Fomo Messaline, Borga Liyousew G, Abel Thomas, Santangelo Philip S, Riggare Sara, Klucken Jochen, Paccoud Ivana
Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.
Digital Medicine Group, Department of Precision Medicine, Luxembourg Institute of Health, Strassen, Luxembourg.
J Med Internet Res. 2025 Jun 27;27:e68458. doi: 10.2196/68458.
Patient empowerment is widely recognized for improving health outcomes, increasing patient satisfaction, and enhancing the overall effectiveness of health care. Digital health technologies (DHTs) contribute to this empowerment by keeping patients informed, involved, and engaged in their own health. However, more evidence is needed to better understand which aspects of empowerment patients value when using DHTs and how DHTs can support these values.
Drawing on Sen's capability approach, this paper conceptualizes patient empowerment in digital health by defining distinct capabilities, resources, and conversion factors that contribute to patient empowerment through DHTs.
We based our scoping review on the methodology recommended by the Joanna Briggs Institute Manual for evidence synthesis and an a priori registered protocol. Papers were included if they focused on patient empowerment in relation to DHTs among patients with chronic diseases (cardiovascular diseases, diabetes, cancer, chronic respiratory diseases, and neurodegenerative diseases), with particular emphasis on the patient perspective. PubMed, Scopus, and Web of Science were searched for evidence published from January 2013 to April 2024. Data were extracted and thematically analyzed via a multidisciplinary workshop to identify empowerment components relevant to the capability framework, such as capabilities, DHTs as resources, and conversion factors.
Our analysis identified 3 core capabilities to achieve patient empowerment supported by DHTs: health information and knowledge management, self-management, and emotional and social support. DHTs as resources supported these capabilities through distinct functional components, including informing patients, communication with the health care team, monitoring, behavior change interventions, individualized feedback, or peer support, each contributing to a varying degree. Conversion factors such as demographic and socioeconomic status, digital literacy, disease status, perceived value of DHTs, sociocultural values and norms, doctor-patient relationship, connectivity, and cost influenced the development of empowering capabilities resulting from using DHTs.
While the capabilities related to patient empowerment in DHTs were clearly distinguishable, our analysis revealed a notable interconnectedness among these components. Our conceptualization of patient empowerment serves as a valuable resource for researchers seeking to understand or assess patient empowerment via DHTs. It also provides guidance for DHT developers, helping them design DHTs that enhance valued capabilities and account for the conversion factors and ultimately promote patient empowerment across diverse population groups.
患者赋权在改善健康结果、提高患者满意度以及增强医疗保健的整体效果方面得到了广泛认可。数字健康技术（DHTs）通过让患者了解、参与并关注自身健康，为这种赋权做出了贡献。然而，需要更多证据来更好地理解患者在使用DHTs时重视赋权的哪些方面，以及DHTs如何支持这些价值观。
借鉴森的能力方法，本文通过定义不同的能力、资源和转化因素，将数字健康中的患者赋权概念化，这些因素通过DHTs促进患者赋权。
我们的范围综述基于乔安娜·布里格斯研究所循证综合手册推荐的方法和一个预先注册的方案。如果论文关注慢性病（心血管疾病、糖尿病、癌症、慢性呼吸系统疾病和神经退行性疾病）患者中与DHTs相关的患者赋权，且特别强调患者视角，则纳入该论文。在PubMed、Scopus和科学网中检索2013年1月至2024年4月发表的证据。通过多学科研讨会提取数据并进行主题分析，以确定与能力框架相关的赋权组成部分，如能力、作为资源的DHTs和转化因素。
我们的分析确定了DHTs支持实现患者赋权的3个核心能力：健康信息和知识管理、自我管理以及情感和社会支持。作为资源的DHTs通过不同的功能组件支持这些能力，包括告知患者、与医疗团队沟通、监测、行为改变干预、个性化反馈或同伴支持，每个组件的贡献程度各不相同。人口统计学和社会经济状况、数字素养、疾病状况、DHTs的感知价值、社会文化价值观和规范、医患关系、连接性和成本等转化因素影响了使用DHTs所产生的赋权能力的发展。
虽然与DHTs中患者赋权相关的能力明显可区分，但我们的分析揭示了这些组成部分之间存在显著的相互联系。我们对患者赋权的概念化是寻求通过DHTs理解或评估患者赋权的研究人员的宝贵资源。它还为DHT开发者提供指导，帮助他们设计能够增强有价值能力并考虑转化因素的DHTs，最终促进不同人群的患者赋权。
