UBC Theses and Dissertations

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UBC Theses and Dissertations

Self-managing with physical activity wearables : emerging ethical issues from the perspectives of persons living with arthritis Leese, Jennifer


Background: Using wearables to self-monitor physical activity is a promising approach to support self-management among persons with arthritis. Little is known, however, about ethical issues (benefits and downsides) that may be experienced by persons with arthritis when using a wearable. Better understanding of these experiences is needed if wearable technology is to be incorporated in arthritis self-management in ways that are ethically aware. Objective: To develop understanding of the perspectives of persons with arthritis on their use of a physical activity wearable in their everyday self-management. Methods: The thesis consists of 3 projects, involving: 1) a meta-synthesis of qualitative evidence that included an exhaustive search of 5 electronic databases and a thematic synthesis of eligible articles; 2) a secondary analysis of qualitative interviews with 21 participants with knee osteoarthritis, following their use of a wearable as part of a physical activity counselling intervention study involving a physiotherapist (PT); 3) a social constructivist application of grounded theory to conduct and analyze qualitative interviews with 14 participants with rheumatoid arthritis, following their use of a wearable as part of a physical activity counselling intervention study involving a PT. Each project draws on a relational ethics lens to explore benefits and downsides identified in participants’ perspectives. Findings: Across projects, participants conveyed 1) how using a wearable expanded and/or challenged their capability of making autonomous choices to be more physically active or not; 2) how using a wearable enhanced and/or threatened to undermine mutual trustworthiness in their relationship with the PT; 3) how using a wearable helped or challenged them in preserving a valued sense of self, in which independence and productivity play a role. Using a relational ethics lens drew attention to how participants’ experiences intertwined with desires to maintain a positive moral identity shaped by the context in which they live. Conclusions: The thesis contributes empirical evidence of relational ethics issues to sparse literature on how persons with arthritis experience using a physical activity wearable positively and/or negatively. It brings to light salient ethical issues pertaining to relational autonomy experienced in participants’ relationships with themselves and health professionals when using a wearable.

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