Narratives Of illness and Wellbeing in Patients Research Paper 2022

Running head: NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS
1
Consumer Interaction and Narrative Reflection
Student Name
Institutional Affiliation

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 2
Consumer Interaction and Narrative Reflection
Introduction
Learning is both an activity and a process. Individuals can obtain knowledge from stories,
experiences from people who have gone through challenges, or achievements in their life or
direct engagements in activities that foster learning. The knowledge gained enables one to build
on existing knowledge, perceptions and beliefs. Additionally, the information is hard to forget
compared to theoretical learning in classroom environments (Kim, Min, & Shin, 2018). During
the narratives, both the narrator and the listener go through transformation as highlighted by
Todorov theory of narration (Barskby, Butcher, & Whysall, 2015). Narratives of illness are
important because the patient looks for ways to cope and manage the situation. This paper is a
reflection of my interaction with a patient that had suffered from diabetes foot ulcer. For ethical
purposes, the name of the consumer is concealed and therefore, will be referred to as Miss JX.
The paper uses Borton’s Framework for Reflections.
What?
Therapeutic relationships are integral to nursing care. They make clients trust health
providers and hence, readily share information with them. During the clinical rotation of my
Nursing placement, I came across a consumer with foot ulcers. At the moment I met him, he had
stayed in the ward for about four months, but his condition was not improving. This client had
suffered from foot diabetes. The patient narrated that he had never been admitted to the hospital
before. He described his pain as “excruciating pain” that was eating away his body.
The consumer reported that he got a small puncture on the sole of his foot. The wound
was minute, and hence he ignored it. He thought it would heal on its own. However, the wound
started getting worse and reddened. He went to a health facility where the wound was cleaned

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 3
and dressed. He also received a tetanus injection, antibiotics, and painkillers. He was assured he
would be okay after a couple of weeks. Guo and Dipietro (2017) explain that wounds undergo
various stages before they heal. These processes include inflammatory, proliferation, and
maturation phases. Eming, Martin, and Tomic-Canic (2014) explain that there are high chances
for wounds to regenerate if they are not well monitored. The consumer was advised that for
better resolution of the wound, he should go for daily dressing and drainage to debride the
traumatized area.
The problem disturbed the consumer because he was unable to perform some activities of
daily living. The wound interfered with his normal functioning and he had to seek medical
attention. On arrival, he was subjected to several tests. The physician told him that he had
uncontrollable sugars and an aggressive gangrenous ulcer. Everett and Mathioudakis (2018)
discuss that wound infection is a common cause of poor wound healing processes. The problem
was that according to the results, he had to undergo a below-knee amputation to save his life.
The pre-operative, intraoperative and post-operative procedures were well coordinated.
He was pleased by the smooth harmony and coordination in the hospital. He narrated to me that
he still had the perception that his leg was intact (he was having delusions). He could sometimes
move toes on the amputated limb. I educated him on foot care, exercise, lifestyle modification,
medication, and follow up as discussed in Berman and Chutka (2016). This information is
important for anti-diabetes patients.
So, What?
The Restitution Narrative
Restitution is the most common and accepted form of narrative concerning illness. It
recounts the story of an individual whose health is regained through interventions of the modern

