The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement

Abstract

eHealth and mHealth interventions for type 2 diabetes are emerging as useful strategies to accomplish the goal of a high functioning integrated care system. However, mHealth and eHealth interventions in order to be successful need the clear endorsement from the healthcare professionals. This cross-sectional study included a sample of 93 Italian-speaking type 2 diabetes patients and demonstrated the role of the perceived ability of healthcare professionals to motivate patients' initiative in improving the level of their engagement and activation in type 2 diabetes self-management. The level of type 2 diabetes patients' activation resulted also in being a direct precursor of their attitude to the use of mHealth and eHealth. Furthermore, patient engagement has been demonstrated to be a mediator of the relationship between the perceived ability of healthcare professionals in motivating type 2 diabetes patients and patients' activation. Finally, type 2 diabetes patients adherence did not result in being a direct consequence of the frequency of mHealth and eHealth use. Patient adherence appeared to be directly influenced by the level of perceived healthcare professionals ability of motivating patients' autonomy. These results offer important insights into the psychosocial and organizational elements that impact on type 2 diabetes patients' activation in self-management and on their willingness to use mHealth and eHealth devices.

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

“…Such initiatives are also essential to ensure the professional well-being of nurses themselves by valuing and recognizing their crucial role in addressing the challenges of the current healthcare environment. If demonstrated effective, learning programs teaching clinicians how to use and act on patient engagement measures in clinical practice might be a key steps in supporting the realization of patient engagement in healthcare (Barello et al, 2015a; Graffigna et al, 2016). Researchers and clinicians from different clinical areas should collaborate to share good practices and develop guidelines to advance the field of patient engagement and shift from theory into practice.…”

“…From this perspective, previous studies have demonstrated a positive correlation between the patients' perception of their clinicians' support for autonomy in self-care and the patients' level of engagement in self-management behaviors and adherence to treatments (Graffigna et al, 2016). There are also studies that discussed the role of health practitioners' beliefs about the importance of patients being active agents in managing their health condition (Greene and Yedidia, 2005; Blakeman et al, 2006).…”

“…In their clinical encounters, nurses are recognized to be key persons whose strategies might hugely affect the patient's level of engagement in the care process (Jordan et al, 2008; Kutney-Lee et al, 2009; Laschinger et al, 2010; Deyo et al, 2016; Morath and Braaten, 2016). Research on the patients' perspective showed how the patients' perception of professionals' positive attitude toward their self-management behaviors is associated with higher level of patient engagement (Graffigna et al, 2016) and adherence to medical prescriptions (Chan et al, 2009; Schmidt et al, 2012) thus confirming the crucial role of nurses who are often in charge of self-care interventions.…”

Understanding the physical, social, and emotional experiences of people with uncontrolled Type 2 diabetes: a qualitative study

“…These include self-efficacy, personality traits, different coping capacities, various dimensions of stress, and social support, as well as the relationship between the patient and health care professionals 9. Patient adherence appeared to be directly influenced by the perceived level of health care professionals ability to motivate patients’ autonomy 10. Family support is another issue that can influence self-management, a study done in 17 countries showed the experiences of family members who support adults living with diabetes: worries about hypoglycemia, employment, how the diabetes negatively affects the relationship and the help of the family member to make positive life changes for their health 11,12…”

Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support (Preprint)

“…Furthermore, it has been suggested that PCC increases patient outcomes and satisfaction in chronic illnesses [45,46] and type 2 diabetes [47]. Thus, using the Web for medical and health facts is an approach in healthcare that can support empowerment and is facilitated by a shift to PCC that can subsequently improve selfmanagement [25,30,48,49] 50] to provide alternatives to them apart from the primary health care centres, and this gives a certain degree of freedom [51]. However, a benefit for healthcare professionals using digitalised technology in selfmanagement support is the option to be in contact with patients more frequently than semi-annually or annually, as is common today [52].…”