Narrative Medicine for Gastrointestinal Cancer

Overseen By Charlean Ketchens, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Southern California

Disqualifiers: Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how narrative medicine might enhance the well-being of patients with gastrointestinal (digestive system) cancer. Narrative medicine uses personal stories about illness to promote healing and resilience. The trial includes activities such as reading, writing, and discussion to help patients reflect on their lives beyond their illness. It seeks participants with gastrointestinal cancer who are currently receiving treatment and are comfortable engaging in reading and writing activities. As an unphased trial, this study offers a unique opportunity to examine personal storytelling as a tool for healing and resilience.

Do I need to stop my current medications for this trial?

The trial does not specify whether you need to stop taking your current medications. However, since it involves narrative medicine and not a new drug, it's likely you can continue your current treatments.

What prior data suggests that narrative medicine methods are safe for GI cancer patients?

Research has shown that narrative medicine has been used in various settings, including with cancer patients. This method employs storytelling, reflective writing, and reading to help patients share and understand their experiences. Although specific safety data for narrative medicine itself is lacking, studies on similar methods, such as narrative interviews with cancer patients, have found these approaches to be generally well-tolerated, with no reports of harmful side effects.

The absence of negative effects indicates its safety. Narrative medicine does not involve drugs or medical procedures. Instead, it focuses on communication and emotional support, making it a low-risk option for patients. While direct safety data is unavailable, the nature of narrative medicine suggests it is safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Narrative Medicine is unique because it focuses on the emotional and psychological aspects of living with gastrointestinal cancer rather than the physical symptoms alone. Unlike traditional treatments like chemotherapy or surgery, which target the cancer cells directly, narrative medicine uses storytelling and personal reflection to help patients process their experiences and improve their emotional well-being. Researchers are excited about this approach because it has the potential to enhance the overall quality of life for patients, potentially leading to better mental health outcomes and more personalized care.

What evidence suggests that narrative medicine is effective for improving well-being in GI cancer patients?

Research has shown that telling personal stories can help patients with stomach and intestinal cancers feel better. One study found that patients using storytelling techniques experienced a better quality of life, adhered more consistently to their medication, and visited the emergency room less frequently. In this trial, participants will engage in narrative medicine sessions, allowing them to reflect on and share their life stories beyond their illness, aiding emotional healing. Patients often feel less isolated and more connected to their doctors. This approach supports the idea that focusing on a patient's personal story can enhance overall well-being during treatment. ^{1 2 3 4 6}

Who Is on the Research Team?

Eve L Makoff, MD

Principal Investigator

University of Southern California

Are You a Good Fit for This Trial?

This trial is for patients with gastrointestinal cancers. Participants should be interested in exploring narrative medicine, which involves discussion, interviews, and surveys to reflect on their life stories and illness experiences.

Inclusion Criteria

I can take care of myself but cannot do any physical work.

I can speak, read, and write in English well enough to fill out questionnaires.

I am currently receiving infusion treatments for gastrointestinal cancer.

Exclusion Criteria

I do not have any mental or cognitive issues that would prevent me from participating in the study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants participate in narrative medicine sessions over 60 minutes once every 2 weeks for 3 sessions

6 weeks

3 visits (in-person)

Follow-up

Participants are monitored for changes in well-being scores and completion of narrative medicine sessions

3 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Narrative Medicine

Trial Overview The study tests if narrative medicine methods like close reading, creative writing, and discussions can improve well-being in GI cancer patients by enhancing communication between them and healthcare providers.

How Is the Trial Designed?

Group I: Supportive Care (narrative medicine sessions) Experimental Treatment 3 Interventions

Patients participate in narrative medicine sessions over 60 minutes Q2W for 3 sessions.

Who Is Running the Clinical Trial?

University of Southern California

Lead Sponsor

Trials

956

Recruited

1,609,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

Narrative medicine (NM) enhances the understanding of disease and suffering by fostering communication between patients and healthcare providers, which is particularly beneficial in the complex field of cancer management.

