Patient-Physician Interaction and Trust in Online Health Community: The Role of Perceived Usefulness of Health Information and Services

Online Health Information-Seeking Behaviors Among the Chongqing Population: Cross-Sectional Questionnaire Study

Background

With the rapid development of the internet and its widespread use, online health information-seeking (OHIS) has become a popular and important research topic. Various benefits of OHIS are well recognized. However, OHIS seems to be a mixed blessing. Research on OHIS has been reported in Western countries and in high-income regions in eastern China. Studies on the population in the western region of China, such as Chongqing, are still limited.

Objective

The aim of the study was to identify the prevalence, common topics, and common methods of health information-seeking and the factors influencing these behaviors among the Chongqing population.

Methods

This cross-sectional questionnaire study was conducted from September to October 2021. A web-based questionnaire was sent to users aged 15 years and older in Chongqing using a Chinese web-based survey hosting site (N=14,466). Data on demographics, web-based health information resources, and health topics were collected. Factors that may influence health literacy were assessed using the chi-square test and multivariate logistic regression models.

Results

A total of 67.1% (9704/14,466) of the participants displayed OHIS behaviors. Participants who were younger, had a higher educational level, and worked as medical staff or teachers were more likely to engage in OHIS, while those living in rural areas, ethnic minorities, and farmers were less likely to seek health information on the web (P<.01). Among the Chongqing population, the most common topic searched on the internet was health behavior and literacy (87.4%, 8483/9704), and the most popular method of seeking health information on the web was through WeChat (77.0%, 7468/9704).

Conclusions

OHIS is prevalent in Chongqing. Further research could be performed based on the influencing factors identified herein and high-priority, effective ways of improving the OHIS behaviors of the Chongqing population.

Exploring online patient-doctor interactions. An epistemic and pragmatic analysis of Q&A patterns in an Italian "Ask to the doctor" medical forum

The main objective of this research is to investigate the epistemic and pragmatic management of patient-doctor interactions in Italian online health communities. To achieve this goal, an advanced web scraping methodology was used to extract from an Italian Q&A service (within the healthcare platforms, Il Mio Dottore) 200 pairs of questions and answers concerning two pathological conditions: anxiety and hypothyroidism. We first tagged the two sub-corpora and analyzed them both quantitatively and qualitatively to establish (i) what types of questions were used by patients, and what epistemic attitude and pragmatic function they convey; (ii) whether doctors' replies were aligned or not; (iii) whether there were differences between the two sub-corpora. The results revealed many similarities between the two sub-corpora, but also some differences, mainly concerning doctors' response patterns, with a tendency towards misalignment more pronounced in the anxiety sub-corpus. The practical implications of this and similar research may be numerous. First, they can improve understanding of the epistemic and pragmatic dynamics at play in Q&A services. Secondly, such knowledge can be used to formulate practical recommendations to foster better alignment with patients, thereby improving their engagement. Finally, this knowledge can guide the development of chatbot design guidelines.

The mediating effects of perceived usefulness and perceived ease of use on nurses' intentions to adopt advanced technology

This study explored the role of technology systems in influencing nurses' intentions to adopt medical applications that enhance their performance and how technology contributes to improvements in hospital systems. The study examines the intention to use technology through the mediating effects of perceived usefulness and perceived ease of use, with technology sophistication. A random sampling method was employed to gather 687 responses from nurses. The statistical analysis was conducted using AMOS version 25.0 and SPSS. The findings indicate a significant association between technology sophistication (TS), perceived usefulness (PU), perceived ease of use (PEU), and intention to use (IU). Additionally, PU and PEU positively mediate the relationship between TS and IU. This research will benefit policymakers aiming to enhance nurses' performance by adopting modern technology. Authorities should consider introducing advanced technology systems to meet the goals of hospital administration and support nurses effectively.

Association Between Intergenerational Support, Technology Perception and Trust, and Intention to Seek Medical Care on the Internet Among Chinese Older Adults: Cross-Sectional Questionnaire Study

BACKGROUND

Avoiding technological innovation does not simplify life. In fact, using internet-based medical services can enhance the quality of life for older adults. In the context of an aging population and the growing integration of information technology, the demand for internet-based medical services among older adults is gaining increased attention. While scholars have highlighted the important role of intergenerational support in promoting digital inclusion for older adults, research on the relationship between intergenerational support and older adults' intentions to seek online care remains limited.

