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帕森斯患病角色在网络空间中的扩展:美国互联网用户代表性样本中的患者信息消费主义与主观健康

Expansion of Parson's sick role into cyberspace: Patient information consumerism and subjective health in a representative sample of U.S. internet users.

作者信息

Seçkin Gül

机构信息

Department of Sociology, University of North Texas, Sycamore Hall 288H, 307 S. Avenue B, Denton, TX 76201, United States.

出版信息

Soc Sci Med. 2020 Feb;247:112733. doi: 10.1016/j.socscimed.2019.112733. Epub 2019 Dec 14.

Abstract

The self-help culture, in the context of the U.S. medical system, demands proactive patient behavior as more responsibility for good health falls on the patient. The presence of health/medical information online alters the dynamics of medical encounters and transforms patients into reflexive consumers or consumer-patients who are engaged in personal health management. This paper examined whether using health information obtained from the Internet to manage personal health care (referred as e-health information consumerism) is associated with subjectively reported negative health outcomes in a representative sample of Internet users in the U.S. These outcomes are conceptualized as experiencing (a) adverse affect (feeling worried and anxious) and (b) health problem due to using Internet information. An online survey (n = 710) was conducted with study participants who were recruited from the largest online probability U.S. research panel developed by a non-profit academic research firm, Knowledge Networks. Analyses included multivariate regressions that included the statistical interactions between e-health information consumerism and the communicational and interactional aspects of medical encounters. Parallel models were tested in the gender-stratified subsamples. Results indicate that robust associations exist between e-health information consumerism and patient-reported health outcomes. Respondents who indicated greater satisfaction with medical communication reported lower averages on experiencing worry and a health problem due to e-health information consumerism. While e-health information consumerism is significantly associated with experiencing a self-reported health problem in both men and women, the association with adverse affect is significant only among women. The moderating role of patient satisfaction with medical communication is stronger among women. Interestingly, the moderating role of patient satisfaction with a medical interaction is stronger among respondents who reported higher averages on experiencing a health problem due to e-health information consumerism. e-Health information consumerism can translate into health benefits if the Internet information is deployed to promote a satisfactory medical partnership.

摘要

在美国医疗体系的背景下,自助文化要求患者积极主动,因为保持健康的更多责任落在了患者身上。在线健康/医疗信息的存在改变了医疗互动的动态,并将患者转变为参与个人健康管理的反思性消费者或消费型患者。本文研究了在美国具有代表性的互联网用户样本中,使用从互联网获取的健康信息来管理个人医疗保健(称为电子健康信息消费主义)是否与主观报告的负面健康结果相关。这些结果被概念化为经历(a)负面影响(感到担忧和焦虑)和(b)因使用互联网信息而出现的健康问题。对从非营利学术研究公司知识网络开发的美国最大的在线概率研究小组招募的研究参与者进行了一项在线调查(n = 710)。分析包括多变量回归,其中包括电子健康信息消费主义与医疗互动的沟通和互动方面之间的统计交互作用。在按性别分层的子样本中测试了平行模型。结果表明,电子健康信息消费主义与患者报告的健康结果之间存在强烈关联。对医疗沟通表示更高满意度的受访者在因电子健康信息消费主义而经历担忧和健康问题方面的平均得分较低。虽然电子健康信息消费主义在男性和女性中都与自我报告的健康问题显著相关,但与负面影响的关联仅在女性中显著。患者对医疗沟通的满意度的调节作用在女性中更强。有趣的是,患者对医疗互动的满意度的调节作用在因电子健康信息消费主义而经历健康问题的平均得分较高的受访者中更强。如果将互联网信息用于促进令人满意的医疗伙伴关系,电子健康信息消费主义可以转化为健康益处。

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