Patients, Families, and Care Settings

Abstract

Involving patients and family members as “experts by experience” in health care research and delivery has become accepted practice. There is a growing reliance on patients to manage their own care, and on families to provide support and informal care in wider settings. It is perhaps surprising, therefore, that patients, families, and informal care settings are absent in most discussions of context in health care. In part, this is because “context” in health service research has traditionally been explored through cross-sectional, “structural” studies at the macro- or mesosystem level, as opposed to taking a longitudinal and/or microlevel psychological perspective concerned with social dynamics or individual staff and patient interactions. The observations in this derive from collective experience in studying both health care organizations and the experiences of patients. Drawing on this corpus of research, this chapter explores the often-neglected role of patients and families in discussions of health care context.