Chiara Libreri

eHealth for patient engagement: A Systematic Review

eHealth interventions are recognized to have a tremendous potential to promote patient engagement. To date, the majority of studies examine the efficacy of eHealth in enhancing clinical outcomes without focusing on patient engagement in its specificity. This paper aimed at reviewing findings from the literature about the use of eHealth in engaging patients in their own care process. We undertook a comprehensive literature search within the peer-reviewed international literature. Eleven studies met the inclusion criteria. eHealth interventions reviewed were mainly devoted to foster only partial dimensions of patient engagement (i.e., alternatively cognitive, emotional or behavioral domains related to healthcare management), thus failing to consider the complexity of such an experience. This also led to a great heterogeneity of technologies, assessed variables and achieved outcomes. This systematic review underlines the need for a more holistic view of patient needs to actually engage them in eHealth interventions and obtaining positive outcomes. In this sense, patient engagement constitute a new frontiers for healthcare models where eHealth could maximize its potentialities.

How to engage type-2 diabetic patients in their own health management: implications for clinical practice.

BackgroundPatient engagement (PE) is increasingly regarded as a key factor in the improvement of health behaviors and outcomes in the management of chronic disease, such as type 2 diabetes. This article explores (1) the reasons for disengagement of diabetic patients and their unique subjective attitudes from their experience and (2) the elements that may hinder PE in health management.Methods29 Type-2 uncontrolled diabetes patients were asked to keep a one-week diary related to their experience of disease management, according to the narrative inquiry qualitative approach. They were interviewed to ascertain reasons for PE. The elicited narratives were subjected to interpretive content analysis.ResultsThe findings suggest that patients give meaning to their diabetes and its management through a complex frame of subjective experiential dimensions (cognitive/thinking, behavioral/conative and emotional/feeling), which have an impact on the spheres of daily life that are considered to be crucial in the management of diabetes (diet, physical activity, therapy, doctor-patient relationship) for each patient. These results suggest that PE develops along a continuum featuring four subsequent phases (blackout, arousal, adhesion, eudaimonic project). Several unmet needs related to the different phases of the PE continuum were discovered and illuminated possible types of support.ConclusionsOur findings appear to confirm some features of PE detected by previous research, such as a behavioral component. We were also able to shed light on the synergic roles played by other subjective dimensions of patient experience (the cognitive/thinking and the emotional/feeling components) in orienting PE towards the care process. The article suggests a possible framework to deeply understand the PE process useful to orient really attuned actions to support it. These results suggest the importance of developing patient engagement assessment tools that are more firmly grounded in the individual patient experience.

Giving patients a starring role in their own care: a bibliometric analysis of the on-going literature debate.

Patient‐centred care has been advocated as a key component of high‐quality patient care, yet its meanings and related actions have been difficult to ascertain.

Temporary employment, job insecurity and their extraorganizational outcomes

Research on job insecurity has traditionally focused on organizational consequences. The present study explores potential extraorganizational outcomes (employees’ consumption and life projects) of job insecurity in terms of both subjective perception and objective condition. Results are based on the secondary analysis of two large data sets: a tracking study with representative samples and a survey, both conducted on Italian employees. The findings suggest that job insecurity (especially the subjective perception, rather than the objective condition) may be associated with sacrifices of daily consumption (e.g. buying groceries, apparel, or entertainment) and life projects (e.g. buying a home, marrying, or having children).

Online exchanges among cancer patients and caregivers: constructing and sharing health knowledge about time

Purpose – The meanings attributed to the quality of a persons illness experience result from important processes of co‐construction not only between healthcare professionals and patients but also among patients and caregivers. In the case of advanced cancer, new treatments extend patients’ lives but they raise the problem of the quality of this “renewed time”. Lay contexts of exchanges appear crucial for orienting the attribution of meaning to the time with cancer and for sharing practices to manage it. Furthermore, the internet is becoming an important space in which cancer patients meet and construct knowledge regarding their illness. The aim of this paper is to study knowledge‐ and practice‐construction among advanced cancer patients and caregivers, and to explore the suitability of online forums for analysis of these processes.Design/methodology/approach – The paper discusses the results of a qualitative study based on one online forum for long‐term cancer patients (second relapse) and one for caregi...

Increasing employability in the emerging tourism sector in Mozambique: Results of a qualitative study

ABSTRACT Mozambique’s tourism sector could play a key role in the country’s socio-economic development, especially in the region of Cabo Delgado where the demand for tourist services is expected to increase. Nonetheless, several constraints (e.g. the lack of adequate training) are hindering the capacity of local people to take full advantage of this opportunity. Qualitative research has been performed in order to align vocational training programmes with the needs of the emerging tourism sector. Local and foreign key informants were interviewed in order to gain a better understanding of training needs and to gain insights into developing training programmes that can enhance local people’s employability. The main findings highlight the lack of symbolisation of tourism and its correlates from local communities. Therefore, rather than just delivering technical skills, training programmes should also promote a ‘culture of tourism’ and a more favourable attitude towards ‘working in the tourism sector’.