Exploring patient empowerment

Differences of patient empowerment between elective and contracted physicians in internal medicine in Austria: a quantitative content analysis

BACKGROUND

Physicians impact and promote patient empowerment at various levels. Elective or contracted physicians uniquely provide specialised ambulatory care in Austria. The difference between the two groups is due to the contractual relationship with the social health insurance providers. This paper researches whether there are differences in the promotion of patient empowerment between elective and contracted physicians in internal medicine in Vienna based on four dimensions of patient empowerment.

METHODS

A quantitative content analysis analyses the comments on DocFinder.at to identify the differences between the two groups. A deductive-inductive approach based on literature and comments from DocFinder.at led to a codebook with seven categories and forty-eight variables. We collected a total of 1,153 comments, and 912 of them are relevant for further analysis. Differences between elective and contracted physicians became evident through defined dimensions of patient empowerment.

RESULTS

In the health literacy dimension, elective physicians apply relationship-relevant factors more effectively. They are also more successful in ensuring that patients feel adequately informed. No significant differences were found in the dimension of shared decision-making, but the discussion of treatment options correlated strongly with the amount of time spent by a physician. In the self-management dimension, elective physicians provide more precise and detailed explanations, highlighting their ability to foster better self-management. Differences in the communication dimension favour elective physicians at both factual and interpersonal levels, although there are no significant differences in patient's ability to ask questions and receive answers. Across all dimensions, the time spent with patients emerges as a crucial factor influencing patient empowerment.

CONCLUSIONS

The findings open up several avenues for further research, offering an initial understanding of the differences in patient empowerment between elective and contracted physicians. The results reveal that elective physicians are more likely to create a supportive environment for patient empowerment, underscoring the crucial role of physician-patient interactions in this process. However, given the limitations of the current methods, future research could explore these differences through alternative approaches, such as surveys or interviews, to provide a more comprehensive understanding.

Clusters of Patient Empowerment and Mental Health Literacy Differentiate Professional Help-Seeking Attitudes in Online Mental Health Communities Users

OBJECTIVES

Grounded in the Health Empowerment Model, which posits that health literacy and patient empowerment are intertwined yet distinct constructs, this study investigates how the interplay of these factors influences attitudes toward seeking professional psychological help in members of online communities for mental health (OCMHs). This while acknowledging the multidimensionality of patient empowerment, encompassing meaningfulness, competence, self-determination, and impact.

DESIGN AND METHODS

A cluster analysis of data gathered from 269 members of Italian-speaking OCMHs on Facebook has been performed.

RESULTS

Four profiles have been identified: dangerous self-managers (11.2%), effective self-managers (21.2%), disempowered (40.5%) and ambivalent empowered (27.1%). Clusters provided meaningful variations in help-seeking attitudes, also when controlling for depression and anxiety severity, F3, 265 = 11.910, p < 0.001.

CONCLUSIONS

The findings provided further evidence of the multidimensionality of patient empowerment. Considering the results, we discussed potential interventions aimed at enhancing the quality of OCMHs, tailoring to the unique characteristics of each cluster.

PATIENT OR PUBLIC CONTRIBUTION

Administrators and moderators of mental health Facebook communities-whether expert-led by mental health professionals or peers-played a key role in this study. They provided valuable insights during the questionnaire design process to ensure the questions were both relevant and appropriate for community members. These administrators and moderators also actively facilitated participant recruitment by creating and sharing posts, either video- or text-based, on community homepages. Furthermore, after completing the questionnaire, participants were encouraged to comment on the Facebook posts where the survey link was shared, mentioning that they participated and inviting other members to take part. This approach aimed to foster a sense of involvement and further promoted the survey within the community.

