The impact of a "narrative interview" intervention in oncology. A study protocol for a feasibility study. A study protocol about "narrative interview" intervention in oncology.

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Giovanna Artioli
Chiara Foà
Maria Bertuol
Linda Benzi
Laura Deiana
Chiara Meneghetti
Cecilia Neri
Laura Pigoni
Martina Zanotti
Leopoldo Sarli


oncological patient; narrative interview; study protocol; intervention; psychological distress; adjustment to cancer.


Background and aim of the work. Oncological diagnosis determines a biographical breakdown and requires the person to adapt to the disease. If patients, after diagnosis, ask professionals for ‘compassionate care’, research on these issues is still underdeveloped. There are currently no studies that use the narrative interview as an intervention tool. The objectives of the study are to evaluate: (1) the feasibility of the narrative interview intervention on cancer patients in the first diagnosis; (2) the impact of the narrative medicine intervention on the patient’s self-perception, his psychological distress and adaptation to the disease. Methods. It is a mixed-method study, with an intervention (narrative interview) and quantitative evaluation before/after intervention and qualitative evaluation post-intervention (reflective writing). The analysis will use the Psychological Distress Inventory scale for the assessment of psychological distress and the Mini-Mental Adjustment to Cancer Scale for the assessment of disease adaptation. Adult patients, with oncological pathology will be recruited one month after the communication of the diagnosis, regardless of the type of tumor. The Wilcoxon test for paired data will be used to verify pre-post-intervention differences. The ‘reflective writings’ will be subjected to thematic analysis. Discussion and conclusion. The study evaluates the feasibility of the narrative interview intervention as a primary outcome. Secondly, the impact of the intervention is assessed in relation to: a) identification of risk or protective factors on psychological distress and adaptation to the disease; b) re-elaboration of the patient’s experiences and experiences related to his/her own illness.


