Article published in:
Narratives as Social Practice in Organisational Contexts
Edited by Dorien Van De Mieroop, Jonathan Clifton and Stephanie Schnurr
[Narrative Inquiry 32:1] 2022
► pp. 9–35

Narrative evaluation in patient feedback

A study of online comments about UK healthcare services

| Lancaster University
| Lancaster University | Xi’an Jiaotong University
| Birmingham City University
| Lancaster University
| Lancaster University

This study examines how patients use narratives to evaluate their experiences of healthcare services online. The analysis draws on corpus linguistic techniques, specifically annotation, applying Labov and Waletzky’s (1967) framework to a sample of online comments about the NHS in England. Narratives are pervasive in this context, being present more than absent in the patients’ comments, but are particularly prominent in comments which evaluate care negatively. Evaluations can be accomplished through all the structural elements of the narrative, including in combination with one another. However, the presence and ordering of these elements does not seem to be influenced by the type of evaluation given (i.e. positive, negative or more neutral). As mediated social practice, the narratives are shaped by the technological affordances and social dynamics of this context, for instance in the placement of particular structural elements and the design of narratives for particular “imagined” audiences.

Keywords: patient feedback, Health Communication, NHS, narrative, annotation
Article outline
  • 1.Introduction
  • 2.Background
  • 3.Data and analytical approach
    • 3.1Data
    • 3.2Analytical approach
  • 4.Analysis
    • 4.1Abstract
    • 4.2Orientation
    • 4.3Complication
    • 4.4Evaluation
    • 4.5Resolution
    • 4.6Coda
  • 5.Discussion
  • 6.Conclusion
  • References
Available under the Creative Commons Attribution (CC BY) 4.0 license.

For any use beyond this license, please contact the publisher at rights@benjamins.nl.

