Noncommunicable diseases (NCDs) are highly prevalent. People living with NCDs require ongoing management, resulting in frequent interactions within healthcare institutions. These interactions can lead to institutional betrayal, which is when institutions harm or fail to prevent harm to individuals that depend on them for care. Institutional courage, contrastingly, promotes accountability and transparency to individuals. This study explored these experiences in people with NCDs. Eleven university students who had an NCD and identified as women were interviewed. Responses were analyzed using Braun and Clarkes thematic analysis. Six themes were identified: systemic invalidation of patient experience, falling through the cracks, emotional burden and institutional barriers, adverse medical experiences, bound by the system, and relational repair. These themes highlight the prevalence of institutional betrayal amongst people with NCDs; however, acts of institutional courage enhanced relationships and trust. These findings demonstrate the need for healthcare institutions to advance patient-centered care and promote accountability.
Roo et al. (Fri,) studied this question.