从混合方法研究的视角反思循证医学与叙事医学的整合

Rethinking on the Integration of Evidence-based Medicine and Narrative-based Medicine from the Perspective of Mixed Methods Research

面对越来越强调真实世界背景下的医学研究,质性方法论视角下的叙事医学受到了极大的关注,并出现了与循证医学整合的发展趋势。深入探讨了循证医学与叙事医学整合的三个问题。基于文献综述剖析定量方法论视角下的临床研究及其应用,强调传统临床研究的黄金法则具有局限性;基于传统临床研究的指南具有局限性;医生决策思维受多种因素影响。进一步阐释质性方法论视角下的叙事医学的概念及基本类型,并从混合方法研究的视角反思循证医学与叙事医学的整合,强调真实世界的证据可以同时纳入循证医学和叙事医学所提供的有效证据,共同加深对疾病和患者的认识,推动医学的发展。

In the face of increasing emphasis on medical research in the real world,narrative medicine from the perspective of qualitative methodology has received great attention,and there has been a development trend of integration with evidence-based medicine.This paper discusses on the 3 questions of the integration of evidence-based medicine and narrative medicine.Based on the literature review,we analyzed clinical research and its application from the perspective of quantitative methodology,emphasizing that the golden rules of traditional clinical research have limitations;guidelines based on traditional clinical research have also some limitations;doctors'decision-making thinking is affected by many factors.We further explain the concept and basic types of narrative medicine from the perspective of qualitative methodology,and reflect on the integration of evidence-based medicine and narrative medicine from the perspective of mixed method research,emphasizing that real-world evidence can be incorporated into the effective evidence provided by both evidence-based medicine and narrative medicine,which together deepen the understanding of diseases and patients,and promote the development of medicine.