OBJECTIVE

This study aims (1) to explore the association between intergenerational support, online medical information, and older adults' intention to seek medical care online, and (2) to examine the mediating role of technology perception and trust, as well as the moderating role of eHealth literacy.

METHODS

A cross-sectional survey was conducted in China, collecting 958 valid responses from older adults aged 60 years and above. A vast majority of participants were between the ages of 60 and 75 years (771/958, 80.5%). Of the 958 participants, 559 (58.4%) resided in rural areas, while 399 (41.6%) lived in urban areas. The survey included questions on intergenerational support, perceived usefulness, perceived ease of use, trust, online medical information, eHealth literacy, and the intention to seek medical care online. Structural equation modeling and linear regression analysis were applied to explore the relationship between intergenerational support and the intention to seek medical care on the internet.

RESULTS

Intergenerational support was positively associated with perceived ease of use (β=.292, P<.001), perceived usefulness (β=.437, P<.001), trust (β=.322, P<.001), and the intention to seek medical care online (β=.354, P<.001). Online medical information also positively affected the intention to seek medical care online among older adults (β=.109, P<.001). Perceived ease of use (β=.029, 95% CI 0.009-0.054), perceived usefulness (β=.089, 95% CI 0.050-0.130), and trust (β=.063, 95% CI 0.036-0.099) partially mediated the association between intergenerational support and the intention to seek medical care online. Further analysis found that perceived ease of use, perceived usefulness, and trust played a chain mediating role between intergenerational support and the intention to seek medical care online (β=.015, 95% CI 0.008-0.027; β=.022, 95% CI 0.012-0.036). Additionally, eHealth literacy played a moderating role in the relationship between intergenerational support and perceived ease of use (β=.177, P<.001), perceived usefulness (β=.073, P<.05), trust (β=.090, P<.01), and the intention to seek medical care online (β=.124, P<.001).

CONCLUSIONS

An integrated model of health communication effects was constructed and validated, providing empirical support for the intention to seek medical care online and for the impact of health communication. This model also helps promote the role of technology in empowering the lives of seniors.

Factors influencing the use of weight management APP among obese patients in Chinese cities in the post-epidemic era

OBJECTIVES

In the post-epidemic era, the prevalence of obesity among urban residents in China has risen sharply, with 34.8% of the population being overweight and 14.1% classified as obese. Obesity has become a critical public health challenge. Given the potential of weight management application (APP) in facilitating health management and weight control, this study aims to explore the factors influencing the adoption of weight management APP by obese patients, providing a scientific basis for the effective health management strategies.

METHODS

From March to October 2023, a randomized sampling method was used to conduct an online survey among 1 728 residents aged 18-65 from six major Chinese cities: Beijing, Shanghai, Guangzhou, Wuhan, Changsha, and Chengdu. A theoretical model extending the technology acceptance model (TAM) was proposed, incorporating psychological variables such as perceived usefulness, perceived ease of use, social influence, perceived risk, health knowledge, and attitude, alongside demographic variables such as gender, age, education level, and residence. Hypothesis testing was conducted using structural equation modeling to analyze the factors influencing the adoption of weight management APP by obese patients.

RESULTS

For obese patients, perceived ease of use significantly predicted perceived usefulness (β=0.301, P<0.001), social influence (β=0.132, P<0.001), and attitude (β=0.266, P<0.001). Perceived usefulness significantly predicted social influence (β=0.171, P<0.001) and attitude (β=0.499, P<0.001). Social influence (β=0.285, P<0.001) and knowledge (β=0.078, P<0.001) were significant positive predictors of attitude. The negative impact of perceived risk on attitude was not significant (P=0.166), but its negative influence on actual use was significant though weak (β=-0.051, P=0.036). Attitude significantly influenced actual use (β=0.549, P<0.001), highlighting that positive user attitudes are a key driver of actual usage behavior. Additionally, demographic variables such as gender, age, education level, and residence significantly moderated the relationships between attitude and actual use. Female users were more likely to translate perceived usefulness into attitudes, whereas male users were more likely to translate attitudes into actual use, characterizing women as "pragmatists" and men as "action-takers". Younger users (below 35 years) focused on effectiveness, while higher-educated users (college level and above) were more likely to forgo APP usage due to risk concerns, although positive attitudes drove their actual use.

CONCLUSIONS

Promoting the use of weight management APP in the post-pandemic era is a critical measure to enhance self-management capabilities among obese patients. Understanding the factors influencing users adoption can help popularize healthy lifestyles, improve chronic disease prevention and control, and elevate overall quality of life and health levels.

