Abstract

Healthcare systems have achieved substantial advances in clinical outcomes, yet the patient’s subjective experience remains a decisive determinant of engagement, adherence, and well-being. Much existing research conceptualises healthcare experience narrowly, treating it as a static, transactional event and reducing it to satisfaction scores or performance metrics. This thesis addresses a critical gap in healthcare service research: the lack of a comprehensive understanding of how patients construct value as a longitudinal, experiential, and temporally unfolding process across their healthcare journey. Existing research is dominated by static, cross-sectional designs that capture experiences at a single point in time and overlook the interpretive and emotional dimensions of care, as well as the ways in which memories of past encounters and anticipations of future ones shape meaning. This narrow focus risks obscuring the complexity of how value is formed, re-evaluated, and embedded within the patient’s broader lifeworld.

Grounded in Customer-Dominant Logic (CDL), the Value-in-Experience (VALEX) framework, and Mental Time Travel (MTT), this study conceptualises healthcare value as a lifeworld-centred process shaped by memory, anticipation, and meaning-making. It adopts a qualitative, longitudinal, and phenomenological design, comprising 54 semi-structured interviews with 18 participants conducted across three temporal stages: pre-service, service encounter, and post-service, complemented by five-participant pilot study that refined the interview design and procedures. Data were analysed using Interpretative Phenomenological Analysis (IPA) to trace how experiences were constructed, interpreted, and reinterpreted over time.

Three themes emerged: (1) anticipatory factors and lifeworld dispositions towards healthcare, encompassing intrinsic and extrinsic enablers and barriers; (2) experiencing actual care, assessed through relational and procedural service quality dimensions; and (3) post-recovery reflections and healthcare experience outcomes, where initial evaluations were often revised, shaping future expectations. Across all themes, MTT influenced how participants revisited past experiences and imagined future scenarios, creating a recursive loop between phases.

Conceptually, this thesis advances CDL through the development of the VALEX framework, integrating MTT to model healthcare value as a temporally unfolding, lifeworld-anchored experience. This theoretical advancement is presented in the novel conceptual framework proposed in the thesis, which captures the dynamic, interpretive, and longitudinal nature of value construction across the pre-service, service encounter, and post-service phases.

The findings provide actionable guidance for healthcare providers, policymakers, and service designers. They highlight the need for temporally sensitive, person-centred strategies that: (1) strengthen engagement before care is accessed, (2) enhance trust, empathy, and responsiveness during service encounters, and (3) support reflective continuity after the encounter, aligning with patients’ lived realities. By addressing both functional outcomes and the emotional, anticipatory dimensions of care, the study offers a foundation for improving patient experience measurement, service evaluation, and the design of integrated care pathways.