TY - JOUR
T1 - Constructions of patient agency in healthcare settings
T2 - Textual and patient perspectives
AU - Hunter, Judy
AU - Franken, Margaret
AU - Balmer, Deborah
N1 - Funding Information:
The Health Literacy Project was funded by the Midlands Health Network (Grant MHNRP10.01 ) through a research project with the University of Waikato. The views expressed are those of the authors and do not necessarily represent those of the Midlands Health Network. To protect the privacy of practitioners and patients, Midlands Health recruited volunteer participants from their patient databases and medical personnel, according to our approved ethical protocols. Midlands Health did not contribute to or influence the actual data collection, analysis, or presentation.
Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - In healthcare settings, patient agency is variously represented and circumscribed through the language of health information texts, the discourses of health practitioners, and patient/practitioner interaction. Patients, as well, construct their identity and act as agents in various ways as they encounter the healthcare system and strive to manage their health conditions. This paper explores the notion of patient agency in healthcare settings and healthcare texts. The data comes from a health literacy project, commissioned by a New Zealand primary healthcare provider, and a Ph.D. project exploring the mediation and use of health information texts in a hospital setting. It draws on multiple data sources: text analyses on over 100 cardiovascular and diabetes information brochures, focus group interviews with cardiovascular and diabetes patients, and observations of patients' interactions with text in a hospital cardiovascular unit. These sources of data show ways that patient agency is represented and restricted and that identity is often constructed in conflict with patients' own conceptions of agency. The focus group interviews and hospital observations show how patients contest, accept, reject, and negotiate the identities constructed of them. As well, our data shows the contrast between patients' enacting agency and healthcare professionals' prescribed agency as compliance. Our sources of data confirm that knowledge of condition and care and associated agency are contingent on a constellation of affordances.
AB - In healthcare settings, patient agency is variously represented and circumscribed through the language of health information texts, the discourses of health practitioners, and patient/practitioner interaction. Patients, as well, construct their identity and act as agents in various ways as they encounter the healthcare system and strive to manage their health conditions. This paper explores the notion of patient agency in healthcare settings and healthcare texts. The data comes from a health literacy project, commissioned by a New Zealand primary healthcare provider, and a Ph.D. project exploring the mediation and use of health information texts in a hospital setting. It draws on multiple data sources: text analyses on over 100 cardiovascular and diabetes information brochures, focus group interviews with cardiovascular and diabetes patients, and observations of patients' interactions with text in a hospital cardiovascular unit. These sources of data show ways that patient agency is represented and restricted and that identity is often constructed in conflict with patients' own conceptions of agency. The focus group interviews and hospital observations show how patients contest, accept, reject, and negotiate the identities constructed of them. As well, our data shows the contrast between patients' enacting agency and healthcare professionals' prescribed agency as compliance. Our sources of data confirm that knowledge of condition and care and associated agency are contingent on a constellation of affordances.
KW - Agency
KW - Health literacy
KW - Patient identity
UR - http://www.scopus.com/inward/record.url?scp=84937950426&partnerID=8YFLogxK
U2 - 10.1016/j.dcm.2015.01.002
DO - 10.1016/j.dcm.2015.01.002
M3 - Article
AN - SCOPUS:84937950426
SN - 2211-6958
VL - 7
SP - 37
EP - 44
JO - Discourse, Context and Media
JF - Discourse, Context and Media
ER -
