Response to Gibson, L et al. ‘Childhood asthma: a narrative approach’, Chest 149 (1): 282-283

To the Editor: We thank Dr Gibson et al1 for their letter in support of our article advocating greater use of a narrative approach to enhance clinical care for asthma2 and their helpful reference to the Asthma UK survey in support of this. We agree that asking questions about symptoms and response to treatment is of key importance, and would also emphasize that a narrative approach involves much more than this. It is also about how the skills of open questioning and active listening are used to understand complex storied aspects of clinical work in patients with asthma; this also enables patients to describe the story of their illness in a way that is meaningful for them, allowing them to share decisions on treatment with their clinician (and other health-care providers) and, ultimately, to improve self-care. Falling under the rubric of a narrative approach is the need to explore the use of tone and metaphors in individuals’ narratives of asthma that, we argue, may provide clinicians with a key indicator of how patients are actually living and coping with asthma..