The advancement of knowledge in the natural sciences has an ideal form. Every secondary school curriculum includes lessons about the scientific method. The authors Wang and Geale remind us that that nursing specifically, and healthcare generally, is what happens when the advancement of this knowledge meets real people. Healthcare is full of dynamic processes characterized by the continuous interaction of human thought and behaviour that continuously
Considering that nursing and medicine contain complex knowledge and messy human behavior careening into one another, what is the best way forward?bumps
into personal, social and material environments.
In the International Journal of Nursing Studies, the authors make a succinct and thoughtful case for the continued expansion of narrative methods in qualitative research. Their arguments, though, are useful as a higher-level look into why anyone would want to try and understand an individual’s story.
“Health” is not one thing
It’s easy to overlook the fact that most patients don’t consider health for health’s sake the goal. There is some purpose to life, whether conscious or not. Narrative, the authors remind us, provides an opportunity to come to a better understanding of what it means to be human and what health means to people. Narrative inquiry does not rest with the researchers’ preconceived ideas of what constitutes health…
Better interactions mean better care
However brief or superficial, medicine is relational. One aspect of this is that most treatments require some measure of action or participation on the patient’s part. Healthcare providers can’t bear the burden for a treatment alone. If the patient is involved on some level with their own care, it’s worth investigating the patient’s understanding of their illness and experience.
The word “understanding” is a key feature of working with narratives for Wang and Geale. Relating patients’ stories can provide a more in-depth understanding of the particulars of the participants’ points of view. The knowledge gained can offer … a deeper understanding of the subject material and extra insight…
Even though the authors are specifically addressing narrative inquiry as research, their discussion about ethics is valid for all healthcare providers. The patient/provider relationship is a strange mixture of closeness and distance: both in an intimate relationship with the participant and in a professionally responsible role in the scholarly community
.1 And again, it’s not just narrative researchers who have a need to recognize and embrace the subjective reality inherent in the process
of care.
Care is more than a science
All throughout the article, the authors bring up a feature of scientific investigation (which is good, beneficial, and important), and comment on how narrative can open its benefits up to make it human. In general, science is interested in generalizing the data in order to develop
whereas laws
,the narrative approach acknowledges human experiences as dynamic
. Other facets to this include scientific prediction vs. narrative interpretation, abstraction vs. context, facts vs. meanings, and impersonal vs. complex.
In their discussion, Wang and Geale mention that a narrative researcher “re-stories” a patient’s narrative into the frame of their inquiry. This is a wonderful summary of the difference in viewpoints: a patient can either be an object for re-search, or a subject to be re-storied.
Sources
The article reviewed: Wang, Carol Chunfen and Geale, Sara Kathleen, 2015. “The Power of Story: Narrative Inquiry as a Methodology in Nursing Research.” International Journal of Nursing Sciences, 2(2), pp.195–198. https://doi.org/10.1016/j.ijnss.2015.04.014.
1 Clandinin, D. Jean, ed. 2007. Handbook Of Narrative Inquiry: Mapping A Methodology. Thousand Oaks, CA: Sage Publications. ↑
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