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Combining creative writing and narrative analysis to deliver new insights into the impact of pulmonary hypertension
  1. Julia C Goddard1,2,3,
  2. Iain J Armstrong2,
  3. David G Kiely2,
  4. Charlie A Elliot2,
  5. Athanasios Charalampopoulos2,
  6. Robin Condliffe2,
  7. Brendan J Stone4 and
  8. Ian Sabroe1,2,3
  1. 1 Department of Infection, Immunity and Cardiovascular Science, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
  2. 2 Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  3. 3 Medical Humanities Sheffield, University of Sheffield, Sheffield, UK
  4. 4 School of English, Faculty of Arts and Humanities, University of Sheffield, Sheffield, UK
  1. Correspondence to Prof Ian Sabroe; i.sabroe{at}sheffield.ac.uk

Abstract

Introduction Pulmonary hypertension is life limiting. Delays in diagnosis are common, and even after treatment has been initiated, pulmonary hypertension has marked effects on many aspects of social and physical function. We believed that a new approach to examining disease impact could be achieved through a combination of narrative research and creative writing.

Methods Detailed unstructured narrative interviews with people with pulmonary hypertension were analysed thematically. Individual moments were also summarised and studied using creative writing, in which the interviewer created microstories from narrative and interview data. Stories were shared with their subjects, and with other patients, clinicians, researchers and the wider public. The study was carried out in hospital and in patients’ homes.

Results Narrative analysis generated a rich data set which highlighted profound effects of pulmonary hypertension on identity, and demonstrated how the disease results in very marked personal change with ongoing and unpredictable requirement for adaptation. The novel methodology of microstory development proved to be an effective tool to summarise, communicate and explore the consequences of pulmonary hypertension and the clinical challenges of caring for patients with this illness.

Conclusions A holistic approach to treatment of chronic respiratory diseases such as pulmonary hypertension requires and benefits from explicit exploration of the full impacts of the illness. Narrative analysis and the novel approach of targeted microstory development can form a valuable component of the repertoire of approaches to effectively comprehend chronic disease and can also facilitate patient-focused discussion and interventions.

  • Primary Pulmonary Hypertension

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Footnotes

  • Contributors JCG conducted the interviews, analysed the data and wrote the microstories. IJA, BJS and IS developed the protocol, supervised the research, guided the analysis, and supported the development of the microstories. DGK, AC, IJA, RC, IS and CAE together managed patient identification and recruitment, and discussion and exploration of the narrative content. The manuscript itself was principally written by JCG and IS, with contributions from all authors.

  • Funding This study was funded by an educational grant from the Pulmonary Hypertension Association UK to support JCG. The research was undertaken as part of an intercalated degree during medical training.

  • Competing interests None declared.

  • Patient consent Patient consent not required for this but written informed consent obtained as routine part of the study.

  • Ethics approval NRES Yorkshire and The Humber.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional microstories are uploaded as a supplemental document.