Background: Cancer is a disease that disrupts not only the patient’s life, but that of the entire family as well, from a care, organizational, and emotional perspective. Patients share their experience of illness frequently with their informal caregiver (IC), a partner, son/daughter, friend, volunteer, or any other person in the family or social network who offers to support them during their clinical journey. The purpose of this study was to investigate ICs’ still unknown cancer experiences through the stories of IC participants in a Literary Artistic Competition the Centro di Riferimento Oncologico di Aviano (CRO) IRCSS organized, and understand the themes that emerged from their texts and hence, the power of expressive writing. Materials and methods: A qualitative study was carried out on literary texts using Mishler’s three levels of narrative analysis: thematic (to detect themes and subthemes); structural (to support the thematic level), and performative (to understand the narratives’ meaning). In addition, the narratives were classified based on Kleinman and Frank’s models. A particular focus was placed on the language of the narratives to identify figures of speech, e.g., metaphors related to cancer. Results: Seven main themes emerged from the 40 stories’ thematic analysis: perceptions of the disease; biographical breakdown; relationships; transformation of the sick body; IC’s role; encounter with death; and strength of memory. The ICs’ stories also highlighted the strengths and weaknesses of the patient’s clinical pathway. ICs are a resource not only for the patient, who, thanks to them, is assured of continuous assistance but also for the healthcare organization, above all because they serve a relational role as a “bridge” between patients and healthcare workers. ICs have important messages to offer to healthcare organizations. If involved adequately, they can provide a strategic strength in supporting patients and healthcare workers themselves. The in-depth analysis of the themes and subthemes in this study led the authors to hypothesize that expressive writing benefit ICs with respect to the possibility of sharing their experiences with others and giving evidence of their role. Their stories are a testimony that can help those who face a similar experience.

This book draws on research within neo-Weberian and neo-institutionalist perspectives to critically analyse National Health Services (NHSs) in Western Europe. Exploring the challenges posed by neo-liberal policies, it also looks at the impact of the role of the state, the medical profession, the public and the medical–industrial complex in their development. Bringing together a top-line range of expert international contributors, this book includes national studies from three European macro-regions: Britain, Scandinavia and the Mediterranean. In the first part, the NHSs of each country considered are examined historically and in a contemporary context in face of emerging challenges – from cost containment to governance. The second part looks across the macro-regions at the influence of the main actors involved in their evolution and sustainability. Comparing and contrasting the NHSs of Western Europe, the book ends with a discussion of future directions. This book makes a vital contribution at a time when health services globally have been under great pressure in the wake of the COVID-19 pandemic. It is written for academics and advanced students of healthcare, management, public policy, social policy and sociology – in addition to health professionals and policymakers.

The concept of a ‘Mediterranean paradigm’ was raised by Josep Figueras in 1994 as a distinctive Southern European model for the health care systems of Italy, Spain and Greece based on the basis of six factors. The subsequent debate (including Portugal, too) is reconstructed on the basis of pros and cons arguments. The specific contribution of the author to the debate - consisting in the proposal of the concept of ‘health macro-region’ as an analytic tool to pursue a more comprehensive approach in comparative terms on the basis of a connectionist model - is then presented in details by showing the peculiar characteristics of the Southern European health macro-region. Finally, an historical perspective involving three different kinds of temporality (long, middle and short span) is proposed in order to explain both the substantial similar timing (diachronic convergence) and, at the same time, the significant differences (synchronic divergences) among Southern European health care systems in the way and levels their national health services were implemented.

Questo intervento ha lo scopo di presentare la nascita e l’evoluzione delle Medical Humanities a livello internazionale sia in senso spaziale che temporale, nell’intento di mostrare come ciò che viene definito “Medical Humanities” non costituisca un ambito statico, ma sia il risultato di un processo di diffusione culturale nel quale l’ampliamento della dimensione spaziale dal Nordamerica all’Europa e, successivamente, agli altri continenti ha coinciso con una evoluzione significativa sul piano temporale, che ha comportato l’attribuzione di significati diversi a questo ambito di studi di natura multi o interdisciplinare.