Division of Advanced Gynecology, Legacy Medical Group, Portland, OR.
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Am J Obstet Gynecol. 2022 Apr;226(4):547.e1-547.e14. doi: 10.1016/j.ajog.2021.10.039. Epub 2021 Nov 6.
Social media is increasingly becoming a health resource for people suffering from complex and debilitating health conditions. A comprehensive understanding of how and why social media and the Internet are used among patients with chronic gynecologic pain will allow for the intentional development and incorporation of web-based tools into patient care plans.
This study aimed to determine whether gynecologic patients with pain are more likely to use social media and the Internet to understand and manage their condition than those without pain. The survey was designed to explore how gynecologic patients with and without pain use and interact with social media and other web-based health resources and the clinical, personal, and demographic factors influencing these behaviors.
Patients presenting with a new complaint to a gynecologist at 1 of 6 Fellowship in Minimally Invasive Gynecologic Surgery-affiliated hospital systems were screened, consented, and assigned to pain and no-pain groups. Participants were surveyed about social media and Internet use, symptoms, bother, physician selection, motivation, trust, and demographic information. Survey responses were compared using the Fisher exact tests, odds ratios, and risk ratios from standard tabular analysis, univariate or multivariate tests of means, and regression analyses, as appropriate.
Of 517 participants included in the study, 475 (92%) completed the survey, 328 (69.1%) with pain and 147 (30.9%) without pain. Study participants in the pain group reported more than double the odds of using social media than those without pain (37.8% vs 19.7%; odds ratio, 2.47; 95% confidence interval, 1.54-3.96) and triple the odds of using the Internet (88.4% vs 69.4%; odds ratio, 3.37; 95% confidence, 2.04-5.56) to understand or manage their condition. Participants with pain were more likely than those without pain to engage in social media at a higher level (3.5 vs 1.7 on a scale of 0 to 10; P<.0001), be motivated by interpersonal elements of online engagement (Hotelling's T=37.3; P<.0001), prefer an interactive component to their online health resource (35.6% vs 24.3%; risk ratio, 1.46; 95% confidence interval, 1.00-2.20; P=.0433), be influenced by others in their choice of a gynecologist (0.37 vs 0.32 on a scale of 0 to 1; P=.009), use social media as a coping tool (38.3% vs 17%; P=.0001), trust information found on social media (31.4% vs 16.7%; P=.0033), and trust other women with the same condition, informal health resources, and personal sources more and doctors and formal health resources less (P=.0083). Participants in both groups reported higher levels of social media engagement with higher levels of symptom bother (28% increase in engagement with every doubling of bother level (P<.0001).
Patients with gynecologic pain were more likely than those without pain to use social media and the Internet to understand and manage their condition. Patients with pain engaged in and trusted social media at a higher level, with engagement rising directly with bother level.
社交媒体正日益成为患有复杂和衰弱性健康状况的人群的健康资源。全面了解患者在慢性妇科疼痛中如何以及为何使用社交媒体和互联网,将有助于有针对性地开发和整合基于网络的工具,纳入患者护理计划。
本研究旨在确定疼痛的妇科患者是否比没有疼痛的患者更有可能使用社交媒体和互联网来了解和管理自己的病情。该调查旨在探讨有疼痛和无疼痛的妇科患者如何使用和与社交媒体和其他基于网络的健康资源互动,以及影响这些行为的临床、个人和人口统计学因素。
在 6 个微创妇科手术专科医师附属医院系统中的 1 家医院,向出现新症状的妇科患者进行筛查、同意并分配到疼痛组和无疼痛组。参与者接受了关于社交媒体和互联网使用、症状、困扰、医生选择、动机、信任和人口统计学信息的调查。使用 Fisher 精确检验、优势比和风险比,从标准表格分析、单变量或多变量均值检验和回归分析中比较调查结果,适当时使用。
在 517 名参与研究的患者中,475 名(92%)完成了调查,其中 328 名(69.1%)有疼痛,147 名(30.9%)没有疼痛。疼痛组患者使用社交媒体的可能性是无疼痛组的两倍多(37.8%对 19.7%;优势比,2.47;95%置信区间,1.54-3.96),使用互联网的可能性是无疼痛组的三倍多(88.4%对 69.4%;优势比,3.37;95%置信区间,2.04-5.56),以了解或管理自己的病情。有疼痛的参与者比没有疼痛的参与者更有可能以更高的水平参与社交媒体(0 到 10 分的评分中,3.5 对 1.7;P<.0001),更受在线互动的人际元素的激励(Hotelling 的 T=37.3;P<.0001),更喜欢在线健康资源的互动性(35.6%对 24.3%;风险比,1.46;95%置信区间,1.00-2.20;P=.0433),受他人对妇科医生选择的影响(0 到 1 的评分中,0.37 对 0.32;P=.009),将社交媒体用作应对工具(38.3%对 17%;P=.0001),信任社交媒体上找到的信息(31.4%对 16.7%;P=.0033),并且比没有疼痛的患者更信任同病情的其他女性、非正式健康资源和个人来源,而信任医生和正式健康资源较少(P=.0083)。两组参与者都报告称,社交媒体参与度随着症状困扰程度的增加而增加(困扰程度每增加一倍,参与度增加 28%(P<.0001)。
患有妇科疼痛的患者比没有疼痛的患者更有可能使用社交媒体和互联网来了解和管理自己的病情。有疼痛的患者以更高的水平参与并信任社交媒体,参与度随着困扰程度的增加而直接增加。