van der Vaart Rosalie, Drossaert Constance H C, de Heus Miriam, Taal Erik, van de Laar Mart A F J
University of Twente, Department of Psychology, Health & Technology, Enschede, Netherlands.
J Med Internet Res. 2013 Feb 11;15(2):e27. doi: 10.2196/jmir.2428.
The Internet offers diverse opportunities for disease management, through information websites (Health 1.0) and interactive applications such as peer support forums, online consults, and insight into electronic medical records (Health 2.0). However, various skills are required to benefit from Health 1.0 and Health 2.0 applications for one's own health, known as eHealth literacy.
To study the eHealth literacy of patients with rheumatic diseases and the types of problems they encounter when using the Internet in relation to their disease.
In two studies, patients were asked about their current disease-related Internet use and their eHealth literacy was observed during performance tests. In study 1, 15 patients (aged 39-74) performed 6 information-retrieval tasks on the Internet (Health 1.0). In study 2, 16 patients (aged 24-72) performed 3 Health 2.0 tasks on a hospital-based online Web portal and 2 Health 2.0 tasks on interactive websites. Participants were asked to think aloud while performing the assignments, and screen activities were recorded. Types and frequency of problems were identified by 2 independent researchers and coded into categories using inductive analysis.
Almost all patients in our studies had searched the Internet for information about rheumatic diseases in the past. Fewer patients had used Health 2.0 applications, but many were nevertheless enthusiastic about the possibilities from Health 2.0 applications after finishing the assignments. However, nearly all participants experienced difficulties, and a substantial number of participants were not able to complete all of the assignments. Encountered problems could be divided into 6 sequential categories: (1) operating the computer and Internet browser, (2) navigating and orientating on the Web, (3) utilizing search strategies, (4) evaluating relevance and reliability, (5) adding content to the Web, and (6) protecting and respecting privacy. Most severe difficulties occurred in levels 3 and 4-in formulating a search query, evaluating the source of the information, and in scanning a website for relevant information.
Many patients have insufficient skills to properly use Health 1.0 and Health 2.0. Formulating proper search strategies and evaluating the found information caused problems among the majority of patients. Concerning Health 2.0, use and awareness of these applications is low and patients should be guided in the use of them. Our findings may contribute to the awareness of patients' eHealth literacy problems among health professionals, and stress the importance of usability guidelines in Web design.
互联网通过信息网站（健康1.0）以及诸如同伴支持论坛、在线咨询和电子病历洞察等交互式应用程序，为疾病管理提供了多样的机会。然而，要从健康1.0和健康2.0应用程序中受益于自身健康，需要具备各种技能，即所谓的电子健康素养。
研究风湿性疾病患者的电子健康素养，以及他们在使用互联网处理与疾病相关事务时遇到的问题类型。
在两项研究中，询问患者当前与疾病相关的互联网使用情况，并在性能测试期间观察他们的电子健康素养。在研究1中，15名患者（年龄39 - 74岁）在互联网上执行6项信息检索任务（健康1.0）。在研究2中，16名患者（年龄24 - 72岁）在医院的在线门户网站上执行3项健康2.0任务，并在交互式网站上执行2项健康2.0任务。要求参与者在执行任务时大声思考，并记录屏幕活动。由2名独立研究人员确定问题的类型和频率，并使用归纳分析将其编码为类别。
在我们的研究中，几乎所有患者过去都曾在互联网上搜索过有关风湿性疾病的信息。使用健康2.0应用程序的患者较少，但许多患者在完成任务后对健康2.0应用程序的可能性仍充满热情。然而，几乎所有参与者都遇到了困难，相当数量的参与者无法完成所有任务。遇到的问题可分为6个连续类别：（1）操作计算机和互联网浏览器；（2）在网络上导航和定位；（3）运用搜索策略；（4）评估相关性和可靠性；（5）在网络上添加内容；（6）保护和尊重隐私。最严重的困难出现在第3和第4级——制定搜索查询、评估信息来源以及在网站上扫描相关信息。
许多患者缺乏正确使用健康1.0和健康2.0的技能。制定适当的搜索策略和评估所找到的信息给大多数患者带来了问题。关于健康2.0，这些应用程序的使用和认知度较低，应该指导患者如何使用。我们的研究结果可能有助于提高医疗专业人员对患者电子健康素养问题的认识，并强调网页设计中可用性指南的重要性。
