PhD Thesis by Jacob Østergaard Madsen: Underprivileged Citizens’ Use of Technology for Everyday Health Management

In this doctoral thesis, Jacob Madsen addresses the problem of inequality in health by focusing on how underprivileged citizens experience and manage health-related problems in their everyday lives. Particularly, he focuses on the citizen’s use of technology for engaging in health-related occupation.

Underprivileged Citizens’ Use of Technology for Everyday Health Management - A Conceptualization of Underprivileged Citizens’ Engagement in Health-Related Occupation by Jacob Østergaard Madsen

In this doctoral thesis, I address the problem of inequality in health by focusing on how underprivileged citizens experience and manage health-related problems in their everyday lives. Particularly, I focus on the citizen’s use of technology for engaging in health-related occupation. The field of research for the thesis is occupational science (OS), while Deweyan pragmatism is called upon as a theoretical frame.

The overall aim of this thesis is to develop conceptual knowledge on how to support underprivileged citizens’ engagement in health-related occupation, with attention to these citizens’ everyday health management using technology. To achieve this aim, three consecutive studies were conducted.

Study I: A state-of-the-art literature study to contribute knowledge of how relevant areas of concern have been described and conceptualized within contemporary occupational science and therapy literature from 2004 to 2014. The study revealed an assumed relation in the literature between occupation and inequality in health. A transactional perspective on occupation was identified and introduced as a possible theoretical perspective on the relation between occupation and inequality in health. From a transactional perspective on occupation, inequality in health may be regarded as a situation that can be experienced by individuals or groups of people due to unequal and limited possibilities for choosing and participating in occupation.

Study II: An empirical study to contribute empirical knowledge about underprivileged citizens’ use of technology for engaging in health-related occupation. John Dewey’s theory of transaction was applied as a conceptual framework for analyzing the citizens´ use of technology for managing everyday health. The study showed that citizens’ use of technology for engaging in health-related occupation is influenced by the technology’s support of the merging of the complex interplay of personal and contextual conditions and its supporting of the citizens in their “inquiry to action” strategies concerning everyday health management.
Study III: A theoretical study of John Dewey’s theory of inquiry to contribute theoretical understanding of engagement in occupation from a situated perspective. In the study, it was found that inherent in occupation is an inquiring process that provides occupation with a transformative capacity. By engaging in occupation, humans situate themselves into ever changeable situations through the explorative and practical acting of inquiry. However, this enacted situated inquiry depends on a context rich enough to provide cues for knowledge strategies on how to engage in the next experimental and transformational doing in everyday life.

Overall, this thesis contributes by conceptualizing underprivileged citizens’ engagement in health-related occupation as a situationally dependent transactional experience, characterized by the practical acting of inquiry on health-related matters. Derived from this conceptualization, underprivileged citizens’ problems in engaging in health-related occupations can be viewed as difficulties with acting inquiringly on health-related indeterminacy in their everyday lives. Based on this perception of engagement in health-related occupation, underprivileged citizens’ use of technology for everyday health management can be described as dependent on whether or not the technology takes account of and supports the merging of the necessary and complex interplay of personal and contextual conditions as well as supporting the citizens in their “inquiry to action” strategies concerning in-depth practical concerns about everyday health management.

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