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The Antecedents, Forms and Consequences of Patient Involvement: A Narrative Review of the literature
Linköping University, Department of Management and Engineering, Logistics & Quality Management. Linköping University, Faculty of Science & Engineering.
Linköping University, Department of Management and Engineering, Business Administration. Linköping University, Faculty of Science & Engineering.
2015 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 53, 351-378 p.Article, review/survey (Refereed) Published
Abstract [en]


Despite the centrality of patient involvement in the policy and rhetoric of health care, the theoretical and empirical basis for patient involvement is lacking at the micro-level of practice. The purpose of this narrative review is to provide an overview and synthesize the current empirical research related to patient involvement at the micro-level of health care.


Narrative review

Data sources: A database search was conducted (in Pubmed, CINAHL, Academic Search Premier, EconLit and PsycINFO) for articles published between 1990 and April 2015 in the field of patient involvement in health care. Out of 4238 references, 214 articles were eligible for this review.

Review methods We analyzed our sample using thematic analysis.


The reviewed articles revealed nine themes for patient involvement, concerning enablers; empowerment, patient education, communication for involvement, staff training, service systems, types; decision making, delivery, development, and consequences of patient involvement. The themes were synthesized into a tentative model that described patient-involvement research.


Our narrative review includes a wide variety of empirical studies on patient involvement in decision-making, delivery and development, and provides an integrative perspective suggesting that patient involvement should be viewed not only as isolated activities, but also as a result of educating and preparing patients, staff and systems.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 53, 351-378 p.
Keyword [en]
Patient involvement; Patient participation; Patient empowerment; Shared decision making; Self-management; Narrative review
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
URN: urn:nbn:se:liu:diva-121591DOI: 10.1016/j.ijnurstu.2015.09.008OAI: diva2:857048
Available from: 2015-09-27 Created: 2015-09-27 Last updated: 2016-05-04Bibliographically approved
In thesis
1. Health Care Customer Creativity
Open this publication in new window or tab >>Health Care Customer Creativity
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Crafting and stimulating service innovation is considered a main research priority and remains a challenge for service providers. One suggested component of stimulating service innovation is customer creativity. Customers who adapt, modify and transform services or products to better suit themselves are increasingly being recognized as a source of competitive value and innovation. It has been proposed that understanding and supporting the customer’s value creating practices is the key to creating and sustaining value over time in health care. Health services directly address a customer’s well-being and have a significant impact on his or her quality of life. In these types of services, the service outcome is highly dependent on the activities of the individual customer. Health care services often require customers to participate extensively, over long periods of time, with limited support and control. Health services also stretch far beyond the particular service setting into the customer’s daily life. While research, policy, and legislation have all emphasized the active role of health care customers, such customers have traditionally had few opportunities to design their health care services. Nevertheless, health care customers solve health-related problems and engage in self-care and medical decision-making on a day-to-day basis, although this creativity is often unknown to the service provider.

To understand how health care customers can enable service innovation, this thesis seeks to conceptualize and investigate the concept of customer creativity in health care. The thesis focuses on customer creativity, not only as an outcome, but also as a dynamic and contextualized process that can be enhanced. The thesis combines insights from health care research with service and innovation research to provide build a framework for health care customer creativity. Building on five papers, the research develops an understanding for health care customer creativity. The individual papers are based on systematic literature reviews as well as empirical data in the form of customers’ ideas for service innovation collected through diaries.

The results of the thesis suggest that despite the negative nature of the service, health care customers are creative. Given the opportunity, health care customers can provide creative ideas and solutions on a multitude of aspects, both within and outside the health care setting. This provides the potential to view the health care experience through the customers’ eyes and take part in their creativity in spheres where the service providers have not traditionally had any access. This thesis contributes to the literature by providing a framework for health care customer creativity that recognizes the concept as a complex interplay of factors operating at the individual, contextual, and situational levels. The proposed framework specifies the health care specific factors upon which customer creativity depends, with the intention of positing potential research directions and developing an enriched theory of health care customer creativity.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 98 p.
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1751
Customer creativity, service innovation, health care, co-creation, customer involvement
National Category
Reliability and Maintenance Health Care Service and Management, Health Policy and Services and Health Economy Reliability and Maintenance Other Medical Engineering Business Administration
urn:nbn:se:liu:diva-125723 (URN)10.3384/diss.diva-125723 (DOI)978-91-7685-807-3 (Print) (ISBN)
Public defence
2016-04-01, C3, C-huset, Campus Valla, Linköping, 10:15 (English)
Available from: 2016-03-01 Created: 2016-03-01 Last updated: 2016-04-18Bibliographically approved

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