Sak Gabriele, Schulz Peter Johannes
Institute of Communication & Health, Faculty of Communication Sciences, Università della Svizzera italiana, Lugano, Switzerland.
JMIR Cardio. 2018 May 30;2(1):e12. doi: 10.2196/cardio.8903.
Patients' engagement in health care decision making is constituted by at least two behaviors: health information seeking and active involvement in medical decisions. Previous research reported that older adults desire a lot of information, but want to participate in decision making to a lesser degree. However, there is only limited evidence on the effect of desire for health information on seniors' perceived confidence in making an informed choice (ie, decision self-efficacy).
The goal of this study was to investigate the role desire for health information has for older patients. More specifically, it tested whether decision self-efficacy increases as a function of an assisted computer-based information search. Additionally, the study allowed insights into the sources seniors with hypertension prefer to consult.
A sample of 101 senior citizens (aged ≥60 years) with high blood pressure in the Italian-speaking part of Switzerland answered a questionnaire before and after an informational intervention was applied. The intervention consisted of offering additional information on hypertension from five different sources and of providing the information the participant desired. Preference for receiving this information was the major independent variable. The main outcome measure was decision self-efficacy (assessed at baseline and posttest). Analyses of covariance were conducted to detect differences between and within who desired additional hypertension-related content (intervention group) and "information avoiders" (control group).
Health care professionals firmly remain the preferred and most trusted source of health information for senior patients. The second most consulted source was the internet (intervention group only). However, among the total sample, the internet obtained the lowest credibility score. A significant increase in decision self-efficacy occurred in seniors consulting additional information compared to information avoiders (F1,93=28.25, P<.001).
Consulting health information on a computer screen, and assistance by a computer-savvy person, may be a helpful activity to increase perceived confidence in making treatment decisions in seniors with hypertension.
患者参与医疗保健决策至少由两种行为构成：寻求健康信息和积极参与医疗决策。先前的研究报告称，老年人渴望获得大量信息，但参与决策的程度较低。然而，关于对健康信息的渴望对老年人做出明智选择（即决策自我效能感）的感知信心的影响，证据有限。
本研究的目的是调查对健康信息的渴望对老年患者的作用。更具体地说，它测试了决策自我效能感是否会随着基于计算机的辅助信息搜索而增加。此外，该研究还能深入了解高血压老年人更喜欢咨询的信息来源。
在瑞士意大利语区的101名60岁及以上的高血压老年人样本，在进行信息干预前后回答了一份问卷。干预措施包括从五个不同来源提供有关高血压的额外信息，并提供参与者想要的信息。对接收此信息的偏好是主要的自变量。主要结局指标是决策自我效能感（在基线和测试后进行评估）。进行协方差分析以检测渴望获得额外高血压相关内容的人群（干预组）和“信息回避者”（对照组）之间以及内部的差异。
医疗保健专业人员仍然是老年患者首选且最信任的健康信息来源。第二常被咨询的来源是互联网（仅干预组）。然而，在整个样本中，互联网的可信度得分最低。与信息回避者相比，咨询额外信息的老年人的决策自我效能感显著增加（F1,93=28.25，P<.001）。
在电脑屏幕上查阅健康信息，以及在精通电脑的人的协助下，可能是一种有助于增强高血压老年人对治疗决策的感知信心的有益活动。