Internet usage time and trust in doctors: evidence from China

BACKGROUND

The growth of internet use has greatly impacted many societal sectors, including healthcare. However, current evidence about the relationship between internet usage time and public trust on doctors is insufficient.

OBJECTIVE

To examine the relationship between the time spent on the internet and the level of trust in doctors, and explore its mechanism.

METHODS

Multiple regression models are employed, utilizing a sample of 19,193 observations from the China Family Panel Studies (CFPS) in 2020. First, we regress the relative trust in doctors compared to trust in strangers on internet usage time. Subsample results across distinct population groups are explored. Second, we examine the mechanism of using the internet as an information channel through the mediation method, and further investigate the role of the internet as a communication platform by analyzing the moderation effects of socializing activity as well as social media engagement.

RESULTS

We find a significant negative relationship between increased internet usage time and trust in doctors. This correlation remains robust across different model specifications and variable measurements. The negative correlation is more pronounced among population groups who are elderly, male, married, with low educational levels, insured and residing in urban areas. The role of the internet as a source of information is validated as a mechanism producing the negative influence. The role of the internet as a communication platform tends to mitigate the negative consequences of internet usage, as engaging in online socializing activity can have a positive moderation effect. However, for social media engagement, its overall effect on trust in doctors is negative, potentially due to social media's dual function as a communication platform and an information source.

CONCLUSIONS

Although individual-focused literature tends to demonstrate a positive impact of the internet on trust in doctors in China, our study, which focuses on the general public, reveals contrasting results. Our findings imply that the primary manner in which internet usage, encompassing social media usage, influences public trust in doctors is by molding a collective perception of them. Consequently, the medical community may need to take a more proactive approach in expanding online communication channels for interacting with patients and the wider public.

Credibility, readability and content analysis of treatment recommendations for adolescents with nonspecific back pain published on consumer websites

BACKGROUND

Parents may seek out health information online when their adolescent has nonspecific back pain to better understand treatment options. Such information directed towards consumers has not been previously analysed.

METHODS

A descriptive cross-sectional content analysis was performed to describe the treatments recommended on consumer websites for nonspecific back pain in adolescents. The credibility and readability of the websites were also assessed. Systematic Google searches were completed in five countries, and relevant content from eligible web pages was analysed. An a priori codebook with 34 treatment-related codes was developed. Nine additional codes were inductively created during analysis. Credibility was assessed using the JAMA benchmark. Readability was assessed via the Flesch Kincaid Grade Level.

RESULTS

Of 245 web pages, 48 were deemed eligible and analysed. Of 43 treatment codes, 37 were present in at least one web page. The five most frequently identified codes were See the doctor/get a diagnosis (found on 85% of web pages), Ergonomics/posture/biomechanics (52%), Reassurance (48%), Physiotherapy (48%) and Non-prescription pharmaceuticals/supplements (46%). Only 21% of the web pages met all four JAMA benchmark criteria, and 15% cited at least one recent or high-quality source. The median Flesch Kincaid Grade Level score was 9.0 (range 3.5-12.9).

CONCLUSIONS

Parents of adolescents with nonspecific back pain may find that treatment recommendations published online are numerous and varied, with visits to the doctor encouraged. The credibility scores of these web pages are generally low, while the median reading level may be too high for the general population.

SIGNIFICANCE STATEMENT

This analysis reveals that public-facing websites with recommendations for treating adolescent nonspecific back pain do not cite the most recent, high-quality research. Although web pages correctly encourage physical activity and exercise over surgery and prescription medications, they do not reflect the psychologically informed or interdisciplinary care emphasized in recently published treatment recommendations. Clinicians must be aware that caregivers of their adolescent patients with nonspecific back pain may be exposed to online messages that encourage them to keep seeking a diagnosis.

Factors influencing user's health information discernment abilities in online health communities: based on SEM and fsQCA

Introduction

Online health communities have become the main source for people to obtain health information. However, the existence of poor-quality health information, misinformation, and rumors in online health communities increases the challenges in governing information quality. It not only affects users' health decisions but also undermines social stability. It is of great significance to explore the factors that affect users' ability to discern information in online health communities.

Methods

This study integrated the Stimulus-Organism-Response Theory, Information Ecology Theory and the Mindsponge Theory to constructed a model of factors influencing users' health information discernment abilities in online health communities. A questionnaire was designed based on the variables in the model, and data was collected. Utilizing Structural Equation Modeling (SEM) in conjunction with fuzzy-set Qualitative Comparative Analysis (fsQCA), the study analyzed the complex causal relationships among stimulus factors, user perception, and the health information discernment abilities.

