Developing a patient narrative interview guide using the Delphi method

Illness narratives are commonly elicited through interviews using structured or semi-structured tools. With the growing emphasis on patient-centered care and narrative medicine, interview guides should integrate both illness narratives and personal life stories. Such integration helps balance the “voice of medicine” with the “voice of the lifeworld,” fostering more holistic, empathetic, and contextually grounded communication between healthcare professionals and patients. Building on this perspective and the growing need in medical education, this study aimed to develop and validate a patient narrative interview tool and to evaluate its feasibility and usability through a pilot study. A preliminary version of the Patient Narrative Interview Guide (PNIG) was developed using a modified Delphi process and refined through three iterative rounds of consultation with 11 experts in narrative medicine, medical humanities, and medical education. Following expert consensus, three senior medical students each conducted a trial interview with a volunteer patient using the finalized guide. Feedback from students and patients was collected and analyzed using editorial analysis to explore perceptions of the PNIG and the interview experience, and to identify potential areas for improvement. The study produced a 26-item PNIG organized within a 3 × 4 multidimensional framework, comprising three lifeworld dimensions and four narrative processes. The narrative processes—forming, retrospective, reflective, and prospective—constitute a temporal sequence that supports a coherent interview flow. When mapped across the lifeworld dimensions (about illness, living with illness, and beyond illness), the framework provides a structured yet flexible approach to exploring patient experiences. Students perceived the PNIG as conceptually sound and practically useful for eliciting both medical and personal narratives, while patients described the interviews as meaningful and engaging. The PNIG is grounded in narrative medicine and patient-centered holistic care and demonstrates content validity through expert consensus. As a multidimensional interview tool, it extends beyond traditional disease-focused narratives and may facilitate deeper insight into patients’ lived experiences. Its use may support a more comprehensive understanding of patient experiences in medical education and, potentially, among healthcare professionals. Further evaluation in broader educational and clinical settings is warranted.