Electronic Personal Health Records That Promote Self-Management in Chronic Illness
Mitchell, Beverly, Begoray, Deborah L., Online Journal of Issues in Nursing
Adequate health literacy is critical for patients charged with the responsibility of self-managing chronic conditions, such as chronic obstructive pulmonary disease (COPD). In COPD, complex care demands require patients to be able to access, comprehend, and evaluate multiple sources of health information. Self-management education programs aim to empower patients by providing information and by teaching skills that can improve self-care and enable patients to live fuller and more functional lives. A growing trend in self-management is to offer patients access to their health information through the use of electronic personal health records (PHRs). However, there needs to be a match between patients' health literacy levels and the PHR software used in electronic PHRs to effectively promote self-management. In this article the authors use COPD as an example of a chronic illness that can be self-managed through the use of electronic PHRs. They begin by providing overviews of COPD management, self-management, health literacy, and the use of electronic personal heaithrecords as self-management tools. Then they draw upon Nutbeam's health literacy framework to guide healthcare providers in matching a patient's health literacy level with a software program appropriate for a particular patient.
Citation: Mitchell, B., Begoray, D., (July 20, 2010) "Electronic Personal Health Records That Promote SelfManagement in Chronic Illness" OJIN: The Online Journal of Issues in Nursing Vol. 15 No. 3.
Keywords: health literacy, patient empowerment, electronic personal health records, chronic illness, chronic obstructive pulmonary disease, self-management, health education, Nutbeam's health literacy framework
the significant economic and social burdens of chronic disease have led to a shift in health policy involving a focus on self-management f jordan & osborne. 2007). chronic disease self-management programs seek to empower patients both by providing information and by teaching skills to improve self-care and provider-patient interactions. a growing trend in many countries is to offer patients access to their health information through the use of electronic personal health records (phrs). these electronic health records can assist patients in managing their health condition through individualized care plans, graphing of symptoms, passive biofeedback, tailored instructive or motivational feedback, decisional aids, and reminders (ea.flua.rj. detmer, & singleton, 2007). however, the value of any self-management program or intervention is influenced by its acceptability and usability. For PHRs to be effective in promoting selfmanagement patients need an adequate level of health literacy and a software health record program appropriate to (a good match with) their health literacy level.
In this article COPD will be presented as an example of a chronic illness that can be self-managed through the use of electronic PHRs. COPD is a major public health problem, ranking as the fourth leading cause of chronic morbidity and mortality throughout the world. The World Health Organization has projected that COPD will rank fifth as a worldwide burden of disease by 2020 fPauwels. Buist. Caiverley. Jenkins. & Hurd. 2001). In the United States (US), COPD affects approximately 10.2 million adults (or 5.95% of the adult population) and is a leading cause of hospitalization, particularly among older populations (ages 55 - 75 years) fMannino, 2002). A Canadian survey showed incidence rates increased from 4.6% in the 55 - 64 age group to 6.8% in those over 75 years of age fVieai. 2001).
Due to the complex care demands of COPD, health literacy is critical for self-management, as patients need to be able to access, comprehend, and evaluate multiple sources of health information. Electronic PHRs (subsequently referred to a PHRs) have the potential to facilitate self-management in COPD patients. …