Murray Elizabeth, Lo Bernard, Pollack Lance, Donelan Karen, Catania Joe, White Martha, Zapert Kinga, Turner Rachel
Department of Health Career Scientist, Department of Primary Care and Population Sciences, Royal Free and University College School of Medicine at University College London, , England.
Arch Intern Med. 2003 Jul 28;163(14):1727-34. doi: 10.1001/archinte.163.14.1727.
Use of the Internet for health information continues to grow rapidly, but its impact on health care is unclear. Concerns include whether patients' access to large volumes of information will improve their health; whether the variable quality of the information will have a deleterious effect; the effect on health disparities; and whether the physician-patient relationship will be improved as patients become more equal partners, or be damaged if physicians have difficulty adjusting to a new role.
Telephone survey of nationally representative sample of the American public, with oversample of people in poor health.
Of the 3209 respondents, 31% had looked for health information on the Internet in the past 12 months, 16% had found health information relevant to themselves and 8% had taken information from the Internet to their physician. Looking for information on the Internet showed a strong digital divide; however, once information had been looked for, socioeconomic factors did not predict other outcomes. Most (71%) people who took information to the physician wanted the physician's opinion, rather than a specific intervention. The effect of taking information to the physician on the physician-patient relationship was likely to be positive as long as the physician had adequate communication skills, and did not appear challenged by the patient bringing in information.
For health information on the Internet to achieve its potential as a force for equity and patient well-being, actions are required to overcome the digital divide; assist the public in developing searching and appraisal skills; and ensure physicians have adequate communication skills.
利用互联网获取健康信息的人数持续快速增长,但其对医疗保健的影响尚不清楚。人们担心的问题包括:患者获取大量信息是否会改善他们的健康状况;信息质量参差不齐是否会产生有害影响;对健康差距的影响;以及随着患者成为更加平等的伙伴,医患关系是否会得到改善,或者如果医生难以适应新角色,医患关系是否会受到损害。
对具有全国代表性的美国公众样本进行电话调查,对健康状况较差的人群进行了额外抽样。
在3209名受访者中,31%的人在过去12个月内在互联网上查找过健康信息,16%的人找到了与自己相关的健康信息,8%的人将从互联网上获取的信息带给了医生。在互联网上查找信息存在明显的数字鸿沟;然而,一旦查找了信息,社会经济因素并不能预测其他结果。大多数(71%)将信息带给医生的人想要听取医生的意见,而不是寻求具体的干预措施。只要医生具备足够的沟通技巧,并且患者带来信息时医生没有表现出受到挑战,那么将信息带给医生对医患关系的影响可能是积极的。
为了使互联网上的健康信息发挥其作为促进公平和患者福祉力量的潜力,需要采取行动来克服数字鸿沟;帮助公众培养搜索和评估技能;并确保医生具备足够的沟通技巧。