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70年5月,2010 (9):1285 - 94。
doi: 10.1016 / j.socscimed.2009.12.034。 Epub 2010年2月12日。

在醫療理論大型IT項目:強烈的結構化理論符合actor-network理論

從屬關係

在醫療理論大型IT項目:強烈的結構化理論符合actor-network理論

格林哈爾希特麗莎et al。 社科地中海 2010年5月

文摘

英國國民健康服務體係是應對各種大型和有爭議的項目。我們試圖開發一個更清晰的理論對這個問題的看法”會發生什麼——在宏觀、中觀和微觀層麵——當政府試圖現代化醫療服務的幫助大嗎?”Using examples from data fragments at the micro-level of clinical work, we considered how structuration theory and actor-network theory (ANT) might be combined to inform empirical investigation. Giddens (1984) argued that social structures and human agency are recursively linked and co-evolve. ANT studies the relationships that link people and technologies in dynamic networks. It considers how discourses become inscribed in data structures and decision models of software, making certain network relations irreversible. Stones' (2005) strong structuration theory (SST) is a refinement of Giddens' work, systematically concerned with empirical research. It views human agents as linked in dynamic networks of position-practices. A quadripartite approcach considers [a] external social structures (conditions for action); [b] internal social structures (agents' capabilities and what they 'know' about the social world); [c] active agency and actions and [d] outcomes as they feed back on the position-practice network. In contrast to early structuration theory and ANT, SST insists on disciplined conceptual methodology and linking this with empirical evidence. In this paper, we adapt SST for the study of technology programmes, integrating elements from material interactionism and ANT. We argue, for example, that the position-practice network can be a socio-technical one in which technologies in conjunction with humans can be studied as 'actants'. Human agents, with their complex socio-cultural frames, are required to instantiate technology in social practices. Structurally relevant properties inscribed and embedded in technological artefacts constrain and enable human agency. The fortunes of healthcare IT programmes might be studied in terms of the interplay between these factors.

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