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The purpose of this study is to explore how vulnerable healthcare consumers foster social support through visual storytelling in social media in navigating healthcare consumption experiences.

This study employs a dual qualitative approach of visual and textual analysis of 180 Instagram posts from female breast cancer patients and survivors who use the platform to narrate their healthcare consumption experiences.

This study demonstrates how visual storytelling on social media normalises hidden aspects of healthcare consumption experiences through healthcare disclosures (procedural, corporeal, recovery), normalising practices (providing learning resources, cohering the illness experience, problematising mainstream recovery narratives) and enabling digital affordances, which in turn facilitates social support among vulnerable healthcare consumers.

This study highlights the potential for visual storytelling on social media to address shortcomings in the healthcare service system and contribute to societal well-being through co-creative efforts that offer real-time and customised support for vulnerable healthcare consumers.

This research highlights that visual storytelling on image-based social media offers transformative possibilities for vulnerable healthcare consumers seeking social support in negotiating the challenges of their healthcare consumption experiences.

This study presents a framework of visual storytelling for vulnerable healthcare consumers on image-based social media. Our paper offers three key contributions: that visual storytelling fosters informational and companionship social support for vulnerable healthcare consumers; recognising this occurs through normalising hidden healthcare consumption experiences; and identifying healthcare disclosures, normalising practices and enabling digital affordances as fundamental to this process.

The purpose of this paper is to set out to explore how cancer patients and their carers perceive and evaluate the healthcare experience in order to develop and validate a classification framework for experience quality in healthcare.

The empirical work is centred on the systematic analysis of 200 cancer patient stories published on an independent healthcare feedback web site. Using the critical incident method, the authors captured 1,351 experience quality data items. Three judges independently sorted and classified these data items.

The authors identify and describe 22 main categories and 51 sub-categories that underlie the experience quality concept in healthcare and present them in a classification framework. The framework is informed through the categorisation of direct, indirect, and independent interactions. It also suggests a relationship between experience quality and satisfaction and loyalty behaviours.

This study provides researchers with a foundation for the further development and validation of a measurement scale for experience quality in healthcare.

The framework assists managers and healthcare professionals with the definition, evaluation, and improvement of the quality of the experience of patients and their carers.

The main contributions of this study lie in: first, a comprehensive classification framework for experience quality in healthcare; second, dimensions that extend existing health service quality models; third, dimensions that contextualise the generic concept of customer experience quality to healthcare.

This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.

This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.

In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.

The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.

This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.

Healthcare service is a process that comprises a series of touchpoints underlying the key facets of service delivery, collectively shaping the users' (i.e. patients, hospital staff, and visitors) experiences. Departing from most sensory studies dedicated to understanding the retail environment and hedonic service, this study focuses on how sensory knowledge can contribute to understanding the sensory-based experiences of hospital users and their interactions with healthcare services at multiple touchpoints.

This study employs a multi-method approach comprising two studies involving semi-structured interviews and a qualitative online survey of past patients.

Drawing upon the user-centered theory, the authors (1) consulted healthcare experts on hospital service touchpoints and standards around medical protocol; (2) explored users' needs, experiences, expectations, and evaluations of healthcare services; and (3) identified the issues and challenges faced by healthcare service users at various service touchpoints. Based on these insights, the authors proposed sensory tactics across healthcare service touchpoints that promote the well-being of major hospital users.

The proposed sensory tactics require follow-up empirical evidence. Future research could adopt robust methodological designs on healthcare environmental interventions and progress with a transdisciplinary approach to advance this research area.

The authors' experience-based framework forms the basis of a valuable toolkit for healthcare service management.

This study advances services literature by integrating sense-based marketing knowledge with healthcare service research to understand the dynamic and interactive relationship between hospital users and the environment.

The purpose of this paper is to determine the relative influence of the different domains of healthcare quality from the Care Experience Feedback Improvement Tool (CEFIT) and identify key predictors of healthcare quality from the patients’ perspective. Measurement is necessary to determine whether the quality of healthcare is improving. The CEFIT was developed as a brief measure of patient experience. It is important to determine the relative influence of the different domains of healthcare quality to further clarify how the CEFIT can be used and identify key predictors of healthcare quality from the patients’ perspective.

In sum, 802 people with a healthcare experience during the previous 12 months were telephoned to complete the CEFIT questions and an additional 11-point global rating of patient experience. To estimate the influence of different domains of healthcare quality on patient overall ratings of quality of healthcare experience, the authors regressed the overall rating of patient experience with each component of quality (safety, effectiveness, timely, caring, enables system navigation and person-centred).

The authors found that all of the domains of the CEFIT influenced patient experience ratings of healthcare quality. Specifically, results show the degree of influence, the impact of demographics and how high scores for overall rating of patient experience can be predicted.

The findings suggest that all of the CEFIT domains are important in terms of capturing the wholeness of the patient experience of healthcare quality to direct local quality improvement.

The customer experience quality (EXQ) cannot be measured by using traditional tools to investigate service quality. There is a need to use new tools to directly measure EXQ from a customer perspective. The current study aims to contribute in this domain of knowledge and validate EXQ scale by linking it to marketing outcomes of satisfaction, loyalty and word of mouth in Malaysian private healthcare settings.

