Future Directions in Healthcare : Writing Assignment 8
Throughout my series of writing assignments, I have explored one main theme: communication in a healthcare setting. I began researching head and neck cancer survivorship and the misconception that life after cancer is not as difficult as with cancer; clinicians should provide support to relieve survivors of psychological side effects of their treatment (Nund, 2015). This topic was of interest to me because this was the focus of my psychology research project at Memorial Sloan Kettering this past summer. However, I quickly realized that I did not feel that I would be able to create a video using this topic, so I broadened my horizons to look at quality of life measures.
Figure 1.Question 1 on SF-36 shows how survivors subjectively quantify their health
I found that overall quality of life was generally measured with questionnaires. However, there were several “standard” surveys that physicians were using (Hammerlid, 2001, Campbell et al., 2004). The search for a standard quality of life measure led me to narrow down my research to encompass pain and how it is measured by physicians. Pain itself is very difficult to communicate because it is language resistant; when one is in pain, they do not speak, but rather shirek or shout (Scarry, 1985). Moreover, the original felt experience of pain is often lost in translation because it is put through the filter of language. There are also a myriad of social factors that play into how someone may express pain to a physician. Differences in class, gender, race are crucial to consider to provide a comprehensive analysis on the topic (Weinick, 2011).
My research pointed me in the direction of narrative medicine. Although it does allow for subjectivity by both the patient and the physician (Herxheimer & Ziebland 2004), it also introduces a new depth to a physician-patient relationship (Meldrum et al., 2009). In my video project, I am aiming to direct the future of clinical medicine towards holistic narrative medicine.
Citations:
Campbell, B. H., Spinelli, K., Marbella, A. M., Myers, K. B., Kuhn, J. C., & Layde, P. M.
(2004). Aspiration, weight loss, and quality of life in head and neck cancer survivors.
Archives of Otolaryngology–Head & Neck Surgery,130(9), 1100-1103.
Hammerlid, E., & Taft, C. (2001). Health-related quality of life in long-term head and neck
cancer survivors: a comparison with general population norms. British journal of cancer,
Herxheimer, A., & Ziebland, S. (2004). The DIPEx project: collecting personal experiences of illness and health care. Narrative research in health and illness, 115-131.
Meldrum, M. L., Tsao, J. C. I., & Zeltzer, L. K. (2009). “I can’t be what I want to be”: Children’s Narratives of Chronic Pain Experiences and Treatment Outcomes. Pain Medicine, 10(6), 1018-1034.
Nund, R. L., Rumbach, A. F., Debattista, B. C., Goodrow, M. N., Johnson, K. A., Tupling, L. N., … & Porceddu, S. V. (2015). Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers. International journal of speech-language pathology,17(3), 263-272.
Scarry, E. (1985). The body in pain: The making and unmaking of the world. Oxford University Press, USA.
Weinick, R. M., Elliott, M. N., Volandes, A. E., Lopez, L., Burkhart, Q., & Schlesinger, M.
(2011). Using standardized encounters to understand reported racial/ethnic disparities in patient experiences with care. Health services research, 46(2), 491-509.
