Empowered E-patient : A phenomenological investigation of patients capabilities in a mediatized healthcare

Abstract: This study explores the digitalization of healthcare phenomenon in relation to patient empowerment. Because digital environments change the way individuals interact with healthcare providers, there are consequences for patients’ ability to act and determine their health outcomes in a digital health ecosystem. An assessment of the mediatization of healthcare was therefore conducted through a critical phenomenological analysis of patients’ lived experiences. This methodology facilitated an investigation of their descriptive and subjective reflections on health structures and the means of entering into capabilities that can, but not necessarily do, emerge from specific technical artifacts. Through in-depth interviews, I accessed patients’ perspectives and narratives to phenomenologically enter into their consciousness intentionalities. These revealed that mediatized healthcare certainly affects, possibly enables, and risks constraining health agency. In theoretical terms, this study was based on structural dimensions within the theories of mediatization (Couldry & Hepp, 2017) and health lifestyles (Cookerham, 2005), combined with the individual dimensions of patients’ capabilities (Oosterlaken, 2015) represented by empowerment constructs (Palumbo, 2017), where it elaborates on matters of structure and agency as interrelated and negotiated concepts. The thesis concludes with a critical discussion of the avoidance of technological determinism of the phenomenon: digital tools were incorporated in some of the capabilities of participants, and indeed sometimes contribute to their empowerment, but not always and not for everything. Empowerment must be seen as a process rather than an outcome and, concerning digitalization processes, must be investigated by scrutinizing individual initiatives embedded in a long chain of interconnectedness.