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VA’s narrative medicine program improves senior patient care, docs’ study finds –

Narrative medicine — the process of listening to and recording patient stories — helps doctors improve the quality of care they provide to older adults, according to the medical students and doctors involved in a new study.

To assess the value of narrative medicine, researchers teamed up with medical students and faculty members at Boston University Chobanian & Avedisian School of Medicine. The school uses the My Life, My Story (MLMS) framework to complete patient interviews during geriatric rotations of students in the clinic and during home visits or nursing home visits. MLMS was created in 2013 by the Veterans Health Administration to include the patient’s voice in their medical record.

The researchers organized group discussions with the students and individual interviews with faculty members. The researchers analyzed themes that emerged during these discussions and interviews.

The information gained from including a story about the patient’s personal history in the medical record is valuable, the results showed. The majority of students said they believed the MLMS experience would positively impact the way they practice medicine. Engagement with their patients’ stories improved the quality of their patient care, they said.

Similarly, faculty members reported that the practice of narrative medicine changed how they shaped patients’ decisions and helped them guide older patients to the most appropriate care settings and treatment modalities at the end of life.

“Much of the medical training focuses on the medical issues patients have, but it’s also important to know the patient as a person,” said author Shivani Kumari Jindal, MD, MPH, a geriatrician with the VA Boston Healthcare System. “Starting with what matters most to patients can help shape the care that is discussed and offered so that it better aligns with a person’s values, goals and life experiences.”

When health care providers meet patients later in life, they sometimes forget that these patients led active lives before the medical meeting, added co-author Megan E. Young, MD. “Narrative medicine, especially My Life, My Story, is a tool for understanding patients’ past experiences and understanding the person who is in the hospital bed or clinic.”

The full findings were published in the Journal of the American Geriatrics Society.

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