University of Bristol Business School, Bristol, UK.
School of Business and Management Royal Holloway, University of London Egham.
Soc Sci Med. 2022 Dec;314:115494. doi: 10.1016/j.socscimed.2022.115494. Epub 2022 Oct 31.
Taking an institutional logics perspective, this study investigates how "internet-informed" patients manage tensions between the logic of personal choice and the logic of medical professionalism as they navigate treatment decisions and the patient-doctor relationship. Based on 44 semi-structured interviews with members of an online health community for people with diabetes, this study finds that patients exercise a great deal of agency in evaluating healthcare options not only by activating the logic of personal choice but also by appropriating the logic of medical professionalism. Furthermore, patients are strategic in deciding what community advice to share with their doctor or nurse depending on the healthcare professionals' reaction to the logic of personal choice. In contrast to many previous studies that emphasise patient consumerism fuelled by information on the Internet, this study provides a more nuanced picture of patient-doctor relationship engendered by patients' participation in online health communities.
本研究从制度逻辑视角出发，探讨了“互联网知情”患者在决策治疗方案和医患关系时，如何应对个人选择逻辑与医学专业主义逻辑之间的紧张关系。通过对一个糖尿病患者在线健康社区的 44 名成员进行半结构化访谈，本研究发现，患者在评估医疗保健选择时行使了很大的自主权，不仅通过激活个人选择逻辑，还通过采用医学专业主义逻辑。此外，患者根据医疗保健专业人员对个人选择逻辑的反应，在决定与医生或护士分享哪些社区建议方面具有策略性。与许多强调互联网信息推动的患者消费主义的先前研究不同，本研究更细致地描绘了患者参与在线健康社区所带来的医患关系。
