Illness narrative

疾病叙事
  • 文章类型: Journal Article
    借鉴亚瑟·弗兰克对叙事修复的概念化,我们考虑儿科肿瘤科护士如何恢复和重新讲述患者和家庭的叙述,这些患者和家庭的传记被诊断为癌症和儿童死亡所抛弃,以及他们自己作为照顾者的叙述。弗兰克认为,当一个人的生活故事被慢性或危及生命的疾病击沉时,讲故事是重新定位一个人的传记到一个新的结局,修复疾病经历造成的叙事残骸。在这项对安大略省9名儿科肿瘤科护士的批判性叙事研究中,加拿大,我们强调如何,通过物理,叙事,和道德上的接近,护士在他们的病人和家庭的疾病叙述中交织在一起,以及如何发展这种叙事知识为护士提供了引导家庭进入新领域的机会。同样,我们研究了护士在被阻止代表儿科癌症患者行事的情况下,如何重塑和修复自己作为“好”护理人员的身份。通过将叙事修复视为儿科肿瘤学护理的一部分,这些发现为有关疾病叙事的文献做出了贡献。
    Drawing on Arthur Frank\'s conceptualization of narrative repair, we consider how pediatric oncology nurses restore and re-story the narratives of patients and families whose biographies have been thrown off course by the diagnosis and death of a child from cancer, as well as their own narratives as caregivers. Frank argued that when one\'s life story is shipwrecked by chronic or life-threatening illness, storytelling is way to reorient one\'s biography to a new ending, repairing the narrative wreckage created by the illness experience. In this critical narrative study with nine pediatric oncology nurses in Ontario, Canada, we highlight how, through physical, narrative, and moral proximity, nurses become entwined in their patients\' and families\' illness narratives, and how developing this narrative knowledge provides nurses with opportunities to steer families onto new terrain. As well, we examine how nurses re-story and repair their own identities as \"good\" caregivers in situations when they are prevented from acting on behalf of their pediatric cancer patients. These findings contribute to literature on illness narratives by considering narrative repair as a relational process enacted as part of pediatric oncology caregiving.
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  • 文章类型: Journal Article
    转介的过程,评估,在英国,注意力缺陷多动障碍(ADHD)的诊断通常是长期的。鉴于父母经常是诊断过程的煽动者,了解父母的经验很重要。根据纵向研究的结果,本文探讨了父母在多动症诊断过程中的经历如何包括三种重要且独特的“疾病工作”形式。在英格兰东北部的ADHD诊断旅程中,对7名儿童的父母进行了为期2年的半结构化连续访谈。我们介绍了父母疾病工作的三种重要形式:(1)“诊断任务”,父母的工作认识到并为孩子的需求和自我而战,寻求诊断并参与系统,(2)“自传疾病工作”,父母对诊断旅程的个人传记反应和(3)“儿童传记疾病的工作和对儿童的重新情境化”,父母的传记调整和子女的重新语境化。我们推进了拉斯穆森等人。的(2021年)模型,通过证明其在理解患有个人多动症诊断的父母如何经历传记中断或凝聚力来回应孩子的诊断方面的有用性。儿童的诊断导致患有ADHD的父母经历自我传记的凝聚力或破坏性反应是一个独特而重要的发现。
    The process of referral, assessment, and diagnosis of attention deficit hyperactivity disorder (ADHD) within the UK is often protracted. Given that parents are frequently the instigators of the diagnostic process, understanding the experience of parents is important. Drawing on findings from a longitudinal study, this article explores how the parental experience of the ADHD diagnostic journey includes three significant and distinct forms of \'illness work\'. Twenty-one semi-structured serial interviews were conducted over a 2-year period with seven parents of children on the ADHD diagnostic journey in North East England. We present three significant forms of parental illness work: (1) The \'diagnostic quest\', parental work recognising and fighting for their children\'s needs and selfhood, seeking diagnosis and engaging with systems, (2) \'self-biographical illness work\', the personal parental biographical response to the diagnostic journey and (3) \'child biographical illness work and recontextualizing the child\', parental biographical adjustment and recontextualisation of their children. We advance Rasmussen et al.\'s (2021) model by demonstrating its usefulness in understanding how parents with a personal ADHD diagnosis experience biographical disruption or cohesion in response to their children\'s diagnosis. That a child\'s diagnosis leads parents with ADHD to experience a self-biographical cohesive or disruptive response is a unique and significant finding.