Results

The results revealed that the dimensions of information, information environment, information technology, and information people all positively influenced health information discernment abilities. Four distinct configurations were identified as triggers for users' health information discernment abilities. The core conditions included information source, informational support, technological security, technological facilitation, and perceived risk. It was also observed that information quality and emotional support can act as substitutes for one another, as can informational support and emotional support.

Discussion

This study provides a new perspective to study the influencing factors of health information discernment abilities of online health community users. It can provide experiences and references for online health community information services, information resource construction and the development of users' health information discernment abilities.

Acceptance of a French e-Mental Health Information Website (CléPsy) for Families: A Web-Based Survey

Background

Childhood mental health issues concern a large amount of children worldwide and represent a major public health challenge. The lack of knowledge among parents and caregivers in this area hinders effective management. Empowering families enhances their ability to address their children's difficulties, boosts health literacy, and promotes positive changes. However, seeking reliable mental health information remains challenging due to fear, stigma, and mistrust of the sources of information.

Objective

This study evaluates the acceptance of a website, CléPsy, designed to provide reliable information and practical tools for families concerned about child mental health and parenting.

Methods

This study examines user characteristics and assesses ease of use, usefulness, trustworthiness, and attitude toward using the website. Platform users were given access to a self-administered questionnaire by means of mailing lists, social networks, and posters between May and July 2022.

Results

Findings indicate that the wide majority of the 317 responders agreed or somewhat agreed that the website made discussions about mental health easier with professionals (n=264, 83.3%) or with their relatives (n=260, 82.1%). According to the ANOVA, there was a significant effect between educational level and perceived trust (F6=3.03; P=.007) and between frequency of use and perceived usefulness (F2=4.85; P=.008).

Conclusions

The study underlines the importance of user experience and design in web-based health information dissemination and emphasizes the need for accessible and evidence-based information. Although the study has limitations, it provides preliminary support for the acceptability and usefulness of the website. Future efforts should focus on inclusive co-construction with users and addressing the information needs of families from diverse cultural and educational backgrounds.

The Influence of Doctor-Patient Communication on Patients' Trust: The Role of Patient-Physician Consistency and Perceived Threat of Disease

Purpose

To investigate the influence mechanism of doctor-patient communication on patients' trust, especially the mediating role of patient-physician consistency and the moderating role of perceived threat of disease.

Methods

A total of 699 patients in Guangzhou, China was investigated by questionnaire. The main effect, mediating effect, and moderating effect of the model was verified by SPSS23.0 and LISREL8.71 statistical software.

Results

It was revealed that doctor-patient communication has a significant positive effect on patients' trust. The consistency between patient and physician partially mediates the relationship between doctor-patient communication and patients' trust. Additionally, the perceived threat of the disease moderates the psychological process through which doctor-patient communication affects patients' trust.

Conclusion

Both doctor-patient communication and patient-physician consistency have predictive effects on patients' trust. Doctor-patient communication is not only a direct influence on patient trust but also an indirect influence mediated by patient-physician consistency. Perceived threat of disease moderates the psychological process through which doctor-patient communication affects patients' trust. Specifically, compared to a high level of perceived threat of disease, a low level of perceived threat of disease can enhance the effect of doctor-patient communication on patients' trust. The results of this study underscore the importance of doctor-patient communication and the value of patient-physician consistency for building patients' trust. To foster a harmonious doctor-patient relationship, medical colleges should place great emphasis on cultivating medical students' communication skills. Hospitals should enhance on-the-job training and provide institutional support for doctors, encourage agreements between doctors and patients regarding disease diagnosis and decision-making, and be attentive to patients' perceived threat of disease, particularly for those with high level of perceived threat of disease.

Understanding Factors Influencing Diabetic Patients' Intention to Use Digital Health Services in Saudi Arabia Using the Technology Acceptance Model

This study employs the Technology Acceptance Model to investigate the factors influencing Saudi Arabian diabetic patients' intention to use digital health services. There is an urgent need to investigate the possibilities of digital health services in managing diabetes given the startlingly rapidly increasing prevalence rate of diabetes in KSA. The study examines the variables affecting patients' acceptance and desire to use digital health tools to manage their diabetes. The study employs the Technology Acceptance Model to ascertain the crucial factors that impact patients' opinions regarding the usefulness and ease of use of digital healthcare technologies. The proposed model extends the traditional Technology Acceptance Model by adding two new constructs, perceived privacy and trust. These constructs were examined by analyzing the intentions of 600 respondents through online surveys. The study's conclusions showed that attitudes toward using digital health services for KSA diabetic patients are greatly influenced by every component of the extended Technology Acceptance Model. The study's conclusions add to the body of knowledge already in existence and offer insightful information to decision-makers hoping to improve digital health services.

