Tailoring Persuasive Health Messages to the Predominant Ego State of Patients

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1 研究背景

慢性疾病，比如心血管疾病、糖尿病、呼吸系统疾等，是全球人口死亡的主要原因。缺乏患者参与度是慢性病管理领域由来已久的一个问题。由于慢性疾病不可治愈且需要长期治疗，就需要患者长期参与完成大量常规的健康任务，比如按时服药，测量健康数据，阅读疾病相关的教育文章等。但长期坚持这些重复的健康任务对患者来说颇具挑战，且缺乏可以有效督促患者进行健康管理的提醒方式。因此，有必要开展关于增进慢病患者健康管理参与度的健康消息设计的研究。

本研究探讨了应用沟通分析理论（Transactional Analysis），根据患者的自我状态定制个性化健康信息的可行性。已有研究表明，沟通分析理论在健康关护领域的实践可以增进有效沟通，比如提高医护工作者的沟通和共情能力，建立有信任感的医患关系等。

沟通分析理论

自我状态（Ego State）

对话（Transaction）

研究假设

应用沟通分析理论构建的劝导式健康消息的应用效果好于一般的客观消息；

应用互补型沟通方式的信息将比交叉型沟通方式容易被患者理解且有效促进触发目标健康行为。

2 相关工作

3 方法

为验证该假设，研究者与领域专家开展了共创个性化的健康信息的工作坊，并邀请具有不同主自我状态特点的慢病患者参与深度访谈以及问卷调研，以测试这些个性化健康信息的应用效果。

3.1 工作坊

3.2 深度访谈

3.3 问卷

4 结果

研究结果并未支持沟通分析理论假设的互补型沟通的应用优势，而是揭示了患者群体对照顾型和理性的沟通者以及支持性、专业性沟通风格的偏好。

仅在患者主要自我状态为成人时，互补型沟通的效果显著高于交叉型沟通；当患者为照顾型父母自我状态时，两种沟通方式无显著差异；当患者为自由型儿童时，交叉型沟通的效果好于互补型沟通；

成人和照顾型父母的沟通风格效果均好于自由型儿童沟通风格，表明在提醒完成健康任务时，慢病患者更倾向于被以成人或照顾型父母的自我状态进行沟通

5 讨论

未来研究应补充探索长期应用沟通分析理论的效果，同时也应考虑情境和文化因素的影响。

6 结论

附录

Category	Toward NP patients	Toward A patients	Toward FC patients
Greetings	Dear XXX Care for the wellbeing of patient	Hello XXX Remind patient of health task with facts	Hey XXX Remind patient of health task by stating purpose
Tone	Be kind, gentle, caring and supportive Informal and varied	Be equal and professional Not tendentious	Be human-like and customized Avoid formulaic/impersonal written language
Psychological capability	Supplementary health knowledge Soft reminders to raise awareness of health demands	Professional health knowledge Objective reminders of health requirements	Accessible health knowledge Supportive prompts of health tasks for increasing self-efficacy
Physical capability	Briefly refer to the target health task	Objective instructions for actions to take	Step-by-step guides
Automatic motivation	Bring self-value for enabling health management experience sharing with others Trigger the desire to keep healthy	Bring responsibility for providing full autonomy in health management Bring self-value for self-control in long-term health management	Evoke curiosity for innovative health management solutions Convey a sense of fighting against the disease together with other patients Trigger desire to keep healthy
Reflective motivation	Facilitate preparations by reminding health tasks in advance Facilitate the evaluation by stating the purpose, importance, or benefits of completing this health task	Provide feedback on progress in health management and indicate a corresponding coping strategy Explain the mechanism or rationale behind the task Analyze the cost/benefits of completing the task	Arrange upcoming health tasks in advance for patients Provide customized service adapting to a patient’s unique needs in healthcare State benefits of completing health task
Social opportunity	Refer family members’ caring and support in health management Express expectations or provide positive feedback from the perspective of the doctor Invite the patient to join a health task together with the virtual avatar Generally express care for the well-being of the patients	Invite the patient to commit to completing the health task Express expectations or provide objective feedback from the perspective of the doctor Briefly restate the analytical contents sent previously, and relate it to real-life practice	Express specific concern and caring continuously according to a patient’s health condition Indicate that other patients are all insisting on excellent adherence State what the virtual avatar has done for the patient to trigger target behaviour via reciprocity
Physical opportunity	A kind reminder of physical resources, timing, or locations needed	Objectively stating the physical resources, timing, or locations needed	Specifying the physical resources, timing, or locations needed

Abstract.

Lack of patient engagement has long been a problem in healthcare for chronic disease management. We report a study that explored the feasibility of applying Transactional Analysis theory to tailor health messages to the patient’s predominant ego state, assuming that messages with a complementary communication approach will be better comprehended and efﬁcacious in triggering the targeted health behaviours. These personalized health messages were constructed by ﬁeld experts in co-creation workshops and tested by chronic disease patients with various predominant ego states via interviews and a survey. Our experiment did not support the hypothesized superiority of complementary communication but revealed a general patient preference for supportive and professional communication styles. Future studies should explore the long-term efﬁcacy of complementary communication considering also situational and cultural factors.

Keywords: Patient engagement · Chronic disease management · Personalized health messages · Transactional analysis

Citation

Zhao, X., Tao, M., Chen, Y., Yin, B., Markopoulos, P. (2023).Tailoring Persuasive Health Messages to the Predominant Ego State of Patients. In: Meschtscherjakov, A., Midden, C., Ham, J. (eds) Persuasive Technology. PERSUASIVE 2023. Lecture Notes in Computer Science, vol 13832. Springer, Cham. https://doi.org/10.1007/978-3-031-30933-5_15

Tailoring Persuasive Health Messages to the Predominant Ego State of P