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  • 文章类型: Journal Article
    在Covid-19大流行爆发时,几个国家宣布“例外状态”,“也就是说,授权的法律手段,面对被认为是灾难性的情况,允许执行非常措施和暂时停止某些权利,以便尽快恢复以前的状况。本文对美国宣布的不同例外状态进行了比较文本分析,法国,和西班牙。我认为,这些文本构成了探索全球政治逻辑和关于疾病的主流话语是如何交织在一起的特权网站。关于全球政治逻辑的作用,我认为这些声明构成了民主自身免疫特征的实例;它攻击自己是为了保护自己。关于疾病的主流话语,我探讨了如何将疾病视为对自我的威胁(看似其他的事物),以及治疗必须包括确保自我战胜看似其他事物的观念。这双重分析表明,在这些宣言中,自我与他人之间的矛盾辩证法-关于政治和疾病,很可能是因为,事实上,同一个辩证法,西方认识论的基础。此外,我建议这些文本反映和促进这些主导逻辑,以某种危险的方式帮助塑造全球的人际关系。
    At the outbreak of the Covid-19 pandemic, several countries declared \"states of exception,\" that is, authorized legal devices that, in the face of circumstances deemed catastrophic, permit the implementation of extraordinary measures and the temporary suspension of some rights in order to restore the previous state of affairs as soon as possible. This paper offers a comparative textual analysis of the different states of exception declared in the USA, France, and Spain. I argue that these texts constitute a privileged site to explore how prevalent global political logics and mainstream discourses on illness are interwoven. Regarding the global political logics in play, I hold that these declarations constitute an instantiation of democracy\'s autoimmune character; it attacks itself in order to protect itself. Regarding mainstream discourses on illness, I explore how illness is regarded as a threat to one\'s self (by something seemingly other) and the notion that therapy must consist of securing the self\'s triumph over anything seemingly other. This twofold analysis reveals that an aporetic dialectic between self and other-as regards politics and illness-operates in these declarations, most likely because it is, in fact, one and the same dialectic, upon which Western epistemology rests. Furthermore, I suggest that these texts reflect and promote these dominant logics, contributing to shape human relationships around the globe in a certain dangerous way.
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  • 文章类型: Journal Article
    当前的研究使用McGill疾病叙事访谈(MINI)来探索患者(n=6)和护理人员(n=3)关于他们如何识别和寻求精神病治疗的叙述。参与者是从Psiquitrico医院的门诊诊所招募的RafaelSerrano博士,普埃布拉的一家公立精神病医院,墨西哥。所有参与者都同意用西班牙语完成半结构化访谈。主题分析用于归纳识别参与者叙述中的共同主题。结果表明,在最初的症状发作期间,大多数参与者注意到幻觉的存在,但没有寻求帮助这一标志性症状。参与者描述了仅当他们或其患病的亲戚表现出不断升级的攻击行为或被解释为常见医学问题的身体症状时才寻求护理。随着参与者与专业心理健康服务联系起来,他们开始将精神病概念化为攻击性障碍。对于一些参与者来说,这种将精神病概念化为攻击性疾病导致了他们对诊断的矛盾。这些结果可以使用文化脚本框架来理解,这表明文化规范受到对行为常态和价值化的集体理解的影响。讨论了对社区运动的影响。
    The current study used the McGill Illness Narrative Interview (MINI) to explore patients\' (n = 6) and caregivers\' (n = 3) narratives about how they identified and sought care for psychosis. Participants were recruited from an outpatient clinic at the Hospital Psiquiátrico Dr. Rafael Serrano, a public psychiatric hospital in Puebla, Mexico. All participants consented to complete semi-structured interviews in Spanish. Thematic analyses were used to inductively identify common themes in participants\' narratives. The results indicated that during the initial symptom onset, most participants noticed the presence of hallucinations but did not seek help for this hallmark symptom. Participants described seeking care only when they or their ill relative exhibited escalating aggressive behaviors or physical symptoms that were interpreted as common medical problems. As participants became connected to specialty mental health services, they began to develop a conceptualization of psychosis as a disorder of aggression. For some participants, this conceptualization of psychosis as an illness of aggression contributed to their ambivalence about the diagnosis. These results can be understood using a cultural scripts framework, which suggests that cultural norms are influenced by collective understandings of normalcy and valorization of behaviors. Implications for community campaigns are discussed.
