• Title/Summary/Keyword: Medical Narrative

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Shanghanlun Diagnostic System : Exploring Value as Narrative Medicine by Analyzing Cases (사례분석을 통한 『상한론(傷寒論)』 변병진단체계(辨病診斷體系)의 서사의학적 가치의 탐색)

  • Kim, Jin-A;Lee, Sung-Jun
    • 대한상한금궤의학회지
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    • v.6 no.1
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    • pp.1-25
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    • 2014
  • Objective : The purpose of this study is exploring value of Shanghanlun six diagnostic system as Narrative Medicine by analyzing cases. Methods : In the article, we examined the theory of narrative medicine and current studies. And then key elements of narrative medicine was defined. On the basis of these, two medical cases were analyzed by reordering in accordance with time sequences and causality for confirming narrative factors. Results : The narrative approach to analyzing cases shows us that different diseases could be the result of same pathological patterns based on Shanghanlun. This tells us following four aspects. [1] Shanghanlun is the causes-oriented records and the text includes narrative factors. [2] Shanghanlun six diagnostic system is a process of constructing plot of medical case history through the clinical interpretation of contextual meaning of patient's life. [3] In the process of diagnosis, Schemata and script are engaged in assuming and confirming six patterns diseases. [4] The subjective factors of an individual can be applied universally through the provision of Shanghanlun. Conclusions : Narrative factors of Shanghanlun six diagnostic system suggest the possibility and value of Shanghan Medicine as Narrative Medicine in terms of Medical Humanities, essence of medical diagnosis and therapeutic action.

A Study on the Narratives of the Chapters Shanggutianzhenlun and Siqidiaoshendalun (「상고천진론(上古天眞論)」과 「사기조신대론(四氣調神大論)」의 서사(敍事)에 대한 연구(硏究))

  • Kim, Yong-jin
    • Journal of Korean Medical classics
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    • v.35 no.4
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    • pp.11-23
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    • 2022
  • Objectives : Recently in the field of medical education, the study of narrative has been gaining much attention. This study examines the Huangdineijing in terms of narrative studies. Methods : The chapter Shanggutianzhenlun, which is narratively sound in its composition, and the chapter Siqidiaoshendalun, whose narrative structure is simple but composed in a way that is difficult to understand were studied. Results : The narrative structure of Shanggutianzhenlun is interrogatory with a main character, making it appropriate for narrative study. However, the Siqidiaoshendalun arranges its content rather simply. Conclusions : The Shanggutianzhenlun needs to be converted into appropriate narrative terminology, while the Siqidiaoshendalun needs narrative supplementation using methods such as visual thinking and mind mapping.

Medical Narrative Texts and Medical Ethics (의료 서사와 의료 윤리)

  • Choi, Sung-Min
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.291-323
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    • 2020
  • In this paper, I review Pellegrino's Reader, The Philosophy of Medicine Reborn. Pellegrino has emphasized the humanities' reflection on the ethics of medicine. He insists that medical ethics should be re-established as modern society changes. This paper, based on Pellegrino's view, noted the problematic situation in literature and popular narrative texts. Indeed, I wanted to see what answer medical ethics could provide for us. Medical personnel had a philosophical dilemma or a conflict between reality and ethics. Pellegrino argues that medical personnel, above all, need to sympathize with the patient's pain and respond to their needs through interaction with them. This may seem like a very legitimate declaration. But a physician in literary texts and popular narrative texts is often exposed to this ethical dilemma. Through Lee Cheongjun's novel, we can reflect on how a medical personnel could lead a patient to a state of "goodness". And through medical dramas, we can grasp what ethical behaviors the public demands from a medical personnel. Now that the world is suffering from COVID-19, medical workers are in a great trouble, but at the same time, they are respected by the public and are also enhancing their value as ethical beings. Now that medical care has become an everyday narrative, medical ethics is becoming a prerequisite for living. This paper attempted to recognize the importance of medical ethics and to review the ethical issues embodied in medical narratives.

