Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Shoulder Elbow Surg. 2022 Jun;31(6S):S57-S62. doi: 10.1016/j.jse.2021.12.038. Epub 2022 Jan 31.
Patients today have access to an increasing number of health resources to guide medical decision making, including specialist health care providers, the Internet, friends, and family members. No prior studies, to our knowledge, have comprehensively explored health information-seeking behavior (HISB) for patients being managed for shoulder pain.
Our primary objective is to identify which health resources patients use and find helpful in a cohort of patients being either evaluated or managed for shoulder pain. With increased access to the Internet and its use, we also hope to quantify the extent of use of Internet resources and identify predictors of patient use.
We interviewed a cohort of new and follow-up patients being surgically or nonoperatively managed for shoulder pain by a single fellowship-trained orthopedic surgeon. All patients were administered a questionnaire to determine HISB, which evaluated the types of resources used and those deemed most helpful in guiding medical decision making. For patients using the Internet, specific websites were documented. Additional variables that were collected included age, gender, ethnicity, and highest education attained. Multivariable logistic regression was used to evaluate predictors of Internet use.
This study included 242 patients. A discussion with an orthopedic surgeon was reported to be the most informative for nonoperatively treated patients, first postoperative patients, and operative follow-up patients. Patients at the first postoperative visit reported YouTube as their preferred resource almost 4 times more than new patients (odds ratio [OR] 3.9, P = .015). Search engine use was significantly higher in patients at the first postoperative visit (OR 5.8, P = .004) and patients at subsequent surgical follow-up (OR 8.3, P = .001) compared with new patients. Having an undergraduate (OR 0.1, P = .037) or graduate degree (OR 0.03, P = .01) had a significant inverse association with difficulty of using Internet resources. Patients of Black race reported significantly higher rates of distrust for Internet resources than those of White race (OR 5.8, P < .001).
This study highlights the patterns of HISB among patients with shoulder conditions. A face-to-face discussion with a physician or a shoulder surgeon was the most crucial resource for information compared to other resources. This study has also defined the preferred Internet resources for patients at different time points of care and the reasons for refraining from seeking health information on the Internet. Such findings can aid shoulder surgeons in understanding the optimal methods for delivering health information for different patient demographics and different phases of their care.
如今,患者可获取越来越多的健康资源来指导医疗决策,包括专科医疗保健提供者、互联网、朋友和家庭成员。据我们所知,之前尚无研究全面探讨正在接受肩部疼痛治疗的患者的健康信息寻求行为(HISB)。
我们的主要目的是确定患者在接受肩部疼痛评估或治疗的过程中使用了哪些健康资源,并确定哪些资源对他们有帮助。鉴于互联网的普及及其使用的增加,我们还希望量化患者使用互联网资源的程度,并确定患者使用资源的预测因素。
我们采访了一位接受单一 Fellowship 培训的骨科医生手术或非手术治疗肩部疼痛的新患者和随访患者队列。所有患者都接受了一份问卷,以确定 HISB,该问卷评估了使用的资源类型以及在指导医疗决策方面最有帮助的资源类型。对于使用互联网的患者,记录了特定的网站。收集的其他变量包括年龄、性别、族裔和最高学历。多变量逻辑回归用于评估互联网使用的预测因素。
本研究共纳入 242 名患者。对于非手术治疗患者、首次术后患者和手术随访患者,与骨科医生的讨论被认为是最有帮助的。首次术后就诊的患者报告说,他们更喜欢使用 YouTube(比值比[OR]3.9,P=0.015)。与新患者相比,首次术后就诊患者(OR 5.8,P=0.004)和后续手术随访患者(OR 8.3,P=0.001)使用搜索引擎的比例显著更高。本科(OR 0.1,P=0.037)或研究生(OR 0.03,P=0.01)学历的患者使用互联网资源的难度有显著的反比关联。黑人种族的患者报告说,他们对互联网资源的不信任程度明显高于白人种族(OR 5.8,P<0.001)。
本研究强调了肩部疾病患者 HISB 的模式。与其他资源相比,与医生或肩部外科医生进行面对面的讨论是获取信息最重要的资源。本研究还确定了不同就诊时间点患者首选的互联网资源以及避免在互联网上寻求健康信息的原因。这些发现可以帮助肩部外科医生了解为不同患者人群和不同治疗阶段提供健康信息的最佳方法。