**4. Concept of empowerment**

Patient empowerment is a paradigm of transferring the responsibility of patient's health care in the hands of patients. Such paradigm is in contradiction with the traditional health care where the care was in the hands of the medical staff.

Compliance and adherence are concepts that arise from an idea of patient submitting and agreeing with health professional, who acts as an authority, whereas empowerment promotes patient active involvement and control over their own health [19].

The empowerment can be achieved through education, self-management, and shared decision making.

To obtain satisfactory outcome, there is more to be done than just encourage patients to selfmanage their chronic disease. Patients need to be educated about their disease, motivated, provided with patient-centered care, which means that self-management plan needs to be tailored to fit patient priorities, goals, resources, culture, and lifestyle [19].

The education typically occurs at the clinic by the doctor and/or nurse. At Stanford School of Medicine, a Chronic Disease Self-Management Program (CDSMP) [20] was developed which empowers patients through a series of workshops in community settings. Its success is evident in Denmark, which decided to implement it in its health care. As a result, Danish patients are the most empowered [21]. This program was also used in EU project EMPOWER [22].

While face-to-face patient education has positive effects, not much work has been done to evaluate the effect of virtual education. Moreover, patient knowledge is a necessary, but not a sufficient factor for change in the self-care behavior [23]. Patients require self-management support. It can be achieved through face-to-face interaction, through self- and telemonitoring and virtually [24–27].

Collaborative decision making represents collaboration and exchange of knowledge among patients, formal and informal care givers. Because it currently occurs in face-to-face meetings in most cases, there is no evidence for the effects of virtual collaborative decision making.

The goal of such efforts is to shape individuals that make rational health care decisions regarding their health and wellness, are less depended on health care service and contribute to more cost-effective use of health care resources [28].

Finally, in the diabetes treatment, notions of compliance and adherence were replaced with the concept of patient empowerment [29]. With Diabetes Empowerment Scale, significant correlation between level of empowerment and better medication adherence, extensive diabetes knowledge, improved general diet and exercise, blood glucose control, and foot care, can be established [30]. In diabetes management, mobile health technologies are already offering different means for introduction of the concept of empowerment into patients' everyday life.

mostly it is a result of combinations of multiple factors [11, 16]. For example, glycemic control and treatment outcomes are less promising among racial minorities, men and people with depression or anxiety disorders [17, 18]. Those differences emphasize the importance of

Patient empowerment is a paradigm of transferring the responsibility of patient's health care in the hands of patients. Such paradigm is in contradiction with the traditional health care

Compliance and adherence are concepts that arise from an idea of patient submitting and agreeing with health professional, who acts as an authority, whereas empowerment promotes

The empowerment can be achieved through education, self-management, and shared decision

To obtain satisfactory outcome, there is more to be done than just encourage patients to selfmanage their chronic disease. Patients need to be educated about their disease, motivated, provided with patient-centered care, which means that self-management plan needs to be

The education typically occurs at the clinic by the doctor and/or nurse. At Stanford School of Medicine, a Chronic Disease Self-Management Program (CDSMP) [20] was developed which empowers patients through a series of workshops in community settings. Its success is evident in Denmark, which decided to implement it in its health care. As a result, Danish patients are the most empowered [21]. This program was also used in EU project EMPOWER [22].

While face-to-face patient education has positive effects, not much work has been done to evaluate the effect of virtual education. Moreover, patient knowledge is a necessary, but not a sufficient factor for change in the self-care behavior [23]. Patients require self-management support. It can be achieved through face-to-face interaction, through self- and telemonitoring

Collaborative decision making represents collaboration and exchange of knowledge among patients, formal and informal care givers. Because it currently occurs in face-to-face meetings in most cases, there is no evidence for the effects of virtual collaborative decision making.

The goal of such efforts is to shape individuals that make rational health care decisions regarding their health and wellness, are less depended on health care service and contribute

Finally, in the diabetes treatment, notions of compliance and adherence were replaced with the concept of patient empowerment [29]. With Diabetes Empowerment Scale, significant correlation between level of empowerment and better medication adherence, extensive

individualized and patient-centered care.

34 Mobile Health Technologies - Theories and Applications

where the care was in the hands of the medical staff.

to more cost-effective use of health care resources [28].

patient active involvement and control over their own health [19].

tailored to fit patient priorities, goals, resources, culture, and lifestyle [19].

**4. Concept of empowerment**

making.

and virtually [24–27].
