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Elective surgical patients' narratives of hospitalization: The co-construction of safety

Doherty, C and Saunders, MNK (2013) Elective surgical patients' narratives of hospitalization: The co-construction of safety Social Science and Medicine, 98. pp. 29-36.

2013 Forthcoming Social Scienc and Medicine [patient safety].pdf - Accepted version Manuscript

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This research explores how elective surgical patients make sense of their hospitalization experiences. We explore sensemaking using longitudinal narrative interviews (n=72) with 38 patients undergoing elective surgical procedures between June 2010 and February 2011. We consider patients’ narratives, the stories they tell of their prior expectations, and subsequent post-surgery experiences of their care in a United Kingdom (UK) hospital. An emergent pre-surgery theme is that of a paradoxical position in which they choose to make themselves vulnerable by agreeing to surgery to enhance their health, this necessitating trust of clinicians (doctors and nurses). To make sense of their situation, patients draw on technical (doctors’ expert knowledge and skills), bureaucratic (National Health Service as a revered institution) and ideological (hospitals as places of safety), discourses. Post-operatively, themes of ‘chaos’ and ‘suffering’ emerge from the narratives of patients whose pre-surgery expectations (and trust) have been violated. Their stories tell of unmet expectations and of inability to make shared sense of experiences with clinicians who are responsible for their care. We add to knowledge of how patients play a critical part in the co-construction of safety by demonstrating how patient-clinician intersubjectivity contributes to the type of harm that patients describe. Our results suggest that approaches to enhancing patients’ safety will be limited if they fail to reflect patients’ involvement in the negotiated process of healthcare. We also provide further evidence of the contribution narrative inquiry can make to patient safety.

Item Type: Article
Divisions : Faculty of Arts and Social Sciences > Surrey Business School
Authors :
Doherty, C
Saunders, MNK
Date : 14 August 2013
DOI : 10.1016/j.socscimed.2013.08.014
Uncontrolled Keywords : UK, patients, safety
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in Social Science and Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Social Science and Medicine, 98, August 2013, DOI 10.1016/j.socscimed.2013.08.014.
Depositing User : Symplectic Elements
Date Deposited : 08 Nov 2013 10:04
Last Modified : 09 Jun 2014 13:45

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