Impact of health science popularization videos on user perceived value and continuous usage intention: based on the C-A-C and ECM model framework

Objective

To enhance individuals' sustained intention to use health science popularization videos, this study investigated the path relationships and influencing mechanisms of health science popularization video factors on users' perceived value, expectancy confirmation, enjoyment, satisfaction, trust, and continuous usage intention based on the cognitive-affective-conative and expectation-confirmation model theoretical framework.

Methods

This study adopted a cross-sectional design and collected data using self-administered questionnaires. The hypotheses were analyzed using the smart partial least squares (Smart-PLS) structural equation modeling method with a dataset containing 503 valid responses. Subsequently, comprehensive data analysis was conducted.

Results

Blogger and video quality factors present in health science popularization videos substantially influenced users' perceived value (p < 0.001). Furthermore, users' expectancy confirmation exerted a positive influence on both users' perceived value (p < 0.001) and satisfaction (p < 0.01). Perceived value, in turn, positively impacted satisfaction (p < 0.001) and pleasure (p < 0.001). User satisfaction (p < 0.001) and pleasure (p < 0.001) directly enhanced trust, which, in turn, significantly and directly impacted continuous usage intention (p < 0.001).

Discussion

This study offers both theoretical and practical insights into enhancing the quality of health science popularization videos. From a theoretical perspective, it expands upon the cognitive-affective-conative and expectation-confirmation model theoretical frameworks, enriches the theoretical model, and offers theoretical references for future research in this domain. From a practical perspective, enhancing the overall quality of health science popularization content significantly influences users' perceived value, emotional engagement, and continued usage intention to engage with the content.

A Bibliometric Review of Constituents, Themes, and Trends in Online Medical Consultation Research

As an emerging form of health care with accelerated growth in recent years, online medical consultation (OMC) has received extensive attention worldwide. Although the number of studies on OMC has increased substantially, few provide a comprehensive and up-to-date review of OMC's research constituents, themes, and trends. This study, therefore, extracted 1,801 OMC-related articles published in English from the Web of Science (WoS) Core Collection database during the past 30 years and employed a bibliometric analysis of WoS and CiteSpace to examine major constituents' distribution, collaboration relationships, themes, and trends. The results indicate that the United States, England, and China contributed the most to the proliferation of OMC studies. The United States had the greatest academic influence and the most collaborative connections, while China demonstrated the sharpest increase and most active development in recent years. However, there is a lack of substantial and close collaboration between researchers worldwide. The main themes of OMC research were Internet hospitals, COVID-19, mixed methods, online health community, and information technology. Researchers have recently shifted their attention to social media, management, efficacy, word of mouth, mental health, and anxiety. This review paper provides researchers and practitioners with a holistic and clear understanding of the features and trends of OMC research. It also identifies potential areas for future OMC research and sheds light on OMC practices.

Who is Facing Higher Increased Demand After the Online-Offline Channel Integration? Evidence from Public Hospitals in China

Background

In recent years, the medical industry has been significantly impacted by internet technology, especially with the growing integration of online and offline channel within public hospitals.

Objective

Our study aims to explore the effects of hospitals' online-offline channel integration on doctors' offline visits and investigate how the effects of integration varied across doctors with different professional titles.

Methods

Our study employs a panel dataset from a large comprehensive hospital in China and conducts staggered difference-in-differences (DID) approach.

Results

We find that online-offline channel integration within public hospitals is associated with about 15.5% increase in offline visits, and the 1% growth of monthly number of online visits is associated with about 10.6% monthly offline visits increase. Furthermore, our results indicate that the effectiveness of online-offline channel integration is more pronounced for doctors with lower professional titles compared to those with higher professional titles.

Conclusion

Our study provides evidence for policymakers and hospital managers that integrating online and offline channels can optimize the distribution of medical personnel resources within public hospitals. We recommend that young or less-experienced doctors actively participate in hospital-operated online platforms to enhance their professional skills through practical experience.

