摘要
人口老龄化以及新型不健康的生活方式导致世界范围内的癌症发病率急剧上升。作为癌症治疗的主要手段,外科手术干预必不可少,其中术前谈话更是术前准备流程中的重要环节。采取参与式观察法对一段癌症患者的外科术前谈话进行文本解析,找出医患双方不同视角下对于疾病叙事的分歧所在,即患者的叙事是涵盖了过去、现在和未来的主观叙事,包括了社会和自我的全方位叙事,是具有人文意义的感性叙事;而医生的叙事则是专注于当下的此时此景的客观叙事,是纯医学性的理性叙事。因此尝试将叙事医学的理念和方法引入医患沟通的具体实践之中,以此提高医生的共情能力和沟通技巧,使得患者得以真正参与到临床决策的制定过程中,达到“医患共同决策”的层面,最终降低医疗风险,提高患者依从性,改善患者的生命质量。
The aging population and the new unhealthy lifestyles have led to a sharp rise in cancer incidence worldwide.As the main means of cancer treatment,surgical intervention is indispensable,in which preoperative conversation is an important part of preoperative preparation process.This paper adopted participatory observation method to analyze the text of a preoperative conversation of cancer patients,to find out the difference of disease narration between doctors and patients from different perspectives.The patient’s narrative was a subjective narrative covering the past,the present and the future,including the all-round narrative of society and themselves,which was a perceptual narrative with humanistic significance.However,the doctor’s narrative was focused on the objective narrative of the current situation,which is a purely medical and rational narrative.Therefore,this paper attempted to introduce the concept and method of narrative medicine into the specific practice of doctor-patient communication,so as to improve the doctors’empathy and communication skills.Then,patients could really participate in the clinical decision-making process,and then achieve the level of“doctor-patient joint decision-making”,reduce medical risk,improve patient compliance,improve the quality of patients’lives.
作者
郑琛
张习禄
ZHENG Chen;ZHANG Xilu(College of Humanities and Management,Shaanxi University of Chinese Medicine,Xianyang 712046,China;The First Affiliated Hospital,Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处
《中国医学伦理学》
2020年第1期85-91,共7页
Chinese Medical Ethics
基金
2019年陕西省教育厅重点科学研究计划项目“基于传统医德和叙事医学的人文元素对医患关系与临床治疗的积极作用研究”(19JZ028)
关键词
叙事医学
医患沟通
癌症治疗
共同决策
术前谈话
Narrative Medicine
Doctor-patient Communication
Cancer Therapy
Shared Decision-making
Preoperative Conversation
