Can narrative medicine methods improve well-being in patients with gastrointestinal malignancy?

Abstract

e24091 A Pilot study - Can Narrative Medicine Methods Improve Well-being in Patients with Gastrointestinal Malignancy? Background: Patients with cancer often face profound physical and emotional challenges. Narrative medicine methods, involving discussions of and writing about creative texts, are utilized to help healthcare providers improve communication and process emotional experiences which, unexplored, may lead to poor well-being. We apply the narrative medicine method to patients with GI malignancies. Methods: The endpoints of this pilot study were feasibility - 7/10 participants completing 2 out of 3 sessions, and assessing the benefit of applying the practice to optimize well-being. 10 patients were identified by a single oncologist at USC/Norris cancer center to undergo three narrative medicine sessions. Sessions addressed themes relevant to well-being: Identity, Meaning making, and Finding joy. A survey with Likert scales (1-5) and free text answers, as well as interviews, were administered. Content analysis was done. ESAS scales were administered before sessions. Results: 7 of 10 patients have been assessed, completing all three sessions.Surveys were administered after session 3, interviews 1 month later. 5 was the most popular Likert choice. 7/7 chose a 5 for feeling comfortable and learning about themselves. In free text answers, 6/7 patient responses reflected themes of enhanced self-reflection, 2/7 improved perspective-taking, and 3/7 enhanced empathy for others. 1/7 said the sessions gave them hope for medical research, and 1/7 noted the sessions helped them tolerate chemotherapy. ESAS scores trending in a positive direction included pain, drowsiness, nausea, anxiety, and well-being. The interviews elicited the following themes: 7/7 noted the narrative medicine experience had been enjoyable, 6/7 noted enhanced meaning-making meaning and perspective-taking. 3/7 noted the sessions made them feel more positively about their healthcare experiences and helped them embrace their identities outside of cancer. 3/7 said the sessions improved their empathy for others. Other individual themes were: the sessions gave them hope, helped with self-reflection, encouraged seeking new experiences, helped them accept circumstances, enhanced connection to creativity and spirituality, and improved their ability to connect to others. Conclusions: This narrative medicine pilot project was feasible and patients were able to complete the assessment. The evaluative scores demonstrated that all participants felt comfortable participating. Additionally, the patients noted benefits related to well-being including but not limited to improved capacity for self-reflection, putting things in perspective, meaning-making, and noticing moments of joy. A larger study is planned to assess the benefits of this approach for patient well-being and clinical outcomes.