Patient involvement and institutional logics: A discussion paper

Area of Science:

• Health Services Research
• Sociology of Health
• Patient Engagement

Background:

• Patient involvement initiatives frequently neglect the impact of cultural and structural determinants.
• Understanding these factors is crucial for effectively translating patient involvement ideals into practice.

Purpose of the Study:

• To explore challenges in implementing patient involvement by examining cultural and structural influences.
• To contribute a theoretical framework for addressing contextual and structural factors in patient involvement.

Main Methods:

• Utilized the concept of "institutional logics" to analyze differing interpretations of patient involvement.
• Drew upon examples from the authors' own research to illustrate these interpretations and their conflicts.
• Proposed the expansion of theoretical models with a "patient logic" for future healthcare systems.

Main Results:

• Demonstrated how distinct "institutional logics" lead to varied understandings and applications of patient involvement.
• Highlighted the conflicts arising when these different interpretations of patient involvement compete during implementation.
• Showcased how cultural and structural factors shape the conversion of patient involvement intentions into interventions.

Conclusions:

• Existing approaches to patient involvement require enhancement to adequately address cultural and structural contexts.
• The concept of "institutional logics" provides valuable insights into the diverse interpretations of patient involvement.
• An expanded theoretical model, incorporating a "patient logic," is necessary for advancing patient involvement in evolving healthcare systems.