Chronic Patients' Emotions Toward Self-Managing Care IT: The Role of Health Centrality and Dependence on IT

Introduction

Chronic conditions, e.g., diabetes, asthma, and cardiovascular diseases, are mainly associated with unhealthy lifestyle behaviors (Fortin et al., 2014) and are one of the major causes of death and disability worldwide. To manage these diseases, patients sometimes use health applications known as self-managing (SM) apps, such as activity trackers, calorie counters, and breathing monitors. These apps generate feedback about patients’ SM performance, which can encourage patients to be active or adopt a healthy diet, and, as such, can engage them in adopting a healthy lifestyle (Chiauzzi et al., 2015).

Past research emphasizes the role of emotions in driving IT use (Cenfetelli, 2004; De Guinea & Markus, 2009; Stein et al., 2015). Positive emotions can lead to more usage; in contrast, negative emotions can adversely influence one’s intentions to use an IT system and lead to resistance and discontinued usage (Maier et al., 2015). The role of emotions is also salient in the healthcare context. Encouraging positive emotions in patients and relieving their negative emotions toward health IT may engage them in using such technologies. Given the importance of emotions in shaping IT use, it is important to understand the antecedents that shape patients’ emotional responses toward self-managing IT (SM IT).

Drawing on appraisal theories (e.g., Lazarus, 1991), extant IT literature argues that emotions toward an IT arise in response to appraisal of the IT (i.e., individuals’ evaluations of the significance and consequences of an IT). For example, when a user finds that the new IT system is making their job more interesting, emotions such as happiness may be triggered. In contrast, if a user thinks that the new system can usurp their job, they might experience fear. Such appraisals can include dimensions such as self-importance, controllability, certainty, and goal conduciveness (Ellsworth & Scherer, 2003). IT research on the appraisal process focuses mainly on users’ assessments of the expected consequence of the IT as either an opportunity or threat (i.e., the degree to which the IT can facilitate or hinder goal achievements) (e.g., Beaudry & Pinsonneault, 2010; Stein et al., 2015). That is, the research tends to look at dimensions such as goal conduciveness and controllability. Although assessing an IT in terms of its possible consequences is an important determinant of the emotions toward IT, a fundamental appraisal dimension is the significance of the IT for one’s self (i.e., self-importance) (Siemer et al., 2007). Even though appraisal theories acknowledge the self-importance dimension, attention to this dimension remains limited. The self-importance dimension may be especially relevant in explaining the emotions toward health IT since health is an important concern for individuals suffering from chronic diseases.

The present study aims to address the above gap by arguing that appraisal of the importance of SM IT for the self may be key in explaining users’ emotions toward it. Since health IT’s design purpose is to improve patients’ health status, the importance of the tool for the self is highly related to how important health is for the user. Therefore, this study draws on identity theories (e.g., Ashforth & Schinoff, 2016; Settles, 2004) to examine the role of patients’ health identity centrality in shaping their emotions toward technology and eventual IT use. Identity centrality, defined as the importance that one ascribes to different self-aspects, has a bearing on one’s actions, attitudes, and behaviors (e.g., Aquino et al., 2009; Murnieks et al., 2014). Drawing on this research, health identity centrality can be defined as the extent to which individuals consider health as integral or central to their sense of self. This paper argues that health identity centrality may be a factor shaping one’s emotions toward SM IT, which will eventually shape their use of it. Thus, this research attempts to address the following question: How does health identity centrality shape emotions toward SM IT in chronic patients while using these tools?-