Abstract
BackgroundChronic diseases often present severe consequences for those affected. The management and treatment of chronic diseases largely depend on patients’ lifestyle choices and how they cope with the disease in their everyday lives. Accordingly, the ability of patients to self-manage diseases is a highly relevant topic. In relation to self-management, studies refer to patient empowerment as strengthening patients’ voices and enabling them to assert control over their health and treatment. Mobile health (mHealth) provides cost-efficient means to support self-management and foster empowerment.ObjectiveThere is a scarcity of research investigating how mHealth affects patient empowerment during patient-physician consultations. The objective of this study is to address this knowledge gap by investigating how mHealth affects consultations and patient empowerment.MethodsWe relied on data from an ethnographic field study of 6 children and adolescents diagnosed with juvenile idiopathic arthritis. We analyzed 6 patient-physician consultations and drew on Michel Foucault’s concepts of power and power technology.ResultsOur results suggest that the use of mHealth constitutes practices that structure the consultations around deviations and noncompliant patient behavior. Our analysis shows how mHealth is used to discipline patients and correct their behavior. We argue that the use of mHealth during consultations may unintentionally lead to relevant aspects of patients’ lives related to the disease being ignored; thus, inadvertently, patients’ voices may be silenced.ConclusionsOur results show that concrete uses of mHealth may conflict with extant literature on empowerment, which emphasizes the importance of strengthening the patients’ voices and enabling patients to take more control of their health and treatment. We contribute to the state-of-the-art knowledge by showing that the use of mHealth may have unintended consequences that do not lead to empowerment. Our analysis underscores the need for further research to investigate how mHealth impacts patient empowerment during consultations.
Highlights
Chronic diseases often have severe consequences for those affected
We argue that the use of Mobile health (mHealth) during consultations may unintentionally lead to relevant aspects of patients’ lives related to the disease being ignored; inadvertently, patients’ voices may be silenced
Our results show that concrete uses of mHealth may conflict with extant literature on empowerment, which emphasizes the importance of strengthening the patients’ voices and enabling patients to take more control of their health and treatment
Summary
Background Chronic diseases often have severe consequences for those affected. In addition to the reduced quality of life, chronic diseases may lead to health emergencies, serious complications, and even death [1]. Improving patients’ abilities to self-manage their health and make informed decisions is recognized as the key to manage chronic disease at a societal level. In relation to self-management, studies refer to patient empowerment as enabling patients to more meaningfully engage with and assert control over their health and treatment of diseases [8,9,10]. To support self-management and foster empowerment, mobile health (mHealth) is a cost-efficient method [11]. In relation to self-management, studies refer to patient empowerment as strengthening patients’ voices and enabling them to assert control over their health and treatment. Mobile health (mHealth) provides cost-efficient means to support self-management and foster empowerment. From the perspective of a health care professional, mHealth technology provides health care services over geographical distances and supports patient self-management. Studies point to greater empowerment, but results regarding clinical outcomes and costs are inconclusive [26]
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