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Health informatics
Protocol
Patient work from a context and time use perspective: a mixed-methods study protocol
  1. Kathleen Yin1,
  2. Teresa Harms2,3,
  3. Kenneth Ho4,
  4. Frances Rapport1,
  5. Sanjyot Vagholkar4,
  6. Liliana Laranjo1,
  7. Enrico Coiera1,
  8. Jonathan Gershuny2,
  9. Annie Y S Lau1
  1. 1 Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Department of Sociology, Centre for Time Use Research, University of Oxford, Oxford, UK
  3. 3 Planning and Transport Research Centre, Business School, University of Western Australia, Perth, Western Australia, Australia
  4. 4 Faculty of Medical and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  1. Correspondence to Dr Kathleen Yin; kathleen.yin{at}mq.edu.au

Abstract

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.

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

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022163

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    Footnotes

    • Patient consent for publication Not required.

    • Contributors Study conceptualisation: AYSL, EC. Study design: AYSL, KY, TH, JG. Data collection preparation and analysis plan: KY, TH, AYSL, LL, FR. Recruitment and liaison: KH, SV. First draft: KY, AYSL. Draft revision: All authors provided feedback and approved the manuscript.

    • Funding The project is supported by the New South Wales Health Early-to-Mid Career Research Fellowship awarded to AYSL.

    • Disclaimer The funding body did not have a role in study design and execution; data collection, management, analysis and interpretation; or manuscript preparation, review or approval.

    • 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.

    • Ethics approval Macquarie University Human Research Ethics Committee (approval number 5201700718).

    • Provenance and peer review Not commissioned; externally peer reviewed.