Abstract
BackgroundMost commercial activity trackers are developed as consumer devices and not as clinical devices. The aim is to monitor and motivate sport activities, healthy living, and similar wellness purposes, and the devices are not designed to support care management in a clinical context. There are great expectations for using wearable sensor devices in health care settings, and the separate realms of wellness tracking and disease self-monitoring are increasingly becoming blurred. However, patients’ experiences with activity tracking technologies designed for use outside the clinical context have received little academic attention.ObjectiveThis study aimed to contribute to understanding how patients with a chronic disease experience activity data from consumer self-tracking devices related to self-care and their chronic illness. Our research question was: “How do patients with heart disease experience activity data in relation to self-care and chronic illness?”MethodsWe conducted a qualitative interview study with patients with chronic heart disease (n=27) who had an implanted cardioverter-defibrillator. Patients were invited to wear a FitBit Alta HR wearable activity tracker for 3-12 months and provide their perspectives on their experiences with step, sleep, and heart rate data. The average age was 57.2 years (25 men and 2 women), and patients used the tracker for 4-49 weeks (mean 26.1 weeks). Semistructured interviews (n=66) were conducted with patients 2–3 times and were analyzed iteratively in workshops using thematic analysis and abductive reasoning logic.ResultsOf the 27 patients, 18 related the heart rate, sleep, and step count data directly to their heart disease. Wearable activity trackers actualized patients’ experiences across 3 dimensions with a spectrum of contrasting experiences: (1) knowing, which spanned gaining insight and evoking doubts; (2) feeling, which spanned being reassured and becoming anxious; and (3) evaluating, which spanned promoting improvements and exposing failure.ConclusionsPatients’ experiences could reside more on one end of the spectrum, could reside across all 3 dimensions, or could combine contrasting positions and even move across the spectrum over time. Activity data from wearable devices may be a resource for self-care; however, the data may simultaneously constrain and create uncertainty, fear, and anxiety. By showing how patients experience self-tracking data across dimensions of knowing, feeling, and evaluating, we point toward the richness and complexity of these data experiences in the context of chronic illness and self-care.
Highlights
Consumer Wearable Activity Trackers in Chronic CareConsumer health information technologies such as wearable activity trackers are increasingly being considered to improve chronic care management [1,2,3,4]
Our results showed how patients with an implanted implantable cardioverter-defibrillator (ICD) device engaged with and made sense of activity data from the Fitbit in the context of chronic illness and self-care
We found that patients with an implanted ICD relate the activity data to their illness experience and their self-care activities in 3 overall dimensions: as something that generated new or destabilized existing knowledge, as something that raised affective responses, and as something that could be used to evaluate themselves and their overall health
Summary
Consumer Wearable Activity Trackers in Chronic CareConsumer health information technologies such as wearable activity trackers are increasingly being considered to improve chronic care management [1,2,3,4]. Most commercial activity trackers aim to monitor and motivate sport activities, healthy living, and similar wellness purposes Wristbands such as Fitbit and smart watches that track bodily signs (eg, heart rate) do not provide diagnostic services or disorder-specific information, and they are regulated less rigorously than are monitoring devices aimed at specific patient groups and clinical measures. This makes them readily available to consumers. Objective: This study aimed to contribute to understanding how patients with a chronic disease experience activity data from consumer self-tracking devices related to self-care and their chronic illness. A more participatory agenda frames eHealth innovation, aiming to enhance independence and enable patients to become more active participants in managing their own disorder (eg, through use of wearable activity trackers) [18,19]
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