叙事素养的理论基础及表现维度

Narrative competence:theoretical rationales and main dimensions

叙事医学是一种注重医疗语境下医护患三大生命主体叙事素养全面提升的医学人文落地模式。本文提出叙事医学强调医患之间的主体间性、主体心-身-病三维度的统一性、医疗语境下主体间关系的相互性与独特性四大理论基础,叙事素养表现为根据不同语境进行话语转换、通过隐喻性故事谈论生老病死、对患者/家属展开回应式聆听、有针对性地指导叙事性阅读、讲述和创作不同视角的故事、从故事中发现有利于诊断的信息、帮助患者走出叙事闭锁实现心身成长的能力等七大表现维度。

Narrative medicine is a medical humanistic landing model that focuses on the comprehensive improvement of the narrative competence of the three major life subjects in the medical context, namely, doctors, nurses and patients. Taking the four basic conceptions and the seven representative dimensions of narrative competence as a departure, this essay illuminates that the intersubjectivity, psycho-somaticness, the reciprocity and uniqueness are the most significant features of narrative medicine and that narrative competence can be tested by the following abilities, namely, the free language code shift from scientific medical world to life world, the metaphorization of life and death, illness and health, the responsive listening, the guidance of patients’ reading, the multiple perspective storytelling, the detective of diagnosis clues as well as the empowerment of patients’ growth and abilities to go out of narrative foreclosures.