Mead Nicola, Varnam Robert, Rogers Anne, Roland Martin
National Primary Care Research and Development Centre, University of Manchester, Manchester, UK.
J Health Serv Res Policy. 2003 Jan;8(1):33-9. doi: 10.1177/135581960300800108.
To identify what factors predict patients' interest in using Internet health information in the light of poor uptake of a free, guided Internet service in one inner-city general practice.
Questionnaires were administered over a five-day period to consecutive adult patients attending two Manchester general practices: an inner-city practice serving a relatively deprived patient population where the free Internet service had previously been available, and a suburban practice serving a relatively affluent population. Data were analysed using multiple regression to identify predictors of self-reported interest in using the Internet for health information.
A total of 753 (74%) patients completed the questionnaire although analyses were restricted to 660 (65%) cases. Independent predictors of patient-reported interest in getting health information from the Internet were (in order of relative 'importance'): positive outcome expectancy (i.e. the patient's strength of belief that it would enable them to deal better with their health); previous use of health websites; positive 'self-efficacy' (i.e. patients' confidence in their ability to use the technology); higher education; a positive attitude to getting health information from alternative sources; social deprivation; and having school-age children living at home. Level of Internet access was an important determinant of self-efficacy, but home access was the key predictor of outcome expectancy and past use of 'e-health'.
Access, demographics and, particularly, motivational factors all influence patients' interest in the Internet as a health resource. Proposals to encourage more widespread use of digital health information need to take account of this complexity and not deal with access issues alone.
鉴于在一个市中心全科诊所免费的、有指导的互联网服务使用情况不佳,确定哪些因素可预测患者对使用互联网健康信息的兴趣。
在五天时间内,对连续就诊的成年患者进行问卷调查,这些患者来自曼彻斯特的两家全科诊所:一家位于市中心,服务于相对贫困的患者群体,此前该诊所提供免费互联网服务;另一家位于郊区,服务于相对富裕的人群。使用多元回归分析数据,以确定自我报告的对使用互联网获取健康信息感兴趣的预测因素。
共有753名(74%)患者完成了问卷,不过分析仅限于660例(65%)。患者报告对从互联网获取健康信息感兴趣的独立预测因素(按相对“重要性”排序)为:积极的结果期望(即患者坚信这将使他们能够更好地应对自身健康问题的信念强度);以前使用过健康网站;积极的“自我效能感”(即患者对自己使用该技术能力的信心);高等教育;对从其他来源获取健康信息持积极态度;社会剥夺;以及家中有学龄儿童。互联网接入水平是自我效能感的重要决定因素,但家庭接入是结果期望和过去使用“电子健康”的关键预测因素。
接入情况、人口统计学因素,尤其是动机因素,都会影响患者将互联网作为健康资源的兴趣。鼓励更广泛使用数字健康信息的提议需要考虑到这种复杂性,而不能仅处理接入问题。