title: Exploring the Legacies of Filmed Patient Narratives: The Interpretation and Appropriation of Patient Films by Health Care Staff.
abstract: We trace the legacies of filmed patient narratives that were edited and screened to encourage engagement with a participatory quality improvement project in an acute hospital setting in England. Using Gabriel's theory of "narrative contract," we examine the initial success of the films in establishing common grounds for participatory project and later, and more varied, interpretations of the films. Over time, the films were interpreted by staff as either useful sources of learning by critical reflection, dubious (invalid or unreliable) representations of patient experience, or as "closed" items available as auditable evidence of completed quality improvement work. We find these interpretations of the films to be shaped by the effect of social distance, the differential outcomes of project work, and changing organizational agendas. We consider the wider conditions of patient narrative as a form of quality improvement knowledge with immediate potency and fragile or fluid legitimacy over time.
authors.affiliation: King's College London, London, United Kingdom mary.adams@kcl.ac.uk.
authors.forename: Mary
authors.initials: M
authors.lastname: Adams
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Glenn
authors.initials: G
authors.lastname: Robert
authors.affiliation: King's College London, London, United Kingdom.
authors.forename: Jill
authors.initials: J
authors.lastname: Maben
mesh_terms: D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001943:Breast Neoplasms; D004739:England; D005260:Female; D006761:Hospitals; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D033262:Narration; D009726:Nurses / Q000523:psychology; D019982:Organizational Case Studies; D009936:Organizational Innovation; D018802:Patient-Centered Care; D010361:Patients / Q000523:psychology*; D010820:Physicians / Q000523:psychology; D011369:Professional-Patient Relations; D058996:Quality Improvement; D014741:Video Recording
keywords: health care, users’ experiences; health care, work environment; knowledge construction; participatory action research (PAR); quality improvement; research; stories / storytelling; visual methods