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Evaluating Patient Empowerment in Association With eHealth Technology: Scoping Review.

作者信息

Risling Tracie, Martinez Juan, Young Jeremy, Thorp-Froslie Nancy

机构信息

College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

J Med Internet Res. 2017 Sep 29;19(9):e329. doi: 10.2196/jmir.7809.


DOI:10.2196/jmir.7809
PMID:28963090
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5640823/
Abstract

BACKGROUND: The prioritization of sustainable patient-centered care in contemporary health care has resulted in an increased focus on patient empowerment, which in turn is considered to facilitate patient independence, self-management, and self-efficacy. However, a definitional consensus of empowerment remains elusive, impeding efforts to translate the conceptual ideals of empowerment into a measurable entity associated with changes in health care behavior or outcomes. The rapid integration of technology in health care serves to add another layer of complexity in the measurability and operationalization of empowerment and helps to create a specific context in which this conceptual entity should be further examined. OBJECTIVE: The primary objective of this scoping review was to explore the concept of patient empowerment within the electronic health (eHealth) context. A further focus on the association or measurement of this concept in conjunction with tethered patient portal use was also employed. METHODS: In this scoping review, a six-step framework was used to guide the search and paper selection process. The review was initiated with two broad research questions, which are as follows: (1) What is the relationship between empowerment and the use of eHealth technologies from a patient perspective? (2) How is patient empowerment (and/or engagement or activation) influenced by accessing personal health information through a tethered patient portal? Multiple databases were employed in a comprehensive search strategy, and papers were primarily evaluated and selected for inclusion by 2 review authors, and a third author was consulted to resolve any issues in reaching consensus. RESULTS: From an initial count of 1387 publications, this review returned nine systematic or literature review papers and 19 empirical studies that pertained to patient empowerment (and/or engagement and activation) in relation to the use of tethered patient portals providing access to electronic health records (EHRs). Of the 19 empirical publications, only four were found to have used specific patient empowerment measures with significant variety in their identified conceptual elements. CONCLUSIONS: There is a persistent lack of conceptual clarity in patient empowerment research, and this has extended to study within the eHealth context. The interchangeable use or conflation of terms such as patient empowerment, engagement, and activation, has further complicated the advancement of distinct conceptual measures. To more strongly align changes in patient empowerment with supportive eHealth solutions, the challenges of achieving a consensus on how best to operationalize and measure patient empowerment must be met.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccff/5640823/d07d969d7847/jmir_v19i9e329_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccff/5640823/d07d969d7847/jmir_v19i9e329_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccff/5640823/d07d969d7847/jmir_v19i9e329_fig1.jpg

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本文引用的文献

[1]
Concepts and measures of patient empowerment: a comprehensive review.

Rev Esc Enferm USP. 2016

[2]
Direct Release of Test Results to Patients Increases Patient Engagement and Utilization of Care.

PLoS One. 2016-6-23

[3]
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Health Commun. 2017-3

[4]
Shared Decision-Making and Patient Empowerment in Preventive Cardiology.

Curr Cardiol Rep. 2016-5

[5]
Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: a quasi-experimental study.

J Am Med Inform Assoc. 2016-1

[6]
The Online Personal Action Plan: A Tool to Transform Patient-Enabled Preventive and Chronic Care.

Am J Prev Med. 2016-7

[7]
Empowering patients through eHealth: a case report of a pan-European project.

BMC Health Serv Res. 2015-8-5

[8]
Conceptualising patient empowerment: a mixed methods study.

BMC Health Serv Res. 2015-7-1

[9]
"Nothing About Me Without Me": An Interpretative Review of Patient Accessible Electronic Health Records.

J Med Internet Res. 2015-6-29

[10]
Patient Portals and Patient Engagement: A State of the Science Review.

J Med Internet Res. 2015-6-23

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