Mano Rita
Department Of Human Services, University of Haifa, Haifa, Israel.
Health Expect. 2015 Dec;18(6):2489-500. doi: 10.1111/hex.12218. Epub 2014 Jun 17.
BACKGROUND/CONTEXT: Access and use of online health information become increasingly important to health-oriented individual that may have implication for their health and wellness. The phenomenon of e-patients suggests that e-patients use the internet to increase health literacy and achieve health information about diagnosis, treatments, specialists and well-being before undergoing a health changes. Online health information may not 'fit' consultations with providers mainly when online source of information is trusted mainly when e-patients express lack of satisfaction with health-care providers. The strain between the two becomes evident when e-patients consider health changes.
We examine health changes among e-patients. We assess the relationship between (a) trust in online health information and (b) satisfaction with health-care provider to predict two types of health changes: (a) well-being and (b) health-care changes. We also control for 'situational' effects including socio-economic and chronic illness variations.
A telephone survey was conducted in 2010 in Israel among approximately 4000 individuals.
Two-thousand individuals completed interviews (54% response rate). Seventy percentage were Internet users (n = 1371).
Well-being health changes; health-care changes; satisfaction with institutional health-care provider; chronic illness: socio-economic: age; gender; marital status; education.
Socio-economic and health status differences generate variations in use of online health information; trusting online health positively affects well-being - not health-care - changes but satisfaction with health-care provider positively improves the likelihood for health-care changes.
The results indicate that (a) e-patients use online health information to make well-being health changes - starting a diet or physical activity programme - but not health-care changes - in medication or in health-care provider - (b) satisfaction with institutional health provider has a significant effect on health-care decisions (c) chronically ill are not likely to use online health information.
E-patients' expectations from health-care institutional providers play a central role in initiating health changes. Access and use of online health information provide an alternative/additional channel for information when e-patients consider health changes and create a push/pull decision-making strain on both providers and recipients of health services. Health-care providers should address e-patients'concerns, mainly in cases of chronic illness concerns, and point to the boundaries of online health information. Traditional and novel sources of health information can increase health empowerment and better health care when communication channels between health providers and e-patients are comfortably verified in advance and agreed upon.
背景/情境：获取和使用在线健康信息对注重健康的个人变得越来越重要，这可能会对他们的健康和幸福产生影响。电子患者现象表明，电子患者利用互联网提高健康素养，并在经历健康变化之前获取有关诊断、治疗、专家和健康状况的健康信息。在线健康信息可能与与医疗服务提供者的咨询“不匹配”，主要是当电子患者主要信任在线信息来源，以及当他们对医疗服务提供者表示不满时。当电子患者考虑健康变化时，两者之间的矛盾就变得明显了。
我们研究电子患者的健康变化。我们评估（a）对在线健康信息的信任与（b）对医疗服务提供者的满意度之间的关系，以预测两种类型的健康变化：（a）健康状况和（b）医疗保健变化。我们还控制了包括社会经济和慢性病差异在内的“情境”影响。
2010年在以色列对约4000人进行了电话调查。
2000人完成了访谈（回复率为54%）。70%是互联网用户（n = 1371）。
健康状况变化；医疗保健变化；对机构医疗服务提供者的满意度；慢性病；社会经济状况；年龄；性别；婚姻状况；教育程度。
社会经济和健康状况差异导致在线健康信息使用的差异；信任在线健康信息对健康状况变化（如开始节食或体育锻炼计划）有积极影响，但对医疗保健变化（如药物治疗或医疗服务提供者的选择）没有影响；而对医疗服务提供者的满意度对医疗保健决策有显著影响；慢性病患者不太可能使用在线健康信息。
电子患者对医疗机构提供者的期望在引发健康变化方面起着核心作用。获取和使用在线健康信息为电子患者考虑健康变化时提供了一个替代/额外的信息渠道，并在医疗服务提供者和接受者之间产生了一种推拉式的决策矛盾。医疗服务提供者应解决电子患者的担忧，主要是在慢性病相关问题上，并指出在线健康信息的局限性。当医疗服务提供者和电子患者之间的沟通渠道提前得到妥善验证并达成一致时，传统和新颖的健康信息来源可以增强健康权能并改善医疗保健。
