Suchergebnisse

Variations in the distribution of power have been used to account for and to advocate different types of doctor-patient relationship. It might be expected that doctors who become patients would have a 'mutual' relationship with their treating doctor. Data from interviews with doctors with a recent illness show that this is not necessarily the case and may not even be doctors' preferred model of doctor-patient relationship for themselves when they become ill. Doctors constitute anomalous patients since they confound two categories generally held to be separate, 'doctor' and 'patient'. This affects the type of medical encounter they have, raising issues of identity and role performance for both patient and treating doctor. Doctor/patients may be in control of the encounter (through choice or default); they may consciously choose or have explicitly ascribed to them the status of 'ordinary patient'; some believe that doctors should be treated as extraordinary patients with particular needs dependent on their insider status as much as their pathology, The negotiation of power in the encounter between doctors and medically qualified patients is problematic but the existence of the power differential in the medical encounter emerges as 'natural' and largely as desirable, since it is linked to the ability and authority to take charge of the disorder which illness represents.

This paper examines citizen participation in health research, where funders increasingly seek to promote and define 'patient and public involvement' (PPI). In England, the focus of our study, government policy articulates a specific set of meanings attached to PPI that fuse patients' rights and responsibilities as citizens, as 'consumers' and as 'lay experts'. However, little is known about the meanings those who take part in PPI activities, attach to this participation. Drawing on ethnographic data of PPI in three clinical areas (stroke, cancer and pre-term birth) we investigate citizen participation in health research as political ritual. We identify tensions between policy-driven and ground-level performance of citizenship, and use ritual theory to show how such tensions are accommodated in participatory structures. We argue that the ritual performance of PPI neutralises the transformational potential of citizen participation, and we draw wider sociological implications for citizen participation beyond the health arena.

BACKGROUND: Lay involvement in implementation of research evidence into practice may include using research findings to guide individual care, as well as involvement in research processes and policy development. Little is known about the conditions required for such involvement. AIM: To assess stroke survivors' research awareness, use of research evidence in their own care and readiness to be involved in research processes. METHODS: Cross sectional survey of stroke survivors participating in population-based stroke registers in six European centres. RESULTS: The response rate was 74% (481/647). Reasons for participation in register research included responding to clinician request (56%) and to 'give something back' (19%); however, 20% were unaware that they were participating in a stroke register. Research awareness was generally low: 57% did not know the purpose of the register they had been recruited to; 73% reported not having received results from the register they took part in; 60% did not know about any research on stroke care. Few participants (7.6%) used research evidence during their consultations with a doctor. The 34% of participants who were interested in being involved in research were younger, more highly educated and already research aware. CONCLUSIONS: Across Europe, stroke survivors already participating in research appear ill informed about stroke research. Researchers, healthcare professionals and patient associations need to improve how research results are communicated to patient populations and research participants, and to raise awareness of the relationship between research evidence and increased quality of care. ; This paper was written on behalf of the European Implementation Score (EIS) project, funded by the EU 7th Framework Programme.