6  •  2023  •  Developmental Observer

A B S T R A C T  —  N I D C A P  T R A I N E R S  M E E T I N G  2 0 2 3

Aim
To present the theoretical background of narrative medicine, 
highlight its specificities in the neonatal period, and show how 
NIDCAP is relevant at all stages of the narrative process.

Methods
Comparative analysis of the theory on NIDCAP and narrative 
medicine. 

Results/Findings
The narrative process defined by Rita Charon1 is divided into 
three stages. 
Attention is the first stage. It refers to the way practitioners 
listen to the patient’s behavior and talk. It needs a special state 
of mindfulness and attention, focused and open-minded. In 
the neonatal period, we listen to the baby’s behavior and to the 
parent’s story and behavior.

The NIDCAP observation tool, naming, describing, and 
preselecting specific behaviors, helps us to listen to premature 
babies. With the help of narrative medicine, we can improve 
the way we listen to parents using our close reading session 
skills. During the close reading session, we learn to be actively 
aware of how the stories are told: perspective, form, temporal 
structure, plot, and desire. 
Representation is the second stage. It refers to the way practi-
tioners write what they have learned from the patient.

When health professionals write, they discover aspects of 
the experience that were not evident to them. Writing is reveal-
ing what was present but hidden. It reveals some truth about 
the patient, and about the writer themselves. It could be seen 
in the words chosen, or in the form of the writing. About the 
words, Roland Barthes2 makes a difference between Denotation 
and Connotation. In the neonatal period, we write about the 
baby’s behavior, and about the parents' stories. 

Considering the baby’s behavior, the guidelines proposed 
to write the NIDCAP report reflect the care philosophy sup-
ported by NIDCAP. By introducing the baby by his name, we 
recognize him as a person. By using the active verb, he is a 
living person in motion. By writing in a fashion that is readily 
understood by and is supportive of parents, we testify to baby 
and family-centered care. By describing a baby as available to 
actively seek well-modulated functioning to approach stimuli, 
we defined them as an actor of their own development.  Re-
specting and endorsing those writing guidelines is pushing us 
to change our care philosophy. 

Considering the parents’ stories, narrative medicine 
proposes to use a parallel chart. In this file, you write what the 
parents tell you, but also how you feel and react to it. Once 
written, the parallel chart is used as a starting point for the 
reflective practice recommended during the NIDCAP process.  
Affiliation is the last stage of the narrative process. It refers to 
how the patient and the practitioner share the writing pro-
ducing an efficient and trustful partnership. This implies that 
they believe in the power of words, as John Langshaw Austin3 
explains in the speech act. In the neonatal period, what is 
written on the baby by the professional and/or the parents can 
affiliate parents and health care professionals for the sake of the 
premature baby.

The way NIDCAP recommendations are written is a 
tremendous example of this speech act. Including parents’ 
preferences is a sign of affiliation with parents. Starting rec-
ommendation with the behavior of the baby, and ending it 
with his developmental goal, is a sign of our affiliation with the 
premature baby. 

Relevance to NIDCAP and Conclusion
To know the theory of narrative medicine helps us to under-
stand how narration plays a powerful role in NIDCAP for the 
parents, and the professionals. 

References: 
1. Charon R. Narrative Medicine: Honoring the Stories of Illness. 2006. Oxford University 

Press. 
2. Allen, G. Roland Barthes (1st ed.). 2003. Routledge. https://doi.

org/10.4324/9780203634424
3. Oishi E. Austin’s Speech Act Theory and the speech situation, Esercizi Filosofici 2006, 1 

(1):1-14. ISSN 1970-0164

Narrative Medicine and NIDCAP: What Can We Learn 
From Each Other?
Frédérique Berne Audeoud
University Hospital of Grenoble, France

DOI:10.14434/do.v16i1.35768

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