The influence of personal knowledge management on individual health care decision-making : an action learning approach : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Management at Massey University, Albany, Auckland, New Zealand

Abstract

Background: Making effective health care decisions is important. Despite the large volumes of information available, individuals often face personal limitations evaluating this information and making optimal decisions. Personal knowledge management has been suggested as a method of addressing information barriers and improving decision-making. Personal knowledge management has, however, been mostly applied within an education context, in order to improve individuals’ learning performance. From the available literature in this area, very limited research or significant conceptual development has been undertaken on personal knowledge management and its influence on decision-making, particularly in the health care context.

Aims and Significance: This study examines an effective personal knowledge management strategy for older adults (aged between 46 and 75) with limited computer/technological skills by answering the following questions: 𝘏𝘰𝘸 𝘥𝘰 𝘰𝘭𝘥𝘦𝘳 𝘢𝘥𝘶𝘭𝘵𝘴 𝘢𝘤𝘤𝘦𝘴𝘴 𝘢𝘯𝘥 𝘦𝘷𝘢𝘭𝘶𝘢𝘵𝘦 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘢𝘯𝘥 𝘬𝘯𝘰𝘸𝘭𝘦𝘥𝘨𝘦 𝘧𝘰𝘳 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘥𝘦𝘤𝘪𝘴𝘪𝘰𝘯-𝘮𝘢𝘬𝘪𝘯𝘨? 𝘏𝘰𝘸 𝘤𝘢𝘯 𝘱𝘦𝘳𝘴𝘰𝘯𝘢𝘭 𝘬𝘯𝘰𝘸𝘭𝘦𝘥𝘨𝘦 𝘮𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵 𝘩𝘦𝘭𝘱 𝘰𝘭𝘥𝘦𝘳 𝘢𝘥𝘶𝘭𝘵𝘴 𝘸𝘪𝘵𝘩 𝘭𝘪𝘮𝘪𝘵𝘦𝘥 𝘤𝘰𝘮𝘱𝘶𝘵𝘦𝘳/𝘵𝘦𝘤𝘩𝘯𝘰𝘭𝘰𝘨𝘪𝘤𝘢𝘭 𝘢𝘣𝘪𝘭𝘪𝘵𝘪𝘦𝘴 𝘮𝘢𝘯𝘢𝘨𝘦 𝘵𝘩𝘦𝘪𝘳 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘢𝘯𝘥 𝘬𝘯𝘰𝘸𝘭𝘦𝘥𝘨𝘦 𝘧𝘰𝘳 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘥𝘦𝘤𝘪𝘴𝘪𝘰𝘯-𝘮𝘢𝘬𝘪𝘯𝘨? 𝘏𝘰𝘸 𝘦𝘧𝘧𝘦𝘤𝘵𝘪𝘷𝘦 𝘪𝘴 𝘢𝘯 𝘢𝘤𝘵𝘪𝘰𝘯 𝘭𝘦𝘢𝘳𝘯𝘪𝘯𝘨 𝘵𝘳𝘢𝘪𝘯𝘪𝘯𝘨 𝘱𝘳𝘰𝘨𝘳𝘢𝘮 𝘪𝘯 𝘴𝘶𝘱𝘱𝘰𝘳𝘵𝘪𝘯𝘨 𝘰𝘭𝘥𝘦𝘳 𝘢𝘥𝘶𝘭𝘵𝘴 𝘸𝘪𝘵𝘩 𝘭𝘪𝘮𝘪𝘵𝘦𝘥 𝘤𝘰𝘮𝘱𝘶𝘵𝘦𝘳/𝘵𝘦𝘤𝘩𝘯𝘰𝘭𝘰𝘨𝘪𝘤𝘢𝘭 𝘢𝘣𝘪𝘭𝘪𝘵𝘪𝘦𝘴 𝘧𝘰𝘳 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘥𝘦𝘤𝘪𝘴𝘪𝘰𝘯-𝘮𝘢𝘬𝘪𝘯𝘨? The aim of this study is to provide an understanding of the use of action learning and personal knowledge management pertaining to older adults’ health care decision-making. Examples of relevant health care concerns include, diabetes and obesity or other issues of this nature, but are exclusive of severe health issues, such as cancer. The findings will offer educators and researchers an understanding of ways to help these individuals to navigate the world of information regarding critical personal decision-making, with specific reference to health care.

Method: To investigate this issue, a qualitative study was conducted using action learning with thematic and grounded theory coding techniques. New Zealand patient health care support groups and churches provided a source of older adults with health-related issues as volunteers. Participants were asked to practice personal knowledge management strategies, focusing on their personal health-related issues after each learning session. In the following session, the issues or experiences that the participants encountered whilst conducting their self-practice exercises, within their groups were discussed.

Findings: This study found that the older adult participants in this study used Google, Facebook closed groups, YouTube, online videos, health care support groups, family and medical professionals as information sources before embarking upon this training program. To evaluate alternative treatment options, these participants rely predominantly on family, friends, medical professionals and their personal life experience for decisions. This study found that major factors that negatively impacted older adults’ effective information interpretation and decision-making include: barriers to accessing accurate and relevant health care information and knowledge, barriers to computer-based technology use, and humanistic barriers. The findings suggest that a four-stage personal knowledge management strategy could help older adults (with limited computer/technological skills) to overcome the barriers to effective information interpretation, and making informed health care decisions.

Finally, this study suggests some practical training/learning techniques for older adults. For instance, major individual health-related issues of the older adults within the pre-training program need to be confirmed, followed by a warm welcome prior to the commencement of the training program. I learned that it is important to pre-diagnose participants’ abilities in learning and computer-based technology before designing the training program. This can help to develop an appropriate training program for a specific cohort.

Conclusions: The findings of this study contribute to the development of an academic understanding of personal knowledge management conceptualisation in the consumer decision-making field, with the aim of improving older adults’ information and knowledge management processes. This study serves as a vantage point for further empirical research in personal knowledge management and older adult education and training.