Psychological Empowerment of Patients with Chronic Diseases: The Role of Digital Integration

Information technology (IT) is enabling better healthcare delivery and care. However, the role of IT in managing chronic diseases is still unclear. Chronic diseases are a challenge today, accounting for a huge cost burden in the United States. This article is focused on addressing the research question that how digital integration can play a role in enhancing patients’ psychological empowerment to manage a chronic disease. Based on existing literature, we develop a conceptual research model that provides antecedents and consequences of psychological empowerment for chronic disease treatment, and suggest a mediating role of digital integration through three tenets of digitization, mobilization and personalization. We develop a set of propositions based on the research model, and suggest a set of measurable constructs to test the propositions. A research methodology is introduced with a plan for the empirical analysis. Contributions and implications of this study are discusse

Relationship Between Electronic Health Literacy, Locus of Control, Trust in Physicians, Attitudes Towards Providers, and Medication Adherence

Health literacy is related to a variety of health outcomes, including diseases, quality of life, and even death. Few studies have investigated the relation of e-health literacy to outcomes or the mechanism by which they may be related. The purpose of this study was to evaluate the relation of e-health literacy to patients\u27 attitudes toward health care providers, trust in physicians, and medication adherence as well as theextent to which these relations were mediated by locus of control. Data were collected on participants 40 years and older having at least one chronic health condition from the Fostering Literacy for Good HealthToday and the Spanish-related project named Vive Desarollando Amplia Salud at Nova Southeastern University. Participants included 335 persons (mean age 57.5 years; 42 Whites and 293 Nonwhites; 161 men, 164 women, 9 transgender, 1 participant self-described as Other; and a sample mean education of 11.9 years). After controlling for age, education, gender, and race, the health literacy scale score was significantly related to Attitudes Towards Health Care Providers and trust in physicians, but not to medication adherence. The Electronic Health Literacy Scale score was significantly related to locus of control. Analysis of indirect effects showed that the relations between e-health literacy and Attitudes Towards Health Care Providers, trust in physicians, and medication adherence were mediated by internal locus of control. These findings have implications for research aimed at improving patient-provider communications through programs and policies that increase patients\u27 efficacy in using the internet to access health information

A Mixed-Method Examination of Primary Care Physician Message Strategies to Correct Patient-Held Health Misinformation: An Application of Goals-Plans-Action Theory

Given the prevalence of health misinformation (i.e., inaccurate health messaging that lacks scientific evidence), there is a need for successful communication strategies to combat this detrimental health issue (Krishna & Thompson, 2021). Guided by goals-plans-action theory (Dillard, 1990), which explains the communicative process of creating and implementing influence messages, the purpose of this dissertation was to: (a) uncover primary care physician goals, plans, and action when correcting patient-held health misinformation and (b) experimentally test corrective influence messages for their effectiveness from the patient’s perspective. Two studies addressed these two purposes. In Study One, results of surveys of primary care physicians (N = 105) discovered significant, positive relationships between their primary goal (i.e., correction of health misinformation) and the secondary goals of identity and conversation management. Additionally, Study One results revealed five types of primary care physician strategic message plans during these conversations (i.e., vocalics, clarity, body positioning, listening behavior, relationship-building tone), and five themes for communicative action strategies that primary care physicians use when correcting patient-held health misinformation (i.e., scientific evidence-based explication, recommendations for evaluating health-related information and sources, emotional and/or relationship-building appeal, simple correction, disregard/judgment). Scenario-based corrective influence messaging was created based on communicative action themes from Study One (i.e., scientific evidence, evaluation recommendation, emotional appeal), checked for validity, and pilot tested. In Study Two, U.S. IX adults ages 18 years and older (N = 371) were asked to imagine they have found information online saying vaccines contain toxic ingredients and decide to bring this information up to their primary care physician, were randomly assigned to read a scenario from one of these three corrective influence messaging themes, and then reported their perceptions of the primary care physician. Results revealed no significant differences between scientific evidence and emotional appeal messages on key patient outcomes including perceived source credibility, patient satisfaction, intent to communicate with and share online health information to a primary care physician. Results of the two studies provide evidence for the applicability of goals-plans-action theory to the context of health misinformation and corrective influence messages, and yield recommendations for primary care physicians to implement when correcting health misinformation

Healing conversations: Developing a practical framework for clinical communication between Aboriginal communities and healthcare practitioners

In recognition of the ongoing health disparities experienced by Aboriginal and Torres Strait Islander peoples (hereafter Aboriginal), this scoping review explores the role and impact of the clinical communication process on Aboriginal healthcare provision. A medical education lens is applied, looking at the utility of a tailored clinical communication framework to assist health practitioners work more effectively with Aboriginal peoples and communities. The initial framework, building on existing communication guides, proposes four domains: content, process, relational and environmental. It places emphasis on critical self-reflection of the health practitioner’s own cultural identity and will be guided by collective Aboriginal world-views in select Australian settings. Using a two-eyed seeing approach the framework will be developed and tested in health professional education. The aim of this research journey is to enable health practitioners to have more effective healthcare conversations with Aboriginal peoples, working toward more socially just and equitable healthcare interactions and outcome

