The Importance Of Integrating Narrative Into Health Care Decision Making.

When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice.

[1]  D. Frosch,et al.  Redefining Risk and Benefit , 2015, Qualitative Health Research.

[2]  Trisha Greenhalgh,et al.  An open letter to The BMJ editors on qualitative research , 2016, BMJ : British Medical Journal.

[3]  Glyn Elwyn,et al.  Investing in Deliberation: A Definition and Classification of Decision Support Interventions for People Facing Difficult Health Decisions , 2010, Medical decision making : an international journal of the Society for Medical Decision Making.

[4]  C. Abramson,et al.  Beyond Text , 2015, Sociological methodology.

[5]  J. Creswell,et al.  Best Practices for Mixed Methods Research in Health Sciences: (566732013-001) , 2011 .

[6]  J. Gruman An accidental tourist finds her way in the dangerous land of serious illness. , 2013, Health affairs.

[7]  Evelyn Y. Ho,et al.  An exploratory typology of provider responses that encourage and discourage conversation about complementary and integrative medicine during routine oncology visits. , 2015, Patient education and counseling.

[8]  K. Devers Qualitative Methods in Health Services and Management Research: Pockets of Excellence and Progress, but Still a Long Way to Go , 2011, Medical care research and review : MCRR.

[9]  Daniel J Buysse,et al.  The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. , 2010, Journal of clinical epidemiology.

[10]  Bryan J Weiner,et al.  Review: Use of Qualitative Methods in Published Health Services and Management Research: A 10-Year Review , 2011, Medical care research and review : MCRR.

[11]  J. McDonough Using and misusing anecdote in policy making. , 2001, Health affairs.

[12]  Pauline Roux,et al.  Quality of qualitative research in the health sciences: Analysis of the common criteria present in 58 assessment guidelines by expert users. , 2016, Social science & medicine.

[13]  Carol L. Brown,et al.  Increasing Minority Enrollment Onto Clinical Trials: Practical Strategies and Challenges Emerge From the NRG Oncology Accrual Workshop. , 2015, Journal of oncology practice.

[14]  Deb Feldman-Stewart,et al.  Do personal stories make patient decision aids more effective? A critical review of theory and evidence , 2013, BMC Medical Informatics and Decision Making.

[15]  Charles M. Perou,et al.  Deconstructing the molecular portraits of breast cancer , 2010, Molecular oncology.