How far from the ideals of narrative medicine are current practices in pediatric nursing? An empirical analysis of nurse-child-parent communication.
other · Level V
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- Record sourced from PubMed, PMID 42743891.
- Also identified by DOI 10.1016/j.pec.2026.109840.
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Abstract
To evaluate how nurses in three hospitals in China communicate in triadic pediatric interactions (nurses-pediatric patients-parents), data were collected and analyzed to identify the extent to which current communication patterns are adequate for the goals of narrative medicine, a patient-story-centered approach to medicine that advocates deep patient engagement. Qualitative ethnographic observation and discourse analysis were combined for this empirical investigation. Audio recordings of 34 triadic interactions by three nurses in three hospitals across China were collected. Communication patterns were evaluated vis-à-vis the three main goals of narrative medicine (Attention, Representation, and Affiliation). Nurses were found to prioritize biomedical needs and nursing procedures at the expense of attending to the emotions of pediatric patients. Interactions frequently failed to adequately represent or recognize the patients' thoughts and feelings, and empathic expressions and triadic collaborative efforts were lacking, hindering the establishment of affiliation. Overall, children's voices were routinely marginalized. Replacing traditional adult-focused dyadic communication models with an explicitly triadic, child-engagement-focused one will elevate attention to children's needs, prioritize their thoughts and emotions, and strengthen triadic affiliation, all of which align with the goals of narrative medicine. The findings suggest an urgent need for pediatric nurses to receive training in communicative strategies that promote deep engagement with pediatric patients: emotion-focused attentiveness, dialogic depth, and an empathic, affiliation-building communicative style. The study introduces a three-layered, communication-focused nursing model that maps the goals of narrative medicine to ideal nursing attributes and, crucially, practical communication strategies that help realize those attributes discursively.