Exploring the hidden demands for patients’ resources: how health researchers risk excluding patients from patient and public involvement in health research during recruitment

Patient involvement in health research is considered important in developing
international healthcare systems, signaling changes in the roles of health
professionals. Policy documents, research strategies, health institutions, and funding
bodies highlight the benefits of co-production in health research. However, patient
recruitment depends not only on health researchers’ decisions but also on other key
factors: patients’ competencies and organizational factors in the healthcare and
academic sectors, which structure recruitment. In this article, I draw on interviews with
health professionals who conduct research (e.g., nurses and doctors, and staff in
hospital administration and research support units in hospitals) to explore how and why
different patients are recruited into research in the Danish healthcare system. I apply
Bourdieu’s concepts of field, capital, and habitus to analyze the role of health
researchers (i.e., as those who control access) in shaping recruitment. The study
contributes to the literature on co-production by revealing health professionals’ tacit
social demands for patients’ skill in communication and understanding of the
healthcare sector, which is ascribed social value in the social process of recruitment.
Furthermore, these findings are related to health researchers’ position, which shapes
the competencies and forms of knowledge that are considered legitimate and can
operate as capital in this complex and dynamic arena. Therefore, forms of
competencies that can function as capital are unequally distributed and thus risk being
mechanisms for exclusion. Understanding the experiences of health professionals as
researchers therefore sheds light on requirements produced in the healthcare sector
regarding how health researchers value certain competencies