Hansen Anne Helen, Claudi Tor, Årsand Eirik
Centre for Quality Improvement and Development, University Hospital of North Norway, Tromsø, Norway.
Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
J Med Internet Res. 2019 Mar 21;21(3):e13465. doi: 10.2196/13465.
Despite the increasing prevalence of diabetes and the increasing use of eHealth, little is known about the association between provider-based health services and eHealth among people with diabetes. This is the second study in a project exploring the associations between the use of eHealth and the use of provider-based health services.
The objective of this study was to investigate which eHealth services are used among out-of-hours (OOH) visitors with type 1 diabetes (T1D), and whether the use of eHealth (eg, apps, search engines, video services, and social media) was associated with the use of OOH services. We also wanted to investigate associations between anxiety, reassurance, and change in doctor-seeking behavior because of health information acquired from the Internet, and the use of OOH services.
We used data from a 2018 email survey of members of the Norwegian Diabetes Association (18-89 years old). Respondents with T1D were eligible for analyses. Using descriptive statistics, we estimated the use of OOH services and eHealth. Using logistic regressions, we studied the associations between the use of OOH services and the use of eHealth, as well as associations between the use of OOH services and reported consequences of using Internet-based health information.
In the sample of 523 people with T1D (mean age 47 years), 26.7% (129/484) visited OOH services once or more during the previous year. Among the OOH visitors, search engines were used for health purposes by 86.7% (111/128), apps (health apps in general) by 63.6% (82/129), social media by 45.3% (58/128), and video services by 28.4% (36/127). The use of OOH services was positively associated with self-reported anxiety/depression (odds ratio [OR] 4.53, 95% CI 1.43-14.32) and with the use of apps (OR 1.73, 95% CI 1.05-2.85), but not with other types of eHealth. Those who had felt anxious based on information from the Internet were more likely to visit OOH services compared with those who had not felt anxious (OR 2.38, 95% CI 1.50-3.78). People who had decided to consult a doctor based on information from the Internet were more likely to visit OOH services (OR 2.76, 95% CI 1.64-4.66), compared to those who had not made such an Internet-based decision.
People with T1D were frequent users of OOH services, and the OOH visitors were frequent users of eHealth. The use of OOH services was positively associated with the use of health apps, with self-reported anxiety/depression, and with feeling anxious based on information from the Internet. Likewise, deciding to consult a doctor based on information from the Internet was positively associated with OOH visits. The use of eHealth seems to have a significant impact on people with T1D.
尽管糖尿病的患病率日益上升且电子健康的使用不断增加，但对于糖尿病患者而言，基于医疗机构的健康服务与电子健康之间的关联却知之甚少。这是一个探索电子健康使用与基于医疗机构的健康服务使用之间关联的项目中的第二项研究。
本研究的目的是调查1型糖尿病（T1D）患者在非工作时间（OOH）就诊时使用了哪些电子健康服务，以及电子健康（如应用程序、搜索引擎、视频服务和社交媒体）的使用是否与OOH服务的使用相关。我们还想研究因从互联网获取健康信息而产生的焦虑、安心感以及就医行为变化与OOH服务使用之间的关联。
我们使用了2018年对挪威糖尿病协会成员（18 - 89岁）进行电子邮件调查的数据。患有T1D的受访者符合分析条件。我们使用描述性统计方法来估计OOH服务和电子健康的使用情况。通过逻辑回归，我们研究了OOH服务使用与电子健康使用之间的关联，以及OOH服务使用与报告的基于互联网的健康信息使用后果之间的关联。
在523名T1D患者样本（平均年龄47岁）中，26.7%（129/484）在过去一年中曾一次或多次就诊于OOH服务。在OOH就诊者中，86.7%（111/128）使用搜索引擎获取健康信息，63.6%（82/129）使用应用程序（一般指健康应用程序），45.3%（58/128）使用社交媒体，28.4%（36/127）使用视频服务。OOH服务的使用与自我报告的焦虑/抑郁呈正相关（比值比[OR] 4.53，95%置信区间1.43 - 14.32）以及与应用程序的使用呈正相关（OR 1.73，95%置信区间1.05 - 2.85），但与其他类型的电子健康无关。与未因互联网信息而感到焦虑的人相比，那些因互联网信息而感到焦虑的人更有可能就诊于OOH服务（OR 2.38，95%置信区间1.50 - 3.78）。与未基于互联网信息做出此类决定的人相比，那些基于互联网信息决定咨询医生的人更有可能就诊于OOH服务（OR 2.76，95%置信区间1.64 - 4.66）。
T1D患者是OOH服务的频繁使用者，而OOH就诊者是电子健康的频繁使用者。OOH服务的使用与健康应用程序的使用、自我报告的焦虑/抑郁以及因互联网信息而感到焦虑呈正相关。同样，基于互联网信息决定咨询医生与OOH就诊呈正相关。电子健康的使用似乎对T1D患者有重大影响。
