Pediatric Illness Narratives: Positivity, Humility, and Transformative Care (S563).

Pediatric Illness Narratives: Positivity, Humility, and Transformative Care (S563).

Aultman, Julie

Grossoehme, Daniel

Friebert, Sarah

Robinson, Nicole

2022

1. Classify types of pediatric illness narratives and essential pro-healthy linguistic properties 2. Articulate best methods to gain insight into patients' values, interests, and goals of care through written texts, and why it matters This study fills a significant gap in narrative medicine and integrated pediatric patient care through an extensive mixed-methods retrospective analysis of pediatric texts acquired through systematic narrative interventions that center on the illness experience in a 365-bed tertiary pediatric hospital. The objective was to characterize linguistic and narrative properties of texts generated by hospitalized patients, who participated in narrative interventions, to classify the illness narrative, and test whether they yield insights and pro-healthy linguistic characteristics about patients and others to transform their care experiences. Eighty texts written by patients from outpatient palliative care or medical/surgical inpatient floors and 41 texts written by patients in a partial hospitalization program were collected between January 2013 and June 2019 and linguistically and thematically analyzed in 2020. NVivo 12.0 Pro was used for analysis. Texts were classified into 1 of 3 types of illness narratives (Chaos, Quest, or Restitution), with Quest narrative being the predominant type; patients wrote their journeys of illness and personal transformations, which provide insight into how they understand themselves and others related to illness or trauma. Patients' texts were highly present-focused, were socially oriented, and used higher percentages of positive emotion words compared to those of young adults. We found that through their imaginative narrative elements, texts were hopeful, playful, and charismatic. Patients' narratives are positive affirmations that healing has started, and there are emotional, cultural, spiritual, and relational needs to be met beyond clinical care; pediatric insights through storytelling foster better communication, cultural and narrative humility, and transformative patient-centered care. This study fills a research gap by determining that stories generated through low-cost, nonpharmacological, replicable, low-risk narrative interventions in a pediatric hospital have linguistic properties associated with pro-healthy outcomes with no side effects. Future narrative medicine studies identifying specific pro-healthy outcomes are needed.

Journal of Pain & Symptom Management. May2022, Vol. 63 Issue 5, p941-941. 1p.

English