The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement
Identifieur interne : 000067 ( Pmc/Curation ); précédent : 000066; suivant : 000068The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement
Auteurs : Guendalina Graffigna [Italie] ; Serena Barello [Italie] ; Andrea Bonanomi [Italie] ; Julia Menichetti [Italie]Source :
- Journal of Diabetes Research [ 2314-6745 ] ; 2016.
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.
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DOI: 10.1155/2016/2974521
PubMed: 26881243
PubMed Central: 4736395
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Gemelli 1, 20123 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan</wicri:regionArea></affiliation></author><author><name sortKey="Barello, Serena" sort="Barello, Serena" uniqKey="Barello S" first="Serena" last="Barello">Serena Barello</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan</wicri:regionArea></affiliation></author><author><name sortKey="Bonanomi, Andrea" sort="Bonanomi, Andrea" uniqKey="Bonanomi A" first="Andrea" last="Bonanomi">Andrea Bonanomi</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan</wicri:regionArea></affiliation></author><author><name sortKey="Menichetti, Julia" sort="Menichetti, Julia" uniqKey="Menichetti J" first="Julia" last="Menichetti">Julia Menichetti</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Diabetes Research</title><idno type="ISSN">2314-6745</idno><idno type="eISSN">2314-6753</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Grone, O" uniqKey="Grone O">O. Gröne</name></author><author><name sortKey="Garcia Barbero, M" uniqKey="Garcia Barbero M">M. Garcia-Barbero</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bellardita, L" uniqKey="Bellardita L">L. Bellardita</name></author><author><name sortKey="Graffigna, G" uniqKey="Graffigna G">G. Graffigna</name></author><author><name sortKey="Donegani, S" uniqKey="Donegani S">S. Donegani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Renders, C M" uniqKey="Renders C">C. M. 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Bos-Touwen</name></author><author><name sortKey="Schuurmans, M" uniqKey="Schuurmans M">M. Schuurmans</name></author><author><name sortKey="Monninkhof, E M" uniqKey="Monninkhof E">E. M. Monninkhof</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Graffigna, G" uniqKey="Graffigna G">G. Graffigna</name></author><author><name sortKey="Barello, S" uniqKey="Barello S">S. Barello</name></author><author><name sortKey="Riva, G" uniqKey="Riva G">G. Riva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Graffigna, G" uniqKey="Graffigna G">G. Graffigna</name></author><author><name sortKey="Barello, S" uniqKey="Barello S">S. Barello</name></author><author><name sortKey="Riva, G" uniqKey="Riva G">G. Riva</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Diabetes Res</journal-id><journal-id journal-id-type="iso-abbrev">J Diabetes Res</journal-id><journal-id journal-id-type="publisher-id">JDR</journal-id><journal-title-group><journal-title>Journal of Diabetes Research</journal-title></journal-title-group><issn pub-type="ppub">2314-6745</issn><issn pub-type="epub">2314-6753</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26881243</article-id><article-id pub-id-type="pmc">4736395</article-id><article-id pub-id-type="doi">10.1155/2016/2974521</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Graffigna</surname><given-names>Guendalina</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Barello</surname><given-names>Serena</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bonanomi</surname><given-names>Andrea</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Menichetti</surname><given-names>Julia</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy</aff><aff id="I2"><sup>2</sup>Department of Statistical Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 20123 Milan, Italy</aff><author-notes><corresp id="cor1">*Guendalina Graffigna: <email>guendalina.graffigna@unicatt.it</email></corresp><fn fn-type="other"><p>Academic Editor: Bernard Portha</p></fn></author-notes><pub-date pub-type="ppub"><year>2016</year></pub-date><pub-date pub-type="epub"><day>5</day><month>1</month><year>2016</year></pub-date><volume>2016</volume><elocation-id>2974521</elocation-id><history><date date-type="received"><day>18</day><month>10</month><year>2015</year></date><date date-type="accepted"><day>29</day><month>11</month><year>2015</year></date></history><permissions><copyright-statement>Copyright © 2016 Guendalina Graffigna et al.</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>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.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Structural Equation Model 1.</p></caption><graphic xlink:href="JDR2016-2974521.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Structural Equation Model 2.</p></caption><graphic xlink:href="JDR2016-2974521.002"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Characteristics of the sample.</p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1">Sociodemographic characteristics</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Age (years)</td><td align="center" rowspan="1" colspan="1">M = 58.3; DS = 12.4</td></tr><tr><td align="left" rowspan="1" colspan="1"> Gender (% female)</td><td align="center" rowspan="1" colspan="1">31.2</td></tr><tr><td align="left" rowspan="1" colspan="1"> Disease duration</td><td align="center" rowspan="1" colspan="1">M = 14.4; DS = 11.1</td></tr><tr><td align="left" rowspan="1" colspan="1">Marital status (%)</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Never married </td><td align="center" rowspan="1" colspan="1">7.5</td></tr><tr><td align="left" rowspan="1" colspan="1"> Married</td><td align="center" rowspan="1" colspan="1">79.5</td></tr><tr><td align="left" rowspan="1" colspan="1"> Divorced</td><td align="center" rowspan="1" colspan="1">10.8</td></tr><tr><td align="left" rowspan="1" colspan="1"> Widowed</td><td align="center" rowspan="1" colspan="1">2.