The introduction of narrative oncology (NO) utilizes NM skills to improve relationships and trust among oncologists, patients, and caregivers, creating a more empathetic healthcare environment that can enhance cancer care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lessons from narrative medicine: Cancer care will improve with narrative oncologyLessons from narrative medicine: Cancer care will improve with narrative oncology. Mohanti, BK.[2022]

The study involved 13 cancer patients (6 men and 7 women, aged 47 to 79) who shared their illness narratives, revealing that encounters with doctors significantly impacted their experiences throughout their cancer journey.

A strong doctor-patient relationship, characterized by continuity of care and effective communication, was crucial for patients, highlighting the need for physicians to provide empathetic support and adapt their communication to meet patients' needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patients' illness narratives-From being healthy to living with incurable cancer: Encounters with doctors through the disease trajectory. Kvåle, K., Haugen, DF., Synnes, O.[2023]

A new assignment for specialist oncology nurses on adverse drug reaction (ADR) reporting resulted in 97% of the 33 reported ADRs being well documented, demonstrating the nurses' capability in pharmacovigilance.

The majority of nurses found the assignment useful and reported that it increased their awareness of medication safety, with 84% stating it changed how they managed ADRs in their practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study. Schutte, T., van Eekeren, R., Richir, M., et al.[2019]

An analysis of narratives from 48 breast cancer patients revealed significant differences between how patients describe adverse drug events (ADEs) and the terminology used on pharmaceutical package inserts, indicating a gap in effective communication.

The study suggests that creating an 'Adverse Drug Event Database' with patient narratives could provide valuable, relatable information to help patients better understand and cope with ADEs, which is currently lacking in standard drug information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Utility of an adverse drug event database based on the narrative accounts of patients with breast cancer. Kikuchi, K., Miki, A., Satoh, H., et al.[2020]

The study analyzed the experiences of 15 women aged 34 to 60 diagnosed with breast cancer, revealing that societal expectations often added pressure to their cancer journey, influencing decisions about treatment and self-presentation.

Participants expressed the need for emotional space to process feelings like rage and sadness, highlighting the importance of supportive communication and validation of their long-term treatment effects, rather than simply promoting a positive attitude.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Thematic analysis of illness narratives as an example of an approach to better understand the lived experience of women diagnosed with breast cancer in Spain. Mesa Freydell, N., Martínez Pérez, A., Schneider Fontán, J.[2022]

Narrative medicine, which emphasizes understanding patients' stories and emotions, has rapidly developed in China since 2011, enhancing the doctor-patient relationship through empathy and trust.

Incorporating narrative medicine courses into medical education can improve future doctors' narrative competence, ultimately leading to better patient-centered care and clinician satisfaction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[What is narrative medicine?] Guo, L.[2022]

A project engaging 36 internal medicine residents in incident reporting through anonymous storytelling led to the submission of 79 narratives about patient care issues, highlighting significant safety concerns.

Key factors contributing to patient safety incidents included communication errors, decision-making lapses, and workload challenges, demonstrating that residents are willing to discuss these issues in a supportive, blame-free environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient safety stories: a project utilizing narratives in resident training. Cox, LM., Logio, LS.[2015]

In a study of 487 admissions involving 355 cancer patients treated with cisplatin, 53% experienced at least one adverse drug event, highlighting the prevalence of such reactions in this patient population.

Nausea was the most commonly documented adverse event, occurring in 43.9% of admissions, with an average duration of 5.2 days, indicating a significant side effect of cisplatin treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse-drug-event surveillance using narrative nursing records in electronic nursing records. Ahn, HJ., Park, HA.[2013]

The Local Healthcare Authority of Romagna developed a desktop application using open-source R software to monitor inpatient falls, which are the most common adverse events in hospitals, helping to improve patient safety.

