Developing person-centred care through the use of autobiography

Background: Postnatal psychosis is a serious psychiatric emergency that can have tragic consequences for the mother and child if the symptoms are not recognised early. An autobiographical account of this condition gives clinicians and researchers a unique opportunity to explore how a patient may view their episode of postnatal psychosis, and how when this account is interpreted through a biomedical lens, new person-centred treatment possibilities can be developed. Aim: This paper aims to demonstrate how to understand a woman's lived experience of postnatal psychosis by examining an autobiographical account of the condition, found in The Book of Margery Kempe. Research design: A qualitative research design based on a textual analysis approach was used. Methods: The text was read against the domains of the common-sense model of illness (identity, cause, consequence, control-treatment, control-personal, coherence and emotional representation). Specific extracts were categorised into each domain and read closely to determine how a patient's account of their illness can be interpreted usefully for healthcare plans. Results: The autobiographical account of postnatal psychosis gives fresh insights into how patients reconstruct the condition from memory and what meaning they may attribute to the cause, progression, treatment and outcome of the illness. Conclusions and implications for practice:Autobiographical accounts of a patient's lived experience of illness can be powerful educational tools that healthcare professionals can use to develop a person-centred approach to treatment; Autobiography demonstrates how not listening to a patient can have a devastating effect on the treatment a patient receives; If researchers and clinicians come to understand how the patient makes meaning of their illness, treatment and care plans can take a more individualised and person-centred approach that could promote positive health outcomes and greater patient satisfaction.