NARRATIVE MEDICINE...norma baru?

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kuihbakar replied at 4-7-2020 07:25 PM
Nanti nak study

lamanya stadi ...

kuihbakar

seribulan replied at 27-7-2020 02:49 PM
lamanya stadi ...

Alamak.... Hehe

seribulan

kuihbakar replied at 27-7-2020 06:27 PM
Alamak.... Hehe

kita nasi tambah...


Space
Storytellers rarely described in detail the physical spaces and geographical places in which events occurred. Rather, these spaces were made meaningful by the intensity and dynamic of the experiences being recounted. For one young storyteller, exiting her parent’s car to see her doctor represented a departure from life as she once knew it:

“A few weeks later I went back to get the stitches removed. My dad waited with my younger brother in the car and I entered the doctor’s office on my own, knowing it would only take a few minutes. Within minutes, I was rushed into the nearby surgery room after being told I had a stage II melanoma. Twenty stitches later, I returned to the car overwhelmed by my experience.”

The ordinary spaces that we occupy in day-to-day life offered a context by which storytellers compared the ‘before and after’ impact of treatment:

“It is always the small things that make the biggest impression. I was leaving our local market after doing the weekly food shopping when I got a flashback of my first attempt at picking up a few groceries by myself after chemo. I was still very very weak and didn’t know if I could do it without my husband with me. He came with me everywhere because of my fear of collapsing due to weakness. I did achieve this task, albeit very slowly. As I remembered this achievement, I remarked to myself what a difference a couple of months made. I was walking to my car with a full basket of groceries at a very quick pace, without any fatigue or weakness at all.”

“After my surgeries on my leg, I wasn’t allowed to go to the gym, climb stairs, or even drive my standard car.”

Physical realms were represented also as relational spaces in which meaningful interactions took place. The relationship between storyteller and physician, for example, is illustrated in the following story via the description of movement—and also stillness—of people within settings:

“[The doctor] came to my hospital room and asked if I wanted a second opinion. I was so touched that she would sit at my bedside and ask that question…She told me she was going to a big oncology conference and would have more information for me when she got back. A few weeks went by and when she came back from the conference I had an appointment to see her. When I got into the office, I was very excited to see her because she had become part of my life, and I wanted to see what she learned at the oncology conference. I noticed that she [the doctor] had some difficulty looking at me, and I made it easier for her. I said, ‘there isn’t anything new out there for me, is there?’ She said, ‘no, and we just sat there for awhile.”

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ipes2 replied at 14-7-2020 01:26 AM
ha ha no, am not replying from the toilet.. baru bangun at 7.30 petang ni since morning tidur
so, ...

don't reply this @ conferencee loo...


Voice
Vocal cues
By attending closely to the linguistic components of the pathographies, we developed an awareness of how storytellers composed their texts to reflect a particular voice. Punctuation was a foundational tool for storytellers who wanted to create a sense of fervor in the text. Intensity of feeling was indicated by extensive use of exclamation marks, question marks and capital letters, extended ellipses and typographical symbols to indicate swearing.

“I couldn’t believe it. Cancer?? Me??? How is this possible? I had a 2 year old and a newborn! What a cruel thing to have this happen after bringing such sweet lives into this world.”

“……with shock having taken over, I blurted out, “ARE YOU ##%%! KIDDING ME?” The thought of my eye ball being cut and frozen and…………………..It’s all just too much. I break. I break down….right there, with this nice eye tumor specialist and his nurse, I just sob.”

“Prior to my diagnosis I had no idea of how aggressive and horrible melanoma is. I thought, ‘Skin cancer – that’s no big deal!’ Boy – was I WRONG!!!”

Some storytellers repeated letters to enact the written version of what would have been their spoken tone. As an example, the following storyteller emphasized the rationalization of his or her distress by lengthening the word ‘oh’ in the phrase ‘oh well’:

“Sleeping at night is hard too between the anxiety and my leg falling asleep no matter what position I'm in. But ohhh well, I always think it could be worse

ipes2

seribulan replied at 28-7-2020 07:46 AM
don't reply this @ conferencee loo...

hari ini dan seterusnya buat analysis of lab works. so much analyses to be done hu hu
doakan ya

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ipes2 replied at 30-7-2020 01:40 AM
hari ini dan seterusnya buat analysis of lab works. so much analyses to be done hu hu
doakan ya

Sure sure hopefully you are not in the lab loo...

