“叙事早交班”:叙事医学的临床实践路径探索  

"Narrative Morning Shift Handover":Exploring the Clinical Practice Pathway of Narrative Medicine

作　　者：周家欣 宁晓红[2] 李飞[1] 杜铁宽[2] 郭俊丽 何仲[1] ZHOU Jiaxin;NING Xiaohong;LI Fei;DU Tiekuan;GUO Junli;HE Zhong(School of Marxism,School of Humanities and Social Sciences,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Palliative Medicine Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院/北京协和医学院马克思主义学院人文和社会科学学院,北京100730 [2]中国医学科学院/北京协和医学院北京协和医院缓和医学中心,北京100730

出　　处：《医学与哲学》2025年第2期42-46,52,共6页Medicine and Philosophy

基　　金：2022年中央高校基本科研业务费专项资金资助项目(3332022177);2022年北京协和医学院本科精品教材项目(2022zlgc0509);2024年北京协和医学院通用项目(WH10022024069);2024年中国人口福利基金会健康中国背景下的安宁疗护与医疗服务人文关怀相关课题资助项目(SLB-2-20240903-503)。

摘　　要：运用观察法与内容分析法,以北京协和医院缓和医学中心早交班工作场景中的医务人员为研究对象,研究该场景下医务人员早交班叙事的内容与特征,以及这种早交班是否是叙事医学实践,具有何种价值。研究发现缓和医学中心早交班的5个叙事主题为再现患者病情、关注患者痛苦、关怀家属、关注沟通与决策以及表达对同事的支持。这种早交班符合叙事医学三要素,属于叙事医学实践,凸显了照护的整体性,体现了医疗情景中的主体间性,并反哺了临床实践,持续印证了“叙事缓和医疗”的理念与实践,为叙事医学进一步融入临床实践提供了参考。Using observation and content analysis methods,this study investigates the narrative content and characteristics of the morning shift handover process in the Palliative Care Center at Peking Union Medical College Hospital,focusing on medical staff as the research subjects.It examines whether this morning shift handover is a practice of narrative medicine and what value it holds.The study finds that the five narrative themes of the palliative care center's morning shift handover are:representing patient conditions,focusing on patient suffering,caring for families,emphasizing communication and decision-making,and expressing support for colleagues.This morning shift handover aligns with the three core elements of narrative medicine,making it a practice of narrative medicine.It highlights the holistic nature of care,embodies intersubjectivity in medical settings,and feeds back into clinical practice,continuously validating the concept and practice of "narrative palliative care".This provides a reference for further integrating narrative medicine into clinical practice.

关 键 词：叙事医学 缓和医疗 叙事缓和医疗 早交班 

分 类 号：R-0[医药卫生]