Structure and agency: making connections

This chapter continues to summarise different theories and methods in mainstream health and illness research in order to compare them to critical realism and show what it might add. Positivist, interpretive and postmodern approaches to human agency within structures are considered. There are also sections on: six features of critical realism; structure, agency and culture; four types of social structures; a comparison of realist evaluation and critical realism theories of structure and agency; the structure-agency dialectic, and Archer’s theory of internal conversations. The detailed examples of applying critical realist concepts are of prison leavers with mental health problems, and nurses working on traumatic brain injury rehabilitation. Throughout, the chapter critically considers problems posed for health researchers, to see how critical realist research theories of structure and agency can serve their work.