The impact of resistance on telemedicine use for people with disabilities

People with disabilities face many challenges in accessing healthcare. They may be provided opportunities to utilize new technologies just like non-disabled patients, but their unique challenges might cause them to resist new technology. The purpose of the study is to explore reasons why disabled patients might resist telemedicine. Using thematic analysis, we analyzed open-ended questions from a larger telemedicine survey for people with disabilities in the United States. The analysis identified the following themes: concerns about the patient-provider relationship and trust, worry about security and privacy, telemedicine has its place - but not for every type of visit, and concerns with overutilization and cost. The paper demonstrated that while telemedicine provides convenience to patients in terms of removing barriers such as transportation and cost, patients still value their doctor relationship and certain features of in-person visits. Resistance to telemedicine occurred on both individual and structural levels. This study has implications for institutions serving people with disabilities through remote means.

The association between abusive behaviour and physician-patient relations: a systematic review

OBJECTIVE

This systematic review aims to explore the association between abusive behaviour and physician-patient relations in healthcare settings.

STUDY DESIGN

Systematic review.

METHODS

We searched for related studies on databases such as PubMed, Embase, and the Cochrane library, without restrictions on language, from inception until July 15, 2022. The risk of bias and the methodological quality was evaluated using the Newcastle-Ottawa Scale and Risk of Bias in Non-randomised Studies of Interventions tool.

RESULTS

Ten studies were included in this systematic review, the participants of which were physicians and patients. The research from all the studies highlighted the detrimental effects of abusive behaviour on the relationship between physicians and patients, regardless of who the abusers were.

CONCLUSIONS

Abusive behaviour in a clinical setting has a negative influence on the physician-patient relationship, whoever the perpetrator might be. The research sheds light on the importance of teaching communication skills to physicians and training them to manage conflicts and aggressive behaviours in healthcare settings.

How Does the Design of Consultation Pages Affect Patients' Perception of Physician Authority and Willingness to Seek Offline Treatment: A Randomized Controlled Trial

This study aimed to assess the impact of the color and font size of a dialogue box on an online physician-patient interaction page on patients' perceptions of the physician's authority and their willingness to schedule an offline appointment. A 2 × 2 between-group experiment was conducted to compare the effects of two dialogue box colors (gold vs. grey) and two font sizes (large vs. regular) on patients' perceptions. The results showed that a larger font size had a significant positive impact on patients' perceptions of the physician's authority, and the use of a gold-colored dialogue box also had a significant positive effect. A significant interaction was found between the dialogue box color and font size and patients' perceptions of the physician's authority. In addition, it was found that positive perceptions of the physician's authority significantly affected patients' willingness to schedule offline appointments and played a fully mediating role in the path of page design affecting offline appointment intentions. This study provides evidence that the design elements of a dialogue box-particularly, its color and font size-can influence patients' perceptions of a physician's authority and their willingness to schedule an offline appointment. These findings suggest that modifying the page design could improve the effectiveness of physician-patient communication.

Factors influencing user acceptance of weight management apps among Chinese obese individuals during the COVID-19 pandemic

Background

During the COVID-19 epidemic, the number of obesities increased rapidly in China. Weight management apps have potential value in controlling obesity.

Objective

Explore the mechanisms behind the adoption of weight management applications by overweight and obese individuals, including psychological factors and demographic variables.

Methods

The theoretical model was extended from the technology acceptance model (TAM), and the structural equation model was used for hypothesis testing. From January 2020 to December 2021, we conducted a cross-sectional survey in six megacities in mainland China during the COVID-19 pandemic by an online questionnaire.

Results

1364 participants completed the questionnaire, and the proposed theoretical model explained 55.7% of the variance in behavioral intention. Perceived usefulness was predicted by perceived ease of use (β = 0. 290), attitude was jointly predicted by perceived usefulness (β = 0.118) and perceived ease of use (β = 0.159). Behavioral intention was predicted by perceived usefulness (β = 0. 256), perceived ease of use (β = 0. 463), attitude (β = 0. 293), and perceived risk (β = -0.136). Health awareness (β=0.016) did not significantly affect behavioral intention. Four demographic variables gender, age, education, and residence exerted significant moderating effects in theoretical model.

Conclusions

During the COVID-19 epidemic, the health awareness and behavior patterns of obese people have changed significantly. Psychological factors and demographic characteristics dynamically interact to generate user behavioral intentions of weight management applications. Weight management application developers and marketers should focus on perceived usefulness, safety, ease of use, and health awareness.

e-Health Literacy Scale, Patient Attitudes, Medication Adherence, and Internal Locus of Control

BACKGROUND

Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related.

