The lived experience of chronic physical health conditions: an evaluation of the conceptual resources of epistemic injustice

Epistemic injustice argues that people can be unfairly discriminated against in their capacity as a ‘knower’. While the concept has been widely promoted, and perceived injustice is addressed within research studies, little work to advance the conceptual development of epistemic injustice with reference to empirical practice has been undertaken. In this article, a systematic review and narrative synthesis of the literature pertaining to the role that epistemic injustice, and the related concepts, plays in the health and healthcare experiences of people with chronic physical health conditions in the UK was undertaken to evaluate epistemic injustice as a theoretical resource to help inform healthcare research. This resulted in the identification of the following themes: threats to concept of self; navigation of awareness contexts; perception of burden; constructions of acceptability. Drawing on the narrative synthesis it was identified that dimensions of epistemic injustice can be developed and applied within empirical healthcare research. The inductive insights from empirical research can then, in turn, help to shape and mould the dimensions of epistemic injustice as flexible and pragmatic middle-range theory. Importantly, this can support insight into the lived experience of people with chronic health conditions.