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Seeing the Narrative Work in Physica...

Johnson, Stefanie Lynn.

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Seeing the Narrative Work in Physical Therapy Practice.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Seeing the Narrative Work in Physical Therapy Practice./
Author:	Johnson, Stefanie Lynn.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
Description:	239 p.
Notes:	Source: Dissertations Abstracts International, Volume: 85-05, Section: B.
Contained By:	Dissertations Abstracts International85-05B.
Subject:	Physical therapy. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30691312
ISBN:	9798380827669

Seeing the Narrative Work in Physical Therapy Practice.
Johnson, Stefanie Lynn.

Seeing the Narrative Work in Physical Therapy Practice. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 239 p.

Source: Dissertations Abstracts International, Volume: 85-05, Section: B.

Thesis (Ph.D.)--Indiana University of Pennsylvania, 2023.

Rita Charon (2007) has defined the term "narrative medicine," as "the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness" (p. 1265). Healthcare practitioners who are able to develop what Charon refers to as "narrative competence," are more empathetic, and patients who can compose narratives about their experiences rebuild self-efficacy lost in an often-dehumanizing diagnostic and treatment process (Frank, 1995). Much of the focus on narrative in the healthcare context has been rooted in a desire to close the gap between expertise as defined by medical practice and expertise as embodied by patients (Charon et al., 2017; Hawkins, 1999; Hunter, 1991; Kleinman, 1988; Frank, 1995). However, while the studies noted here make a strong case for the connection between narrative and positive health outcomes, the composition of narratives in these contexts is almost always a solitary act. When patients and healthcare practitioners narrate their experiences separately, patients are empowered and practitioners listen more closely, but the gap between them remains, sustained by a power differential embedded in healthcare systems.Physical therapists have a uniquely collaborative understanding of narrative because successful therapy depends heavily upon a shared understanding of patients' experiences and goals (Lakke et al., 2019; Topp et al., 2018). In fact, patient/practitioner collaboration fostered through narrative reasoning has been identified as a key marker of expert physical therapy practice (Jensen et al., 2007). A widely used physical therapy textbook puts it this way: "Narrative reasoning figures centrally in those health professions such as rehabilitation therapies, where efficacious practice requires developing a strong collaboration with clients...Collaboration with patients is so central, it is probably more accurate to speak of co-construction" (Higgs et al., 2019, pp. 122-123).While narrative reasoning and collaborative reasoning are both recognized as expert and interrelated approaches to therapy, this knowledge is often tacit, developed over time, and without clear parameters for practice (Jensen et al., 2007; Higgs et al., 2019). Physical therapy scholars have identified a need for more research that can explore how new practitioners learn narrative forms of reasoning and the related collaborative models of practice (Ajjawi & Higgs, 2012; Cruz et al., 2014; Greenfield et al., 2015; Jensen, 2011). In this study, interviews with expert physical therapists informed the development of an initial taxonomy of narrative practices along with a model and heuristic that offer some approaches to teaching and learning these practices. Ultimately, the hope is that this dissertation will lead to additional studies designed to assess the impact of these practices on patient outcomes in physical therapy.

ISBN: 9798380827669Subjects--Topical Terms:

588713
Physical therapy.
Subjects--Index Terms:

Narratives

Seeing the Narrative Work in Physical Therapy Practice.
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245 1 0 $a Seeing the Narrative Work in Physical Therapy Practice.
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300 $a 239 p.
500 $a Source: Dissertations Abstracts International, Volume: 85-05, Section: B.
500 $a Advisor: Hanauer, David Ian.
502 $a Thesis (Ph.D.)--Indiana University of Pennsylvania, 2023.
520 $a Rita Charon (2007) has defined the term "narrative medicine," as "the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness" (p. 1265). Healthcare practitioners who are able to develop what Charon refers to as "narrative competence," are more empathetic, and patients who can compose narratives about their experiences rebuild self-efficacy lost in an often-dehumanizing diagnostic and treatment process (Frank, 1995). Much of the focus on narrative in the healthcare context has been rooted in a desire to close the gap between expertise as defined by medical practice and expertise as embodied by patients (Charon et al., 2017; Hawkins, 1999; Hunter, 1991; Kleinman, 1988; Frank, 1995). However, while the studies noted here make a strong case for the connection between narrative and positive health outcomes, the composition of narratives in these contexts is almost always a solitary act. When patients and healthcare practitioners narrate their experiences separately, patients are empowered and practitioners listen more closely, but the gap between them remains, sustained by a power differential embedded in healthcare systems.Physical therapists have a uniquely collaborative understanding of narrative because successful therapy depends heavily upon a shared understanding of patients' experiences and goals (Lakke et al., 2019; Topp et al., 2018). In fact, patient/practitioner collaboration fostered through narrative reasoning has been identified as a key marker of expert physical therapy practice (Jensen et al., 2007). A widely used physical therapy textbook puts it this way: "Narrative reasoning figures centrally in those health professions such as rehabilitation therapies, where efficacious practice requires developing a strong collaboration with clients...Collaboration with patients is so central, it is probably more accurate to speak of co-construction" (Higgs et al., 2019, pp. 122-123).While narrative reasoning and collaborative reasoning are both recognized as expert and interrelated approaches to therapy, this knowledge is often tacit, developed over time, and without clear parameters for practice (Jensen et al., 2007; Higgs et al., 2019). Physical therapy scholars have identified a need for more research that can explore how new practitioners learn narrative forms of reasoning and the related collaborative models of practice (Ajjawi & Higgs, 2012; Cruz et al., 2014; Greenfield et al., 2015; Jensen, 2011). In this study, interviews with expert physical therapists informed the development of an initial taxonomy of narrative practices along with a model and heuristic that offer some approaches to teaching and learning these practices. Ultimately, the hope is that this dissertation will lead to additional studies designed to assess the impact of these practices on patient outcomes in physical therapy.
590 $a School code: 0318.
650 4 $a Physical therapy. $3 588713
650 4 $a Rhetoric. $3 516647
650 4 $a Health care management. $3 2122906
653 $a Narratives
653 $a Narrative practices
653 $a Positive health outcomes
653 $a Healthcare practitioners
653 $a Linguistics
690 $a 0681
690 $a 0382
690 $a 0769
710 2 $a Indiana University of Pennsylvania. $b English. $3 1026395
773 0 $t Dissertations Abstracts International $g 85-05B.
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793 $a English
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