Washington University School of Medicine, St. Louis, USA.
Department of Surgery, Minimally Invasive Surgery, Washington University School of Medicine, Campus Box 8109, St. Louis, MO, 63110, USA.
Surg Endosc. 2020 Nov;34(11):5132-5141. doi: 10.1007/s00464-019-07300-0. Epub 2019 Dec 12.
As internet access improves, patient self-education continues to increase. However, patient surgical background, e-literacy, and media exposure potentially influence what information patients search online. This impacts patient concern, healthcare decisions, and subsequent patient-physician interactions. The purpose of this pilot study is to characterize hernia patients' use and the impact of internet self-education regarding surgical mesh.
The target population included patients presenting for evaluation of hernia repair with mesh. A total of 30 patients were enrolled. Patients took surveys before and after the initial surgical consult. The surveys evaluated internet use, mesh research completed, the impact on patient opinions/decisions, and the impact of research on the patient-physician interaction.
The average age of the patients was 58.7 years; sixteen had prior surgery with surgical mesh. 93% of patients were aware of surgical mesh through the media, and 60% were motivated by the media to conduct research. 90% of patients conducted research, and 67% used the internet. Patients with negative attitudes toward mesh had more media exposure in comparison to those with neutral or positive attitudes (p = 0.046), and they were more likely to have researched surgical mesh because of media influence (p = 0.033). This group had the highest rate of perceived knowledge on mesh risks and the lowest regarding benefits (p = 0.013). Patients who had prior surgery without complication had the most positive attitude toward surgical mesh (p = 0.010) and were less likely to plan to do future internet research (p = 0.041) in comparison to patients who had surgery with complications or no prior surgery.
Patients' attitudes and perceived knowledge regarding surgical mesh are associated with media exposure and internet research. These attributes along with prior surgical experience impact the patient-physician relationship and shared decision-making model regarding patient care.
随着互联网接入的改善，患者自我教育不断增加。然而，患者的手术背景、电子素养和媒体接触情况可能会影响患者在网上搜索的信息。这会影响患者的关注点、医疗决策以及随后的医患互动。本初步研究的目的是描述疝患者使用互联网进行自我教育以及对手术网片的影响。
目标人群包括因疝修补术而就诊的患者。共纳入 30 例患者。患者在初次就诊前和就诊后进行问卷调查。这些调查评估了互联网的使用情况、完成的网片研究、对患者意见/决定的影响，以及研究对医患互动的影响。
患者的平均年龄为 58.7 岁；16 例患者之前接受过有网片的手术。93%的患者通过媒体了解到手术网片，60%的患者受媒体影响而进行研究。90%的患者进行了研究，67%的患者使用了互联网。与态度中立或积极的患者相比，对网片持消极态度的患者媒体接触更多（p=0.046），并且他们更有可能因媒体影响而研究手术网片（p=0.033）。该组对网片风险的认知程度最高，对其益处的认知程度最低（p=0.013）。无并发症手术史的患者对手术网片的态度最为积极（p=0.010），与有并发症手术史或无手术史的患者相比，他们不太可能计划进行未来的互联网研究（p=0.041）。
患者对手术网片的态度和认知知识与媒体接触和互联网研究有关。这些特征以及先前的手术经验会影响医患关系以及对患者护理的共同决策模式。
