The Importance Of Integrating Narrative Into Health Care Decision Making

Health Aff (Millwood). 2016 Apr;35(4):720-5. doi: 10.1377/hlthaff.2015.1373.

Abstract

When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice.

Keywords: Consumer Issues; Evidence-Based Medicine; Medicine/Clinical Issues; Personal Experience (-Narrative Matters-).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Community Participation / statistics & numerical data
  • Consumer Health Information*
  • Decision Making
  • Delivery of Health Care / standards*
  • Delivery of Health Care / trends
  • Delivery of Health Care, Integrated
  • Female
  • Health Services Research
  • Humans
  • Male
  • Narration*
  • Patient Participation / statistics & numerical data
  • Physician-Patient Relations*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends
  • Qualitative Research
  • Quality of Health Care*
  • United States