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1. Laskow T, Small L, Wu DS. Narrative Interventions in the Palliative Care Setting: A Scoping Review. J Pain Symptom Manag. 2019, 1(2): 1-11.
2. Murphy JW, Franz BA, Schlaerth C. The Role of Reflection in Narrative Medicine. J MedEducCurricu Devel 2018, 5(1): 1-5.
3. Adelstein KE, Anderson JG, Taylor AG. Importance of meaning-making for patients undergoing hemapoietic stem cell transplantation. Oncol Nurs 2014, 41(2): E172-E184.
4. Istituto Superiore di Sanità, Centro Nazionale Malattie Rare. Conferenza di consenso. Linee di indirizzo per l’utilizzo della Medicina Narrativa in ambito clinico-assistenziale, per le malattie rare e cronico-degenerative. [Consensus conference. Guidelines for the use of Narrative Medicine in the clinical-care setting, for rare and chronic-degenerative diseases]. Il Sole 24 Ore – Sanità 2015, 13.
5. Artioli G, Cosentino C, Taffurelli C, Ferri P, Foà C. The narrative interview for the assessment of the assisted person: structure, method and data analysis. Acta Bio Med, 2019, 90 (6-S) 7-16.
6. Anderson C, Kirkpatrick S. Narrative interviewing. IJCP2016, 38(3): 631-634.
7. Mauritz MW, Van Gaal BGI, Jongedijk RA, Schoonhoven L, Nijhuis-van der Sanden MWG, Goossens PJJ. Narrative exposure therapy for posttraumatic stress disorder associated with repeated interpersonal trauma in patients with severe mental illness: a mixed methods design. Eur J Psychotraumatol 2016, 7(1): 32473.
8. Artioli G, Foà C, Taffurelli C. An integrated narrative nursing model: towards a new healthcare paradigm. Acta Bio Med 2016, 87 (4-S), 13-22.
9. Picchi S, Bonapitacola C, Borghi E, Cassanelli S, Ferrari P, Iemmi B, Alfieri E, Artioli G. The narrative interview in therapeutic education. The diabetic patients’ point of view. Acta Bio Med 2018, 89(6-S): 43-50.
10. Haydon G, Browne G, Van Der Riet P. Narrative inquiry as a research methodology exploring person centred care in nursing. Collegian 2018, 25(1): 125-129.
11. Artioli G, Foà C, Cosentino C, Sollami A, Taffurelli C. Integrated narrative assessment exemplification: a leukemia case history. Acta Bio Med 2017, 88 (3-S), 13-21.
12. Artioli G, Foà C, Cosentino C, Sulla F, Sollami A, Taffurelli C. “Could I return to my life?” Integrated Narrative Nursing Model in Education (INNE). Acta Bio Med 2018, 89 (4-S), 5-17.
13. Sinclair S, Norris JM, McConnell SJ, Chochinov HM, Hack TF, Hagen NA, McClement S, Bouchal SR. Compassion: a scoping review of the healthcare literature. Bio Med Central Palliative Care 2016, 15(6): 1-16.
14. Perez-Bret E, Altisent R, Rocafort J. Definition of compassion in healthcare: a systematic literature review. Int. J Palliat. Nurs 2016, 22(12): 599-606.
15. Sakalys JA. Restoring the patient’s voice. The therapeutics of illness narratives. J Holist Nurs 2003, 21(3): 228-241.
16. Koskinen CAL, Lindström UA. An envisioning about the caring in listening. Scand. J Caring Sci 2015, 29(3): 548-554.
17. Chan AE, Tsang PL, Yin Ching SS, Wong FY, Lam W. Nurses’ perspectives on their communication with patients in busy oncology wards: A qualitative study. PLoS One 2019, 14(10).
18. Jacobi S, MacLeod R. Making sense of chronic illness – a therapeutic approach. J. Prim Health Care 2011, 3(2): 136-141.
19. Granek L, Nakash O, Ariad S, Shapira S, Ben‐David MA. Oncology health care professionals' perspectives on the causes of mental health distress in cancer patients. Psych Oncol.2019, 28:1695–1701.
20. MacArtney J, Malmström M, Overgaard Nielsen T, Evans J, Bernhardson BM, Hajdarevic S, Chapple A, Eriksson LE, Locock L, Rasmussen B, Vedsted P, Tishelman C, Andersen RS, Ziebland S. Patients’ initial steps to cancer diagnosis in Denmark, England and Sweden: what can a qualitative, cross-country comparison of narrative interviews tell us about potentially modifiable factors?. BMJ Open 2017, 7(11): e018210.
21. Yang N, Xiao H, Cao Y, Li S, Yan H, Wang Y. Influence of oncology nurses’ empathy on lung cancer patients’ cellular immunity. Psychol Res Behav Manag2018, 11: 279-287.
22. De Vincentis G, Monari F, Baldari S, Salgarello M, Frantellizzi V, Salvi E, Reale L, Napolitano S, Conti G, Cortesi E. Narrative medicine in metastatic prostate cancer reveals ways to improve patient awareness & quality of care. Future Oncol 2018, 14(27): 2821-2832.
23. Zwingmann J, Baile WF, Schmier JW, Bernhard J, Keller M. Effects of patient-centered communication on anxiety, negative affect, and trust in the physician in delivering a cancer diagnosis: a randomized, experimental study. Cancer 2017, 123(16): 3167-3175.
24. Mortilla MG. La comunicazione delle cattive notizie. [The communication of bad news] Giornale Italianodi Endoscopia Digestiva 2006, 29(1): 269-273.
25. Truccolo I, Bufalino R, Annunziata MA, Caruso A, Costantini A, Cognetti G, Florita A, Pero D, Pugliese P, Tancredi R, De Lorenzo F. National cancer information service in Italy: an information points network as a new model for providing information for cancer patients. Tumori 2011, 97(4): 510-516.
26. Sandén U, Nilsson F, Thulesius H, Hägglund M, Harrysson L. Cancer, a relational disease exploring the needs of relatives to cancer patients. Int J Qual Stud Health Well-being 2019, 14(1).
27. Bruce A, Sheilds L, Molzahn A, Beuthin R, Schick-Makaroff K, Shermak S. Stories of liminality. Living with life-threatening illness. J Holist Nurs 2014, 32(1): 35-43.
28. Porensky EK, Carpenter BD. Breaking bad news: effect of forecasting diagnosis and framing prognosis. Patient Educ Couns2016, 99(1): 68-76.
29. Nicol C, Ownsworth T, Cubis L, Nguyen W, Foote M, Pinkham, MB. Subjective cognitive functioning and associations with psychological distress in adult brain tumour survivors. J Cancer Surviv2019, doi: 10.1007/s11764-019-00784-8.
30. Morasso G, Costantini M, Baracco G, Borreani C, Capelli M. Assessing psychological distress in cancer patients: validation of a self-administered questionnaire. Oncology 1996, 53(4): 295-302.
31. Watson M, Law MG, Dos Santos M, Greer S, Baruch J, Bliss J. The Mini-MAC: Further development of the Mental Adjustment to Cancer Scale. J Psychosoc Oncol 1994, 12(3): 33-46.
32. Grassi L, Buda P, Cavana L, Annunziata MA, Torta R, Varetto, A. Styles of coping with cancer: the Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) Scale. Psycho-oncology 2005, 14(2): 115-124.
33. Tashiro J, Shimpuku Y, Naruse K, Matusani M. Concept analysis of reflection in nursing professional development. Jpn J Nurs Sci2013, 10(2): 170-179.
34. Syed Q, Pinheiro SO, Factora R. Reflective writing to teach interdisciplinary management of delirium to internal medicine residents. J Grad Med Educ2016, 8(5): 785-786.
35. Craft M. Reflective writing and nursing education. Int J Nurs Educ2005, 44(2): 53-57.
36. Allan EG, Driscoll DL. The three-fold benefit of reflective writing: improving program assessment, student learning, and faculty professional development. Assessing Writing 2014, 21(1): 37-55.
37. Epstein RM. Reflection, perception, and the acquisition of wisdom. Med Educ 2008, 42(11): 1048-1050.
38. Rolfe G, Freshwater D, Jasper MA. Critical Reflection for nursing and the helping professions, a user’s guide. Palgrave Macmillan: Hampshire 2001.
39. Launer J. Managing the threat to reflective writing. Postgrad Med J2018, 94(1111): 314-315.
40. Rojì R, Noguera-Tejedor A, Pikabea-Dìaz F, Carrasco JM, Centeno C. Palliative care bedside teaching: a qualitative analysis of medical students’ reflective writings after clinical practices. J Palliat Med2017, 20(2): 147-154.
41. SlocumRB, Howard T A, Villano J L. Narrative Medicineperspectives on patient identity and integrative care in neuro-oncology. J Neuro-Oncol 2017, 134(2): 417-421.
42. EgnewTR. A narrative approach to healing chronic illness. Ann Fam Med 2018, 16(2): 160-165.
43. Fortuna J. Integrating Art and Narrative to Enhance Quality of Life inPalliative Care. OJOT 2018, 6(4), 14.
44. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ Theory Pract 2009, 14(4): 595-621.
45. Wald HS, Borkan JM, Taylor J, Anthony D, Reis SP. Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing. Acad Med2012, 87(1): 41-50.
46. Launer J. What’s the point of reflective writing? Postgrad Med J2015, 91(1076): 357-358.

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