数字媒体使用行为及其对医患关系的影响:德国银屑病患者的横断面研究。

Digital Media Usage Behavior and Its Impact on the Physician-Patient Relationship: Cross-Sectional Study Among Individuals Affected by Psoriasis in Germany.

机构信息

Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.

Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden.

出版信息

J Med Internet Res. 2024 Aug 7;26:e57823. doi: 10.2196/57823.

Abstract

BACKGROUND

Psoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals' knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals' health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers.

OBJECTIVE

The study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment.

METHODS

A cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use.

RESULTS

Among 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician.

CONCLUSIONS

This study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians' digital media recommendations despite their patients' desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.

摘要

背景

银屑病是一种慢性皮肤疾病,疾病负担沉重。越来越多的银屑病患者因健康相关原因使用互联网,尤其是年龄较小、受教育程度较高和疾病严重程度较高的患者。尽管使用数字媒体增强了个人的健康知识,但也存在一些缺点,例如质量控制和个人健康信息素养的差异。尽管在医疗环境中,银屑病患者通常更信任医生而不是数字媒体,但他们通常不会向医疗保健提供者透露他们在网络上的研究结果。

目的

本研究旨在:(1) 确定与定期银屑病相关互联网使用相关的其他因素;(2) 对使用的特定数字媒体平台进行排名;(3) 检查有和没有皮肤科治疗的个体之间的医生-患者关系中的数字媒体。

方法

这是一项在德国于 2021 年 9 月至 2022 年 2 月期间进行的基于横断面问卷调查的研究,研究对象为自我报告患有银屑病的个体。参与者通过数字媒体平台和德国南部一家大学医院皮肤科以招募。问卷询问了人口统计学和医学信息、个体银屑病相关数字媒体使用情况以及数字媒体对医生-患者关系的影响。数据进行描述性分析,并进行逻辑回归模型评估与定期银屑病相关互联网使用相关的因素。

结果

在 321 名年龄中位数为 53 岁(IQR 41-61)岁(非正态分布;女性:195/321)的个体中,女性、疾病持续时间较短、中度精神疾病负担和良好的自我评估银屑病相关知识与定期银屑病相关互联网使用相关。在 188 名平均年龄为 51.2(SD 13.9)岁(正态分布)的参与者中,有 106 名(56.4%)通常在基于银屑病的网站上搜索信息,98 名(52.1%)在搜索引擎上搜索信息,主要是为了获取有关疾病和治疗选择的信息,而社交媒体的使用频率较低(49/188,26.1%)。近三分之二的互联网用户(125/188)声称他们的医生没有推荐数字媒体平台。大约 44%(82/188)的个体报告由于医生提供的信息不足而寻求额外信息。

结论

这项研究揭示了数字媒体在银屑病背景下的重要性,尤其是在女性、疾病持续时间较短和中度精神疾病严重程度的个体中。尽管患者希望获得此类信息,但医生并未推荐数字媒体,这似乎是医患关系中的一个缺点。医生应该通过推荐基于证据的信息的平台来指导患者使用数字媒体,从而为共同决策创造适当的框架。未来的研究应侧重于制定策略来防止数字媒体上虚假信息的传播,并满足患者和医生的需求,以增强健康相关的数字媒体服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3d9/11339573/2f2a050721c5/jmir_v26i1e57823_fig3.jpg

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