Professional Abstract

Objective

(1) To identify personal strengths relevant to chronic illness management; (2) To create a tablet-based app to help patients identify these strengths when managing chronic illness; (3) To identify scenarios in which a strengths-based approach might be helpful

Study Design

Health care for patients has traditionally focused on deficits, such as diseases, risk factors, and unhealthy behaviors rather than strengths, such as skills or resources. Academic researchers worked with patients with multiple chronic illnesses and primary care physicians, nurse practitioners, nurses, and social workers to conduct this study in two phases.

In the first phase, the research team conducted focus groups and interviews with 76 patients who had chronic conditions and got care at three safety net practices in Cleveland, Ohio. Of these patients, 41 were African American, 20 were white, 1 was Asian, 1 was multi-race, and 13 were unknown race. From the focus groups and interviews, the team created a list of patient-identified strengths relevant to managing chronic illness or improving health habits.

During the second phase, the research team invited 19 patients, caregivers, and healthcare professionals to form a design team. The design team had 10 two-hour sessions to refine the list of strengths. With assistance from programmers, the design team developed a tablet-based app to help patients identify their personal strengths. The app included four videos of patients speaking about the importance of patients knowing their strengths. It directed patients to select their strengths from the design team’s list and rate the relevance of each strength to healthcare visits for chronic illnesses. The app then generated a prioritized list of the patient’s strengths to discuss during the healthcare visit. Finally, the design team identified clinical situations in which patient strengths would be particularly helpful.

Results

Patients reported 30 personal strengths in focus groups and interviews that fit into three categories:

• Personal attributes, such as having a positive attitude
• Interpersonal relationships, such as having support from family or friends
• Access to community resources, such as knowing where to go when one has a health problem

The design team identified scenarios in which a strengths-based approach might be particularly helpful for patients. Examples included managing diabetes, managing chronic pain, and when patients frequently use health care.

Limitations

The research team tested the app only with patients who were members of the design team. As a result, the research did not demonstrate the usefulness of the app for other patients. The team also was not able to see if using patient strengths improved patient health.

Conclusions and Relevance

Patients could use the app to identify and prioritize personal strengths that may be useful in talking to healthcare providers about how to manage their chronic conditions.

Future Research Needs

Future research could determine if patients and clinicians can use the app beneficially in real-world clinical settings. Additional studies could also examine whether strengths-based care improves patient health outcomes.