Could Empathy Be Taught? The Role of Advanced Technologies to Foster Empathy in Medical Students and Healthcare Professionals: A Systematic Review

The physician-patient relationship relies mostly on doctors' empathetic abilities to understand and manage patients' emotions, enhancing patient satisfaction and treatment adherence. With the advent of digital technologies in education, innovative empathy training methods such as virtual reality, simulation training systems, mobile apps, and wearable devices, have emerged for teaching empathy. However, there is a gap in the literature regarding the efficacy of these technologies in teaching empathy, the most effective types, and the primary beneficiaries -students or advanced healthcare professionals-. This study aims to address this gap through a literature review following PRISMA guidelines. A comprehensive literature search was conducted in the PsychINFO, Scopus, PubMed, and Web of Science databases using specific keywords. Inclusion criteria for articles were established, and two researchers independently rated the selected articles, resolving any disagreements by consensus. Out of 1137 articles screened, a total of 14 articles were included in this review with a total of 1285 participants, who received empathic training integrated with the use of digital technologies. Only 9 articles defined the construct of empathy, focusing on cognitive, affective, clinical, or cultural aspects. Empathy was assessed with various methods and promoted through various digital technologies, including wearables (e.g. HMDs, SymPulse™ armband) and non-wearable devices (computer monitors, Mobile Apps, Kinect System). Participants were primarily medical students (68.1%), with few healthcare workers (31.9%) and nurses (2.9%). All digital technologies effectively promoted empathy among the target population except for 3 studies that involved advanced career healthcare workers. This review highlights the potential efficacy of digital technologies in fostering empathy among medical students, though not as effectively among advanced healthcare professionals. These insights have implications for designing targeted educational programs that address the distinct needs of healthcare professionals at varying career stages. Limitations and future research directions are also discussed.

From physician’s authority to patient expertise: the effects of e-health technology use on patient’s behavior and physician-patient relationship

Purpose

This paper aims to examine the health technology use in health information seeking, communication and personal health information management, as well as in the effects they may have on his relationship with the physician and on the consumption of medical resources.

Design/methodology/approach

An online survey was conducted. The questionnaires were distributed via online health discussion forums using Google's survey software with a summary presentation of the study’s objective. The final selection of 362 individuals was made using social media, direct email and collaboration with community groups. The empirical validation of the causal model was conducted using the partial least square approach.

Findings

The results show that the use of e-health strengthens the quality of the patient–physician relationship and patient empowerment while increasing the consumption of medical resources.

Originality/value

The results of this research indicate that the internet has transformed the relationship of patients to health, to their doctors and to the health-care system. In this new context, a reconsideration of the status of the patient must be considered by health service providers.

Toward digital transformation in healthcare: a framework for remote monitoring adoption

Purpose

Digital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.

Design/methodology/approach

The authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).

Findings

According to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.

Research limitations/implications

The authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.

Practical implications

The paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.

Social implications

RM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.

Originality/value

The study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.

Enablers of Patient Knowledge Empowerment for Self-Management of Chronic Disease: An Integrative Review

The non-development of the concept of patient knowledge empowerment for disease self-management and the non-development of the theory of patient knowledge empowerment in patients with chronic diseases, cause methodological inconsistency of patient empowerment theory and does not provide a methodological basis to present patient knowledge empowerment preconditions. Therefore, the aim of the present integrative review was to synthesize and critically analyze the patient knowledge enablers distinguished in the public health management theory, the knowledge sharing enablers presented in the knowledge management theory and to integrate them by providing a comprehensive framework of patient knowledge enablers. To implement the purpose of the study, in answering the study question of what patient knowledge empowerments are and across which levels of patient knowledge empowerment they operate, an integrative review approach was applied as proposed by Cronin and George. A screening process resulted in a final sample of 78 papers published in open access, peer-review journals in the fields of public health management and knowledge management theories. Based on the results of the study, the Enablers of Patient Knowledge Empowerment for Self-Management of Chronic Disease Framework was created. It revealed that it is important to look at patient knowledge empowerment as a pathway across the empowerment levels through which both knowledge enablers identified in public health management theory and knowledge sharing enablers singled out in knowledge management theory operate. The integration of these two perspectives across patient empowerment levels uncovers a holistic framework for patient knowledge empowerment.