Patient work and their contexts: scoping review

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dc.contributor.authorYin, K.
dc.contributor.authorJung, J.
dc.contributor.authorCoiera, E.
dc.contributor.authorLaranjo, L.
dc.contributor.authorBlandford, A.
dc.contributor.authorKhoja, A.
dc.contributor.authorTai, W.-T.
dc.contributor.authorPhillips, D.P.
dc.contributor.authorLau, A.Y.S.
dc.date.issued2020
dc.description.abstractBackground: Having patients self-manage their health conditions is a widely promoted concept, but many patients struggle to practice it effectively. Moreover, few studies have analyzed the nature of work required from patients and how such work fits into the context of their daily life. Objective: This study aimed to review the characteristics of patient work in adult patients. Patient work refers to tasks that health conditions impose on patients (eg, taking medications) within a system of contextual factors. Methods: A systematic scoping review was conducted using narrative synthesis. Data were extracted from PubMed, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, including studies from August 2013 to August 2018. The included studies focused on adult patients and assessed one or more of the following: (1) physical health-related tasks, (2) cognitive health-related tasks, or (3) contextual factors affecting these tasks. Tasks were categorized according to the themes that emerged: (1) if the task is always visible to others or can be cognitive, (2) if the task must be conducted collaboratively or can be conducted alone, and (3) if the task was done with the purpose of creating resources. Contextual factors were grouped according to the level at which they exert influence (micro, meso, or macro) and where they fit in the patient work system (the macroergonomic layer of physical, social, and organizational factors; the mesoergonomic layer of household and community; and the microergonomic triad of person-task-tools). Results: In total, 67 publications were included, with 58 original research articles and 9 review articles. A variety of patient work tasks were observed, ranging from physical and tangible tasks (such as taking medications and visiting health care professionals) to psychological and social tasks (such as creating coping strategies). Patient work was affected by a range of contextual factors on the micro, meso, or macro levels. Our results indicate that most patient work was done alone, in private, and often imposing cognitive burden with low amounts of support. Conclusions: This review sought to provide insight into the work burden of health management from a patient perspective and how patient context influences such work. For many patients, health-related work is ever present, invisible, and overwhelming. When researchers and clinicians design and implement patient-facing interventions, it is important to understand how the extra work impacts one's internal state and coping strategy, how such work fits into daily routines, and if these changes could be maintained in the long term.
dc.description.statementofresponsibilityKathleen Yin, Joshua Jung, Enrico Coiera, Liliana Laranjo, Ann Blandford, Adeel Khoja, Wan-Tien Tai, Daniel Psillakis Phillips, Annie YS Lau
dc.identifier.citationJournal of Medical Internet Research, 2020; 22(6):e16656-1-e16656-16
dc.identifier.doi10.2196/16656
dc.identifier.issn1438-8871
dc.identifier.issn1438-8871
dc.identifier.orcidKhoja, A. [0000-0003-1513-408X]
dc.identifier.urihttp://hdl.handle.net/2440/126432
dc.language.isoen
dc.publisherJMIR Publications
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1134919
dc.rights©Kathleen Yin, Joshua Jung, Enrico Coiera, Liliana Laranjo, Ann Blandford, Adeel Khoja, Wan-Tien Tai, Daniel Psillakis Phillips, Annie Y S Lau. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.06.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
dc.source.urihttps://doi.org/10.2196/16656
dc.subjectSelf-care; burden of illness; self-management
dc.titlePatient work and their contexts: scoping review
dc.typeJournal article
pubs.publication-statusPublished

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