The Narrative Medicine Approach in the Treatment of Diabetic Macular Edema: An Italian Experience.
Edoardo MidenaChiara PoloLuisa FrizzieroMaria Giulia MariniRosangela LattanzioMaria VadalàElisabetta PilottoMonica VaranoPublished in: International journal of environmental research and public health (2022)
The study retraces the healthcare pathway of patients affected by diabetic macular edema (DME) through the direct voice of patients and caregivers by using a "patient journey" and narrative method approach. The mapping of the patient's journey was developed by a multidisciplinary board of health professionals and involved four Italian retina centers. DME patients on intravitreal injection therapy and caregivers were interviewed according to the narrative medicine approach. Narratives were analyzed through a quali-quantitative tool, as set by the narrative medicine method. The study involved four specialized retina centers in Italy and collected a total of 106 narratives, 82 from DME patients and 24 from caregivers. The narratives reported their difficulty in identifying the correct pathway of care because of a limited awareness of diabetes and its complications. Patients experienced reduced autonomy due to ocular complications. In the treatment of diabetes and its complications, a multidisciplinary approach currently appears to be missing. DME reduces the quality of life of affected patients. The narrative medicine approach offers qualitative and emotional patient-guided information. The patient journey provides all of those involved in the management of DME with flowcharts to refer to, identifying the critical points in the healthcare journey of DME patients to improve the management of the disease.
Keyphrases
- end stage renal disease
- healthcare
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- type diabetes
- palliative care
- stem cells
- cardiovascular disease
- risk factors
- mass spectrometry
- high resolution
- diabetic retinopathy
- weight loss
- metabolic syndrome
- endothelial cells
- combination therapy
- social media
- glycemic control
- age related macular degeneration