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Innovating service while fighting cancer?: User involvement, motivation, and patient well-being
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Purpose – The purpose of this paper is to examine the motives and experiences service users have to participate in service innovation and how participation effects of the relationship with the caregiver.

Method –Twenty-five patients agreed to participate in the project, in which they were asked to use a diary to record their reflections and ideas for innovations. Fourteen participants completed the task, and we performed additional in-depth interviews with six of these. Using the NVIO software, we applied the theoretical framework to perform a qualitative analysis of the patients’ contributions and the interviews.

Findings – We propose a range of motives from patients being not-interested; believing that participation will give restitution; participating as a form of sociality; feeling an obligation and finally as enjoyment. As patients engaged in the service innovation initiative we also assessed the ways in which involvement may affect quality-of-life. We here use the dimensions of well-being, psychological, physical, existential and support to categorize these influences. The participation seems to have affected two of these dimensions – psychological well-being and support, more than the other two.

Practical implications – We propose that user involvement initiatives should be evaluated not only in terms of the improvements to the service process, but also on the outcomes to the individual user. This study shows that, to the participant, involvement in service innovation is an important event in the context of the relationship with the service provider and is deeply meaning-laden. While service innovation can be a positive and transformative experience, important ethical dilemmas also emerge.

Originality/value – Little research has been conducted into user involvement from a service users’ point of view. This article studies shows the impact user involvement has on the user and the relationship with the service provider.

National Category
Reliability and Maintenance
Identifiers
URN: urn:nbn:se:liu:diva-106659OAI: oai:DiVA.org:liu-106659DiVA: diva2:717867
Available from: 2014-05-19 Created: 2014-05-19 Last updated: 2014-05-19Bibliographically approved
In thesis
1. Patient involvement and service innovation in healthcare
Open this publication in new window or tab >>Patient involvement and service innovation in healthcare
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) and innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005; Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Vargo and Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation.

Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought.

Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change.

Thirdly, the thesis explores patients’ motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients’ contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social- and meaningladen event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting.

Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare.

Abstract [sv]

Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bidrar till en strömning inom forskningen som menar att sjukvården kan förbättras genom en omdefiniering av patientrollen – från en roll som passiv mottagare till aktiv, samskapande aktör. Patienten kan ses som en resurs både i utförande av vården (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) och inom utveckling och innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Avhandlingen kombinerar sjukvårdsforskning (Anderson and Funnell, 2005; Nelson et al., 2002) med tjänsteforskning (Grönroos, 2006; Vargo and Lusch, 2008, 2004) i en forskningsansats som innefattar fyra vårdenheter och 68 patienter. Den utforskar tre aspekter av patientinvolvering och tjänsteinnovation.

För det första undersöks konceptet patientinvolvering genom en omfattande litteraturöversikt av den empiriska forskningen på området. Översikten leder till en konceptuell modell för att beskriva patientinvolvering: vad dess förutsättningar är, vilka former av patientinvolvering som finns och vad patientinvolvering leder till. Avhandlingen diskuterar även begreppet värde och hur patienter kan samskapa värde, utifrån perspektiv inom vårdforskning och tjänsteforskning.

För det andra föreslår avhandlingen en dagboksbaserad metod för att involvera patienter i tjänsteinnovation. Deltagande patienter skriver i denna metod ner sina ner sina idéer och upplevelser varje dag under två veckors tid. Mina kollegor och jag utvecklade metoden i samarbete med personal från de deltagande vårdenheterna och applicerade den på praktiken. Erfarenheterna från projektet och de deltagande patienternas bidrag användes för att utforska möjligheterna med patientinvolvering i utvecklingen av vården. Vi föreslår tre sätt att lära sig från det insamlade materialet: som direkta idéer till förbättringar; summerat till rapporter för att ge kvalitativ förståelse av andra kvantitativa mätningar; och enskilda patienters berättelser kan användas för att förmedla patientperspektivet i organisationen och mana till förändring.

För det tredje undersöker avhandlingen patienters motivation att bidra till tjänsteinnovation, ett hittills outforskat område. Genom en analys av patienters bidrag och genom intervjuer med deltagare finner vi att patienter motiveras att delta av en rad olika anledningar, från ett behov av upprättelse till en glädje av att utföra aktiviteten. Deltagandet uppfattas som en social och meningsfull händelse. Patienter upplever psykiskt välbefinnande och stöd genom att delta, även om sjukdom kan vara ett hinder i deltagandet. Avhandlingen undersöker även hur de allra mest motiverade patienterna kan identifieras och inkluderas i tjänsteinnovation, detta inspirerat av lead  user-metoden (von Hippel, 1986).

Sammantaget utforskar avhandlingen patientinvolvering och tjänsteinnovation från nya perspektiv och bidrar därmed till våra gemensamma ansträngningar för att förbättra vården och patienters välbefinnande.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. 91 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1604
Keyword
Patient Involvement, participation, co-creation, patient empowerment, user involvement. patient centered care, motivation, user experiences, co-creation, service development, service innovation, service design, health care, lead users, diary, value
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-106661 (URN)10.3384/diss.diva-106661 (DOI)978-91-7519-304-5 (ISBN)
Public defence
2014-05-28, A-cas, A-huset, Campus Valla, Linköpings universitet, Linköping, 13:15 (English)
Opponent
Supervisors
Available from: 2014-05-19 Created: 2014-05-19 Last updated: 2014-06-17Bibliographically approved

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Engström, JonElg, Mattias

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