title: The Importance Of Integrating Narrative Into Health Care Decision Making.
abstract: When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice.
authors.affiliation: Daniel Dohan (daniel.dohan@ucsf.edu) is a professor in the Philip R. Lee Institute for Health Policy Studies and in the Department of Anthropology, History, and Social Medicine, both at the University of California, San Francisco (UCSF).
authors.forename: Daniel
authors.initials: D
authors.lastname: Dohan
authors.affiliation: Sarah B. Garrett is a research analyst in the Philip R. Lee Institute for Health Policy Studies, UCSF.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Garrett
authors.affiliation: Katharine A. Rendle is a cancer prevention fellow in the Division of Cancer Prevention, National Cancer Institute, in Bethesda, Maryland.
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Rendle
authors.affiliation: Meghan Halley is an assistant scientist at the Palo Alto Medical Foundation Research Institute, in California.
authors.forename: Meghan
authors.initials: M
authors.lastname: Halley
authors.affiliation: Corey Abramson is an assistant professor in the School of Sociology at the University of Arizona, in Tucson.
authors.forename: Corey
authors.initials: C
authors.lastname: Abramson
mesh_terms: D001291:Attitude of Health Personnel; D003256:Community Participation / Q000706:statistics & numerical data; D054626:Consumer Health Information; D003657:Decision Making; D003695:Delivery of Health Care / Q000592:standards* / Q000639:trends; D019033:Delivery of Health Care, Integrated; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D033262:Narration; D010358:Patient Participation / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D036301:Qualitative Research; D011787:Quality of Health Care; D014481:United States
keywords: Consumer Issues; Evidence-Based Medicine; Medicine/Clinical Issues; Personal Experience (-Narrative Matters-)