La responsabilisation du patient dans un contexte de télé soins à domicile

Abstract

The willingness to transform the health care system is conducive to a new wave of public discourse on patient empowerment. Information and communications technologies (ICT) are regularly considered as means that allow the patient to exercise increased control in addressing health issues. This text aims at examining this phenomenon within the tele-homecare context. The study of a follow-up homecare service highlights one of the four paradigms of the interpretation of patient empowerment: the professional paradigm that is health empowerment-oriented. By using both a sociological and a psychological approach, the study identifies the possibilities and limitations of tele-homecare technology, based on six major variables: access to knowledge, development of critical thinking, personal impact on action or decision, perceived competency, perceived control, and internalization of goals. The results show the high level of requirements needed for an initiative that would produce informed, competent and, most importantly, "expert" patients according to a vision of empowerment based on the recognition of the holistic nature of knowledge, the principle of autonomous thinking, and the patient's potential impact on a variety of decisions. In conclusion, the article defines the implications of these results in terms of the management of the public health system.