Spoken and Written Narrative in Persian-Speaking Students Who Received Cochlear Implant and/or Hearing Aid

  • Zamani, Peyman;Soleymani, Zahra;Rashedi, Vahid;Farahani, Farhad;Lotfi, Gohar;Rezaei, Mohammad
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.250-258
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    • 2018
  • Objectives. To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance. Methods. The subjects were 174 students aged 10-13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters. Results. Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions. Conclusion. Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative.

Course on Death and Dying for Medical Students (의과대학생을 위한 죽음학 수업)

  • Park, Joong Chul
    • Korean Medical Education Review
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    • v.22 no.3
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    • pp.153-162
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    • 2020
  • The aim of modern medicine is to prolong life by fighting death. Doctors have traditionally believed that this was an ethical good deed. The negative connotation surrounding death has led to the avoidance of terminally ill patients. But in a modern society where death is medicalized, doctors have to see dying patients every day and are in a state of guilt from implementing meaningless life-sustaining treatments. Therefore, medical schools should allow medical students to embrace a new perspective through death education. Yonsei University Medical College has implemented death education since 2017 as an optional class for first and second year medical students. Students watch videos related to death once a week for 6 weeks and submit their reflections by e-mail. The professor reads the students' reflections and gives them weekly feedback. Through this coursework, students realize that death is not a medical event, but rather a part of life and completion. The ultimate purpose of death education is to transform blind life-absolutist identity into narrative identity.

Age-dependent root canal instrumentation techniques: a comprehensive narrative review

  • Solomonov, Michael;Kim, Hyeon-Cheol;Hadad, Avi;Levy, Dan Henry;Itzhak, Joe Ben;Levinson, Oleg;Azizi, Hadas
    • Restorative Dentistry and Endodontics
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    • v.45 no.2
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    • pp.21.1-21.12
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    • 2020
  • The aim of this article was to review age-dependent clinical recommendations for appropriate root canal instrumentation techniques. A comprehensive narrative review of canal morphology, the structural characteristics of dentin, and endodontic outcomes at different ages was undertaken instead of a systematic review. An electronic literature search was carried out, including the Medline (Ovid), PubMed, and Web of Science databases. The searches used controlled vocabulary and free-text terms, as follows: 'age-related root canal treatment,' 'age-related instrumentation,' 'age-related chemo-mechanical preparation,' 'age-related endodontic clinical recommendations,' 'root canal instrumentation at different ages,' 'geriatric root canal treatment,' and 'pediatric root canal treatment.' Due to the lack of literature with practical age-based clinical recommendations for an appropriate root canal instrumentation technique, a narrative review was conducted to suggest a clinical algorithm for choosing the most appropriate instrumentation technique during root canal treatment. Based on the evidence found through the narrative review, an age-related clinical algorithm for choosing appropriate instrumentation during root canal treatment was proposed. Age affects the morphology of the root canal system and the structural characteristics of dentin. The clinician's awareness of root canal morphology and dentin characteristics can influence the choice of instruments for root canal treatment.

A Narrative Inquiry of Medical Students' Experiences of Expulsion and Military Service (의과대학 과정 중 제적과 군복무를 경험한 학생들에 대한 내러티브 연구)

  • Lee, Won Kyoung;Park, Kyung Hye
    • Korean Medical Education Review
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    • v.21 no.2
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    • pp.92-99
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    • 2019
  • The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.

