Abstract

Narrative (storytelling) is an essential tool for reporting and illuminating the cultural contexts of health – that is, the practices and behaviour that groups of people share and which are defined by customs, language and geography. This report reviews the literature on narrative research, offers some quality criteria for appraising such research and gives three detailed worked case examples: diet and nutrition, well-being, and mental health in refugees and asylum seekers. Storytelling (and story interpretation) belongs to the humanistic disciplines and is not a pure science, although established techniques of social science can be applied to ensure rigour in sampling and data analysis. The case studies illustrate how narrative research can convey the individual experience of illness and well-being, thereby complementing (and sometimes challenging) epidemiological and public health evidence.

Contents

• CONTRIBUTORS
• SUMMARY
• 1. INTRODUCTION
  • 1.1. Background
  • 1.2. Methodology
• 2. FINDINGS
  • 2.1. Narrative research methods in health care
  • 2.2. Examples of narrative research on the cultural contexts of health
• 3. DISCUSSION
  • 3.1. Strengths and limitations of the review
  • 3.2. Summary of findings
  • 3.3. Policy considerations
• 4. CONCLUSIONS
• REFERENCES
• ANNEX 1. SEARCH STRATEGY
• ANNEX 2. HERMENEUTIC REVIEW
• ANNEX 3. A BRIEF HISTORY OF NARRATIVE RESEARCH IN HEALTH CARE

Suggested citation:

Greenhalgh T. Cultural contexts of health: the use of narrative research in the health sector. Copenhagen: WHO Regional Office for Europe; 2016 (Health Evidence Network (HEN) synthesis report 49).

The Health Evidence Network

HEN – the Health Evidence Network – is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the European Health Information Initiative (a multipartner network coordinating all health information activities in the European Region).

HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized evidence, HEN proposes policy options, not recommendations, for further consideration of policy-makers to formulate their own recommendations and policies within their national context.

HEN and the cultural contexts of health project at the WHO Regional Office for Europe

The project on the cultural contexts of health was initiated at the WHO Regional Office for Europe in response to the Member States’ recommendation that the implementation of Health 2020 could be improved by a more thorough understanding of the cultural contexts of health in the highly diverse European Region. As a consequence, an expert group meeting on the cultural contexts of health and well-being was convened by the WHO Regional Office for Europe on 15–16 January 2015. The expert group recommended that current well-being and health reporting could be improved through the use of new types of evidence, particularly qualitative and narrative research from a larger variety of academic disciplines and from a wide array of cultural contexts. In order to test this recommendation, and to better understand how narrative research was currently being deployed in the health sector, this HEN synthesis report was commissioned.

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ISSN 2227-4316

ISBN 978 92 890 5168 2

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