Using the literary folkloristic method to understand why people refuse medical interventions

BACKGROUND: Biomedicine is the dominant model in Western medicine. This regards disease as an identifiable reality located in people's bodies and best managed through medical interventions. Biomedicine has limited recognition of the effects of societal and cultural forces on health behaviours, so those who reject medical advice are problematic. This highlights the need for a method that considers the wider range of experiences that influence health behaviours. AIM: To describe the use of the literary folkloristic method to understand why people refuse medical interventions that reduce the risk of disease. DISCUSSION: This paper describes an innovative approach that was useful in understanding why people refuse conventional medical interventions. The literary folkloristic method provided a contextualised narrative of the experiences of high-risk women who refused risk-reducing surgery. Their stories revealed how their understandings of the risks from cancer contrasted starkly with the dominant medical discourse, ultimately leading them to reject interventions that could potentially save their lives. CONCLUSION: The literary folkloristic method gave voice to those who might otherwise have been silenced by the healthcare system. IMPLICATIONS FOR PRACTICE: Nurses and nurse researchers can influence policy and practice by offering alternative understandings of poorly understood phenomena, such as patients refusing medical interventions. It is important healthcare providers approach this from the viewpoints of those directly involved, since strategies to support patients may be ineffective without such understanding.