Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands.
Minddistrict, Amsterdam, Netherlands.
J Med Internet Res. 2021 Jul 5;23(7):e23670. doi: 10.2196/23670.
Today, many cancer patients engage in online health information seeking (OHIS). However, little is known about how patients differ in their OHIS levels. In addition, OHIS might influence patient participation during a consultation with a physician, which might mediate the effects on patient outcomes.
The aim of this study is twofold: first, to provide insight into which personal characteristics and psychosocial factors affect patients' OHIS levels and, second, to test the hypothesis that the effects of OHIS on patient outcomes are mediated by patient participation during the consultation.
Patient participation was operationalized in terms of patients' absolute word count; the relative contribution of the patient, compared with the health care provider; and the number of questions and assertions expressed during the consultation. The patient outcomes measured were anxiety after the consultation, satisfaction with the consultation, and information recall. Participants in this study were patients recently diagnosed with colorectal cancer recruited from 6 hospitals in the Netherlands (n=90). Data were collected using questionnaires and audio-recorded consultations of patients with health care providers before their surgery.
The results showed that younger patients, higher educated patients, patients with a monitoring coping style, and patients who experienced more cancer-related stress engaged more in OHIS. In turn, OHIS was related to patient participation in terms of the patient's absolute word count but not to the relative contribution to the consultation or expressing questions and assertions. We did not find a relation between OHIS and anxiety and OHIS and recall mediated by patient participation. However, we found that patients' absolute word count significantly mediated the positive association between OHIS and patients' satisfaction with the consultation.
Results indicate positive implications of OHIS for patients' care experience and, therefore, the importance of helping patients engage in OHIS. However, the results also suggest that OHIS is only successful in increasing a single aspect of patient participation, which might explain the absence of relations with anxiety and recall. The results suggest that more beneficial effects on patient outcomes may be achieved when health care providers support patients in OHIS.
如今，许多癌症患者会在线搜索健康信息（OHIS）。然而，人们对患者在 OHIS 水平上的差异知之甚少。此外，OHIS 可能会影响患者在与医生咨询时的参与度，而这种参与度可能会对患者的结局产生影响。
本研究旨在深入了解哪些个人特征和心理社会因素会影响患者的 OHIS 水平，其次，检验 OHIS 通过咨询期间患者的参与度对患者结局产生影响的假设。
本研究将患者的参与度定义为患者的绝对字数；患者相对于医疗保健提供者的贡献度；以及咨询期间提出的问题和主张的数量。本研究中测量的患者结局为咨询后的焦虑、对咨询的满意度和信息回忆。该研究的参与者是从荷兰的 6 家医院招募的最近被诊断为结直肠癌的患者（n=90）。使用问卷和患者与医疗保健提供者在手术前的咨询音频记录收集数据。
结果表明，年轻患者、受教育程度较高的患者、采用监测应对方式的患者以及经历更多癌症相关压力的患者会更多地进行 OHIS。反过来，OHIS 与患者参与度呈正相关，具体表现为患者的绝对字数，但与咨询的相对贡献或提出问题和主张无关。我们没有发现 OHIS 与焦虑和 OHIS 通过患者参与度介导的回忆之间存在关联。然而，我们发现患者的绝对字数显著介导了 OHIS 与患者对咨询的满意度之间的正相关关系。
结果表明，OHIS 对患者的护理体验有积极影响，因此，帮助患者参与 OHIS 非常重要。然而，结果还表明，OHIS 仅成功地增加了患者参与度的一个方面，这可能解释了其与焦虑和回忆之间缺乏关联的原因。结果表明，当医疗保健提供者支持患者进行 OHIS 时，可能会对患者的结局产生更有益的影响。