Value cocreation as a double-edged sword in customers\u27 quality of life and service outcomes

Both Service Dominant (SD) logic and transformative service research have received attention from marketing managers and scholars as a result of the expansion of the service sector. However, the SD logic perspective on the growth of human wellbeing needs more explanation and attention (Vargo & Lusch, 2016, p. 20). Healthcare is particularly relevant to both streams of research and enables customers to contribute to their wellbeing through cocreation of value. The marketing literature indicates customer value cocreation (CVCC) in healthcare activities enhances service perceptions and quality of life (QoL). However, the healthcare literature demonstrates that cocreation may damage patients\u27 psychological health and wellbeing. Thus, this research explores the mechanism and conditions to determine when and how CVCC may have positive/negative consequences on firms and patients. I study CVCC in the four areas of adherence, communication, goal setting, and decision making, and highlight the roles that anxiety, service quality, and disease severity play in explaining the relationship between CVCC and QoL. The conceptual model of this research is tested in two empirical studies, including a field study among pregnant women and an online survey among individuals with chronic diseases. Furthermore, the model was explored and confirmed using two analytical approaches: partial least square and covariance-based structural equation modeling. The results support in general the proposed conceptual model and reveal the double-edged character of CVCC as capable of producing both positive and negative consequences. Even though anxiety declines with increased CVCC in the areas of adherence, communication, and goal setting, customers feel greater anxiety when they cocreate in decision making, since the latter is perceived as an effortful and difficult activity. Subsequently, anxiety reduces QoL and satisfaction with service through service quality. Disease severity moderates the effect of CVCC on anxiety as well as the effects of service quality and satisfaction on QoL. More specifically, the mitigating effects of adherence, communication, and goal setting on anxiety heighten when disease is highly severe. Interestingly, disease severity flips the escalating effect of decision making on anxiety to a mitigating effect, indicating that in highly severe situations cocreation in decision making reduces anxiety

Examining the Influence of Wearable Health Monitors on Patients and Physicians in a Filipino Community

Ph.D.Ph.D. Thesis. University of Hawaiʻi at Mānoa 201

"This illness diminishes me. What it does is like theft" : A qualitative meta-synthesis of people's experiences of living with asthma

ACKNOWLEDGEMENTS This review was funded through a Seed Grant from the Centre for Research Excellence in Severe Asthma, Australia. The Healthtalk resources included in the systematic review were produced by two of the co-authors on the systematic review (SK and LL). LL is supported by NIHR Oxford Biomedical Research Centre.Peer reviewedPublisher PD

Is it COVID or a Cold? An Investigation of the Role of Social Presence, Trust, and Persuasiveness for Users\u27 Intention to Comply with COVID-19 Chatbots

The COVID-19 pandemic challenged the existing healthcare system by demanding potential patients to self-diagnose and self-test a potential virus contraction. In this process, some individuals need help and guidance. However, the previous modus-operandi to go to a physician is no longer viable because of the limited capacity and danger of spreading the virus. Hence, digital means had to be developed to help and inform individuals at home, such as conversational agents (CA). The human-like design and perceived social presence of such a CA are central to attaining users’ compliance. Against this background, we surveyed 174 users of a commercial COVID-19 chatbot to investigate the role of perceived social presence. Our results provide support that the perceived social presence of chatbots leads to higher levels of trust, which are a driver of compliance. In contrast, perceived persuasiveness seems to have no significant effect

A Systematic Review of Effective Intercultural Communication in Mental Health

Purpose of the Research: Effective intercultural communication between patients and clinicians is essential for the delivery of high quality health care. To date, there has been no systematic assessment of empirical literature on effective communication within a mental health context, despite theoretical models purporting certain criteria make health communications more effective. The current research aims to determine factors which aid or hinder communication effectiveness in such a context, and to see whether the literature supports Teal and Street’s (2009) theoretical model specifically. Additionally, the review considered the role of language disparity between patients and clinicians within the mental health context. Method: Electronic databases Medline, Psych Info and Web of Science were searched using an optomised search strategy in June 2014. Studies were considered where intercultural communication between a clinician and patient was a primary focus. To meet inclusion the papers needed to be empirical in nature, written in English, peer-reviewed and of sound quality. Data relating to the study type and analysis used, characteristics of participants (both patients and clinicians), cultural and communication information were extracted.Results: Eight papers were included in the final review. The results largely support Teal and Street’s model and highlight that nonverbal and verbal behaviour skill, recognition of cultural differences, incorporating cultural knowledge, alongside negotiation and collaboration with patients and family members, all aid in effective communication. Additionally, language barriers were found to pose a significant barrier to communication. The quantity of current literature investigating the effectiveness of intercultural communication specifically within a mental health setting is limited, highlighting the need for further investigation.