成年人因急性冠状动脉综合征住院时的在线健康信息搜索：谁在寻找信息，谁与医疗保健提供者讨论信息？
Online health information seeking by adults hospitalized for acute coronary syndromes: Who looks for information, and who discusses it with healthcare providers?
机构信息
Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA.
出版信息
Patient Educ Couns. 2018 Nov;101(11):1973-1981. doi: 10.1016/j.pec.2018.06.016. Epub 2018 Jun 30.
OBJECTIVE
To describe characteristics associated with online health information-seeking and discussing resulting information with healthcare providers among adults with acute coronary syndromes (ACS).
METHODS
Consecutive patients hospitalized with ACS in 6 hospitals in Massachusetts and Georgia who reported Internet use in the past 4 weeks (online patients) were asked about online health information-seeking and whether they discussed information with healthcare providers. Participants reported demographic and psychosocial characteristics; clinical characteristics were abstracted from medical records. Logistic regression models estimated associations with information-seeking and provider communication.
RESULTS
Online patients (N = 1142) were on average aged 58.8 (SD: 10.6) years, 30.3% female, and 82.8% non-Hispanic white; 56.7% reported online health information-seeking. Patients with higher education and difficulty accessing medical care were more likely to report information-seeking; patients hospitalized with myocardial infarction, and those with impaired health numeracy and limited social networks were less likely. Among information-seekers, 33.9% discussed information with healthcare providers. More education and more frequent online information-seeking were associated with provider discussions.
CONCLUSION
Over half of online patients with ACS seek health information online, but only 1 in 3 of these discuss information with healthcare providers.
PRACTICE IMPLICATIONS
Clinician awareness of patient information-seeking may enhance communication including referral to evidence-based online resources.
目的
描述急性冠状动脉综合征（ACS）成人患者与在线健康信息搜索相关的特征，并讨论与医疗保健提供者讨论这些信息的情况。
方法
在马萨诸塞州和佐治亚州的 6 家医院连续住院的 ACS 患者中，询问在过去 4 周内报告使用互联网的患者（在线患者）是否进行在线健康信息搜索以及是否与医疗保健提供者讨论信息。参与者报告了人口统计学和社会心理特征；从病历中提取临床特征。使用逻辑回归模型估计与信息搜索和提供者沟通相关的关联。
结果
在线患者（N=1142）的平均年龄为 58.8（标准差：10.6）岁，30.3%为女性，82.8%为非西班牙裔白人；56.7%报告进行了在线健康信息搜索。受教育程度较高和难以获得医疗服务的患者更有可能报告进行信息搜索；因心肌梗死住院的患者，以及健康算数能力受损和社交网络有限的患者则较少进行信息搜索。在信息搜索者中，33.9%与医疗保健提供者讨论了信息。受教育程度较高和更频繁的在线信息搜索与提供者讨论相关。
结论
ACS 的在线患者中有超过一半的人在网上搜索健康信息，但其中只有 1/3的人会与医疗保健提供者讨论信息。
实践意义
临床医生对患者信息搜索的认识可能会增强沟通，包括将患者转介到基于证据的在线资源。
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