Heterogeneity among exercise participants: latent profile analysis and differential persistence pathways based on the pressure-support-motivation (PSM) framework.

The persistent global burden of chronic diseases has catalysed the integration of digital monitoring systems into healthcare, a promise of personalised, efficient, and proactive management []. In chronic care settings, data-driven surveillance systems, comprising continuous remote monitoring, predictive analytics, and automated alerting, are increasingly deployed to track patient physiology and behaviour in real time []. Proponents argue these technologies enhance clinical outcomes through early intervention and data-informed decision support []. However, chronic care comes with distinct challenges: long-term disease trajectories, sustained behavioural change, complex self-management, and a nurse-patient relationship built on repeated encounters and trust. The introduction of continuous, data-centric surveillance into this intimate context potentially disrupts the very foundations of care, embodied presence, empathetic communication, and shared decision-making []. Yet, prevailing research and ethical guidelines largely approach such technologies through a techno-centric or normative lens, focusing on technical accuracy, data privacy, and abstract principles such as autonomy and beneficence. This discourse tends to treat monitoring tools as neutral adjuncts, overlooking how they actively reshape the social fabric of care. To critically investigate this transformation, we turn to Michel Foucault’s analysis of disciplinary power, particularly his later work on governmentality []. Governmentality shifts the focus from overt repression to the subtle ways in which technologies, knowledge, and everyday practices guide individuals into self-regulation. Unlike a simple panoptic metaphor, governmentality allows us to examine how digital monitoring systems produce certain forms of subjectivity, e.g., the “data-compliant patient” and the “system-responsive nurse”, and how power operates through the very desire to be healthy, efficient, and monitored [].