Ironic Medications: A Narrative-Based Psycho-Educational Intervention to Explore Patient–Provider Communication in Adolescents With Haematological Cancer

Background: Adolescents with haematological malignancies face significant emotional and relational challenges, often accompanied by difficulties in communicating their needs within the healthcare context. To address these issues, a narrative-based psycho-educational intervention based on the creation and prescription of Ironic Medications was developed. These fictional remedies were designed to express emotions, experiences and needs in a playful yet meaningful way while exploring differences in how adolescents and healthcare staff perceive communication and relational needs. Procedure: The intervention unfolded in two phases: (1) weekly group sessions in which adolescents explored irony and storytelling while developing Ironic Medications addressing relational and communicative needs; and (2) a presentation of the medications to hospital staff followed by a metacognitive exercise exploring alignment in perceived needs. Quantitative surveys assessed the perceived usefulness of the medications and differences between adolescents' and healthcare professionals' perspectives. Results: Adolescents rated Ironic Medications as equally valuable for relational and communication needs, whereas staff mainly recognised their intragroup function, overlooking their intergroup communicative potential. Misalignments emerged at multiple levels: staff's self-prescriptions and predictions of adolescents' choices did not align with adolescents' actual prescriptions, with greater discrepancies among physicians than nurses. Adolescents prioritised normality (Normalvit) and relational support (Conversan), while staff emphasised confidence-building (Xpecta) and temporal relief (Temporil). Nurses showed greater alignment with adolescents but reported lower comfort in receiving Ironic Medications. Conclusions: The intervention revealed perspective-taking gaps between adolescents and staff. Ironic Medications fostered self-reflection, empathy and relational skills, suggesting a promising narrative-based tool to support patient-provider communication in adolescent oncology care.