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  • 文章类型: Journal Article
    围绕衰老的复杂性,痴呆症,护理是超越制度界限的及时而紧迫的问题,在跨学科的晚年生活中引发了一场批判性的辩论。近几十年来,痴呆症和护理叙事的文学和文化表现显着增加,这提供了对这种情况下生活和变老的复杂范例的宝贵见解。在她的回忆录《我留在黑暗中》(1999)中,诺贝尔奖获得者安妮·厄诺克斯(AnnieErnaux)坦率地讲述了她母亲在痴呆症中的经历,从开始到逐渐下降。Ernaux真诚地探索了家庭和机构背景下痴呆症和护理的细微差别,并阐明了母女之间复杂而不安的关系。通过见证的行为,她走上了疗伤的道路,这让她能够面对过去的创伤,更好地驾驭未来的挑战。Ernaux对她母亲的痴呆症和衰老的痛苦描述既是一种忏悔性的写作,也是一种叙事疗法,这揭示了衰老的挑战,疾病,和未解决的家庭紧张关系。她的作品阐明了过去之间的相互联系,present,和未来,并表明疾病叙事可以作为变革的催化剂,身份形成,和自我反省。然而,Ernaux\的自白回忆录也困扰着生活写作和身份问题的伦理,并且似乎通过暴露母亲在面对痴呆症和护理时的脆弱性和亲密关系,使病态的医学凝视永存。
    The complexities surrounding aging, dementia, and care are timely issues that transcend beyond institutional boundaries, evincing a critical debate on later life across disciplines. The aim of this study is to offer fresh insights into the intricate paradigms of living and growing older with dementia. The study focuses on the Nobel Prize-winning author Annie Ernaux\'s memoir I Remain in Darkness (1999), which provides a candid account of her mother\'s journey through dementia from its onset to the gradual decline.
    This article employs the theoretical frameworks of literary gerontology, illness narratives and life writing to address the challenges of aging, dementia and care that are represented in Ernaux\'s memoir. It also addresses societal attitudes and stigma associated with aging and dementia by exploring the embarrassment that individuals and families experience when confronted with the deteriorating mental health of their loved ones.
    Ernaux\'s memoir explores the nuances of dementia and caregiving within both the familial and institutional context, and sheds light on the complex relationship between a mother and a daughter. Through the act of witnessing, Ernaux embarks on a path of healing, which allows her to confront her past wounds and better navigate the challenges that lie ahead. However, Ernaux\'s confessional memoir also troubles the ethics of life writing and identity issues, and seems to perpetuate the pathologizing medical gaze through the exposure of her mother\'s vulnerability and intimacy in the face of dementia and care.
    Ernaux\'s account of her mother\'s dementia and aging is both a confessional piece of writing and a narrative therapy, which reveals the challenges of aging, illness, and unresolved family tensions. Her work illuminates the interconnectedness between the past, present, and future, and shows that illness narratives can act as a catalyst for transformative change, identity formation, and self-reflection. The article addresses the intricacies of old age, showcasing how life writing and humanities-based inquiry can bring to the fore key aspects of the latest stages in life, which are often unvoiced because they represent the most unpleasant and feared aspects of aging in contemporary society.
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  • 文章类型: Journal Article
    长COVID影响着全球数百万人,但仍然知之甚少,也存在争议。本文转向对患者经历的描述,问:叙事对长期COVID和患有这种疾病的人都有什么影响?随着数百万人患病,2020年出现了哪些特定的叙事策略,恩大众,一种新的病毒,在第一次封锁三年后盛行?这可以告诉我们关于疾病和叙事以及在数字中文学批评方法对该主题的重要性,大流行后的年龄?通过仔细阅读记者露西·亚当斯对长长的COVID的自传,本文探讨了个体疾病叙事与疾病的集体叙事(或制造)之间的相互作用。我们对时间性和苦难的关注将现象学和社会性结合在一起,目的是开放亚当斯的叙事并更深入地理解生活在这种情况下意味着什么。最后,我们关注目前围绕长篇COVID流传的故事,并考虑疾病是如何叙述和开放的,好奇,以患者为中心的方法可能会塑造医学,患者参与,和关键的医学人文研究。
    Long COVID affects millions of individuals worldwide but remains poorly understood and contested. This article turns to accounts of patients\' experiences to ask: What might narrative be doing both to long COVID and for those who live with the condition? What particular narrative strategies were present in 2020, as millions of people became ill, en masse, with a novel virus, which have prevailed three years after the first lockdowns? And what can this tell us about illness and narrative and about the importance of literary critical approaches to the topic in a digital, post-pandemic age? Through a close reading of journalist Lucy Adams\'s autobiographical accounts of long COVID, this article explores the interplay between individual illness narratives and the collective narrativizing (or making) of an illness. Our focus on temporality and suffering knits together the phenomenological and the social with the aim of opening up Adams\'s narrative and ascertaining a deeper understanding of what it means to live with the condition. Finally, we look to the stories currently circulating around long COVID and consider how illness narratives-and open, curious, patient-centered approaches to them-might shape medicine, patient involvement, and critical medical humanities research.
