Feasibility and Acceptability of a Narrative Medicine Intervention in a Burn Center.

Abstract

Psychosocial sequelae from burn injuries may be significant for both patients and caregivers, affecting functional recovery. Narrative medicine, one aspect of medical humanities, uses guided reading, discussion, and writing to allow persons to feel seen and heard, and to reflect and express themselves. This low-cost, non-pharmacologic intervention may benefit persons recovering from a burn injury, as well as caregivers. A prospective, uncontrolled, feasibility and acceptability trial was carried out in a 12-bed regional burn center with six patients and six caregivers (not dyadic pairs). Feasibility was defined as a minimum threshold of 85% completed intervention sessions; acceptability was defined as a minimum enrollment rate of 35%. Anticipating a subsequent quasi-experimental design, candidate outcome variables (anxiety and emotional regulation) were measured for potential use. Participants' written texts were collected and analyzed using thematic analysis. The study was acceptable (35%) and feasible to deliver to burn patients (100%). Caregiver acceptability was low (under 35%), although it was feasible to deliver to caregivers (86%). Two candidate outcome variables (anxiety and emotional regulation) showed measurable change in the expected direction in both patients and caregivers. Thematic analysis yielded four themes: out of hospital stressors, hope and compassion, medical updates, and emotions. Meaningful contributions may be made by narrative medicine interventions, offering a low-cost, non-pharmacological option to reduce anxiety and regulate emotions. Results warrant revising the study design and proceeding with further development of this behavioral intervention.