Risling Tracie, Martinez Juan, Young Jeremy, Thorp-Froslie Nancy
College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.
JMIR Med Inform. 2018 Sep 10;6(3):e43. doi: 10.2196/medinform.8828.
The increasing presence of technology in health care has created new opportunities for patient engagement and with this, an intensified exploration of patient empowerment within the digital health context. While the use of technology, such as patient portals, has been positively received, a clear linkage between digital health solutions, patient empowerment, and health outcomes remains elusive.
The primary objective of this research was to explore the views of participants enrolled in an electronic health record portal access trial regarding the resultant influence of this technology on their feelings of patient empowerment.
The exploration of patient empowerment within a digital health context was done with participants in a tethered patient portal trial using interpretive description. Interpretive description is a qualitative methodology developed to pragmatically address clinical health questions. Patient demographics, self-reported health status, and self-identified technology adaptation contributed to the assessment of empowerment in this qualitative approach.
This research produced a view of patient empowerment within the digital health context summarized in two overarching categories: (1) Being Heard and (2) Moving Forward. In each of these, two subcategories further delineate the aspects of empowerment, as viewed by these participants: Knowing More and Seeing What They See under Being Heard, and Owning Future Steps and Promoting Future Care under Moving Forward. This work also highlighted an ongoing interconnectedness between the concepts of patient empowerment, engagement, and activation and the need to further articulate the unique aspects of each of these.
The results of this study contribute needed patient voice to the ongoing evolution of the concept of patient empowerment. In order to move toward more concrete and accurate measure of patient empowerment and engagement in digital health, there must be further consideration of what patients themselves identify as essential aspects of these complex concepts. This research has revealed relational and informational elements as two key areas of focus in the ongoing evolution of patient empowerment operationalization and measure.
医疗保健领域技术的日益普及为患者参与创造了新机会，与此同时，在数字健康背景下对患者赋权的探索也日益深入。虽然诸如患者门户网站等技术的使用受到了积极欢迎，但数字健康解决方案、患者赋权与健康结果之间的明确联系仍然难以捉摸。
本研究的主要目的是探讨参与电子健康记录门户网站访问试验的参与者对该技术对其患者赋权感产生的影响的看法。
在一项绑定式患者门户网站试验中，采用解释性描述方法，让参与者参与在数字健康背景下对患者赋权的探索。解释性描述是一种为切实解决临床健康问题而开发的定性方法。在这种定性方法中，患者人口统计学、自我报告的健康状况以及自我认定的技术适应情况有助于对赋权进行评估。
本研究得出了在数字健康背景下患者赋权的观点，可归纳为两个总体类别：（1）被倾听和（2）向前迈进。在每一个类别中，又有两个子类别进一步阐述了这些参与者所认为的赋权方面：在“被倾听”类别下的“了解更多”和“看到他们所看到的”，以及在“向前迈进”类别下的“掌控未来步骤”和“促进未来护理”。这项工作还强调了患者赋权、参与和激活概念之间持续的相互联系，以及进一步阐明这些概念各自独特方面的必要性。
本研究结果为患者赋权概念的不断演变提供了必要的患者声音。为了在数字健康中朝着更具体、准确地衡量患者赋权和参与的方向发展，必须进一步考虑患者自己认为这些复杂概念的关键方面是什么。本研究揭示了关系和信息要素是患者赋权操作化和衡量不断演变过程中的两个关键关注领域。
