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Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are unable to participate in the design process. Although the reduced participation of a particular user group may harm the end result, the literature on solving this issue is sparse. In this article, proxy design is outlined as a method for involving a user group as proxy users to speak on behalf of a group that is difficult to reach. The article investigates the following research question: How can roleplaying be embedded in co-design to engage users as proxies on behalf of those who are unable to represent themselves?

The article presents a design ethnography spanning three years at a cancer rehabilitation clinic, where digital artifacts were designed to be used collaboratively by nurses and patients. The empirical data were analyzed using content analysis and consisted of 20 observation days at the clinic, six proxy design workshops, 21 telephone consultations between patients and nurses, and log data from the digital artifact.

The article shows that simulated consultations, with nurses roleplaying as proxies for patients ignited and initiated the design process and enabled an efficient in-depth understanding of patients. Moreover, the article reveals how proxy design as a method further expanded the design. The study findings illustrate: (1) proxy design as a method for initiating design, (2) proxy design as an embedded element in co-design and (3) six design guidelines that should be considered when engaging in proxy design.

The main contribution is the conceptualization of proxy design as a method that can ignite and initiate the co-design process when important users are unreachable, vulnerable or unable to represent themselves in the co-design process. More specifically, based on the empirical findings from a design ethnography that involved nurses as proxy users speaking on behalf of patients, the article shows that roleplaying in proxy design is a fitting way of initiating the design process, outlining proxy design as an embedded element of co-design.

Contrary to want-based services, customer participation has got lesser attention in high-credence services like health care. Customer participation for patients with chronic illnesses could be life-threatening and goes beyond the service organization’s physical environment. Realizing the importance of transformative service research in health-care services, this study aims to propose and validate the conceptualization of customer participation for patients with chronic illnesses.

The study uses sequential exploratory research design with mixed method research. The first phase is a qualitative exploration of the nature and meaning of customer participation by synthesizing theory and insights from semi-structured interviews (N = 75) with doctors, patients and paramedical staff. Next, survey data (N = 690) of patients with chronic illnesses is used to validate the proposed conceptualization. Finally, nomological validity was also tested on an additional survey data set (N = 362) using SEM and FsQCA.

The findings reveal that health-care customer participation is a three-dimensional behavioral construct in which a customer can participate by sharing information, involving in decision-making and ensuring compliance. The study also demonstrates that customer participation is a critical driver of satisfaction with life and perceived control on illness.

The research provides policy guidelines for owners and operators of health-care organizations in developing frameworks for collecting participation data, which can be used in strategies for seeking customer participation.

The research conceptualizes and validates “customer participation” as a multidimensional higher-order construct for patients with chronic illnesses, rarely focused in services marketing and management research on health care.

Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.

Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.

The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.

This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

The mental healthcare is experiencing an ever-growing surge in understanding the consumer (e.g., patient) engagement paradox, aiming to vouch for the quality of care. Despite this surge, scant attention has been given in academia to conceptualize and empirically investigate this particular aspect. Thus, drawing on the Stimulus-Organism-Response (S-O-R) paradigm, the study explores how patients engage with healthcare service providers and how they perceive the quality of the healthcare services.

Data were collected from 279 respondents, and the derived conceptual model was tested by using Smart PLS 3.2.7 and PROCESS. To complement the findings of partial least squares (PLS)-based structural equation modeling (SEM), the present study also applied fuzzy set qualitative comparative analysis (fsQCA) to identify the necessary and sufficient conditions to explore substitute conjunctive paths that emerge.

Findings show that patients’ perceived intimacy (PI), cohesion and privacy enhance the quality of mental healthcare service providers. The results also suggest that patients’ PI, cohesion and privacy have indirect effects on the perceived quality of care (PQC) by the service providers through consumer engagement. The fsQCA results derive that the relationship among conditions leading to patients’ perception of the quality of care in regard to mental healthcare service providers is complex and is best reflected as multiple and conjectural causation configurations.

The findings from this research contribute to the advancement of studies on patients’ experiences by empirically examining the unique dynamics of interaction between consumers (patients) and mental healthcare service providers, thereby enriching both the literature on social interactions and the understanding of the consumer–provider relationship.

The results of this study provide practical implications for mental healthcare service providers on how to combine the study variables to enhance the quality of care and satisfy more patients.

A significant research gap has ascertained the inter-relationship between PI, cohesion, privacy, engagement and PQC from the perspective of mental healthcare service providers. This research is one of the primary studies from a managerial and methodological standpoint. The study contributes by combining symmetric and asymmetric statistical tools in service marketing and healthcare research. Furthermore, the application of fsQCA helps to understand the interactions that might not be immediately obvious through traditional symmetric methods.

This research paper aims to explore how social intrapreneurs use serious games to generate social innovation. In particular, the study depicts the coproduction process between caregivers acting as intrapreneurs, patients and other stakeholders, and unveils the contributions of serious games and their key features in producing social innovation within healthcare facilities.

Through an original case study, the article analyzes a social innovation initiated by caregivers in the French care eco-system. Primary and secondary data were used to observe and examine the successful implementation of a serious game. Specifically, caregivers in hospital designed a game that helps children overcome the stress and anxiety inherent to their hospital journey.

