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The power of symbolic capital in patient and public involvement in health research

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Locock, Louise, Boylan, Anne-Marie, Snow, Rosamund and Staniszewska, Sophie (2017) The power of symbolic capital in patient and public involvement in health research. Health Expectations, 20 (5). pp. 836-844. doi:10.1111/hex.12519 ISSN 1369-6513.

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Official URL: http://dx.doi.org/10.1111/hex.12519

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Abstract

Background:
Policy-makers and health research funders increasingly require researchers to demonstrate that they have involved patients in the design and conduct of research. However, the extent to which patients and public have the power to get involved on an equal footing is dependent on their economic, cultural, social and symbolic capital.

Objective:
To explore power relations in patient and public involvement (PPI) in research, particularly how patients may wield symbolic capital to develop a more equal relationship.

Methods:
Narrative interviews with a maximum variation sample of 38 people involved as patients, carers or public in health research, analysed thematically.

Findings:
Symbolic capital may be demonstrated in a range of ways (sometimes alongside or in the absence of other forms of capital): illness experience, technical illness knowledge and the challenging outsider. Symbolic capital is unstable and dependent on others for recognition and legitimacy. Nonetheless, participants identify a gradual shift in power relations over time.

Discussion and conclusions:
Research into PPI has been conceptually and theoretically poor, limiting our understanding of its mechanisms and wider contextual elements. Our findings demonstrate the importance of reflecting on the forms of power and capital wielded by the health research community, and of acknowledging the way in which PPI is challenging the status quo. As one of the first papers to conceptualize how different forms of symbolic capital operate and their critical role in challenging the balance of power, our findings may help researchers better plan their PPI activities and reflect on their own power.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing > Royal College of Nursing Research Institute (RCN) (- July 2017)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Patient participation, Medicine--Research--Evaluation, Medical care--Research
Journal or Publication Title: Health Expectations
Publisher: Blackwell
ISSN: 1369-6513
Official Date: October 2017
Dates:
DateEvent
October 2017Published
24 November 2016Available
13 October 2016Accepted
Volume: 20
Number: 5
Page Range: pp. 836-844
DOI: 10.1111/hex.12519
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 31 March 2017
Date of first compliant Open Access: 4 April 2017
Funder: National Institute for Health Research (Great Britain) (NIHR)

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