Thesis (MEdPsych)--University of Stellenbosch, 2005. / Bibliography. Also available via the Internet.

Medicine and bioethics today are though as fields of pure logic, reasoning, and science, with physicians and ethicists trained to approach patients with an attitude of detatched rationality. In reality, neither medical care nor ethics can be practiced well without an acknowledgement for their deeply emotional, relational, and narrative qualities. Medical care and bioethics must both be practiced through a narrative lense in order to truly meet the humanity of both patients and practitioners. There are practical methods to integrate narrative skills into clinical practice, as well as tangible benefits to doing so. Practially, this is performed through narrative medicine: an approach to medical care that recognizes the stories as a critical component to healthcare; as well as narrative ethics: an awareness of the essential role of narrative in moral understanding. Using narrative as a tool to understanding illness and moral grounds the more abstract and universal aspects of both in practical, individual reality. There are many practical aspects of narratives when applied to bioethics, such as aquiring narrative skills, what happens when stories are shared, recognizing how narratives are built, how they convey knowledge, organize life, and provide meaning. Illness creates an isolation – for both patient and practitioner – and stories allow each to express their experience and be supported though the stories of others. Stories help brigdge the gap in experiences of illness between practioner and patient while helping pracitioners to maintin their empathy in the face of continual suffering. Narrative skills are also useful for practioners to bring awareness to the power dynamics that influence patient stories, such as the power of practitioner as co-creator, whose voice is given credibility, external and internal influences on a story, who determines the meaning of a story, and how the patient is characterized within the story. Narrative permeates every aspect of human life, including medical and ethical situations, and approaching both through a narrative lens is imperative for the development of true understanding, empathy, and compassion. Cultivating a narrative framework towards illness allows both practioners and patients to be cared for while also caring for the other, thus creating deep, meaningful connections. / Urban Bioethics

Medicine and bioethics today are though as fields of pure logic, reasoning, and science, with physicians and ethicists trained to approach patients with an attitude of detatched rationality. In reality, neither medical care nor ethics can be practiced well without an acknowledgement for their deeply emotional, relational, and narrative qualities. Medical care and bioethics must both be practiced through a narrative lense in order to truly meet the humanity of both patients and practitioners. There are practical methods to integrate narrative skills into clinical practice, as well as tangible benefits to doing so. Practially, this is performed through narrative medicine: an approach to medical care that recognizes the stories as a critical component to healthcare; as well as narrative ethics: an awareness of the essential role of narrative in moral understanding. Using narrative as a tool to understanding illness and moral grounds the more abstract and universal aspects of both in practical, individual reality. There are many practical aspects of narratives when applied to bioethics, such as aquiring narrative skills, what happens when stories are shared, recognizing how narratives are built, how they convey knowledge, organize life, and provide meaning. Illness creates an isolation – for both patient and practitioner – and stories allow each to express their experience and be supported though the stories of others. Stories help brigdge the gap in experiences of illness between practioner and patient while helping pracitioners to maintin their empathy in the face of continual suffering. Narrative skills are also useful for practioners to bring awareness to the power dynamics that influence patient stories, such as the power of practitioner as co-creator, whose voice is given credibility, external and internal influences on a story, who determines the meaning of a story, and how the patient is characterized within the story. Narrative permeates every aspect of human life, including medical and ethical situations, and approaching both through a narrative lens is imperative for the development of true understanding, empathy, and compassion. Cultivating a narrative framework towards illness allows both practioners and patients to be cared for while also caring for the other, thus creating deep, meaningful connections. / Urban Bioethics

No description available.

The physician-patient dichotomy is reinforced continuously in medical education and medical practice. The physician possesses knowledge that will be used to help the patient in some way. However, as human beings, physicians are subject to the illnesses and diseases that affect their patients. Physicians moved by this role-reversal may feel compelled to record their experiences, leading to an accumulation of “physician-as-patient literature.” Five examples of “physician-as-patient” literature illustrate five fundamental lessons that can be adapted by physicians: relating to patient vulnerability, fostering hope for patients, mobilizing support systems, recognizing physical consequences of disease, and appreciating patient quality of life. By generalizing these individual stories, it is not necessary for physicians to experience the exact disease or illness they treat. Rather, they can draw from their unique life experiences to practice empathy. The concept of empathetic medicine can be introduced in medical school training by integrating empathy education into scientific curriculum. Current practitioners can benefit from narrative exercises, reflection and physician self-disclosure in efforts to promote empathy. Medical practice requires solid relationships between human beings, physicians and patients. This basic principle is further emphasized in “physician-as-patient” literature and concerted efforts by institutions and individual physicians can lead to a foundation for a culture of empathy. / Urban Bioethics

This dissertation is made up of three distinct parts: 1) A comprehensive, structured literature review 2) a mixed-methods descriptive study and 3) an inductive thematic qualitative analysis. The objective of this dissertation is to explore the concepts of compassion fatigue, compassion satisfaction and burnout as they relate to the practices of narrative medicine among expatriate humanitarian aid workers. Data collected for this research focuses on expatriate healthcare workers who provided direct patient care during the 2013-2016 Ebola response in Sierra Leone, Liberia and Guinea. Findings from these studies support the growing body of evidence and discussion regarding psychosocial support of healthcare workers in humanitarian contexts. To the extent that global health is public health (Fried, 2010), results from this dissertation will contribute guidance in the understanding and management of aid workers in contexts beyond the Ebola response.

Thesis supervisor: Garrett Stewart. Includes bibliographic references (p. 193-202).

THESIS (D.N.P. (Doctor of Nursing Practice))--School of Nursing, University of San Francisco, 2010. / Bibliography: leaves 61-67.

The goals of this project are twofold. The first goal is to articulate my sense making of reproductive health for Women of color in the United States as a postcolonial condition; one that I trace back to the logics of elimination of settler colonialism (Wolfe, 2006) and frame as maintained through the colonial institutions, or racial projects (Omi & Winant, 2015), of the Prison Industrial Complex, the welfare system, and the health care system which create and perpetuate dominant cultural narratives of “the welfare queen”, “the negligent Black mother”, and “the wily patient”. I show how these narratives colonize the minds of health care providers and contribute to the current stratification of health care. My second goal with this project is to show how postcolonial interpretive ethnography can be used as a narrative medicine educational intervention for providers. Currently, Narrative Medicine asks providers to read themselves, their patients, and their interactions as literature to emphasize the personal and interpersonal tensions that are often lost in the fast paced biomedical world (Charon, 2001). With this project I aim to expand the field of Narrative Medicine to consider the ways patient-provider interactions are postcolonial, and how analyses of these interactions can be a method of decolonization. I do so by analyzing three interpretive ethnographic narratives that I have created which story my interactions with three Women of color: Tiffany, Rose, and Jane. I then analyze each of these interactions for colonizing and decolonizing sense making.

No description available.