Patients, Professionals and the Internet: Renegotiating the Healthcare Encounter (original) (raw)
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Patients’ use of health-related information from the Internet is increasing at an exponential rate. Although we have some information about how health professionals use the Internet (Roscoe, 1998; Wilson, 1999) we know little about how patients utilise this information. Some patients may actively seek information to assume more responsibility for their health. However, others may feel forced into doing so because of failing confidence in health care provision. Health professionals have the potential to assist patients to make sense of health information from the Internet; however, they may not necessarily welcome this role (Wilson, 1999; Eberhart-Phillips et al., 2000). This study aims to evaluate patient use of such information in primary care and to establish how this can be directed in the future. 851 adult patients from general practice were surveyed about the health information they use, including the Internet. 50 patients from the survey were then randomly selected for interview. Abstracts 242 International Journal of Consumer Studies, 27, 3, June 2003, pp218–251 © 2003 Blackwell Publishing Ltd 12 health care professionals were also interviewed about how patients use the Internet and the impact this has on consultations. The majority of patients (80%) prefer to use their GP as a source of health information. The remaining sources of information received significantly lower ratings. However, the Internet was the second most preferred source of information (7%). Of those using the Internet about two thirds felt more prepared and able to participate in decision-making about treatments. The majority of patients rely on their doctor for health information. However, many patients actively use the Internet as an information source. The use of Internet information during consultations is on the increase, and although patients are positive about such use, doctors do not necessarily welcome Internet informed patients. It is now necessary to identify the training needs of health care professionals for dealing appropriately with Internet informed patients.
Consumer use of the internet for health information:
An increasing number of patients use the internet to obtain information about health. Although some information is available about how health professionals use the internet, little is known about how patients utilize this information. Some patients may actively seek information to assume more responsibility for their health. However, others may feel obliged to do so because of failing confidence in health care provision. Health professionals have the potential to assist patients to make sense of health information from the internet; however, they may not necessarily welcome this role. This study aims to evaluate patients’ use of such information in a primary care setting. The sample consisted of adult patients ( n = 851) from two general practice populations at different levels of the socio-economic spectrum in South Wales (UK). Patients were surveyed by questionnaire about the health information they use, including the internet. The majority of patients preferred to use their general practitioner as the main source of health information. The internet was jointly the second preferred source for information about an illness (6%). Just over half (51%) of patients in this study had access to the internet, of which about half use it to access health information. Just under a quarter (24%, n = 55) of health internet users had discussed information accessed from the internet during a subsequent consultation with a health professional. Of these, three-quarters felt more prepared and able to participate in decision-making about treatments. This study provides a greater understanding of how patients are making use of health-related information from the internet. These findings can be used to help prepare health care professionals for dealing appropriately with internet-informed patients.
Health and the Internet--changing boundaries in primary care
Family Practice, 2004
Little is known about the frequency with which information from the Internet is presented by patients within primary care consultations or the subsequent impact that it may have on those consultations. The aims of this study were to describe the frequency with which Internet information was presented within primary care consultations in one inner-city health authority and to describe the characteristics of the subsequent consultation from the perspective of the health professionals involved. A postal survey was used to estimate the frequency of Internet information presentation and eight in-depth interviews were used to obtain health professionals' perceptions of the consultations that followed. Presentation of information from the Internet was relatively infrequent within primary care at the time of the survey (November 2000 to March 2001), but frequencies of presentation were higher for GPs than for any other health professional group. Health professionals have stereotypical views of Internet users and fear for their own professional status in relation to the Internet-informed patient or client. Although presentation of information from the Internet to date remains relatively infrequent, health professionals appear to feel threatened by it and adopt strategies that minimize its impact on the subsequent consultation.