Published online: 23 August 2021
https://doi.org/10.1075/ni.20098.bro
References
Anthony, L.
(2020) AntConc (Version 3.5.9) [Computer Software]. Tokyo, Japan: Waseda University. Available from https://​www​.laurenceanthony​.net​/software
Arribas-Ayllon, M.
(2021) Narrative Analysis: DNA testing and collaborative knowledge-building in a CFS/ME forum. In G. Brookes & D. Hunt (Eds.), Analysing Health Communication: Discourse Approaches. Palgrave Macmillan. CrossrefGoogle Scholar
Atkinson, P., & Delamont, S.
(2006) In the Roiling Smoke: Qualitative Inquiry and Contested Fields. International Journal of Qualitative Studies in Education, 19(6), 747–755. CrossrefGoogle Scholar
Austin, J.
(1962) How to do things with words. Oxford: Oxford University Press.Google Scholar
Bell, A.
(1984) Language Style as Audience Design. In N. Coupland and A. Jaworski (Eds.), Sociolinguistics: A Reader and Coursebook (pp. 240–250). Palgrave Macmillan.Google Scholar
Baker, P., Brookes, G., & Evans, C.
(2019) The Language of Patient Feedback: A Corpus Linguistic Study of Online Health Communication. Routledge. CrossrefGoogle Scholar
Brookes, G., & Baker, P.
(2017) What does patient feedback reveal about the NHS? A mixed methods study of comments posted to the NHS Choices online service. BMJ Open, 71: e013821. CrossrefGoogle Scholar
Brookes, G., & Harvey, K.
(2016a) Opening up the NHS to market: using multimodal critical discourse analysis to examine the ongoing corporatisation of health care communication. Journal of Language and Politics, 15(3), 288–302. CrossrefGoogle Scholar
(2016b) Examining the discourse of mental illness in a corpus of online advice-seeking messages. In L. Pickering, E. Friginal and S. Staples (Eds.), Talking at Work: Corpus-based Explorations of Workplace Discourse (pp. 209–234). Palgrave Macmillan. CrossrefGoogle Scholar
Brookes, G., & McEnery, T.
(2020) Corpus Linguistics. In S. Adolphs and D. Knight (Eds.), The Routledge Handbook of English Language and Digital Humanities (pp. 378–404). Routledge. CrossrefGoogle Scholar
Bruner, J.
(1991) The narrative construction of reality. Critical Inquiry, 181, 1–21. CrossrefGoogle Scholar
Charon, R.
(2006) The self-telling body. Narrative Inquiry, 161, 191–200. CrossrefGoogle Scholar
Clark, J., & Mishler, E.
(1992) Attending to patients’ stories: Reframing the clinical task. Sociology of Health and Illness, 141, 344–370. CrossrefGoogle Scholar
Cortazzi, M., & Jin, L.
(2000) Evaluating Evaluation in Narrative. In S. Hunston and G. Thompson (Eds.), Evaluation in Text: Authorial stance and the construction of discourse (pp.102–120). Oxford University Press.Google Scholar
Davis, J., Lister, J., & Wringley, D.
(2015) NHS for Sale. Merlin Press.Google Scholar
Frank, A.
(1995) The Wounded Storyteller. University of Chicago Press. CrossrefGoogle Scholar
Georgakopoulou, A.
(2007) Small Stories, Interaction and Identities. John Benjamins. CrossrefGoogle Scholar
Goffman, E.
(1955) On Face-Work: An Analysis of Ritual Elements in Social Interaction. Psychiatry: Interpersonal and Biological Processes, 18(3), 213–231. CrossrefGoogle Scholar
Greenhalgh, T.
(1999) Narrative based medicine in an evidence based world. British Medical Journal, 3181, 232. CrossrefGoogle Scholar
Greenhalgh, T., & Hurwitz, B.
(1999) Why study narrative? British Medical Journal, 318(7175), 48–50. CrossrefGoogle Scholar
Harvey, K., & Koteyko, N.
(2012) Exploring Health Communication: Language in Action. Routledge. CrossrefGoogle Scholar
Holmes, J., & Marra, M.
(2005) Narrative and the construction of professional identity in the workplace. In J. Thornborrow and J. Coates (Eds.), The Sociolinguistics of Narrative (pp. 913–213). John Benjamins. CrossrefGoogle Scholar
Jones, R.
(2013) Health and Risk Communication: An Applied Linguistic Perspective. Routledge. CrossrefGoogle Scholar
Kleinman, A.
(1988) The illness narratives: Suffering, healing, and the human condition. Basic Books.Google Scholar
Labov, W., & Waletzky, J.
(1967) Narrative analysis. In J. Helm (Ed.) Essays on the Verbal and Visual Arts (pp. 12–44). University of Washington Press.Google Scholar
Lamerichs, J., & Te Molder, H.
(2003) Computer-mediated communication: from cognitive to a discursive model. New Media & Society, 5(4), 451–473. CrossrefGoogle Scholar
Linde, C.
(1997) Evaluation as a linguistic structure and social practice. In B. L. Gunnarsson, P. Linell & B. Nordberg (Eds.), The Construction of Professional Discourse (pp. 151–172). Routledge.Google Scholar
Polanyi, L.
(1979) So what’s the point? Semiotica, 251, 207–241. CrossrefGoogle Scholar
Polkinghorne, D.
(1988) Narrative knowing and the human sciences. New York Press.Google Scholar
Riessman, C.
(1990) Strategic Uses of Narrative in the Presentation of Self and Illness. Social Science and Medicine, 301, 1195–1200. CrossrefGoogle Scholar
Sarangi, S., & Clarke, A.
(2002) Constructing an account by contrast in counselling for childhood genetic testing. Social Science & Medicine, 541, 295–308. CrossrefGoogle Scholar
Ziebland, S.
(2013) Narrative interviewing. In S. Ziebland, A. Coulter, J. D. Calabrese & L. Locock (Eds.), Understanding and Using Health Experiences: Improving patient care (pp. 38–47). Oxford University Press. CrossrefGoogle Scholar
Narrative evaluation in patient feedback