Skip to main content

Table 3 Normalization Process Theory Coding frame for the effects of online self-diagnosis on the patient-healthcare professional relationship

From: A mixed methods systematic review of the effects of patient online self-diagnosing in the ‘smart-phone society’ on the healthcare professional-patient relationship and medical authority

Coherence (Sense-Making Work) Cognitive Participation (Relationship Work) Collective Action (Enacting Work) Reflexive Monitoring (Appraisal Work)
Differentiation Initiation Interactional workability Systemization
Understanding the differences between peoples’ use of the internet for online self-diagnosis with the healthcare professional’s diagnosis. HCPs communicating and recommending online health websites to people. Bringing online health information to consultations and the effect on the consultation and communication between the patient and HCP. Determining the benefits and risks of online self-diagnosis.
Communal specification Enrolment Relational integration Communal appraisal
Using online health forums and communities to gain information and self-diagnose. HCPs reactions and behaviours towards internet-informed patients. The influence (e.g. on confidence) of bringing online information to the relationship between the HCP and internet-informed patients. Sharing online health information with HCPs and how HCPs react to this.
Individual specification Legitimation Skillset workability Individual appraisal
People achieving an understanding of health information gained through the internet. HCPs perspectives of online self-diagnosis and if they believe this is beneficial or the right thing for people to do. The effect of using online information on roles and responsibilities of members of the public or HCPs. Judging the quality of online information; to what extent do the public or HCPs think the information on the internet is reliable and accurate?
Internalization Activation Contextual integration Reconfiguration
Peoples understanding and perceptions of using the internet to self-diagnose and knowing if this is their preference or if they value the role of the HCP consultations instead. Communicating effectively with internet-informed people and adapting behaviour towards them. Integrating online self-diagnosis into social circumstances. Understanding how online self-diagnosis affects the patient-HCP relationship and altering behaviour and reactions to ensure it is a positive change.