METHODS

Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed the e-Health Literacy Scale (eHEALS), the Multidimensional Health Locus of Control scale, a modified version of the Attitudes Toward Health Care Providers Scale (ATHCPS), the Wake Forest Physician Trust Scale (WFPTS), and the Gonzalez-Lu adherence questionnaire. Hypothesized relations were evaluated in a bootstrapped path analytic model using the Mplus statistical software.

KEY RESULTS

Participants included 334 individuals (mean age: 57.5 years; 173 women and 161 men) with Black, Indigenous, and People of Color accounting for 83.3% of the participants and White individuals making up 16.7% of the participants. Model results showed that after controlling for age, education, gender, and race, the eHEALS score was significantly related to the ATHCPS and WFPTS but not to the Gonzalez-Lu adherence questionnaire (p < .05). The eHEALS score was significantly related to the Multidimensional Health Locus of Control scale. Analysis of indirect effects showed that a portion of the relation between e-health literacy and patient attitude and adherence was mediated by internal locus of control (all p < .05).

CONCLUSIONS

In this study, e-health literacy was related to important patient attitude and behavior variables via locus of control. This finding has implications for the importance of improving patients' ability to use the internet to access and effectively use health information. [HLRP: Health Literacy Research and Practice. 2023;7(2):e80-e88.].

The impact of perceived value and affection on Chinese residents' continuous use intention of mobile health science information: An empirical study

Introduction

Disseminating health science information via the internet has become an essential means for improving Chinese residents' health literacy, which has received constant attention from the Chinese government. Therefore, it is important to explore Chinese residents' perceived value and emotional response to mobile health science information for determining Chinese residents' satisfaction and use intention.

Methods

This study applied the cognition-affect-conation model to evaluate the perceived value, arousal, pleasure, trust, satisfaction, and continuous use intention. A mobile device was used to obtain health science information from 236 Chinese residents via an online survey and the data were analyzed using partial least squares (PLS)-structural equation modeling.

Results

The results showed that Chinese residents' perceived value of health science information obtained using the mobile device directly affect the degree of arousal (β = 0.412, P < 0.001), pleasure (β = 0.215, P < 0.01), and trust (β = 0.339, P < 0.001). The degree of arousal (β = 0.121, P < 0.01), pleasure (β = 0.188, P < 0.01), and trust (β = 0.619, P < 0.001) directly affected Chinese residents' satisfaction, which further affected their continuous use intention (β = 0.513, P < 0.001). Similarly, trust directly affected Chinese residents' continuous use intention (β = 0.323, P < 0.001). The degree of arousal directly affected their degree of pleasure (β = 0.304, P < 0.001), and pleasure also imposed a direct effect on trust (β = 0.293, P < 0.001).

Discussion

The result of this study provided an academic and practical reference to improve mobile health science popularization information. Affective changes have imposed an important effect on Chinese residents' continuous use intention. High-quality, diversified and frequent use of health science information can significantly increase residents' continuous use intention, improving their health literacy as a consequence.

Enhancing students' English language learning via M-learning: Integrating technology acceptance model and S-O-R model

With the impact of COVID-19, many university students may not be able to learn English in the physical classroom in a traditional way. Students' English learning effectiveness and outcome were threatened when English learning was forced to turn online. Thus, a variety of technological media and platforms to improve their learning outcomes are in need. Mobile learning (M-learning) that involves interacting with other devices through mobile devices and wireless networks can also be a solution to improve students' online English learning effectiveness. In order to explore the learning behaviors and attitudes of university students when learning English with M-learning, this study integrated technology acceptance model and Stimulus Organism Response model including the concepts of perceived convenience, curiosity and self-efficacy in addition to the original technology acceptance model to verify university students' usage cognition and attitude toward English M-learning. This study disseminated surveys to 10 targeted universities/colleges and collected 1432 valid surveys. This study implemented Smart-PLS 4.0 to examine structural model and verify the hypotheses. Results indicated that perceived convenience have positive impact on perceived ease of use, perceived usefulness and attitude toward using; there is a significant and positive relationship among perceived ease of use, perceived usefulness, attitude toward using and intention to using; curiosity and self-efficacy have positive impact on intention to using. Based on the findings, this study further provides abundant theoretical insights and practical significance on language learning.

