What Can TA Learn from Patient Narratives: Using Narrative Methodology to Assess the Role of Patients in Dutch Hospitals

Using narrative methodology, we assess the feasibility of the active and independent patient, an image portrayed in Dutch government papers and contested by patient organizations, medical occupational groups and political parties. 109 stories about hospital care from 103 patients were collected online. Storyline analysis resulted in nine experience types that describe prototypical situations in which patients find themselves in the hospital. These nine types offer a rich picture of patient perspectives on quality and safety of hospital care. Being in the hospital creates a tension for the patient. On the one hand, many patients are scared and become silent. On the other hand, many patients feel the need to speak out, and to be involved in their own care trajectory. We argue that this tension cannot be taken away, as it is a part of being a patient in a hospital. Instead, we propose that the hospital system should be designed in such a way that sensitivity for this tension is taken into account. Patient narratives could be fruitfully deployed for this purpose. Our study shows that narrative research is a promising method for TA as it offers a tool for identifying contextualised dilemma’s experienced by stakeholders and users of large socio-technical systems.