Evidence for person-centeredness in telehealth research

  • Claudia C Bartz International Council of Nurses
Keywords: Telehealth, Diabetes, Research Design, Human Subjects Research


This paper describes person-centred care and distinguishes it from person-centred medicine and patient-centred care. Three characteristics of person-centeredness are drawn from human subjects research principles: respect, benefit and justice. Using reports of telehealth research involving people with diabetes, an exploratory assessment of the methods was done to look for descriptors and processes that would contribute to evidence for the identified characteristics of person-centeredness. Reports from fourteen studies were explored. The study methods and results had great variability; four of the 14 studies used a descriptive design and five studies used a design that included randomization. From a person-centred perspective, respect of study participants could be seen in their willingness to aid, when asked, in the development of intervention approaches and they were grateful for personal attention. Benefit could be seen in that participants responded positively to the offer of improved diabetic self-management and overall better health. As evidence of justice or fairness, telehealth researchers described using various and wide-ranging methods for inviting people comprising populations to become research participants. The triad of concepts may provide guidance for the improvement of research involving people with diabetes.

Author Biography

Claudia C Bartz, International Council of Nurses
Coordinator, ICN eHealth Programme


WHO Definition of eHealth. (2013). Available at: http://www.who.int/topics/ehealth/en/

accessed 18 September 2013.

Universal Declaration on Bioethics and Human Rights. (2005). Available at:


accessed 18 September 2013

WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. (2008). Available at: http://www.wma.net/en/30publications/10policies/b3/ accessed 18 September 2013.

Morris K. Revising the declaration of Helsinki. Lancet 2013;381(9881):1889-1890.

The Belmont Report. (1979). Available at http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html accessed 18 September 2013

Miles A, Mezzich JE. The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice. Int J Person Centered Med 2011;1(2):207-222.

Miles A, Mezzich JE. The patient, the illness, the doctor, the decision: negotiating a ‘new way’ through person-centered medicine. Int J Person Centered Med 2011;1(4):637-640.

Carman KL, Dardess P, Maurer M, et al. Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affair 2013;32(2):223-231.

Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Affair 2013;32(2):250-258.

Daley KA. Person-centered care – what does it actually mean? Am Nurse 2012;44(6):3.

Miln D, Sheeran L, Dryden T, et al. Care requirements of patients with advanced cancer within a specialist centre- moving to person-centered approaches. Int J Person Centered Med 2011;1(1):167-176.

Chan M. Universal coverage is the ultimate expression of fairness. (2010). Available at: http://www.who.int/dg/speeches/2012/wha_20120523/en/index.html# accessed 28 January 2013.

Wild S, Roglic G, Green A, et al. Global prevalence of diabetes. Diab Care 2004;27(5):1047-1053.

Chau JP-C Chung LC-L, Wong RY-M, et al. An evaluation of a web-based diabetes education program designed to enhance self-management among patients living with diabetes. CIN-Comput Inform Nu 2012;30(12):672-679.

Evans NR, Richardson LS, Dhatariya KK, et al. Diabetes specialist nurse telemedicine: admissions avoidance, costs and casemix. European Diabetes Nursing 2012;9(1):17-21.

Gonzalez-Molero I, Dominguez-Lopez M, Guerrero M, et al. Use of telemedicine in subjects with type 1 diabetes equipped with an insulin pump and real-time continuous glucose monitoring. J Telemed Telecare 2012;18:328-332.

Rollo ME, Ash S, Lyons-Wall P, et al. Trial of a mobile phone method for recording dietary intake in adults with type 2 diabetes: Evaluation and implications for future applications. J Telemed Telecare 2011;17:318-323.

Wakefield BJ, Holman JE, Ray A, et al. Outcomes of a home telehealth intervention for patients with diabetes and hypertension. Telemed E Health 2012;18(8):575-579.

Stone RA, Sevick MA, Rao RH, et al. The Diabetes Telemonitoring Study Extension: An exploratory randomized comparison of alternative interventions to maintain glycemic control after withdrawal of diabetes home telemonitoring. J Am Med Inform Assoc 2012;19(6):973-979.

Glasgow RE, Christiansen BA, Kurz D, et al. Engagement in a diabetes self-management website: Usage patterns and generalizability of program use. J Med Internet Res 2011;13(1):e9.

Wu C-J, Chang AM, Courtney M, et al. Using user-friendly telecommunications to improve cardiac and diabetes self-management programme: A pilot study. J Eval Clin Prac 2012;18:695-697.

Walker EA, Shmukler C, Ullman R, et al. Results of a successful telephonic intervention to improve diabetes control in urban adults. Diab Care 2011;34(1):2-7.

Luley C, Blaik A, Reschke K, et al. Weight loss in obese patients with type 2 diabetes: Effects of telemonitoring plus a diet combination – The Active Body Control (ABC) Program. Diab Res Clin Pract 2011;91:286-292.

MacLean LG, White JR, Broughton S, et al. Telephone coaching to improve diabetes self-management for rural residents. Clin Diab 2012;30(1):13-16.

Mulvaney SA, Anders S, Smith AK, et al. A pilot test of a tailored mobile and web-based diabetes messaging system for adolescents. J Telemed Telecare 2012;18:115-118.

Chen S-Y, Chang Y-H, Hsu H-C, et al. One year efficacy and safety of the telehealth system in poorly controlled type 2 diabetic patients receiving insulin therapy. Telemed E Health 2011;17(9):683-687.

Nijland N, van Gemert-Pijnen JWEC, Kelders SM, et al. Factors influencing the use of a web-based application for supporting the self-care of patients with type 2 diabetes: A longitudinal study. J Med Internet Res 2011;13(3):e71.

Buetow S. A framework for doing person-centered health research. Int J Person Centered Med 2011;1(2):358-361.

How to Cite
Bartz, C. (2013). Evidence for person-centeredness in telehealth research. Journal of the International Society for Telemedicine and EHealth, 1(3), 86-92. Retrieved from https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/46
Original Research