Li Na, Orrange Sharon, Kravitz Richard L, Bell Robert A
Department of Communication, University of California, Davis, Davis, CA.
Department of Internal Medicine, University of Southern California, Los Angeles, CA and.
Fam Pract. 2014 Oct;31(5):550-6. doi: 10.1093/fampra/cmu034. Epub 2014 Jun 24.
Little is known about patients' online health information seeking after a primary care or specialist medical visit.
To examine predictors of patients' post-visit online health information seeking, reasons for seeking information and information sources used.
Survey of online support group members (N = 311) with a recent medical visit. Measures included eHealth literacy, patient-centred communication (PCC), post-visit changes in worry, online health information seeking and reasons for seeking information. Analyses were based on descriptive statistics and logistic regression.
Eighty per cent of patients went online post-visit. The most common source used was others' forum posts (91%). The most common reason was curiosity (68%). Dissatisfaction with the physician's performance motivated information seeking for 40% of respondents. In a multivariate analysis, post-visit online health information seeking was highest among patients who were more eHealth literate [odds ratio (OR) = 1.73 (95% confidence interval (CI): 1.11, 2.71), P = 0.016], gave lower PCC ratings to their providers [OR = 0.45 (0.22, 0.90), P = 0.024] and experienced increased worry due to the visit [OR = 5.19 (1.36, 19.82), P = 0.016]. eHealth literate patients made greater use of specialized medical information (e.g. online medical journal articles) than less literate patients. Primary care physicians were rated as more patient centred than specialists. Visit-induced worry led to greater use of interpersonal channels (e.g. e-mailing other forum members). Patients who saw their doctor as less patient-centred were more likely to go online due to dissatisfaction with doctor performance.
Online support forum members often turn to the Internet for health information following their medical visits. Their information seeking is shaped by patient, relational and visit factors.
对于患者在接受初级保健或专科医疗就诊后进行在线健康信息搜索的情况，我们了解甚少。
研究患者就诊后在线健康信息搜索的预测因素、搜索信息的原因以及所使用的信息来源。
对近期有过医疗就诊经历的在线支持小组成员（N = 311）进行调查。测量指标包括电子健康素养、以患者为中心的沟通（PCC）、就诊后担忧程度的变化、在线健康信息搜索情况以及搜索信息的原因。分析基于描述性统计和逻辑回归。
80%的患者在就诊后上网。最常用的信息来源是他人的论坛帖子（91%）。最常见的原因是好奇心（68%）。40%的受访者因对医生表现不满意而促使其搜索信息。在多变量分析中，电子健康素养较高的患者就诊后在线健康信息搜索率最高[优势比（OR）= 1.73（95%置信区间（CI）：1.11，2.71），P = 0.016]，对其医疗服务提供者的PCC评分较低[OR = 0.45（0.22，0.90），P = 0.024]，且因就诊而担忧程度增加[OR = 5.19（1.36，19.82），P = 0.016]。与电子健康素养较低的患者相比，电子健康素养较高的患者更多地使用专业医学信息（如在线医学期刊文章）。初级保健医生被评为比专科医生更以患者为中心。就诊引发的担忧导致更多地使用人际渠道（如给其他论坛成员发电子邮件）。那些认为医生不太以患者为中心的患者，由于对医生表现不满意而更有可能上网。
在线支持论坛成员在就诊后经常会转向互联网获取健康信息。他们的信息搜索受到患者、医患关系和就诊因素的影响。