Narrative Review on the Mechanism of Whidam's Vibrator Sugi Therapy (휘담식 진동기 수기요법의 기전에 대한 서술적 고찰)

  • Hun Mo Ahn;Dae Sung Jung;Han Joo Kang
    • Journal of Korean Medical Ki-Gong Academy
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    • v.22 no.1
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    • pp.1-27
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    • 2023
  • Objective : This paper provides a narrative review of the research literature on the neurophysiological and neurochemical mechanisms of local vibration while studying the treatment principles and mechanisms of Whidam's vibrator Sugi therapy. Methods : Searches related to vibration therapy research were conducted in PUBMED using "Vibration", "Whole Body Vibration", "Localized Vibration", and "Focal Vibration". The Conditions were limited to review and systematic review. Results : Roberto Casale's paper was selected as an inquiry task and reviewed critically and narratively by referring to other papers. The stimulation process of local vibration (LV) was broadly classified into receptor transmission (pain reception phase), ascending sensory pathway to the spinal cord (segmental phase), and action of the cortex and subcortical structures (systemic control phase) according to the pain pathway. In addition, the role of C-tactile mechanoreceptors, changes in neurotransmitters and neurohormones, LV stimulation below perception threshold (lower threshold), pain control and kinesiologic illusions were specially addressed. In addition, the expression and function of Piezo Channels were added to supplement the human pain and tactile sensing mechanism. Conclusions : LV exerts pain control mechanisms through different interactions that can interfere with pain transmission and pain perception. Since LV provides sufficient neurophysiological reasons for clinical application, it is necessary to expand the use of Whidam's vibrator Sugi therapy to a wider range of clinical applications.

Korean and United States: Comparison of Costs of Nursing Interventions (NIC과 연계된 산부인과 환자 간호중재에 대한 한국 건강보험 수가체계와 미국 ABC 코드체계와의 수가 비교 분석)

  • Hong, Sung-Jung;Lee, Eun-Joo
    • Korean Journal of Adult Nursing
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    • v.24 no.4
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    • pp.358-369
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    • 2012
  • Purpose: This study was performed to compare the costs of nursing interventions implemented for the obstetrical and gynecological patients using Korean Reimbursement System and ABC codes system developed in the US for costing out interventions performed by health care professional. Methods: First, the narrative data on nursing interventions were extracted from electronic medical record system of a tertiary university and mapped with Nursing Intervention Classification (NIC) by two researchers until 100% consent was reached. Narrative nursing interventions mapped with NIC were then remapped with ABC codes system using the electronic program developed in the research. The mapping data were analyzed with real numbers, frequency, percentage, mean, and standard deviation. Results: More nursing interventions were mapped with ABC codes than Korean reimbursement system. Total of 97 different types of narrative interventions could be mapped with NIC, 43 NIC interventions could be reimbursed by ABC code but only 16 NIC interventions were reimbursed by Korea Reimbursement System. Conclusion: Korean medical insurance fee system needs amendment to include more comprehensively interventions performed by nurses which are very important to patient outcomes. Further study is needed to develop strategies to costing out nursing interventions.

A Narrative of Medical School Professors' International Medical Experience: Applicability of Medical Humanities Curriculum (의과대학 교수의 국제진료 경험에 대한 내러티브: 의료인문학 교육과정의 적용 가능성)

  • Kim, Yura;Park, Hye jin;Kim, Byunghee
    • Journal of the International Relations & Interdisciplinary Education
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    • v.1 no.1
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    • pp.1-12
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    • 2021
  • This study is a study on the applicability of the medical humanities curriculum through a narrative study on international treatment of foreign patients. Korea's medical system and standards are world-class, and it can be seen that the knowledge and skills for patient care are sufficient, which shows that the competence for patient care emphasized by Korean doctors is sufficient. In terms of social responsibility for doctors in Korea, the importance of volunteering is learned from medical school education, and through medical field experiences in various cultures, it can be seen that volunteering is important to lead to lifelong work as a doctor. In the field of professionalism, professionalism could be expressed as a doctor, and in all processes, the medical staff understood and empathized with the pain of the patient, and it was found that the sincerity was conveyed to the patient. Professionalism is an area that is being emphasized more recently, and it is necessary to provide educational opportunities for professionalism to doctors as well as medical school education. This international medical experience can be applied to the medical humanities curriculum of the medical school, and a harmonized and integrated medical humanities curriculum can be operated throughout the six-year curriculum.