Actors, patients and agency: a recent history

Armstrong, David

doi:10.1111/1467-9566.12100

Cited by 89 publications

(73 citation statements)

References 56 publications

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“…On a theoretical front, we would argue that the talk of our respondents reflects on central features of what sociologists have referred to as the structure/agency debate (Armstrong, 2014;Giddens, 1984). This is especially in so far as such talk so clearly connects individual 'behaviour' to civic, social, political and physical structures far more strongly than to motives and personal preferences.…”

Section: And I Know It's Not Your (Ie the Moderator's) Remit But Imentioning

confidence: 99%

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Prior¹,

Scott²,

Hunter³

et al. 2014

Social Science & Medicine

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It is now recognised that inactive lifestyles underpin much of the disease burden evident in the richer nations of the world. Indeed, the WHO has identified physical inactivity as a 'global public health problem' and has established minimum physical activity (PA) targets for people at different stages of the life-course. Yet, according to WHO, just under 1/3 of working age adults across the globe meet those targets and it is not at all clear how the disjunction between the recommendations of policy makers and the behaviour of ordinary people might be surmounted. Using an opportunity to examine the impact of an urban regeneration project on community residents in East Belfast (Northern Ireland) this paper examines the views of some 113 people on how to increase rates of PA in an area of multiple deprivation. The results of the analysis suggest that lay people rarely consider PA as a discrete issue, or one that centres on individuals and their motivation, but rather as one component in a complex web of concerns, processes and events that include such things as the actions of neighbours and relatives, material and political environments, vandalism, violence, and the weather. We explore and unravel the nature of those concerns using novel methods of content analysis that generate 'issue webs'. Particular attention is paid to the ways in which lay people conceptualize 'activity' and to the manner in which they point to ways of encouraging activity that are rooted in everyday life rather than in the corpocentric, agent-centred, and sport dominated strategies favoured by local policy makers. Our results support those who argue that interventions to increase rates of PA need to move beyond behavioural approaches that focus on individuals and consider the social, political and material contexts in which 'activity' occurs. Research Highlights. Challenges the dominance of behavioural approaches to public health interventions. Supports a social ecology perspective on policy relating to physical activity. Introduces the notion of 'issue webs' as a focus for qualitative research. Explores the complexity of public health problems in a conflict zone.

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Section: And I Know It's Not Your (Ie the Moderator's) Remit But Imentioning

confidence: 99%

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Prior¹,

Scott²,

Hunter³

et al. 2014

Social Science & Medicine

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“…Pasienter forstås dermed som å ha «agency», dvs. muligheten for individuell, selvstendig handling (Armstrong, 2014), i stedet for å vaere objekter mer eller mindre prisgitt helsepersonells vurderinger og beslutninger. Dette innebaerer ifølge Armstrong (2011) at pasienter har gått fra å tidligere ha sykdom til nå i større grad å erfare/oppleve sykdom.…”

Section: Individualisering Som Medbestemmelseunclassified

“…Standardisering forbindes, som tidligere beskrevet, ofte med noe kjedelig, likt og undertrykkende for individuelle uttrykk, som noe entydig determinerende og dehumaniserende (Timmermans og Epstein, 2010). Individualisering knyttes derimot ofte til noe som er frigjørende for individet, hvor pasienter forstås som å ha mulighet for selvstendig handling i stedet for å vaere objekter underlagt helsepersonells kontroll (Armstrong, 2014). Vi ser i våre tekster at forståelsene av standardisering og individualisering beskrevet over, delvis skrives frem på lignende måter og delvis skrives frem på helt andre måter -og at forståelsen også skifter i løpet av tekstenes ulike deler.…”

Section: God Pasientbehandling Som Standardisering Og Individualiseringunclassified

Individualisert standardisering?

Håland¹,

Melby

2017

NOST

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FørsteamanuensisInstitutt for pedagogikk og livslang laering, NTNU erna.haland@ntnu.no Line MelbySeniorforsker SINTEF Teknologi og samfunn, avd. helse line.melby@sintef.no SAMMENDRAG Dagens helsevesen er preget av stadig økende krav om standardisering av pasientbehandling på den ene siden og stadig økende krav om individualisering av pasientbehandling på den andre siden. Med utgangspunkt i en analyse av politisk diskurs, undersøker vi i denne artikkelen hvordan god pasientbehandling -uttrykt som individualisering og standardisering -blir til i politiske taler som omhandler innføring av pakkeforløp for kreft. Vi finner at det argumenteres for en form for individualisert standardisering hvor pasienten skal få det beste fra to verdener. Talene henter dermed argumenter fra begge diskurser for å kommunisere en mer overordnet helsepolitisk strategi hvor organisering og ikke mer penger lanseres som løsning på helsepolitiske utfordringer, eksemplifisert gjennom innføringen av pakkeforløp for kreft. Nøkkelord:Helsetjeneste, individualisering, organisering, pakkeforløp for kreft, standardisering This article is downloaded from www.idunn.no.

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“…The management and control of patient choices and practices through cultural and institutional means has been a mainstay of health sociology since Talcott Parsons' investigations into the 'sick role' (Willis, 2015;Armstrong, 2013). Sociologists have demonstrated that individual choices and experiences are partly the consequence of the knowledge they bring to their interactions with healthcare practitioners, but these interactions are themselves structured and constrained by widespread public discourses about healthcare, as well as by the organisation of the healthcare setting itself, for instance by its payment systems (Shim, 2010).…”

Section: Introductionmentioning

confidence: 99%

Knowledge matters: producing and using knowledge to navigate healthcare systems

Willis

Collyer

Lewis

et al. 2016

Health Sociology Review

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In many contemporary healthcare systems, individuals are expected to be rational actors -weighing up available knowledge and making choices about their healthcare needs. In the policy context this has been most explicitly applied to the financing of healthcare where there is encouragement for the purchase of private health insurance. However, perceptions of public and private healthcare provision, knowledge about healthcare needs, and the types of services people choose, are far from straightforward. Drawing on Bourdieu's concepts of habitus, field and capital, and a study of individual experiences of choice in Australian healthcare, we explore the knowledges used by people as they navigate through the healthcare system. Such navigation takes place in a milieu where authoritative medical knowledge intersects with knowledge from other sources, including the Internet and lived experience. However, our study reveals that navigation of healthcare is assisted most of all by the capacity to draw on 'system knowledge'. System knowledge takes two, sometimes overlapping, forms. First, acquired system knowledge is produced through drawing on experience, formal knowledge and the capacity to undertake research (primarily cultural capital). Second, assumed system knowledge enables navigation of the healthcare system through accessing and utilising networks of privilege (primarily economic and social capital).

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Actors, patients and agency: a recent history

Cited by 89 publications

References 56 publications

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Individualisert standardisering?

Knowledge matters: producing and using knowledge to navigate healthcare systems

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