Patient education and …, 2009
Objective: Many patients use the Internet to obtain health-related information. It is assumed that healthrelated Internet information (HRII) will change the consultation practice of physicians. This article explores the strategies, benefits and difficulties from the patients' and physicians' perspective. Methods: Semi-structured interviews were conducted independently with 32 patients and 20 physicians. Data collection, processing and analysis followed the core principles of Grounded Theory. Results: Patients experienced difficulties in the interpretation of the personal relevance and the meaning of HRII. Therefore they relied on their physicians' interpretation and contextualisation of this information. Discussing patients' concerns and answering patients' questions were important elements of successful consultations with Internet-informed patients to achieve clarity, orientation and certainty. Discussing HRII with patients was appreciated by most of the physicians but misleading interpretations by patients and contrary views compared to physicians caused conflicts during consultations. Conclusion: HRII is a valuable source of knowledge for an increasing number of patients. Patients use the consultation to increase their understanding of health and illness. Determinants such as a patientcentred consultation and timely resources are decisive for a successful, empowering consultation with Internet-informed patients. Practical implications: If HRII is routinely integrated in the anamnestic interview as a new source of knowledge, the Internet can be used as a link between physicians' expertise and patient knowledge. The critical appraisal of HRII during the consultation is becoming a new field of work for physicians. ß
Consumer use of the internet for health information: a survey of primary care patients
International Journal of Consumer Studies, 2004
An increasing number of patients use the internet to obtain information about health. Although some information is available about how health professionals use the internet, little is known about how patients utilize this information. Some patients may actively seek information to assume more responsibility for their health. However, others may feel obliged to do so because of failing confidence in health care provision. Health professionals have the potential to assist patients to make sense of health information from the internet; however, they may not necessarily welcome this role. This study aims to evaluate patients' use of such information in a primary care setting. The sample consisted of adult patients (n = 851) from two general practice populations at different levels of the socioeconomic spectrum in South Wales (UK). Patients were surveyed by questionnaire about the health information they use, including the internet. The majority of patients preferred to use their general practitioner as the main source of health information. The internet was jointly the second preferred source for information about an illness (6%). Just over half (51%) of patients in this study had access to the internet, of which about half use it to access health information. Just under a quarter (24%, n = 55) of health internet users had discussed information accessed from the internet during a subsequent consultation with a health professional. Of these, three-quarters felt more prepared and able to participate in decision-making about treatments. This study provides a greater understanding of how patients are making use of health-related information from the internet. These findings can be used to help prepare health care professionals for dealing appropriately with internet-informed patients.
Health information on the Internet: a qualitative study of NHS Direct Online users
Aslib Proceedings, 2003
Examines the way the general public exploits the Internet for health information, the motives behind usage, attitudes towards issues such as quality concerns, and the extent to which Internet interventions affect the doctor-patient relationship. Although a questionnaire survey was used (posted on the NHS Direct Web site), the questions asked were open, and invited free-text``qualitative'' answers. This method was a success in terms of the amount and richness of the data accrued. Results suggested that the Internet is exploited in a wide variety of ways, by users acting in a number of roles ± patient, intermediary or professional. Some health professionals are now so comfortable with the Internet that they encourage Internet usage by their patients. Lay users demonstrated a high level of understanding of issues raised, and showed a (healthy?) scepticism regarding the information provided. Many users felt that their consultations with doctors had been enriched by Internet-acquired information.
BMC Family Practice, 2007
Background: Both doctors and patients may perceive the Internet as a potential challenge to existing therapeutic relationships. Here we examine patients' views of the effect of the Internet on their relationship with doctors. Methods: We ran 8 disease specific focus groups of between 2 and 8 respondents comprising adult patients with diabetes mellitus, ischaemic heart disease or hepatitis C. Results: Data are presented on (i) the perceived benefits and (ii) limitations of the Internet in the context of the doctor-patient relationship, (iii) views on sharing information with doctors, and (iv) the potential of the Internet for the future. Information from the Internet was particularly valued in relation to experiential knowledge. Conclusion: Despite evidence of increasing patient activism in seeking information and the potential to challenge the position of the doctor, the accounts here do not in any way suggest a desire to disrupt the existing balance of power, or roles, in the consultation. Patients appear to see the Internet as an additional resource to support existing and valued relationships with their doctors. Doctors therefore need not feel challenged or threatened when patients bring health information from the Internet to a consultation, rather they should see it as an attempt on the part of the patient to work with the doctor and respond positively.
This article presents some preliminary findings concerning patient's use of the Internet for medical information. The aim is to increase our understanding of patient's on-line activities using the perspective of Virtual Communities. The study reported takes the point of departure in Internet use by patient associations and their contact with patients. This approach provides an opportunity to analyse a larger and more varying group of patients and their use of the Internet for medical information. The results of the study points at a number of opportunities and challenges both for patients as individuals but also for health care providers and society in a larger perspective.