ERJ Open Research (May 2018)

Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease

  • Antonietta Cappuccio,
  • Alessandro Sanduzzi Zamparelli,
  • Massimo Verga,
  • Stefano Nardini,
  • Alessandro Policreti,
  • Pasquale Alberto Porpiglia,
  • Silvia Napolitano,
  • Maria Giulia Marini,
  • Anna Annunziata,
  • Sabrina Arondi,
  • Sara Balestracci,
  • Elena Bargagli,
  • Angelo Bastianelli,
  • Michele Battilana,
  • Maria Grazia Boi,
  • Bassal Boulos,
  • Luisa Brussino,
  • Guglielmo Bussoli,
  • Biagio Campana,
  • Silvia Capato,
  • Chiara Carraro,
  • Francesco Carrozzi,
  • Maria Antonietta Ceccon,
  • Franco Chiaravalloti,
  • Mongiardi Christian,
  • Ida Ciamarra,
  • Antonello Colangeli,
  • Claudia Coli,
  • Paola Contini,
  • Eugenio Cosentino,
  • Nicola Costanzo,
  • Emilio De Angelis,
  • Francesca De Filippis,
  • Nicola De Rosa,
  • Ginevra Del Giudice,
  • Felice Di Perna,
  • Bledar Elezi,
  • Varzaneh ShoKoofoe Eslami,
  • Giorgio Ferraro,
  • Maria Concetta Giofrè,
  • Francesca Giovannelli,
  • Simona Guerra,
  • Giuseppe La Fauci,
  • Claudia Madaschi,
  • Ennio Mantellini,
  • Silvia Marani,
  • Rita Marchi,
  • Ali Asghar Masoudì,
  • Claudio Mastruzzo,
  • Emilio Melica,
  • Filomena Minicozzi,
  • Aldo Miraglia,
  • Antonio Molino,
  • Maria Adelaide Moschella,
  • Massimiliano Napolitano,
  • Patrizia Palmulli,
  • Alberto Pavan,
  • Andrea Pelucchi,
  • Antonio Perciaccante,
  • Vincenzo Pezzella,
  • Vittorio Pietrangeli,
  • Biagio Polla,
  • Maurizio Rizzi,
  • Javier Rosada,
  • Sandro Rossi,
  • Maurizio Russo,
  • Giancarlo Santanocto,
  • Giorgio Scarmagnan,
  • Fabio Scotto,
  • Ernesto Serpe,
  • Manuela Serpilli,
  • Maria Serra,
  • Maria Serravillo,
  • Danilo Taccaliti,
  • Chiara Ticozzi,
  • Aniello Tinto,
  • Nello Tobia,
  • Victoria Tourchenko,
  • Andrea Turati,
  • Paolo Vivoli,
  • Erika Zanardi

DOI
https://doi.org/10.1183/23120541.00155-2017
Journal volume & issue
Vol. 4, no. 2

Abstract

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Chronic obstructive pulmonary disease (COPD) is characterised by a progressive loss of pulmonary function. Often patients do not adhere to inhaled therapies and this leads clinicians to switch treatments in order to improve control of the symptoms. Narrative medicine is a useful approach that helps healthcare professionals to think over the doctor–patient relationship and how patients live with their disease. The aim of this training project was to teach pulmonologists the basics of narrative medicine: to carefully listen to patients and to practice reflective writing in their relationship with them. Training on narrative medicine and parallel charts was provided through a webinar and a weekly newsletter. Across 362 narratives, written by 74 Italian pulmonologists, 92% of patients had activity limitations at their first visit. The main factor influencing the effectiveness and adherence to therapy was a positive doctor–patient relationship; indeed, if such relationship is difficult, only 21% of patients are able to resume all their activities. After learning the narrative approach, clinicians became aware of the need to spend more time listening to patients, to reflect through writing and to understand more deeply the motivations that lead people towards adherence to new therapies.