INSERM, UMR-912 ‘‘Economic & Social Sciences, Health Systems & Societies’’ (SE4S), Marseille, France (CP, ADB, AGLCS, JPM)
Universite´ Aix-Marseille, IRD, Marseille, France (CP, ADB, AGL, JPM)
Med Decis Making. 2012 Mar-Apr;32(2):362-75. doi: 10.1177/0272989X11415114. Epub 2011 Aug 24.
This study aimed to determine whether cancer patients report different information-seeking behaviors (ISBs), investigate why they searched for information, and determine the relationship between their ISBs and their socioeconomic and behavioral characteristics. The authors also explored the relationship between ISB and participation in the medical decision-making process as well as the patients' health state.
A sample of 4270 French cancer survivors aged 18 or older was interviewed at 2 years following diagnosis. Rather than deciding a priori who should be considered an information seeker, the authors chose to statistically define the different ISBs using cluster analysis.
The authors identified 4 distinct profiles: Stereotypical high-information seekers and acquainted seekers are generally highly educated. They search for information due to their own motivation or because they are close to the medical profession. Constrained information seekers are characterized by a low socioeconomic status. They perceive themselves as "dropouts" of the health care system. Finally, the general information seekers did not systematically resort to any specific ISB. The authors show that after adjustment, belonging to a specific ISB was associated with the likelihood of participating in the medical decision-making process and, more surprisingly, with health state.
A key finding of this study is that social disparities are significantly associated with the different ISBs. If these relationships are found in other samples, it would further support the need for medical teams to pay more attention to patients with lower levels of education, particularly in health care systems that have acknowledged equality as a founding principle. The clusters determined in this study offer a potential theoretical framework that can be used in future studies.
本研究旨在确定癌症患者是否表现出不同的信息寻求行为(ISB),探讨他们搜索信息的原因,并确定其 ISB 与社会经济和行为特征之间的关系。作者还探讨了 ISB 与参与医疗决策过程以及患者健康状况之间的关系。
在诊断后 2 年,对 4270 名年龄在 18 岁或以上的法国癌症幸存者进行了抽样调查。作者没有事先决定谁应该被视为信息寻求者,而是选择使用聚类分析从统计学上定义不同的 ISB。
作者确定了 4 个不同的特征:典型的高信息寻求者和熟悉的寻求者通常受过高等教育。他们出于自身动机或因为接近医疗行业而寻求信息。受限制的信息寻求者的社会经济地位较低。他们认为自己是医疗保健系统的“弃儿”。最后,一般信息寻求者并没有系统地采用任何特定的 ISB。作者表明,在调整后,属于特定的 ISB 与参与医疗决策过程的可能性相关,更令人惊讶的是,与健康状况相关。
本研究的一个重要发现是,社会差异与不同的 ISB 显著相关。如果这些关系在其他样本中得到证实,这将进一步支持医疗团队更加关注教育程度较低的患者的需要,特别是在承认平等是基本原则的医疗体系中。本研究确定的聚类为未来的研究提供了一个潜在的理论框架。