Wangler Julian, Jansky Michael
Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz.
Dtsch Med Wochenschr. 2019 Aug;144(16):e102-e108. doi: 10.1055/a-0842-8285. Epub 2019 Mar 1.
It may happen that extensive internet search leads to health anxiety in patients, which solidify in the long term. Dealing with such 'cyberchondria' presents a special challenge for the physician. The study highlights general medical attitudes and experiences with regard to patients who are increasingly searching the Internet for symptoms, illnesses or therapies. Particular emphasis will be given to persons who develop health anxieties due to previous Health information on the Internet. It will be determined which procedures make sense in order to respond appropriately to patients with internet-related health concerns.
In the course of a written survey, a total of 844 general practitioners and primary care internists in southern Hesse and additionally in the rural districts of Gießen, Marburg-Biedenkopf, Kassel and the city of Kassel were interviewed between April 20 and June 20, 2018.
Two-thirds of respondents assume that 15 % or more of their own patients confront them with the results of their own internet search. 73 % see the emergence of internet-related health anxiety as an increasing problem in patient care. Against this background, the respondents predominantly see negative effects caused by online self-information (psychological stability, expectations towards the doctor). Almost one of five doctors (18 %) has already experienced the termination of care relationships due to an extensive internet search by the patient. In order to respond to unsettled or frightened patients, the physicians surveyed rely on a detailed explanation of the diagnosis and/or therapy and recommend certain websites that they consider to be reputable.
The authors argue that the online information search should be actively discussed in the patient interview in order to prevent possible negative effects on the doctor-patient relationship. Accordingly, it would be worth considering to extend the medical history by the dimension of online self-information.
广泛的网络搜索可能会导致患者产生健康焦虑，且这种焦虑会长期固化。应对这种“网络疑病症”对医生来说是一项特殊挑战。该研究突出了医生对于患者越来越多地在网上搜索症状、疾病或治疗方法的总体医疗态度和经历。将特别关注那些因之前在网上获取的健康信息而产生健康焦虑的人。将确定哪些程序对于妥善应对有网络相关健康问题的患者是有意义的。
在一项书面调查过程中，2018年4月20日至6月20日期间，对黑森州南部以及吉森、马尔堡 - 比登科普夫、卡塞尔农村地区和卡塞尔市的总共844名全科医生和初级保健内科医生进行了访谈。
三分之二的受访者认为，他们自己的患者中有15%或更多会将自己网络搜索的结果摆在他们面前。73%的人认为与网络相关的健康焦虑的出现是患者护理中日益严重的问题。在此背景下，受访者主要看到了在线自我信息带来的负面影响（心理稳定性、对医生的期望）。近五分之一的医生（18%）已经经历过因患者广泛的网络搜索而导致护理关系终止的情况。为了应对不安或恐惧的患者，接受调查的医生依赖于对诊断和/或治疗的详细解释，并推荐他们认为信誉良好的某些网站。
作者认为，应在患者访谈中积极讨论在线信息搜索，以防止对医患关系可能产生的负面影响。相应地，值得考虑通过在线自我信息这一维度来扩展病史。
