Coordinate to change the therapeutic relationship: study of the “use relationships” in health networks

Abstract

Evaluation of health networks has been studied in academic studies which mainly observe effects of coordination among health professionals. This article proposes to take the view of patients, asking how health networks contribute to change the therapeutic relationship towards a model of “partnership and balance” (Routelous, 2005), represented by the figure of the user. To do this, we focus on the case of oncology health networks and we are adopting a qualitative approach. Semi-structured interviews (54) where conducted among professional members of health networks, cancer patients and family members. The approach of “use relationships» defined by M. Chauvière, allows to show that the user is not a neutral administrative category. The use relationship is based on an exchange: networks help to empower users by giving them information and in return, users represent a source of legitimacy for networks when they speak for the well-being of users. The results reveal the ambiguity of the reference to users between empowerment and social control, notably through the norm of participation.