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Employment (%)</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Employed </td><td align="center" rowspan="1" colspan="1">43.0</td></tr><tr><td align="left" rowspan="1" colspan="1"> Retired</td><td align="center" rowspan="1" colspan="1">44.0</td></tr><tr><td align="left" rowspan="1" colspan="1"> Housewife</td><td align="center" rowspan="1" colspan="1">3.2</td></tr><tr><td align="left" rowspan="1" colspan="1"> Student</td><td align="center" rowspan="1" colspan="1">2.2</td></tr><tr><td align="left" rowspan="1" colspan="1"> Unemployed</td><td align="center" rowspan="1" colspan="1">5.4</td></tr><tr><td align="left" rowspan="1" colspan="1"> Other</td><td align="center" rowspan="1" colspan="1">2.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Education (%)</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> Elementary school</td><td align="center" rowspan="1" colspan="1">5.4</td></tr><tr><td align="left" rowspan="1" colspan="1"> Junior high school</td><td align="center" rowspan="1" colspan="1">14.0</td></tr><tr><td align="left" rowspan="1" colspan="1"> High school</td><td align="center" rowspan="1" colspan="1">50.5</td></tr><tr><td align="left" rowspan="1" colspan="1"> College education</td><td align="center" rowspan="1" colspan="1">23.7</td></tr><tr><td align="left" rowspan="1" colspan="1"> Ph.D. or M.S. degree</td><td align="center" rowspan="1" colspan="1">6.4</td></tr><tr><td align="center" colspan="2" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Psychometric measures</td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"> PHE-S </td><td align="center" rowspan="1" colspan="1">Median = 3 (range 1–4); entropy = 0.89; ordinal alpha = 0.82 </td></tr><tr><td align="left" rowspan="1" colspan="1"> PAM</td><td align="center" rowspan="1" colspan="1">M = 66.8 (range 0–100); DS = 18.3; Cronbach's alpha = 0.93</td></tr><tr><td align="left" rowspan="1" colspan="1"> MMAS-4</td><td align="center" rowspan="1" colspan="1">M = 1.3 (range 0–4); DS = 1.3; Cronbach's alpha = 0.81</td></tr><tr><td align="left" rowspan="1" colspan="1"> HCCQ</td><td align="center" rowspan="1" colspan="1">M = 66.8 (range 13–91); DS = 15.1; Cronbach's alpha = 0.92</td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Frequency of mHealth/eHealth use.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" colspan="2" rowspan="1">I usually use internet or mobile devices to seek information for managing my care (%)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Never</td><td align="center" rowspan="1" colspan="1">14.0</td></tr><tr><td align="left" rowspan="1" colspan="1">Almost never</td><td align="center" rowspan="1" colspan="1">5.3</td></tr><tr><td align="left" rowspan="1" colspan="1">Occasionally</td><td align="center" rowspan="1" colspan="1">5.3</td></tr><tr><td align="left" rowspan="1" colspan="1">Sometimes</td><td align="center" rowspan="1" colspan="1">19.4</td></tr><tr><td align="left" rowspan="1" colspan="1">Often</td><td align="center" rowspan="1" colspan="1">17.2</td></tr><tr><td align="left" rowspan="1" colspan="1">Almost always</td><td align="center" rowspan="1" colspan="1">19.4</td></tr><tr><td align="left" rowspan="1" colspan="1">Always</td><td align="center" rowspan="1" colspan="1">19.4</td></tr></tbody></table></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Linear correlations coefficients between psychometric measures and frequency of mHealth/eHealth use.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th><th align="center" rowspan="1" colspan="1">HCCQ</th><th align="center" rowspan="1" colspan="1">PHE-S</th><th align="center" rowspan="1" colspan="1">PAM</th><th align="center" rowspan="1" colspan="1">MMAS-4</th><th align="center" rowspan="1" colspan="1">mHealth/eHealth</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">HCCQ</td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">0.356<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">0.406<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">−0.315<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">0.292<sup><italic>∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">PHE-S</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">0.428<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">−0.244<sup><italic>∗</italic></sup></td><td align="center" rowspan="1" colspan="1">0.034</td></tr><tr><td align="left" rowspan="1" colspan="1">PAM</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">−0.222<sup><italic>∗</italic></sup></td><td align="center" rowspan="1" colspan="1">0.373<sup><italic>∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">MMAS-4</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">−0.090</td></tr><tr><td align="left" rowspan="1" colspan="1">mHealth/eHealth</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">—</td></tr></tbody></table><table-wrap-foot><fn><p><sup><italic>∗</italic></sup><italic>p</italic> < 0.05; <sup><italic>∗∗</italic></sup><italic>p</italic> < 0.01.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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