Re-thinking technology and its growing role in enabling patient empowerment

© The Author(s) 2018. The presence and increase of challenges to eHealth in today’s society have begun to generate doubts about the capability of technology in patient empowerment, especially within the frameworks supporting empowerment. Through the review of existing frameworks and articulation of patient demands, weaknesses in the current application of technology to support empowerment are explored, and key constituents of a technology-driven framework for patient empowerment are determined. This article argues that existing usage of technology in the design, development and implementation of patient empowerment in the healthcare system, although well intentioned, is insufficiently constituted, primarily as a result of fragmentation. Systems theory concepts such as holism and iteration are considered vital in improving the role of technology in enabling patient empowerment

Misuse (and abuse?) of the concept of empowerment: the case of online offer of predictive direct-to-consumer genetic tests

oai:ojs.www.jphres.org:article/2Using the field of direct-to-consumer genetic tests as a case in point, this paper argues against the misuse of the term empowerment, and calls for a regulation of its usage. The misleading assumption under certain current usages of the concept of empowerment is that it is enhanced by the provision of health information. While the ‘information-empowerment’ correlation is misleading, if not wrong, the feeling of being empowered imposes an increasing burden of critical thinking on those people (patients and consumers) who have to evaluate that information and act for the benefit of their health

Intentional and unintentional medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs

Background: Medication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence. Design and methods: A cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics. Results: Patients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate. Conclusions: Regarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence

Nutrition knowledge and influence on diet in the carer-client relationship in residential care settings for people with intellectual disabilities

People with intellectual disabilities generally have poorer health outcomes compared to those who do not, including outcomes related to nutrition-related non-communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients’ food shopping and preparation and therefore the diet consumed by their clients. Ninety-seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to be have higher scores in ‘making everyday food choices’ (p=0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 39% of the carers and for vegetables by 44% of the carers), whilst most carers reported avoiding consuming full fat dairy products, sugary foods and fried foods. Concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client-centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on client’s dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients’ health

Nutrition knowledge and influence on diet in the carer–client relationship in residential care settings for people with intellectual disabilities

From Wiley via Jisc Publications RouterHistory: received 2022-04-28, rev-recd 2022-12-11, accepted 2022-12-13, pub-electronic 2023-01-17Article version: VoRPublication status: PublishedFunder: University of Chester; Id: http://dx.doi.org/10.13039/100010333; Grant(s): QR225People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition‐related non‐communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety‐seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in ‘making everyday food choices’ (p = 0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full‐fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client‐centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health

The Association of Health Literacy with Self-care Agency in Older Adults in Jamaica

Older adults are the fastest growing segment of the population in Jamaica. With an increase from 10% (252,225) of the total Jamaican population in 1995 to 11% (279,051) in 2005, the rate is expected to rise to 25% by 2025. Thus, it will be critically important to understand factors that may contribute to health maintenance, disease prevention, and wellness promotion. Two such factors – not studied extensively in this country - are health literacy and self-care. The purposes of this study were to (a) generate health literacy profile data with the newly-developed Health Literacy Questionnaire for community-dwelling older adults in Jamaica and (b) determine whether relationships exist among aspects of health literacy and self-care practices while controlling for potential socio-demographic influences. The research design was cross-sectional and correlational; multistage sampling and a survey were used. The Health Literacy Questionnaire measures nine aspects of health literacy (e.g., gathering, reading, and understanding health information, social support, and healthcare provider and system engagement). Self-care was measured with an established scale, Appraisal of Self-care Agency Scale. A sample of 200 community-dwelling elders 60 years and older completed the survey. Because the Health Literacy Questionnaire is new, there are no published normative data. There was variation is scores across the nine aspects of health literacy, and among the highest scores were those for social support and active engagement with healthcare providers. Scores for self-care were relatively high, with 84% of the sample scoring in the high perceived capacity range (based on an established cut off score). As predicted, there was a strong positive correlation between health literacy and self-care. Regression analysis revealed three of the health literacy scales - critical appraisal, social support and ability to engage the healthcare provider - to be statistically significant predictors for self-care after controlling for education, region, health status, age, and sex. It seems reasonable to conclude that gains in health literacy can facilitate improvements in older adults’ self-care ability. Nurses can play pivotal roles in this by assessing health literacy, providing education and information, and, particularly, fostering genuine understanding. Key words: older adult, community dwelling, health literacy, self-care, self-care agenc

Exploring patient empowerment : presenting an enhanced model for delivery in practice

Patient empowerment evolved as a strategy to address multi-faceted healthcare management issues. Studies over the past decades have provided different patient empowerment frameworks, but even with the emergent frameworks, there is no marked desired result. To date there has been no reliable patient empowerment. This thesis is driven by the ambition to enable greater patient empowerment in our global healthcare services.The methodological approach adopted was a mixed methodology approach based on taxonomical analysis, questionnaire study and focus group discussions. To better understand a patient empowered system, this work explored empowerment, patient empowerment and the role of technology. The thesis built through critical analysis on the knowledge of existing patient empowerment frameworks coupled with technology practice to develop an improved patient empowered system. Through review of existing frameworks and articulation of patients’ demands, weaknesses in current structures to support empowerment are determined.This thesis provides a platform for articulating an improved patient empowerment model, which considered systems theory ideas such as holism and iteration. Further research would propose implementing a trail of this model in practice and exploring with a wider range of stakeholders its potential for integration in the NHS or other health service organisations