Patient work from a context and time use perspective: a mixed-methods study protocol.

Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE

Original Publication: [London] : BMJ Publishing Group Ltd, 2011-

Comorbidity* ; Employment* ; Task Performance and Analysis*; Diabetes Mellitus, Type 2/*diagnosis ; Monitoring, Physiologic/*instrumentation ; Self-Management/*methods; Adult ; Chronic Disease ; Databases, Factual ; Diabetes Mellitus, Type 2/drug therapy ; Female ; Health Behavior ; Humans ; Male ; Monitoring, Physiologic/methods ; Patient Compliance/statistics & numerical data ; Patient Selection ; Qualitative Research ; Sickness Impact Profile ; Workplace ; Young Adult

Introduction: Self-management is widely promoted but less attention is focused on the work required from patients. To date, many individuals struggle to practise self-management. 'Patient work', a concept that examines the 'work' involved in self-management, is an approach to understanding the tasks, effort, time and context from patient perspective. The purpose of our study is to use a novel approach combining non-obstructive observations via digital devices with in-depth qualitative data about health behaviours and motivations, to capture the full range of patient work experienced by people with type 2 diabetes and chronic comorbidities. It aims to yield comprehensive insights about 'what works' in self-management, potentially extending to populations with other chronic health conditions.
Methods and Analysis: This mixed-methods observational study involves a (1) prestudy interview and questionnaires, (2) a 24-hour period during which participants wear a camera and complete a time-use diary, and a (3) poststudy interview and study feedback. Adult participants living with type 2 diabetes with at least one chronic comorbidity will be recruited using purposive sampling to obtain a balanced gender ratio and of participants using insulin and those using only oral medication. Interviews will be analysed using thematic analysis. Data captured by digital devices, diaries and questionnaires will be used to analyse the duration, time, context and patterns of health-related behaviours.
Ethics and Dissemination: The study was approved by the Macquarie University Human Research Ethics Committee for Medical Sciences (reference number 5201700718). Participants will carry a wallet-sized card that explains the purpose of the study to third parties, and can remove the camera at any stage. Before the poststudy interview begins, participants will view the camera images in private and can delete any images. Should any images be used in future publications or presentations, identifying features such as human faces and names will be obscured.
Competing Interests: Competing interests: Some participants may be recruited via the Macquarie Health General Practitioner clinic and Macquarie Hospital, where SV is practising as a general practitioner and KH is practising as an endocrinologist, respectively. Therefore, the two team members may be responsible for the treatment of some participants. However, SV and KH will not know whether a patient is a participant unless the participant informs them.
(© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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Keywords: body-worn cameras; burden of disease; mixed-methods study; passive data collection; patient work; time-use diary

Date Created: 20181224 Date Completed: 20191029 Latest Revision: 20200309

20231215

PMC6307620

10.1136/bmjopen-2018-022163

30580259