Provider–patient dialogue about internet health information: An exploration of strategies to improve the provider–patient relationship

https://doi.org/10.1016/j.pec.2007.01.009Get rights and content

Abstract

Objective

This study examined patients’ experiences talking to their providers about internet health information.

Methods

Participants (n = 770) recruited from internet health message boards completed an online survey, including questions focusing on a recent interaction with a provider about internet health information.

Results

Face-saving patient introduction strategies were associated with providers validating patients’ efforts. Providers’ validation of patients’ efforts was associated with higher patient ratings of satisfaction, validation, and reduced concern, while providers’ disagreement with the information was associated with lower ratings. The provider taking the information seriously was associated with higher patient satisfaction.

Conclusion

An understanding of the occurrence of provider–patient talk about internet health information and its relationship to patient satisfaction, validation, and reduced concern is important for providers and medical educators who seek to better understand, and thus improve, provider–patient communication.

Practice implications

Showing the patient that the information is being seriously considered and validating the patients’ efforts in researching the information may ameliorate some of the negative effects of disagreement.

Introduction

Patients have always had a need for health information [1], [2] and come to their health care providers with information from multiple sources, including print and telephone resources [3]. However, the internet is “transforming the access and delivery of health information” [4, p. 260] as patients have access to the same information as their providers [4]. Because of its distinctive characteristics of accessibility and privacy [5], the internet has received much academic attention over the past decade.

Eighty percent of adult internet users seek health information from the internet, with about seven percent of internet users searching for health information on each day [6]. Although many internet users search for health information, the majority do not do so frequently. Eighty percent of respondents say that they search for health information every few months or less [7]. Among those online, there are differences between those who use the internet for health information and those who do not. Compared to those who do not search for health information online, those who report using the internet for health and health care self-report a poorer health status [8], [9]; are more likely to have a stigmatized illness [10]; and are likely to be more educated, have higher incomes, be female, and be younger than 65 [7], [11], [12].

After searching for internet health information, patients may take the information to their providers. Varying studies report 28%–41% of those who researched internet health information also had a conversation concerning the information with their provider [9], [11], [13]. Compared to those who do not discuss their internet health information with their provider, those who do have poorer health, rate the quality of the information higher [11], [14], and are less reliant on their providers to make decisions about their care [15].

This study focuses on how talking about online health searches impacts the provider–patient relationship. Provider–patient discussions about internet health information can be difficult. For example, providers may feel that patients will be unwilling to accept treatments offered to them [16], that patients will make inappropriate self-diagnoses or that patients are challenging their authority [17]. If providers feel their authority is being challenged, further negative outcomes may include a deterioration in the relationship, the quality of the health care, and patient health outcomes [18]. Some patients report feeling disapproved of by their providers when they share information that they found online [19].

Although research has examined providers’ and patients’ reactions to and assessments of such conversations, no study to our knowledge has studied conversations, recorded or recalled, about internet health information. Thus, the overall goal of this project was to provide an initial, exploratory analysis of patients’ recalled conversations with health care providers about internet health information and examine the associations between strategy usage and patient satisfaction, validation, and reduced concern.

  • RQ1: Are patients’ strategies for introducing internet health information associated with the health care providers’ responses?

  • RQ2: Do health care provider responses predict patient satisfaction, validation, and reduced concern?

Section snippets

Participants

With a goal of finding participants who had experience discussing internet health information with a provider, we purposively recruited patients from internet health message boards to participate in a survey. A total of 1311 participants completed the survey. For this study, we were interested in the 920 participants who reported that they had discussed internet health information with a health care provider in the past 12 months. Our study sample is the 770 participants who recalled such a

Demographics

Participants tended to be female (86%), Caucasian (93%), and living in the United States (86%) with a mean age of 43 years (S.D. = 12 years) and a median annual household income of $40,000–$59,999. On scales from 1–5, respondents reported using the internet frequently (M = 4.43, S.D. = 0.72, 5 = constantly), having high levels of experience with (M = 4.10, S.D. = 0.79, 5 = expert) and access to (M = 4.76, S.D. = 0.54, 5 = extremely easy to access) the internet.

Participants were asked to report on a specific,

Discussion

This study begins to explore the relationship between provider responses to internet health information and patient satisfaction, validation, and reduced concern. We have some evidence that when providers validate patients’ efforts, this improves patient satisfaction, validation, and reduced concern. In addition, our data show these same improvements are seen when the provider does not disagree with the information they have found. Certainly, providers will disagree with information their

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