The authors collected data from 330 randomly selected Malaysians, visiting private hospitals in the city of Kuala Lumpur. The data analysis is performed by confirmatory factor analysis using structural equation modelling – SEM – procedures.

The results reveal that two dimensions of EXQ scale moments of truth and peace of mind are highly valued by customers. Furthermore, the EXQ perceptions significantly contribute to satisfaction and loyalty. In a mediating relationship, the customer satisfaction is found to be a positive and significant variable.

Healthcare marketing policymakers should emphasize on recruitment of frontline staff – individuals with strong interpersonal skills and expertise who are able to create a memorable customer service experience.

The study is an original contribution to the existing body of knowledge – generally in services marketing literature and specifically in the field of healthcare marketing with a focus on customer experience in a developing country context of Malaysia.

The purpose of this study is to empirically examine the impact of technology-enabled service co-creation on patients' service patronage behaviour in healthcare retailing. The first objective is to examine the mediating roles of spatial presence and co-presence in the relationship between technology enabled co-creation and service experience. The second objective is to investigate if healthcare service experience impacts patients' relationship value with hospitals and subsequent patronage intention.

Data were collected from a sample of 516 customers of three leading hospitals in India during the social isolation period of COVID-19. The data were analysed using structural equation modelling.

The study results demonstrate that customers' favourably perceived technology-enabled co-creation generates feelings of spatial presence and co-presence in the technology-enabled platform. The feeling of presence enhances patients' health care service experiences which in turn predict their relationship value perceptions towards the healthcare service provider. Co-presence dominates as a mediator in terms of magnitude over spatial presence. The favourable value perception positively impacts patients' intention to come back to the same hospital.

The study uses cross-sectional data, which does not incorporate any temporal variations in the investigated relationships. The study does not account for differences in government vs. private undertakings of healthcare system.

The findings envisage a digital healthcare retail system, where hospitals can enhance patients' perceptions of healthcare service experience, relational value and re-patronage intention, based on the digital mediated environment design elements, i.e. spatial presence and co-presence. As co-presence is a dominant factor, ensuring that human healthcare experts (rather than technology based e-service elements like chatbots) participate in healthcare service co-creation is of prime importance to provide enriching service experience to the patients.

The value of the research lies in extending the theories of presence, UTAUT and S-O-R to understand digital healthcare retailing, in order to identify the mechanism of how online co-creative platform can generate hospital patronage behaviour among patients through the serial mediation of presence, augmented service experience and relationship value.

Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate logistic regression models to identify factors related to users' demographics, emotional and informative support, technical and physical aspects of the provision, influencing satisfaction and willingness-to-recommend, before and during a crisis.

The value-in-use, defined in terms of a positive or negative value given by the experience with services, can be evaluated by users and influenced by the context of provision. The authors tested whether and how the value-in-use of services changed in a context of crisis. This study is applied to the healthcare sector during the coronavirus disease 2019 (COVID-19) epidemic, by evaluating the impact of the pandemic on hospitalisation experience.

Overall, analyses of 8,712 questionnaires found a greater value after the pandemic spread. In a time of crisis, technical and informative aspects of care were found to be most valued by patients that may recognise the extraordinary professionalism of workers during the crisis.

This study empirically suggests that context can affect the evaluation of value-in-use by patients during unprecedented circumstances, producing additional value-in-context.

These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

The level of healthcare system distress, due to the COVID-19 epidemic, positively affects patients' propensity to recommend, which the authors suggest is driven by healthcare services' feelings of reverse compassion. These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience, which can have positive social implications. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

Research based on the intersection of theoretical and empirical research regarding value-in-use, value-in-context and service quality measured through user experience is scarce, in particular in the healthcare sector. The authors' findings set the direction for future research on the influence of context on value creation and value creation's perception by users, on the concept of reverse compassion and on reverse compassion's impact on organisational well-being, particularly in times of crisis.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

This chapter explores age-based variations in the healthcare experiences of transgender people. Specifically, we outline how transgender people narrate their experiences with coming out and transition in later life as well as possibilities for future research and clinical practice concerning older transgender populations. To this end, we begin with a review of the limited literature on older transgender populations including the ways such findings converge and diverge from studies of younger transgender populations. Then, we analyze data gathered from older transgender people throughout the United States concerning their experiences with health events, healthcare providers, and healthcare settings. For this empirical analysis, we draw on over 250 qualitative responses from transgender people over the age of 40. The findings of this chapter demonstrate the importance of adjusting existing healthcare protocols to provide adequate care for aging transgender populations. Specifically, our analyses highlight gaps in access and quality of healthcare delivery as well as issues related to medical education, trans-inclusive protocols, and sex-gender segregated medical traditions. The implications of our work here reveal important possibilities for expanding transgender healthcare access as well as existing barriers to such access. We specifically utilize the case of our respondents and the existing literature to illuminate gaps in needs assessment and healthcare delivery concerning older transgender populations. We will conclude the chapter with recommendations for bridging such gaps in research, education, and system operation.