临床叙事思维及其在医学实践中的价值  

Clinical Narrative Thinking and Its Value in Medical Practice

作　　者：杨晓霖 沈洁 YANG Xiaolin;SHEN Jie(Research Center of Narrative Medicine,Shunde Hospital,Southern Medical University,Foshan 528000,China;Department of General Education,Southern Medical University,Guangzhou 510515,China;Shunde Hospital,Southern Medical University,Foshan 528000,China)

机构地区：[1]南方医科大学顺德医院叙事医学中心,广东佛山528000 [2]南方医科大学通识教育部,广东广州510515 [3]南方医科大学顺德医院,广东佛山528000

出　　处：《医学与哲学》2025年第2期53-58,共6页Medicine and Philosophy

基　　金：2024年广东省本科高校教学质量与教学改革工程重大项目(GZD202430-08);2021年南方医科大学顺德医院科研启动项目(SPSP2021024)。

摘　　要：临床叙事思维是临床实践中与循证思维同样重要的一种思维模式,包括叙事患教/疾病科普思维、叙事诊断思维、叙事决策思维、叙事照护/介入思维等。以“中国叙事医学话语体系”为框架,在提出“临床叙事思维”定义的基础上,详细分析叙事思维与循证思维之间的辩证互补关系,阐述临床叙事思维与其他沟通思维的异同,并从医疗诊治开始之前的患教、医疗诊断与共同决策和治疗过程中的全人健康调节三个维度阐明临床叙事思维在医疗实践中的重要价值,藉此呼吁更多医疗机构重视叙事领导力人才的培养和临床医者的叙事思维训练。Clinical narrative thinking is a thinking mode equally significant as evidence-based thinking in clinical practice.It encompasses narrative patient education/disease popularization thinking,narrative diagnostic thinking,narrative decisionmaking thinking,and narrative care/intervention thinking.Based on the discourse system of "Chinese narrative medicine",this article proposes the definition of "clinical narrative thinking" and elaborates on the dialectical complementary relationship between narrative thinking and evidence-based thinking,expounds the similarities and differences between clinical narrative thinking and other thinkings,and explains the value of clinical narrative thinking in medical practice from three dimensions,namely,patient education before medical diagnosis and treatment,collaborative decision-making in medical diagnosis,and holistic health regulation during treatment.This article calls on more medical institutions to pay attention to the cultivation of narrative talents and the narrative thinking of clinicians.

关 键 词：叙事医学 医者职业叙事能力 临床叙事思维 

分 类 号：R-0[医药卫生]