Brazil's Community Health Workers Practicing Narrative Medicine: Patients' Perspectives

Area of Science:

• Healthcare Delivery
• Public Health
• Medical Humanities

Background:

• Narrative medicine (NM) enhances therapeutic alliances through provider experiences.
• While NM in nursing and medicine is documented, its application by community health workers (CHWs) remains understudied from patient perspectives.

Purpose of the Study:

• To investigate how CHWs apply NM concepts within Brazil's Family Health Strategy (FHS).
• To understand patient perspectives on CHW application of NM in building provider-patient, provider-colleague, provider-society, and provider-self relationships.

Main Methods:

• Semi-structured interviews guided by Charon's (2001) NM framework.
• Thematic analysis of data from 27 patients (18 female, diverse racial backgrounds) interacting with CHWs.

Main Results:

• CHWs demonstrated compassion, empathy, and clear communication in provider-patient relationships.
• CHWs perceived a lack of credibility from physicians, hindering effectiveness.
• CHWs empowered patients for civic and political advocacy.
• Patients noted CHWs' potential low self-esteem and need for self-care due to demanding work.

Conclusions:

• Patient perspectives reveal CHWs utilize NM to foster key relationships.
• Improving provider-colleague dynamics requires interprofessional training.
• Enhanced organizational support and public education are crucial for CHW roles.
• Further research into CHW personality traits and NM application is recommended.