Narratives about negative healthcare service experiences

“I think it’s wrong if the person is being operated or treated and no matter how small the thing is you shouldn’t have to fight in that situation for anything that should be done.”

When you are seriously ill, narratives and life stories become essential. These narratives are very important, for example, in terms of re-examining and transforming one’s identity, and for maintaining and developing one’s self-concept. It has also been found that illness narratives also offer experiences of agency and control for the ill. Alongside such narratives, narratives about the treatment of the disease are also told and developed. Narratives about healthcare customers’ service experiences are a key instrument for customers to understand their illness, its treatment, and their own role in the service process. In addition, they offer customers the opportunity to experience themselves as competent and experienced service users who are qualified to evaluate both their own condition and healthcare service systems.

In our research, we investigated how the healthcare service users position themselves and the healthcare professionals in their narratives on negative service experiences in the context of research interviews. We found three types of client narratives in our data in which clients positioned themselves differently in terms of socially shared norms and expectations, and the cultural ideal of an “active client”. In the narrative story type, the clients presented themselves as strong, active citizens striving to do the right thing, who seek help primarily to identify and treat their illness. In the second narrative type, the customers appeared helpless and inactive – left without the care they needed. In the third narrative story type, the clients specifically objected to the idea that disadvantaged should have to fight to get help. These negative experiences show that the expectations of the role of an active agent can be quite challenging for clients and lead to challenging moral considerations; clients must be sick enough to receive the care they need, and competent enough to meet the activity expectations of a good client.

Our research emphasizes the importance of narratives in understanding negative healthcare customer experiences. The narrative experience narratives of healthcare customers showed that the cause of discontent was not only the negative event itself (for example, an inappropriate treatment decision or the doctor’s rude behavior), but also socially shared expectations about the health care customer’s activity. Therefore, to improve service experiences, one should understand not only the actions performed in healthcare, but also the moral struggles experienced by customers. Through this, healthcare professionals could also find new ways to genuinely improve the quality of their professional practices.


Research has been done in collaboration with Social and health care professionals as experts of client involvement -project, which is coordinated by Finnish Institution of Occupational Health and funded by European Social Fund.

Text is based on Weiste, E., Ranta, N., Stevanovic, M. ,Nevalainen, H., Valtonen, A., & Leinonen, M. (2022). Narratives about negative healthcare service experiences: Reported events, positioning, and normative discourse of an active client -article.