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World J Clin Cases. Aug 6, 2025; 13(22): 105684
Published online Aug 6, 2025. doi: 10.12998/wjcc.v13.i22.105684
Embedding narrative medicine in primary healthcare: Exploration and practice from a medical humanities perspective
Ning-Jia Lei, Deep K Vaishnani, Mohmmad Shaheen, Haniah Pisheh, Jing Zeng, Fu-Rong Ying, Qiu-Qin Yang, Cong-Ying Wang, Jun Ma, Jing-Ye Pan, Ning-Jian Hou
Ning-Jia Lei, College of Pharmacy, Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Deep K Vaishnani, Haniah Pisheh, School of International Studies, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
Mohmmad Shaheen, Department of Medicine, Misr University for Science and Technology, Cairo 3237101, Al Qāhirah, Egypt
Jing Zeng, Qiu-Qin Yang, School of Clinical Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
Fu-Rong Ying, Department of Clinical Laboratory, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Cong-Ying Wang, School of Medical Technology and Pharmacy, Renji College of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Jun Ma, Department of Pathology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Jing-Ye Pan, Key Laboratory of Intelligent Treatment and Life Support for Critical Diseases of Zhejiang Province, Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Zhejiang Engineering Research Center for Hospital Emergency and Process Digitization, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Ning-Jian Hou, Department of International Cooperation and Exchange, Wencheng Branch of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Co-first authors: Ning-Jia Lei and Deep K Vaishnani.
Author contributions: Lei NJ and Vaishnani DK led the conceptualization and analysis of narrative medicine in primary healthcare, focusing on its clinical applications and patient-centered care; Shaheen M examined institutional barriers and the impact of healthcare commercialization on the implementation of medical humanities; Pisheh H contributed to policy analysis and explored global healthcare disparities in the integration of narrative medicine; Zeng J conducted a literature review and comparative study of narrative medicine practices across different healthcare systems; Ying FR focused on case study research and synthesized data on the role of narrative medicine in improving doctor-patient communication; Yang QQ evaluated medical humanities education and training strategies for healthcare professionals; Wang CY handled statistical analysis and contributed to the methodological design for assessing healthcare service quality improvements; Ma J provided insights into the theoretical framework for integrating medical humanities into clinical practice; Pan JY reviewed and critiqued existing medical humanities policies and their impact on primary healthcare services; Hou NJ supervised the research, conducted the final manuscript review, and coordinated the overall study; Lei NJ and Vaishnani DK contributed equally to this work as co-first authors.
Supported by National Natural Science Foundation of China, No. 82272204 and No. 82472188; 2022 Key Clinical Specialty of Zhejiang Province (Critical Care Medicine); “Pioneer” and “Leading Goose” R&D Program of Zhejiang, No. 2023C03084; Wenzhou Major Science and Technology Innovation Project, No. ZY2023005; Central Guiding Local Technology Development, No. 2024ZY01012; Zhejiang Provincial College Students' Science and Technology Innovation Activity Program, No. 2024R413A037; National Innovation and Entrepreneurship Training Program for College Students, No. 202410343030.
Conflict-of-interest statement: The authors have nothing to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ning-Jian Hou, Department of International Cooperation and Exchange, Wencheng Branch of the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. 540065381@qq.com
Received: February 4, 2025
Revised: March 7, 2025
Accepted: April 8, 2025
Published online: August 6, 2025
Processing time: 99 Days and 21.8 Hours
Abstract

This study examines the integration of narrative medicine (NM) into primary healthcare (PHC) settings, evaluating its role in enhancing medical humanities education within grassroots healthcare institutions. Through a comprehensive literature review and case analysis, the research investigates the current state, challenges, and practical barriers to embedding NM into PHC systems, while proposing targeted strategies for improvement. The findings suggest that NM fosters stronger doctor-patient trust, enhances healthcare quality, and promotes humanistic care. However, primary hospitals face numerous challenges in advancing medical humanities, including a lack of trust between doctors and patients, tensions arising from the commercialization of healthcare, institutional limitations, unequal distribution of resources, and issues related to physicians' professional competencies and stress management. These interrelated obstacles detract from the quality of PHC services and the overall patient experience. Drawing on successful case studies from primary hospitals, the paper outlines effective strategies for overcoming these challenges. The study provides both theoretical and practical insights for advancing medical humanities in PHC, contributing to improvements in healthcare service quality and supporting the development of high standards in the healthcare sector. Ultimately, the findings aim to promote the broader adoption and ongoing refinement of NM within PHC institutions.

Keywords: Narrative medicine; Primary healthcare; Medical humanities; Doctor-patient relationship; Healthcare quality

Core Tip: This study explores the integration of narrative medicine (NM) in primary healthcare (PHC) to enhance doctor-patient relationships, medical education, and healthcare quality. By identifying institutional barriers such as resource disparities, commercialization, and limited humanities training, the research proposes practical strategies to embed NM into PHC settings. Through case studies and policy analysis, the findings highlight how NM fosters patient-centered care, trust, and communication, ultimately improving healthcare service delivery. This study contributes to advancing medical humanities and shaping a more empathetic and effective healthcare system.