(Un)bridgeable Chasms?: Doctor-Patient Interactions in Select Graphic Medical Narratives

We are all ordinary: the shared visual narratives of daily life promote the patients' positive attitudes toward doctors

BACKGROUND

Current research on the doctor-patient relationship primarily focuses on the responsibilities of doctors, with relatively less emphasis on examining the contributions patients can make. As a result, there is an urgent demand for exploring innovative approaches that highlight the active role patients play in cultivating a robust doctor-patient relationship. The purpose of this study was to devise an intervention strategy centered around patients to enhance the doctor-patient relationship. Comics were developed to depict shared narratives encompassing challenging daily life experiences between doctors and ordinary individuals. The study aimed to assess the efficacy of this approach in cultivating positive attitudes toward doctors.

METHOD

A 3-group design trial was conducted in Shanghai, China. A total of 152 participants were randomly assigned to one of three conditions: the parallel presenting group (n = 51), where narratives about a doctor and an ordinary employee were presented side by side in comics; the single presenting group (n = 50), where only narratives about a doctor were presented; and the control group (n = 51). The outcomes assessed in this study encompassed changes in identification with the doctor portrayed in the comics, perceived intimacy between doctors and patients in reality, and appraisal of the doctor in a prepared doctor-patient interaction situation.

RESULTS

The parallel presenting group exhibited significantly larger increases in identification with the doctor portrayed in the comics, perceived intimacy between doctors and patients in reality, and appraisal of the doctor in a prepared doctor-patient interaction scenario compared to the single presenting group. The observed enhancements in the appraisal of the doctor in a prepared doctor-patient interaction scenario can be attributed to the changes in identification with the doctor portrayed in the comics experienced by the participants.

CONCLUSION

Our study responds to the doctor-centric focus in existing research by exploring patients' contributions to the doctor-patient relationship. Using comics to depict shared narratives, the parallel presenting group demonstrated significantly increased identification with the depicted doctor, perceived intimacy, and positive appraisal in prepared scenarios compared to the single presenting group. This underscores the effectiveness of patient-centered interventions in shaping positive attitudes toward doctors, highlighting the pivotal role patients play in fostering a resilient doctor-patient relationship.

TRIAL REGISTRATION

Chinese Clinical Trail Registry: ChiCTR2400080999 (registered 20 February 2024; retrospectively registered).

Facilitators and barriers in using comics to support family caregivers of patients receiving palliative care at home: A qualitative study

BACKGROUND

Family caregiving at home is highly important for people receiving palliative treatment, but also a complex experience, subject to implicit social expectations. This study empirically explored the claim that comics benefit palliative care practice, through evaluating a graphic novel's value as an aid in supportive conversations with family caregivers.

AIM

To identify facilitators and barriers in using Naasten (Loved ones), a Dutch research-based graphic novel about family caregivers providing care at the end-of-life.

DESIGN

Qualitative study, following thematic content analysis.

PARTICIPANTS

Three focus groups with family caregiver consultants, palliative care volunteers, and healthcare professionals (total N = 23) who supported family caregivers; and individual telephone interviews with family caregivers to whom the book was presented (N = 4).

RESULTS

Barriers and facilitators related to: (1) the family caregiver, (2) impact on the family caregiver, (3) impact on the conversation between the person who provides support and the family caregiver, (4) their relationship, and (5) the person who provides support. Naasten was reported as recognizable and supportive, and powerful in raising emotions, awareness and conversation. Barriers concerned the book's impact due to its style and guidance of a conversation, and doubts about its surplus-value.

CONCLUSIONS

Emotionally impactful comics may support bereaved family caregivers, but should be introduced with care among current family caregivers, for example, ensuring a right fit, introduction, and follow-up-while taking into account a caregiver's individual situation, needs, abilities, and affinity with the medium. Comics are preferably used in educational settings, contributing to professional awareness and tailored support of family caregivers.

Slicing through Thin Layers of Humanity: Narratives of the Abject

This essay examines narratives about cadaver dissection through the lens of psychoanalytic theory in order to better understand the nature of medical students' socialization into medicine and its implications for physician-patient communication. The theoretical framework provided by Julia Kristeva focuses attention on the nature of subject-formation in relation to abjection - that which reveals the contingent nature of the speaking self. Analysis of memoirs and other narratives by medical students demonstrates that students encounter the abject in the process of dissecting a corpse, but are rigorously trained to map over this experience using the technical tools of biomedicine. Other students rely on dark and morbid forms of humor to develop a sense of emotional distance from their cadaver. This analysis reveals new insights about the nature of the gap between physicians and their patients. In particular, it indicates that this gap is not fixed or static but fluid and malleable. Physicians are always shifting between the symbolic realm of biomedicine and the affective, semiotic mode of encountering the abject. This malleability provides the key to training and educating medical students, socializing them in such a way that they are reflexive about this process of oscillation. How physicians handle the reality of their fluctuation between the semiotic and the symbolic is what will determine their ability to engage with patients.