Results unveil the role of social innovations as catalyst of social intrapreneurship and the coproduction of services. In the healthcare setting, serious games both participate in improving the stay of child in hospitals, and in facilitating the working conditions of caregivers.

This article brings together the theoretical background of social intrapreneurship, social innovation and serious games. The successful implementation of social innovation depends on the intrinsic features of social intrapreneurs, coupled with those pertaining to serious games. The positive outcome of social innovation benefits both internal and external stakeholders. Such innovation improves the end users' experience, as the latter participate in the coproduction of their own care.

It is over 20 years since the publication of the Wanless Report, “Securing our Future Health: Taking a Long-Term View”. The Wanless Report argued that the National Health Service (NHS) would survive in its current form only if the population became “fully engaged” with it.

In this discussion paper, the authors explored what “fully engaged” meant to Wanless, what it might mean now (allowing for the impact of the anti-vaxxer movement) and what policymakers could do to enhance public engagement.

Although the Wanless Report neatly fitted into other long-term thinking about the NHS, it was unique in that it built economic models to predict the costs and impact of different patterns of NHS performance. Wanless predicted that people’s poor levels of health would put considerable pressure on the NHS. This pressure could swamp efforts to meet healthcare targets and improve health outcomes, despite its sizeable investment of money. Wanless set out three possible scenarios for public engagement with the NHS: solid progress, slow uptake and fully engaged.

The authors pose questions for policymakers and practitioners. Would a reboot of the Wanless approach be worth the effort for policymakers? If yes, how would it differ from the original? The NHS faces the whole of society; could it be the vehicle for engaging the anti-vaxxer public with the truthfulness of medical science, and will it be this, that is, Wanless' enduring legacy?

The exploration of the Wanless Report is complicated (at least for the time being) by the rise of the anti-vaxxer movement’s resistance to health promotion and mistrust of part of the NHS.

This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow assessment, providing information on the demographic characteristics, referral trends, co-occurring health conditions and reasons for referrals highlighting the complex health-care needs of this population.

This study used a standardised patient data extraction method over a six-month period involving 74 adults with ID referred to speech and language therapy for swallow assessment.

This study revealed a high prevalence of dysphagia among adults with ID referred to speech and language therapy for swallow assessment. Increasing age and severity of ID were associated with an increased likelihood of swallowing difficulties. Co-occurring health conditions such as mobility difficulties, epilepsy and gastrointestinal conditions were prevalent, suggesting that adults with ID and swallowing difficulties are often living with complex health conditions. Choking incidents and hospital admissions were primary reasons for referral.

This study stresses the pressing need for strategies to mitigate risks associated with choking incidents and hospital admission among this vulnerable population. Possible limitations include a reliance on referral and the focus being on a single service over a short period which may limit generalisation to the wider ID population.

This study emphasises the need to understand each person’s unique profile of health needs and the value of a specialised speech and language therapy service.

The importance of increasing awareness among caregivers and medical experts is highlighted.

The findings underscore the importance of tailored assessment, caregiver involvement and heightened interdisciplinary awareness to effectively manage dysphagia in individuals with ID.

This study aims to explore the effects of cat-assisted therapy (Ca-AT) on a patient in their homes, specifically investigating the effects on patient’s memory, behavioral pathology and ability to perform activities of daily living, independently.

A case study design was used in patient’s homes using three measuring scales, namely, Mini-Mental State Examination (MMSE), Barthel index (BI) and Behavioral Pathology in Alzheimer’s Disease (AD) Rating Scale.

The MMSE and BI mean scores were increased, whereas the Behavioral Pathology mean score was decreased. Patient negative behaviors were improved specifically, aggressiveness, anxieties, phobias, and caregiver burden was decreased.

Patients with AD could significantly benefit from Ca-AT in their own homes, and it could decrease caregiving burden.

Ca-AT is a newly developed type of animal-assisted therapy that uses cats to treat patients, especially elderly people with AD, in their homes.

The purpose of this study is to capture patients' and employees' perception of quality of care in the Indian private hospitals and to find the possible perceptual gaps between both the groups.

Authors have referred to the Victorian patient satisfaction monitoring (VPSM) scale and studied the responses of 327 patients and 327 employees collected from six private Indian tertiary care hospitals. SPSS v26 software was used to conduct the data reliability test, descriptive analysis and Mann–Whitney U test.

Authors have found significant differences in perceptions of quality of care between the patients and employees in the Indian hospitals. Employees have high positive perceptions towards the provided medical care whereas the patients have less favourable perceptions for many quality indicators.

This study findings help the healthcare managers, practitioners and healthcare workers of the Indian hospitals to understand the perceptions of both the employees and the patients towards healthcare quality elements and help to reduce the existing perceptual gap in the process of providing quality healthcare services.

To the best of authors knowledge, this is one of the pioneering studies conducted in Indian healthcare industry to capture and compare the perceptions of both the employees' and the patients' perceptions of various quality of care elements. This study highlighted the existing perceptual gap between the employees and the patients on various healthcare quality elements and indicated the critical areas for improvement to provide high quality healthcare services.