Resources and Insights for Researchers

Cultural-Historical Activity Theory (CHAT) is a framework used to understand how people work together in complex systems, like healthcare. Developed from the ideas of Russian psychologists Vygotsky and Leontiev, and later expanded by Engeström, CHAT focuses on how human activities are shaped by culture, history, and social interactions. CHAT has been used across many aspects of healthcare and education research. 

An activity system is the central concept in CHAT, where an “activity” is any purposeful human action aimed at achieving a goal. 

The central activity system in our study was compassionate care, which served as the unifying focus across diverse perspectives. All participants—whether in the role of providing or receiving care—were connected to this activity through their shared experiences within compassionate healthcare.

Our study applied CHAT as a structured and organized way to highlight the interactions between patients, caregivers, and healthcare providers. Using CHAT, we looked at how participants’ actions, ideas, and goals about compassionate care were influenced by the clinical environment, tools, and social rules.

Cultural-Historical Activity Theory (CHAT) provides a structured framework for analyzing equity in healthcare by examining how actions are shaped through tools, communities, rules, and divisions of labor within an activity system. By situating individual practices within these broader social dynamics, CHAT helps researchers uncover the contextual factors that influence actions and outcomes. This systemic perspective is particularly valuable for equity-focused research, where addressing disparities requires attention to both lived experience and the surrounding structures. In doing so, CHAT can help minimize researcher bias by shifting emphasis away from individual interpretation and toward relational and systemic interactions.

Nevertheless, applying CHAT to abstract, narrative-based topics such as compassionate care can be challenging. Defining components such as tools or objectives may be difficult, and when data are generated primarily through reflective rather than observational methods, contradictions and adaptations are reconstructed instead of directly observed. While CHAT enriches understanding of equity-related dynamics, its insights may at times overlap with those yielded by other qualitative approaches, highlighting the importance of methodological triangulation to ensure depth and rigor.

Below are examples of research presentations and articles related to our research in Compassionate Care, education and healthcare.