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Metaphor

Metaphors for psychosocial states

Metaphorical expression helped storytellers to express the philosophical, emotional and psychosocial impact of the disease and treatment on their lives. The following storyteller likens the feeling of diagnosis to the lack of control and wreckage experienced as a victim of a road accident and likens involuntary immobility to the devastation he or she feels:

“Well, I felt as though I had been hit by a truck….the reality that this was happening to me was paralyzing….nothing can really prepare you to hear those words. There seemed to be no end to the bad news.”

The use of the conventional metaphor of being hit by a truck contrasts with the use of original metaphor in the following pathographies. This storyteller also uses vehicles as metaphors by which to measure the impact of treatment:

“I just finished my third round of chemo yesterday and I’m feeling OK- about 50% capacity. Used to be a V8 super car now I’m a wimpy 4 cylinder running on diesel.”

Another storyteller combined figurative and symbolic language with metaphor to convey the shifting nature of the relationship between self and disease:

“My mortality lay down on me like a heavy, itchy, woollen blanket. Every night, it was my loyal companion. Most friends fell away, but the real ones stuck around. My new friends keeping me company were fever, vomiting, and diarrhea. Miraculously, they brought wisdom, insight, and compassion. Day after day, night after night, my real self, my soul, began to emerge. I watched my hair fall out and saw courage, character, and strength grow in. Gone was the self-absorbed beach bunny, and in her place was someone new, but familiar.”

Hikaripinky

Love it.. sangat bermanfaat

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Hikaripinky replied at 6-10-2020 09:31 AM
Love it.. sangat bermanfaat

Nasi tambah



Bagi orang yang mencari pengalaman penjagaan kesihatan yang lebih memuaskan, ubat naratif mungkin menjadi jawapannya. Sebagai bidang penjagaan kesihatan yang semakin meningkat, amalan ini mendorong pesakit untuk menceritakan kisah kesihatan mereka supaya doktor dapat merawat keadaan yang lebih baik dan berkesan.  Dalam perubatan naratif, doktor berusaha untuk mendapatkan pemahaman yang lebih mendalam mengenai pengalaman dan emosi yang mungkin mempengaruhi kesihatan setiap pesakit. Dengan berkongsi cerita anda, anda membuat gambaran yang lebih lengkap mengenai penyakit anda dan kesannya terhadap kehidupan anda. Pada masa yang sama, ubat naratif memberikan gambaran mengenai pendekatan rawatan dan strategi rawatan diri yang mungkin menghasilkan manfaat terbesar bagi setiap individu.
Pada akhirnya, ubat naratif memberikan cara yang kuat untuk "merapatkan jurang yang memisahkan doktor dari pesakit," menurut Rita Charon, MD, PhD, seorang profesor Columbia University yang berasal dari bidang perubatan naratif. Cara yang lebih holistik untuk merawat penyakit, ubat naratif kelihatan di luar gejala dan pilihan rawatan untuk mempertimbangkan keseluruhan pesakit dan keperluan, kepercayaan, dan nilai unik mereka.


Kebaikan Salah satu prinsip utama perubatan naratif adalah bahawa menerima kisah pesakit membantu membina empati pada doktor dan seterusnya meningkatkan kualiti rawatan. Sesungguhnya, sejumlah kajian baru-baru ini menunjukkan bahawa tahap empati doktor yang lebih tinggi mungkin dikaitkan dengan hasil yang lebih positif pada pesakit.
Dalam kajian yang diterbitkan di Perubatan Akademik misalnya, pada tahun 2011, penyelidik menganalisis kesan empati doktor terhadap 891 orang yang menghidap diabetes. Mereka mendapati bahawa pesakit doktor dengan skor empati yang tinggi lebih cenderung untuk mengawal tahap gula darah mereka (berbanding pesakit doktor dengan skor empati yang rendah).
Di samping itu, kajian yang diterbitkan di Annals of Indian Academy of Neurology pada tahun 2012 menetapkan bahawa orang yang menderita migrain mempunyai hasil kesihatan yang lebih baik dan lebih cenderung untuk mematuhi rancangan pengurusan mereka ketika mereka merasakan bahawa doktor mereka tidak bersikap empati terhadap keadaan mereka.


