"Putting people in charge of their own health and care?" Using meta-narrative review and the example of online sexual health services to re-think relationships between e-health and agency

被引:7
作者
Baraitser, Paula [1 ]
Cribb, Alan [2 ]
机构
[1] Kings Coll London, Kings Ctr Global Hlth & Hlth Partnerships, Weston Educ Ctr, Sch Populat Hlth & Environm Sci, London, England
[2] Sch Educ Commun & Soc, Waterloo Bridge Wing,Franklin Wilkins Bldg, London, England
关键词
agency; e-health; sexual health; DECISION-MAKING; PATIENT; PROFESSIONALS; PRINCIPLES; REALIST; ILLNESS; DESIGN; WORK;
D O I
10.1111/hex.12895
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Introduction Policy discussions reference ideas of informed and active users of e-health services who gain agency through self-management, choice and care delivered outside clinical settings. In this article, we aim to problematize this association by "thinking with" material from multiple disciplines to generate higher order insights to inform service development, research and policy. Methods Drawing on meta-narrative review methods, we gathered perspectives from multiple disciplines using an iterative process of expert consultation to identify seminal papers citation mapping, synthesis and peer review. Results We identify six relevant paradigms from sociology, philosophy, health services research, public health, the study of social movements and computer studies. Bringing these paradigms together illuminates the contrasting epistemological and ontological framings that co-exist in this area, including competing conceptualizations of e-health technologies as: neutral tools for service delivery, mediators within complex and unpredictable clinical interactions and as agents in their own right. Discussion There is a need for e-health policy to recognize many human and non-human actors, the blurred boundaries between them and the unpredictable and evolving interactions that constitute engagement with e-health care. Established models for e-health service development and policy making are not designed for this landscape. There is nothing to be gained by asking whether e-health, in general, either "increases" or "decreases" agency. Rather specific types and aspects of e-health have diverse effects and can be simultaneously enabling and disempowering, and be differentially experienced by differently positioned and resourced actors.
引用
收藏
页码:838 / 848
页数:11
相关论文
共 69 条
[1]  
Ajzen, 1985, UNDERSTANDING ATTITU, P11, DOI DOI 10.1007/978-3-642-69746-3_2
[2]  
[Anonymous], 2008, IDS BULL I DEV STUD
[3]  
[Anonymous], 2012, HLTH SOC CAR ACT
[4]  
[Anonymous], 2015, NHS CONST ENGL
[5]  
[Anonymous], 1962, LEVI STRAUSS SAVAGE
[6]  
[Anonymous], 1971, Boston Women's Health Collective, Our Bodies, Our Selves
[7]   Actors, patients and agency: a recent history [J].
Armstrong, David .
SOCIOLOGY OF HEALTH & ILLNESS, 2014, 36 (02) :163-174
[8]   How online sexual health services could work; generating theory to support development [J].
Baraitser, Paula ;
Syred, Jonathan ;
Spencer-Hughes, Vicki ;
Howroyd, Chris ;
Free, Caroline ;
Holdsworth, Gillian .
BMC HEALTH SERVICES RESEARCH, 2015, 15
[9]   Comparing the characteristics of users of an online service for STI self-sampling with clinic service users: a cross-sectional analysis [J].
Barnard, Sharmani ;
Free, Caroline ;
Bakolis, Ioannis ;
Turner, Katy M. E. ;
Looker, Katharine J. ;
Baraitser, Paula .
SEXUALLY TRANSMITTED INFECTIONS, 2018, 94 (05) :377-383
[10]  
Berg M., 1997, Rationalising medical work: decision support techniques and medical practices