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 4
medicine (Miraglia & Asselin, 2015). This intervention focuses on restoration of good health to
the patient. Since health is understood as a state of psychological, physiological, and social well-
being, restitution narratives help the clinician to have a bigger picture of the disease. As a result,
the body returns to its pre-disease state. The Consumer (2019) narrated the path he went through
until he recovered from the foot ulcer as a result of the modern medicine embracement. This
theory ascertains that the disease forms a transition point for the patient. Buckley, Corless, and
Mee (2016) explain that narratives of illness are important because they help patients to accept
their condition while at the same time improving the condition and status of the patient.
The Chaos Narrative
This narrative theory tends to contradict with the restitution narrative theory. The story
teller in chaos narratives undergoes a dynamic prognosis of his condition (Chandler, 2014). The
disease process goes from bad to worse without any improvement. In line with Consumer (2019),
his condition began with a small ulcer that complicated into a gangrenous foot ulcer. Though,
with intervention, his condition kept deteriorating. Consequently, he lost his leg due to
amputation. This attracted both physical and emotional effect on his life because he felt that he
had lost his physical abilities. The consumer explained his condition and described as having
excruciating pain in his leg. This is a description of how he had lost control of his body and an
indication of his painful experience.
Quest Narrative
On the other hand, when the patients meet the condition head-on, accept and use the
situation is termed as quest. Egnew (2018) defines quest narrative as a narration of a journey that
the patient has gone through with the illness. During quest narration, shares his experience about
how he feels to be in that condition. The narrator tells the story as he wants the listener to hear

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 5
and anticipates that the listener is prepared to hear each part of the narrative. Consumer (2019)
shared his encounter and experience with foot ulcer, though it was uneasy to him at some point,
he gave in and he became emotional. I listened attentively and her to keep explaining because I
knew that through sharing, she was also undergoing emotional healing.
Now What?
The narrative experience from Consumer enlightened me on a holistic approach to patient
care rather than depending on clinical symptoms. Even though this was my first-hand
conversation with a patient that had suffered from diabetes foot ulcer, I realized that the session
was more of a success story. I learned a lot from this interaction and understood that it was not
only the patient that was healing, but also I became compassionate when I listened to her.
According to Gonzalez, Costa, Andrade, and Medrado (2016) once patients are given a chance to
express their experiences in relation to an illness, the need for clinical manifestation of the
disease will be vague. The holistic approach makes narrative to be patient-centered (Gonzalez,
Costa, Andrade, & Medrado, 2016). A lot of information is obtained about physical, emotional,
physiological, psychological issues. For instance, Consumer (2019) disclosed that he feels the
amputated foot still exists. Therefore, it is clear that the narrative reveals a lot compared to
elicited symptoms. The consumer interaction changed my interaction with my patients. It helped
me understand them and show empathy.
Narrations provide an opportunity for learning and teaching. During the narration, I
realized that a therapeutic relationship is important. When patients’ trust you, they become open
and express themselves freely (consumer, 2019). Also, it provides a chance to identify patient
weakness, knowledge deficits regarding the disease and attitude. Identification of those gaps
gives health personnel an opportunity on areas to give health education on the patient. The

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 6
healthy person learns and empathies the patient through there disease process experience. It
enables them to understand the patients in a broader perspective. Rosti (2017) explains that
narratives are knowledge sharing episodes and they help spread best practices, and provide
opportunity for peer learning among health professionals. These encounters add wisdom to the
practitioners. Through these narrations I gained knowledge about foot ulcers.
In line with above it improved my knowledge about medical surgical conditions that I
had only learned in my theory classes. Listening skills play a major role in narrative stories. The
Consumer (2019) opened up because I was interested about her condition. The health providers
should be attentive during the narration because it is a wider source of a lot of information.
Patients tend to communicate with health personnel in different ways. The patient could not
move her limbs, so she used facial expressions.
Conclusion
The healthcare sector needs to be revolutionized to incorporate narratives in patient
history taking. My interaction with the patient in this learning activity had a significant impact on
my understanding of the emotional and physiological impact of the disease on the patient’s body.
I became compassionate about the patient and also gained new skills of how interactions foster
the emotional healing in the patient. The health system needs a simplified method of patient care
and illness and wellbeing narratives are potential interventions in patient-centered service
delivery. There is a need for interventional methods that can increase efficiency, reduce patient
wait time, and improve quality and patient-centered care through the understanding of the patient
through interactions rather than a focus on medications alone. Therefore, the narrative approach
comes out as the best method to bring tremendous changes in healthcare sector. Narratives are
impactful because they have a positive impact on both the patient and the caregiver.

NARRATIVES OF ILLNESS AND WELLBEING IN PATIENTS 7
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