The application not only tracked fall rates effectively across 29 hospital units but also identified critical data collection issues, leading to targeted improvement actions and significant cost savings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Process Control Charts in Falls Prevention: The Experience of the Local Healthcare Authority of Romagna, Italy. Scagliarini, M., Boccaforno, N., Donati, R., et al.[2022]

A Narrative Medicine course using Herman Melville's 'Bartleby, the Scrivener' helps medical students develop essential skills like empathy and narrative competence by reflecting on complex human experiences.

The story illustrates the challenges of empathy in medical practice, prompting discussions about professionalism and personal values, which are crucial for effective patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Pity as pain: Narrative Medicine and Melville's "Bartleby"]. Wohlmann, A.[2023]

A pilot study at the 'Regina Elena' National Cancer Institute involving seven patients and five healthcare professionals found that using digital narrative diaries significantly improved patients' self-expression, disease awareness, and sense of empowerment, with high satisfaction scores (4.8/5).

Healthcare professionals also reported enhanced communication and relationships with patients, indicating that integrating patients' narratives into their care can strengthen the therapeutic alliance and improve overall care pathways.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Narrative Medicine: A Digital Diary in the Management of Bone and Soft Tissue Sarcoma Patients. Preliminary Results of a Multidisciplinary Pilot Study. Cercato, MC., Vari, S., Maggi, G., et al.[2022]

The narrative path program at the IRCSS 'Regina Elena' National Cancer Institute, initiated in 2015, emphasizes the importance of storytelling in clinical practice to enhance understanding and communication between patients and healthcare providers.

A pilot study in 2017 demonstrated that integrating patient narratives with clinical data during chemotherapy is feasible and beneficial, but its success relies heavily on the involvement of the entire care team and effective health organization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Narrative medicine in the oncological clinical practice: the path from a story-telling intervention to a narrative digital diary.] Cercato, MC.[2019]

The Life Story Narrative Program for outpatient oncology patients led to a significant improvement in patient experience scores, with 100% of participants rating their experience positively compared to 78.4% in the control group.

Despite a small sample size of 27 participants, the program demonstrated that engaging patients in sharing their life stories can enhance their overall satisfaction and well-being during cancer treatment, as indicated by a statistically significant difference in Press Ganey™ scores (mean score of 5.00 vs. 4.71).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of a Narrative Medicine Life Story Pilot Program on Press Ganey™ Scores in an Outpatient Cancer Center. Raff, JP., Sege, J., Braiotta, R., et al.[2023]

A nurse-led storytelling intervention significantly reduced anxiety levels in cancer patients, even as their disease progressed, suggesting a potential therapeutic benefit for mood management.

The study, involving 10 patients with various cancer diagnoses, indicates that storytelling could be a valuable tool for improving psychosocial well-being, although further research is needed due to the small sample size.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Storytelling intervention for patients with cancer: part 2--pilot testing. Crogan, NL., Evans, BC., Bendel, R.[2013]

Citations

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Effect of Narrative Nursing Intervention on Patients with ... Abstract. Objective. To explore the effect of narrative nursing intervention on patients with esophageal, gastric, and intestinal cancers.

2. withpower.com withpower.com/trial/phase-gastrointestinal-neoplasms-8-2023-eb939

Narrative Medicine for Gastrointestinal Cancer Trial Overview The study tests if narrative medicine methods like close reading, creative writing, and discussions can improve well-being in GI cancer patients ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S2405844024078332

Evaluating a nurse-led narrative interview intervention with ... This study explores the feasibility and utility of employing narrative interviews with cancer patients at their initial diagnosis, conducted by seasoned nurses.

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(PDF) Effect of Narrative Nursing Intervention on Patients ... PDF | Objective To explore the effect of narrative nursing intervention on patients with esophageal, gastric, and intestinal cancers.

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Narrative Medicine: The Power of Shared Stories to ... Outcome measures included quality of life, improved medication adherence, decreased emergency room visits, overcoming of social withdrawal and ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11439222/

Narrative medicine interventions for oncology clinicians Narrative medicine interventions may include reflective writing, storytelling, and/or other creative activities related to reflection on, ...