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  • 文章类型: Journal Article
    今天,大多数被诊断患有癌症的儿童有望长大并生活到老年。尽管如此,对儿童癌症幸存者的生活经历的了解很少。为了追求知识扩张,通过结合我作为学者的交叉角色,教育顾问,和儿童癌症幸存者,我接近我的个人疾病叙述。通过唤起的人种学,我故意写关于我的经历,并让他们考虑。我通过档案探索我的叙述,神器,对过去的回忆,和谈话在现在引起的。我重新参观了一个在00年代患有癌症的挪威南部女孩的文化景观。通过这个,我的疾病叙事呈现为定位,纠结,与发展轨迹交织在一起。具体的教育经验似乎挥之不去,许多与生病后缺课或重新入学有关。要把握年轻时重病的交叉和冲突的经历,我建议埃里克·埃里克森的暂停作为一个关键概念。为了补充亚瑟·弗兰克关于恢复原状的疾病叙述,混乱,和追求,我建立了暂停的叙述。作为一种新鲜的资源,暂停叙事强调了我们的学术界对疾病轨迹在形成阶段展开的关注和由成长定义的疾病叙事的需要。通过提供一个提示详细说明的识别点,这也可以为年轻人和重病人提供急需的机会叙事空间,其中更多的叙述被邀请和坚持。
    Today, a majority of children diagnosed with cancer are expected to grow up and live-hopefully until old age. Still, knowledge of the lived experience of childhood cancer survivors is sparse. In pursuit of knowledge expansion, by combining my intersecting roles as an academic, educational counselor, and childhood cancer survivor, I approach my personal illness narrative. By means of evocative autoethnography, I write intentionally vulnerably about my experiences and make them available for consideration. I explore my narrative through archives, artifacts, memories of the past, and conversations evoked in the present. I re-visit the cultural landscape of a southern Norwegian girl growing up in the 00s with cancer. Through this, my illness narrative presents as positioned, tangled, and interwoven with a developmental trajectory. Specific educational experiences seem to linger, and many are related to being absent from or re-entering school after the onset of illness. To grasp the intersecting and conflicting experiences of being very ill while also young, I suggest Erik Erikson\'s moratorium as a key concept. To complement Arthur Frank\'s illness narratives of restitution, chaos, and quest, I establish the moratorium narrative. As a fresh resource, the moratorium narrative underlines the need to make sensitive our academic community\'s gaze on illness trajectories unfolding in formative phases and illness narratives defined by growing up. By providing a point of recognition that prompts elaboration, this could also provide the young and very ill with a much-needed narrative space of opportunity, of which more narratives are invited and insisted upon.
