Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Thematic Studies - Child Studies, Linköping University, Linköping, Sweden.
Sociol Health Illn. 2020 Jan;42(1):50-64. doi: 10.1111/1467-9566.12985. Epub 2019 Aug 18.
Drawing from case examples of medication review implementation in three hospital settings in Sweden, this article examines patients' medication use. Based on a practice theory approach and utilising data from interviews with patients and participant observation, we reconstruct three practices of everyday medication use centring on accepting, challenging or appropriating medication orders. This article argues that patients' medication practices are embedded in wider practice arrangements that afford different modes of agency. Reconceptualising patients' medication use from a practice-based perspective revealed the meaning-making, order-producing and identity-forming features of these practices. Also, we illustrated how different modes of agency were achieved in patients' medication practices, suggesting a fluidity of both the meanings attached to and the identities related to medication use. Our findings have practical implications as these practices of medication use can be transformed when altering the arrangements they are embedded in, thus going beyond the clinical encounter.
本文从瑞典三家医院药物审查实施的案例中，研究了患者的药物使用情况。基于实践理论方法，并利用对患者的访谈和参与观察数据，我们重构了以接受、质疑或采用药物医嘱为中心的三种日常用药实践。本文认为，患者的用药实践嵌入在更广泛的实践安排中，为不同的代理模式提供了可能。从基于实践的角度重新构想患者的药物使用情况，揭示了这些实践的意义建构、秩序产生和身份形成的特征。此外，我们还说明了在患者的药物实践中是如何实现不同的代理模式的，这表明与药物使用相关的身份认同和意义具有流动性。我们的研究结果具有实际意义，因为当改变药物使用所嵌入的安排时，这些药物使用实践可以被改变，从而超越临床接触。