Petua Memulakan Perbualan Dengan Doktor Anda Dalam beberapa tahun kebelakangan ini, sekolah perubatan di seluruh negara telah mula melatih penduduk dalam perubatan naratif. Universiti Columbia bahkan menawarkan program master perubatan naratif yang ditujukan untuk profesional penjagaan kesihatan dan pelatih. Walau bagaimanapun, kerana perubatan naratif adalah bidang yang masih muncul, banyak doktor mungkin tidak mengetahui prinsip praktik ini.
Sekiranya anda berminat dengan ubat naratif dan peranannya yang berpotensi dalam penjagaan kesihatan anda, beritahu doktor anda. Walaupun doktor anda tidak mempunyai latihan perubatan naratif, dia harus terbuka untuk mendengar kisah kesihatan anda.
Sejumlah soalan boleh membantu membimbing anda dalam memulakan perbualan ini dengan doktor anda. Sebagai contoh, Dr. Charon biasanya memulakan lawatan pesakit pertamanya dengan bertanya, "Apa yang anda ingin saya ketahui mengenai anda?" Memikirkan soalan ini sebelum lawatan doktor anda dapat membantu anda membina naratif anda.
Berikut adalah beberapa soalan lain yang sering ditanyakan oleh pengamal perubatan naratif kepada pesakit mereka semasa lawatan ke doktor:

• "Bagaimana perasaan anda tentang keadaan anda?"
• "Apa yang anda fikir berlaku dengan keadaan anda?"
• "Bagaimana hidupmu berubah akibat kondisi kamu?"
  

Sekiranya anda merasa takut untuk memulakan perbualan ini dengan doktor anda, ingatlah bahawa ubat naratif dapat menunjukkan petunjuk penting mengenai kesihatan anda dan, akhirnya, bantu doktor anda untuk mencari pendekatan yang optimum untuk merawat keadaan anda.
Apa yang Perlu Dibincangkan Pengamal perubatan naratif sering mengesyorkan agar pesakit mendekati proses ini sebagai bentuk penceritaan. Untuk itu, adalah mustahak untuk mempertimbangkan watak-watak (iaitu, rakan, saudara, dan orang lain dalam hidup anda) dan plot plot (iaitu, peristiwa kehidupan utama dan kecil) yang menonjol kepada anda semasa anda mengkaji sejarah anda sendiri dengan kesihatan dan penyakit.
Semasa anda menceritakan kisah anda, pastikan untuk mengatasi tekanan dan kegelisahan yang berkaitan dengan keadaan anda. Perlu diingat bahawa sejarah kesihatan keluarga anda juga banyak mempengaruhi ketakutan anda mengenai penyakit anda. Dan jika anda merasa khuatir atau malu untuk membocorkan perincian intim mengenai kehidupan anda, ingatlah bahawa kebanyakan doktor terbiasa membincangkan masalah peribadi.


Lebih Banyak Panduan Persiapan yang teliti dapat membantu anda memanfaatkan lawatan doktor anda dengan sebaik-baiknya, terutamanya jika anda merasa gementar untuk berkongsi lebih banyak elemen peribadi mengenai kisah kesihatan anda. Sebelum lawatan anda, catatlah setiap perkara yang ingin anda nyatakan dengan doktor anda, kemudian bawa nota tersebut ke temujanji anda.
Menyimpan jurnal kesihatan juga dapat membantu anda mengumpulkan butiran narasi kesihatan anda. Cuba luangkan sekurang-kurangnya 10 minit untuk menulis secara bebas mengenai pengalaman penyakit anda, yang mungkin membongkar fikiran dan perasaan yang selama ini anda ditekan.
Sekiranya anda memerlukan sokongan lebih lanjut, membawa rakan atau ahli keluarga ke janji temu doktor anda juga mungkin bermanfaat.


Akhirnya, jika doktor anda tidak bersedia membincangkan kisah kesihatan anda dengan anda, pertimbangkan untuk berjumpa doktor dengan minat yang lebih besar dalam perubatan naratif.


https://ms.cc-inc.org/narrative- ... -tips-4143186-12395


@ipes2