care practice, although the evidence is unclear. Our preliminary results from a realist synthesis of published papers supported several outcomes relating to personal attributes to provide holistic care, such as better communication, enhancement of patient care, reflection, self-care, and improvement in knowledge. Therefore, this study will seek to explore more deeply the connection between Narrative Medicine and holistic care, explore the realist programme theory of Narrative Medicine leading to improve medical student’s holistic care practice.Aim: We aim to refine what realist programme theory of narrative medicine leads to improve medical students’ holistic health care practice to inform educators across Taiwan and internationally about what works, for whom, and why. Research design: We will take a realist research approach to test and refine the narrative medicine programme theory. We will also develop a ‘competency for holistic care’ questionnaire and analysis of medical professionals’ responses to this according to aspects identified in the programme theory. This will be a 2-year project: Year 1 will comprise (1) focus group interviews with students involved in the narrative medicine course and receiving Western (n=45) and Chinese (n=45) medical training (to enable us to understand how students receive their narrative medicine education and whether they think this facilitates their readiness for holistic care). This data will facilitate the development of a “realist” programme theory to explain the mechanisms through which narrative medicine appears to achieve its intended outcomes and the contexts that facilitate or impede such mechanisms. Year 2 will focus on the questionnaire development phase. The programme theory C-M-Os will be transferred into a questionnaire and a ‘competency for holistic care’ questionnaire will be developed. We will send five hundred questionnaires to health professionals including doctors, undergraduate and graduate medical students, nurses, ,and medical staffs. We will create the online questionnaire on “Online Surveys” platform (https://www.onlinesurveys.ac.uk/). The participants will be invited by e-mail and brochure to complete the questionnaire online.Anticipated research outcomes We will be able to unpack and understand the black box that narrative medicine leads to improve medical trainees’ holistic health care practice in the Taiwanese culture and to develop a transferable theoretical model of what works, for whom and why.

Project ID:PF10907-1887
External Project ID:MOST109-2511-H182-006