Hou Yi, Sun Manyao, Huang Xueying, Nan Jiang, Gao Jing, Zhu Nan, Jiang Yuyu
Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
Front Public Health. 2025 Mar 14;13:1544840. doi: 10.3389/fpubh.2025.1544840. eCollection 2025.
Autonomy support plays a critical role in safeguarding patients' fundamental rights and promoting health behaviors. The context of autonomy support is transitioning from traditional face-to-face healthcare settings to telehealth, leading to an evolution in the connotation of autonomy support. This study aimed to clarify the connotation of autonomy support in telehealth and to develop a conceptual framework to guide innovations in clinical practice and the advancement of related theories.
Rodgers' evolutionary method was used to clarified attributes, antecedents, and consequences of autonomy support in telehealth. The integrative review strategy of Whittemore and Knafl was used as the methodology for searching relevant literature.
Twenty-five articles were included. The attributes were identified as: (i) technical feedback; (ii) virtual agent; (iii) choice; (iv) rationale; (v) empathy; (vi) collaboration; and (vii) strengths. The antecedents were: (i) telehealth service system; (ii) change in awareness toward autonomy support; and (iii) patient preference of needs for autonomy. The consequences were: (i) multidimensional perception; (ii) emotional experience; (iii) health behavior; (iv) social relation; and (v) technological dependence.
This study clarified the attributes, antecedents, and consequences of autonomy support in telehealth, developing and improving a conceptual framework for autonomy support. These findings will provide a theoretical foundation for developing technology-enabled autonomy support strategies in telehealth practice, better adapting to the emerging needs of patients in the context of the digital age.
自主性支持在保障患者基本权利和促进健康行为方面发挥着关键作用。自主性支持的背景正在从传统的面对面医疗环境向远程医疗转变，这导致了自主性支持内涵的演变。本研究旨在阐明远程医疗中自主性支持的内涵，并构建一个概念框架，以指导临床实践创新和相关理论的发展。
采用罗杰斯的演化方法来阐明远程医疗中自主性支持的属性、前因和后果。使用惠特莫尔和克纳夫的综合综述策略作为检索相关文献的方法。
纳入了25篇文章。确定的属性为：（i）技术反馈；（ii）虚拟代理；（iii）选择；（iv）理由；（v）同理心；（vi）协作；（vii）优势。前因为：（i）远程医疗服务系统；（ii）对自主性支持认识的变化；（iii）患者对自主性需求的偏好。后果为：（i）多维度感知；（ii）情感体验；（iii）健康行为；（iv）社会关系；（v）技术依赖。
本研究阐明了远程医疗中自主性支持的属性、前因和后果，开发并完善了自主性支持的概念框架。这些发现将为在远程医疗实践中制定技术支持的自主性支持策略提供理论基础，更好地适应数字时代患者的新需求。
