An Investigation of a Collaborative Chronic Illness Management System: Improving Patients' Self-Management by Enhancing Adult Children's Social Support Provision

對合作型慢性病管理系統的研究: 通過優化成年子女的幫助來改善病人的自我管理

Student thesis: Doctoral Thesis

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Award date21 Nov 2018

Abstract

Smart health devices and applications become an integral aspect of all aspects of everyday life, especially in the field of health, constituting the ‘eHealth movement’. The growing prevalence of chronic illnesses all over the world calls for a more important place for eHealth alongside conventional preventive services. However, research about these devices is at a nascent stage. To date, little is known about the real value of these devices as tools for chronic illness management. Given this consideration, in this dissertation, I aim to unveil how smart health devices change the dyadic illness management behaviors of parents with chronic illnesses and their adult children by focusing on a collaborative chronic illness management system.

The existing literature on Internet interventions often misses the critical IT capability and as a result it cannot bring in new insights or radically transcend the achievements of the research on traditional interventions. This dissertation breaks through this barriers. I investigate the mechanisms of the focal healthcare system and conceptualize two IT capabilities. In order to improve the quality of adult children’s social support offered to their parents, I divide social support into positive and negative aspects and elaborate their dimensions in the context where children live far from their parents. Therefore, I can discuss the determinants of positive and negative social support and solve the paradoxical effects of enacted support on health outcomes.

Ground in social support theories, I develop a model that explains how IT capability (i.e., sensing capability and knowledge quality) facilitates positive social support (i.e., instrumental, emotional, informational support) and restrains negative social support (i.e., avoidance and blame) by influencing adult children’s evaluation of parents’ coping and their self-efficacy in providing support. Survey data from 146 pairs of parents and their adult children validates the structural model. The results show that high sensing capability enables adult children to understand parents’ health status and coping behaviors comprehensively thereby increasing the positive support provision and decreasing the negative support provision. High knowledge quality enhances adult children’s self-efficacy in providing support thereby improving the quality of social support. Besides, sensing functionality results in children’s overestimation of parents’ coping as smart health devices bring a greater sense of security to adult children.