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互联网如何影响医患关系:一项多中心研究。

How the Internet influences the relationship between outpatients and gastroenterologists: A multicenter study.

机构信息

University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania; Institute of Gastroenterology and Hepatology, Iasi, Romania.

University of Medicine and Pharmacy "Gr. T. Popa", Iasi, Romania; Environmental Health Department, National Institute of Public Health - RcoPH, Iasi, Romania.

出版信息

Turk J Gastroenterol. 2020 Jan;31(1):17-22. doi: 10.5152/tjg.2019.18353.

Abstract

BACKGROUND/AIMS: The Internet offers a lot of non-filtered medical information which may interfere with the patient-doctor relationship. The aim of the present study was to assess the influence of the Internet on the classical doctor-patient relationship in gastroenterological outpatient settings.

MATERIALS AND METHODS

A multicenter study was conducted, including a representative sample selected from five major regional medical centers throughout Romania. We designed a questionnaire which had two parts. One had to be filled out by adult patients on their first visit to a gastroenterology clinic and the other by physicians, stating the diagnosis and giving a doctor-patient collaboration score.

RESULTS

From a total of 485 patients (49.9% females, mean age 50.42 years), 64.9% had Internet access, 75% out of whom searched for their symptoms online. University graduates searched for their symptoms online more often than secondary school graduates (80% vs. 31.1%, p<0.05). Most patients stated that they used the Internet to identify the most appropriate medical specialist for their condition. Internet users were less likely to visit a general practitioner (GP) before coming to a specialist (85.3% vs. 92.2%, odds ratio (OR) 0.491, 95% confidence interval (CI) 0.24-0.98, p<0.05). Patients who had searched for their symptoms online were less likely to follow the treatment prescribed by the GP (53.6% vs. 67.5%, p=0.004), but they received a better collaboration score (OR 1.12, 95% CI 1.05-1.36, p<0.05).

CONCLUSION

The Internet exerts a positive influence on specialist doctor-patient relationship, but it might burden the health system with the incorrect tendency to replace the role of the GP.

摘要

背景/目的:互联网提供了大量未经筛选的医疗信息,可能会干扰医患关系。本研究旨在评估互联网对胃肠病门诊环境中经典医患关系的影响。

材料和方法

进行了一项多中心研究,包括从罗马尼亚五个主要地区医疗中心中选择的代表性样本。我们设计了一份问卷,分为两部分。一部分由首次到胃肠科诊所就诊的成年患者填写,另一部分由医生填写,说明诊断并给出医患协作评分。

结果

在总共 485 名患者(49.9%为女性,平均年龄为 50.42 岁)中,64.9%有互联网接入,其中 75%的人在网上搜索过自己的症状。大学毕业生比中学毕业生更经常在网上搜索自己的症状(80%比 31.1%,p<0.05)。大多数患者表示他们使用互联网来确定最适合自己病情的医学专家。互联网用户在看专科医生之前不太可能去看全科医生(85.3%比 92.2%,优势比(OR)0.491,95%置信区间(CI)0.24-0.98,p<0.05)。在网上搜索过自己症状的患者不太可能遵循全科医生开出的治疗方案(53.6%比 67.5%,p=0.004),但他们获得了更好的协作评分(OR 1.12,95% CI 1.05-1.36,p<0.05)。

结论

互联网对专科医生与患者的关系产生了积极影响,但它可能会使卫生系统承受不正确的倾向,即替代全科医生的角色。

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