Wearable health technology supporting a rheumatoid arthritis patient in shared decision-making with a physician

Abstract

The primary purpose of this thesis is to describe how shared decision-making between a Rheumatoid arthritis (RA) patient and a rheumatologist can be facilitated with the use of wearable health technology (WHT), focusing on the role of the patient. The study was conducted following interpretivist research paradigm and the empirical data was gathered in three parts with five RA patient participants: one preliminary semi-structured interview with each RA patient participant; a two-week test period during which the participants wore a WHT device provided and filled their answers to a follow-up form; and a second main discussion semi-structured interview.

The main theoretical contribution is the description of the role of an active patient in shared decision-making between herself and physician: 1) willing to take care of herself; 2) active in her own self-management; 3) expert of her own life regarding the disease; and 4) active towards physician. Key findings tell that WHT may help an RA patient to play an active role in patient-physician relationship 1) by empowering the patient through better motivation and positive perception of the disease management and self-confidence; 2) by improving patient's self-management through better understanding about her own condition; 3) by supporting her to take initiative in communicating with physician. As result, theoretical framework of shared decision-making model from the patient perspective shaped by WHT is illustrated.

This study gives a solid ground for further discussions with rheumatologists and nurses. Among others, future research directions should include studying how WHT may serve different groups in new situations, e.g. recently diagnosed person, when beginning to take biological medication.