Advances in Nursing & Midwifery

چکیده

DEAR EDITOR,
Narrative medicine was introduced in the early 2000s by Rita Charon as a method to better understand patients by listening to and interpreting their stories of illness. However, its application is not limited to the medical profession alone it emphasizes the need for the nursing community to be equipped with narrative knowledge as well. A narrative is someone telling someone else that something happened. Narrative knowledge is what we use to understand the meaning and significance of the patient's story [1]. Narrative nursing, as a human-centered nursing intervention, focuses on listening to, understanding, and interpreting patients’ narratives in order to provide more holistic, personalized, and high-quality care. It fosters a deeper and more empathetic relationship between the nurse and the patient [2]. In other words, narrative nursing is based on active listening, deep understanding of lived experiences, and reflection of those experiences in care delivery, treating the patient’s story as a valuable source of human-centered care [3].
Children in accordance with their age and cognitive development, also have their own narratives about their illness, treatment, and the hospital environment. Narrative nursing in pediatric care carries particular significance and complexity, as children have specific cognitive, emotional, and linguistic needs at each developmental stage. While children’s lives are impacted by illness just like adults, they often lack the skills to articulate themselves clearly. Their emotions, hopes, needs, anxieties, fears, preferences, and perceptions may be expressed in vague or nonverbal ways. Nurses must consider that a child’s cognitive and language development greatly affects how they express and narrate their experiences, and thus, narratives must be accessed through multiple channels [4].
Children often use tools such as play, drawing, storytelling, or even silence to express fears and make sense of their illness. These narrative forms offer an opportunity for the nurse to act as a listener and supporter [4]. Nurses can utilize age-appropriate and creative techniques including art, drawing, photography, video, interviews, puppetry, crafts, journaling, and storytelling to hear the child's voice. This enables them to access deeper layers of the child's illness experience and provide comprehensive and individualized care to both the child and the family. In addition, families play a crucial role in the narrative of a child’s illness and treatment. Often, the child’s narrative alone is insufficient, and parents act as narrative mediators. Using narrative nursing in collaboration with parents enhances family-centered care, fosters a better understanding of cultural context, values, and psychological challenges, and facilitates participatory care [4]. Studies show that narrative nursing improves adaptation to illness, reduces anxiety, enhances cooperation, and leads to better clinical outcomes in children [3, 5]. It also reduces negative emotions and increases family satisfaction with nursing care [4]. Analyzing and interpreting children’s narratives in narrative nursing means uncovering hidden messages, emotions, and actual needs conveyed through their stories. Nurse reflection on those narratives is a vital tool for understanding the implicit content and offering more humanized care [6]. Qualitative analysis methods, such as content analysis, can be effectively used in this context [7].
In short, in pediatric care, we must recognize that children, in their own language and ways, can be credible narrators of their lived experiences. Narrative nursing in child and family care is an innovative approach that identifies and addresses nursing problems and diagnoses based on the narratives of children and their families. The health system in Iran faces several challenges, including a shortage of human resources, heavy workloads, a predominant focus on the patient’s physical condition, and insufficient training in narrative nursing within pediatric hospitals. It is recommended to foster a culture among healthcare teams that values the importance of children’s narratives, conduct training workshops for nurses on narrative nursing, and teach techniques for receiving and understanding the stories of hospitalized children. Training pediatric nurses in
narrative-based approaches enhances their empathy,
holistic care abilities, and communication with children
and families moving the nursing profession one step
closer to truly humanized and child-centered care.
AUTHOR CONTRIBUTIONS
Fatemeh Ebrahimpour conceived the idea, prepared the first draft of the manuscript, and performed the revisions and finalization of the manuscript.
FUNDING
There is no funding or support.
CONFLICT OF INTEREST
There is no funding or support.