IP4 healthcare: The physician-patient relationship in the adoption and everyday life integration process of digital media for chronic disease self-management

背景：数字化和个性化是医患关系的大趋势。医生在慢性疾病患者的自我管理中发挥着至关重要的作用，通过提供有关疾病及其治疗的知识，并在医患关系中对治疗期间的行为提出建议。在这种关系中，数字媒体可用于不同目的，例如，用于信息交换和搜索，或用于数据交换和联系（例如，通过远程医疗）。到目前为止，研究只考虑了具体方面，例如医生或患者对数字媒体使用的自我感知，以及影响自我管理中对数字媒体的建议和接受程度的选定因素。为了获得一个整体的图景，研究必须以理论为基础，并将重点放在协商和调解过程上，作为关于治疗的协商沟通，从而关于使用数字媒体进行慢性疾病的自我管理，其目标是与健康相关的数字媒体的日常生活整合。本研究项目采用Uwe Schimank的行动者-结构动力学，分析决定个体行为和互动的行动者星座和结构，以及通过治疗与健康相关的数字媒体日常生活整合的发展。目标：IP4旨在(1)通过调整行为者-结构动力学，从理论上概念化医患关系；(2)对医患关系获得一个整体的、系统的和互惠的观点；(3)作为行为者-结构动力学，研究医患关系的各个方面，捕捉医生和患者的自我和相互感知。工作计划：IP4进行了四项相互关联的研究：(1)对250名全科医生、耳鼻喉科医生、糖尿病医生或内科医生进行在线调查，(2)对60名医患二人组进行半结构化访谈，(3)对咨询时间进行参与性观察，(4)由四名医生和四名患者组成的焦点小组讨论、解释和背景化我们的研究结果。研究3和4被设计为定性小组（两波）。合作和利益团体：主要与IP5同行、IP6组织和IP7报告进行双边和多边合作。从理论和方法的角度来看，IP4：医疗保健涉及RU中的三个概念组，即CG：持续使用、CG：期望值理论和CG：网络方法。预期结果/贡献：医患关系的理论模型将根据实证结果进行调整。本研究项目采用多方法设计，从医患关系的过程视角拓展研究现状，整体关注数字媒体用于慢性病自我管理的协商和调解过程。

Background: Digitalization and individualization as megatrends challenge the physician-patient relationship. Physicians play a vital role in patients’ self-management of chronic dis-eases by providing knowledge about the disease and its therapy and advising on behaviors during treatment in the physician-patient relationship. Within this relationship, digital media can be used for different purposes, for example, for information exchange and search or for data exchange and contact (e.g., via telemedicine). So far, research has only considered specific aspects, e.g., the self-perception of physicians’ or patients’ digital media use, and selected factors influencing the recommendations and acceptance of digital media for self-management. To gain a holistic picture, research must be theory-based and focus on the ne-gotiation and mediation process as deliberative communication about therapy and thus about the use of digital media for self-management of chronic diseases, which aims at the everyday life integration of health-related digital media. The research project adapts the actor-structure dynamics of Uwe Schimank to analyze actor constellations and structures that determine individual action and interaction and the development of the everyday life integration of health-related digital media through therapy. Objectives: IP4 aims to (1) theoretically conceptualize the physician-patient relationship by adapting the actor-structure-dynamics, (2) gain a holistic, systematic, and reciprocal view of the physician-patient relationship, and (3) investigate all facets of the physician-patient rela-tionship as actor-structure-dynamics, capturing physicians’ and patients’ self- and mutual perceptions. Work program: IP4 conducts four interrelated studies: (1) An online survey of 250 general physicians, otolaryngologists, diabetologists, or internists, (2) semi-structured interviews with 60 physician-patient dyads, (3) participatory observations of consulting hours, and (4) focus groups with four physicians and one with four patients each to discuss, interpret, and contex-tualize our findings. Studies 3 and 4 are designed as qualitative panels (two waves). Collaborations and Interest groups: Bi- and multilateral cooperation mainly with IP5: peers, IP6: organizations, and IP7: reporting. From a theoretical and methodological point of view, IP4: healthcare is engaged in the three concept groups within the RU, namely, CG: continued use, CG: expectancy-value theories, and CG: network approach. Expected results/contributions: The theoretical modeling of the physician-patient relation-ship will be adapted based on the empirical results. With its multi-methodological design, the research project expands the state of research by casting a process perspective on the phy-sician-patient relationship, focusing on the negotiation and mediation process of digital media use for chronic disease self-management in its entirety.