Culture Linked to Increasing Ageism During COVID-19: Evidence From a 10-Billion-Word Corpus Across 20 Countries.

OBJECTIVES: Older adults experience higher risks of getting severely ill from coronavirus disease 2019 (COVID-19), resulting in widespread narratives of frailty and vulnerability. We test: (a) whether global aging narratives have become more negative from before to during the pandemic (October 2019 to May 2020) across 20 countries; (b) model pandemic (incidence and mortality), and cultural factors associated with the trajectory of aging narratives. METHODS: We leveraged a 10-billion-word online-media corpus, consisting of 28 million newspaper and magazine articles across 20 countries, to identify nine common synonyms of "older adults" and compiled their most frequently used descriptors (collocates) from October 2019 to May 2020-culminating in 11,504 collocates that were rated to create a Cumulative Aging Narrative Score per month. Widely used cultural dimension scores were taken from Hofstede, and pandemic variables, from the Oxford COVID-19 Government Response Tracker. RESULTS: Aging narratives became more negative as the pandemic worsened across 20 countries. Globally, scores were trending neutral from October 2019 to February 2020, and plummeted in March 2020, reflecting COVID-19's severity. Prepandemic (October 2019), the United Kingdom evidenced the most negative aging narratives; peak pandemic (May 2020), South Africa took on the dubious honor. Across the 8-month period, the Philippines experienced the steepest trend toward negativity in aging narratives. Ageism, during the pandemic, was, ironically, not predicted by COVID-19's incidence and mortality rates, but by cultural variables: Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation. DISCUSSION: The strategy to reverse this trajectory lay in the same phenomenon that promoted it: a sustained global campaign-though, it should be culturally nuanced and customized to a country's context.

De la medicina narrativa a los cuidados humanizados: El hospital El Cruce en pandemia

Este libro intenta compartir los aportes técnicos de los enfoques con las vivencias emocionales recogidas en múltiples relatos. Contiene descripciones rigurosas de las dos disciplinas que confluyen, la medicina narrativa y los cuidados humanizados, así como de las medidas adoptadas en la organización del hospital y la asistencia. Suma a esos contenidos el relato de la experiencia en todo el enfoque humanístico de la crisis, de la reflexión grupal en los talleres, las estrategias adoptadas para la resolución de problemas complejos como las visitas, el aislamiento y los cuidados del final de la vida. En cada tema, aporta textos comprometidos y personales de los actores y diversos profesionales de la salud que comparten sus emociones y conmociones en la circunstancia extrema de la pandemia. (AU)

Storytelling as instrument of communication in healthcontexts / Storytelling como instrumento de comunicación en contextosde salud

Storytelling (ST) has emerged as an instrument that helps us in the learning and management of the disease, by taking advantage of the teachings transmitted by other patients who have gone through the same illness: sharing experiences. It requires an interaction between the one who relates (implicit emotional and corporal language: visual, auditory and gestural) and the listener, allowing the listener to conceptualize and create more valuable ideas. The use of ST can serve as a means, establishing a network of trust and equality among participants, allowing a way of expression that would eliminate the stigmatization of suffering from a disease. In addition, telling stories can be a vehicle that breaks resistance to the messages promoting a healthy lifestyle, or that dilutes them to face behavioral changes facilitating the incorporation of new behaviors that improve health or overcome the disease. ST facilitates support for the disease by allowing the patient to examine their emotions and problem-solving strategies, set objectives and exchange social support. With this article we intended to conduct a review of empirical studies on ST and health education, considering contexts, purposes, learning, attitudes and behaviors improvements related to the use of this tool of communication

Lo que podríamos denominar "contar historias", Storytelling (ST), se ha convertido en un instrumento que nos ayuda en el aprendizaje y el manejo de la enfermedad, aprovechando las enseñanzas transmitidas por otros pacientes que han pasado por la misma enfermedad: compartiendo experiencias. Requiere una interacción entre el relator (lenguaje emocional y corporal implícito: visual, auditivo y gestual) y el oyente, lo que le permite conceptualizar y crear ideas más valiosas. El uso de ST puede servir como un medio, estableciendo una red de confianza e igualdad entre los participantes, permitiendo una forma de expresión que eliminaría la estigmatización del sufrimiento de una enfermedad. Además, contar historias puede ser un vehículo que rompa la resistencia a los mensajes que promueven un estilo de vida saludable, o que los diluya para enfrentar cambios conductuales que faciliten la incorporación de nuevos comportamientos que mejoren la salud o superen la enfermedad. ST facilita el apoyo a la enfermedad al permitir al paciente examinar sus emociones y estrategias de resolución de problemas, establecer objetivos e intercambiar apoyo social. Con este artículo intentamos realizar una revisión de estudios empíricos sobre ST y educación para la salud, considerando contextos, propósitos, aprendizaje, actitudes y mejoras de comportamiento relacionadas con el uso de esta herramienta de comunicación

The mechanisms and processes of connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives.

BACKGROUND: Mental health recovery narratives are a core component of recovery-oriented interventions such as peer support and anti-stigma campaigns. A substantial number of recorded recovery narratives are now publicly available online in different modalities and in published books. Whilst the benefits of telling one's story have been investigated, much less is known about how recorded narratives of differing modalities impact on recipients. A previous qualitative study identified connection to the narrator and/or to events in the narrative to be a core mechanism of change. The factors that influence how individuals connect with a recorded narrative are unknown. The aim of the current study was to characterise the immediate effects of receiving recovery narratives presented in a range of modalities (text, video and audio), by establishing the mechanisms of connection and the processes by which connection leads to outcomes. METHOD: A study involving 40 mental health service users in England was conducted. Participants were presented with up to 10 randomly-selected recovery narratives and were interviewed on the immediate impact of each narrative. Thematic analysis was used to identify the mechanisms of connection and how connection leads to outcome. RESULTS: Receiving a recovery narrative led participants to reflect upon their own experiences or those of others, which then led to connection through three mechanisms: comparing oneself with the narrative and narrator; learning about other's experiences; and experiencing empathy. These mechanisms led to outcomes through three processes: the identification of change (through attending to narrative structure); the interpretation of change (through attending to narrative content); and the internalisation of interpretations. CONCLUSIONS: This is the first study to identify mechanisms and processes of connection with recorded recovery narratives. The empirically-based causal chain model developed in this study describes the immediate effects on recipients. This model can inform selection of narratives for use in interventions, and be used to support peer support workers in recounting their own recovery narratives in ways which are maximally beneficial to others.

[What is narrative medicine?]

Narrative medicine first entered China in 2011 and has developed rapidly since then. The patient-centered care, shared decision making and relational medicine in the medical sphere, together with patients narrating their illness and narratology contributed to the rise of narrative medicine. Through listening to patients' narratives, paying attention to their emotions, and representing their stories in various ways, clinicians can connect with patients and empathize with them. In this way, affiliation and mutual trust with patients can be established. Patients will feel good in the doctor-patient encounter because of such humane care, and clinicians may get satisfaction from their work. Narrative medicine courses characterized by close reading of literature and writing should be added to the curriculum of medical education as the major content of medical humanities, so as to train narrative competence for the future doctors.