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  • 文章类型: Journal Article
    癌症护理领域仍然缺乏沟通的最佳实践。很少有研究生培训计划提供正式培训来发展这种技能。患者伙伴关系已用于医学教育,以提高患者主观体验的敏感性。在我们的加拿大中心,居民和患者伙伴参加了一个以患者叙事为重点的交流教育研讨会。这项试点定性研究的目的是探索研讨会参与者的经验。使用理论采样,我们招募了6名住院医师和6名患者伴侣.进行了半结构化访谈并进行了转录。进行了专题分析。从分析来看,出现了4个主题:(1)缺乏沟通技巧培训;(2)癌症护理中有效沟通的障碍;(3)患者合作伙伴对居民面临的沟通挑战的同情;(4)参与者对研讨会的反应。根据我们的发现,我们的沟通技巧研讨会以叙事医学为中心,并让患者-合作伙伴参与,看来是可行的.未来的研究可以研究其教学价值和所需的最佳学习环境。
    The field of cancer care still lacks best practices in communication. Few postgraduate training programs offer formal training to develop such skills. The patient partnership has been used in medical education to increase the sensitivity of the subjective experiences of patients. In our Canadian center, residents and patient-partners participated in an educational workshop on communication focusing on patient\'s narrative. The aim of this pilot qualitative study was to explore the experiences of participants in the workshop. Using theoretical sampling, we recruited 6 residents and 6 patient-partners. Semi-structured interviews were conducted and transcribed. A thematic analysis was performed. From analysis, 4 themes emerged: (1) lack of communication skills training; (2) barriers to effective communication in cancer care; (3) the empathy of patient-partners towards the communication challenges faced by residents; and (4) the participants\' reactions to the workshop. Based on our findings, our communication skills workshop centered on narrative medicine and involving patient-partners appears feasible. Future research could study its pedagogical value and the optimal learning environment required.
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  • 文章类型: Journal Article
    法国的药丸恐慌通常是由MarionLarat案引发的“媒体辩论”,一名年轻女子因服用避孕药而中风。本文旨在关注之前的一项实践,陪伴,并遵循这种健康恐慌:在法国肺栓塞和中风与激素避孕相关的受害者协会(Avep)的网站上发布了血栓性反应的在线证词。通过语篇分析,我们打算将这些在线公开自我报告作为一种激进的实践来分析,旨在批评避孕方面的主导医学话语。出现了四个话语框架:妇女和医生的准备不足,否认指责并寻找原因,打破沉默,建立团结,集体行动。前两个框架涉及妇女为获得谈论和批评医疗实践的权利而采取的程序。话语权是通过注重事实的简洁叙述方式来实现的,身体表现,和风险因素。第二对是指药丸受害者的形成是具有矛盾状态和短暂代理的受试者。证词建立了我们所谓的“孤独的团结”,也就是说,围绕见证医疗不公正的共同经历建立社会纽带和行动,这种经历在成员之间没有任何交流的情况下发展。这被证明是包容和病毒式的,但与此同时,在政治斗争或社会认同方面强烈反代表性。
    The French pill scare is usually presented as a \"media debate\" triggered by the case of Marion Larat, a young woman who suffered a stroke attributed to the pill she was taking. This article intends to focus on a practice that preceded, accompanied, and followed this health scare: the publication of online testimonies of thrombotic reactions posted on the website of the French Association of Victims of Pulmonary Embolism and Stroke Associated with Hormonal Contraception (Avep). Through a discourse analysis, we intend to analyze these online public self-reports as an activist practice aimed at criticizing the dominant medical discourse on contraception. Four discursive frames emerged: unpreparedness of women and doctors, denial of blame and search for the cause, breaking the silence and building solidarity, and collective action. The first two frames concern the process women put in place to obtain the right to speak about and criticize a medical practice. The right to speak is achieved through a concise narrative style focusing on facts, bodily manifestations, and risk factors. The second pair refers to the formation of pill victims as subjects with an ambivalent status and ephemeral agency. The testimonies build what we call \"lone solidarity\", that is, the creation of a social bond and action around a common experience of witnessing medical injustice that develops without any exchange between members. This proves to be inclusive and viral, but at the same time fiercely anti-representational with respect to political struggles or social identification.
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  • 文章类型: Journal Article
    许多在医学和人文学科交叉的教学都在机构空间内孤立。本文讲述了SarahManguso的“两种衰变”对不同学术背景下的学生的教学,并考虑了当我们将教室相互交谈时我们可以学到什么。这篇文章论证了像Manguso\的文本的价值,明确地将疾病叙述的主题和形式进行批判性检查。作者呼吁更多的协作教学,在健康人文科学中具有特殊的共鸣,对话已经依赖于桥接学科和倾听别人可以讲述的故事。
    Many of those teaching at the intersection of medicine and the humanities are siloed within institutional spaces. This essay recounts the teaching of Sarah Manguso\'s The Two Kinds of Decay to students across different academic contexts and considers what we can learn when we put classrooms in conversation with each other. This essay argues for the value of texts like Manguso\'s, which explicitly hold the narrating subject and form of illness narrative up for critical examination. The authors call for more collaborative teaching, which has special resonance in the health humanities, where conversations already depend on bridging disciplines and listening to the stories others can tell.
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