Best-Worst Scaling Survey of Inpatients' Preferences in Medical Decision-Making Participation in China

This study assesses inpatients' preferences for participating in medical decision-making and determines the factors' rankings in order of importance and whether they vary for respondents with different characteristics. Case 1 best-worst scaling (BWS) was used for the study design. Thirteen attributes influencing inpatient medical decision-making participation were identified based on a literature review and interview results. A balanced incomplete block design was used to form choice sets for the BWS questionnaire for a cross-sectional study examining inpatients' preferences for participating in medical decision-making. Based on results from 814 inpatient participants, the three most important factors influencing inpatients' medical decision-making participation were inpatients' trust in physicians, physicians' professional expertise, and physicians' attitudes. The mixed logit model results reflect the significant heterogeneity in respondents' preferences for shared decision-making. To facilitate resource allocation, improve the physician-patient relationship, and encourage patient decision-making participation more actively and effectively, decision-makers should emphasize patients' trust, enhance physicians' ability to diagnose and treat diseases, and improve their attitudes toward providing care and communication from the perspectives of patients, physicians, and the social environment. Further research is needed on the heterogeneity of patients' preferences for participating in medical decision-making and how to improve patient participation.

How the use of an online healthcare community affects the doctor-patient relationship: An empirical study in China

Possible improvements to the doctor-patient relationship are an important subject confronting national healthcare policy and health institutions. In recent years, online healthcare communities have changed the ways in which doctors and patients communicate, especially during the COVID-19 pandemic. However, previous research on how usage of online healthcare communities has affected the doctor-patient relationship is rather limited. This paper proposes a research model to investigate the relationship between online healthcare community usage and the doctor-patient relationship. An analysis of 313 patients' data using structural equation modeling showed the following. First, the use of an online healthcare community has a positive impact on doctor-patient communication, helps improve the performance of healthcare procedures, and reduces healthcare costs. Second, doctor-patient communication and healthcare costs have a positive impact on patients' emotional dependence and patients' perception of healthcare quality, while healthcare procedures do not have this impact. Finally, patients' emotional dependence and perception of healthcare quality have a positive effect on doctor-patient relationship through the mediator of patients' satisfaction.

Exploring the effects of health information seeking on e-satisfaction in online health communities: an empirical investigation

BACKGROUND

Online health communities (OHCs) are becoming effective platforms for people to seek health information. Existing studies divide health information into general and specific information in OHCs. However, few studies discuss the effects of different types of information seeking in OHCs on users' electronic satisfaction (e-satisfaction).

OBJECTIVE

This study explores the effects of general and specific information seeking on users' e-satisfaction with OHCs through the mediating roles of perceived benefits and costs drawing on the social information processing theory and the social exchange theory.

METHODS

This study conducted an online survey to collected data from individuals who used OHCs to seek information. The structural equation model was used to analyze the collect data and the research model. Specifically, this study examined the common method bias and conducted a robustness check.

RESULTS

Results show that general and specific information seeking affect e-satisfaction through the mediating roles of perceived benefits and costs. An interesting result is that general information seeking has a stronger effect on e-satisfaction than specific information seeking.

CONCLUSIONS

This study suggests that e-satisfaction should be further enhanced by information seeking as online healthcare practices evolve and change. Managers of OHCs should focus on increasing users' perceived benefits, thereby increasing their e-satisfaction. Besides, this study discusses implications, limitations, and future research directions.

Research on the influencing factors of users’ information processing in online health communities based on heuristic-systematic model

With the rapid development of the Internet and the normalization of COVID-19 epidemic prevention and control, Online health communities (OHCs) have gradually become one of the important ways for people to obtain health information, and users have to go through a series of information processing when facing the massive amount of data. Understanding the factors influencing user information processing is necessary to promote users’ health literacy, health knowledge popularization and health behavior shaping. Based on the Heuristic-Systematic Model (HSM), Information Ecology Theory, Privacy Trade-Off and Self-Efficacy Theory, we constructed a model of factors influencing user information processing in online health communities. We found that information quality and emotional support had indirect effects on heuristic and systematic information processing, and these effects were mediated by privacy concerns and self-efficacy. In our research model, systematic information processing was most positively influenced directly by self-efficacy. Privacy concerns had a direct negative correlation with both dual information processing pathways. Therefore, OHCs managers should develop relevant regulations to ensure the information quality in OHCs and improve privacy protection services to promote user information processing by improving users’ self-efficacy and reducing their privacy concerns. Providing a user-friendly and interactive environment for users is also recommended to create more emotional support, thus facilitating more systematic information processing.

Internal or External Word-of-Mouth (WOM), Why Do Patients Choose Doctors on Online Medical Services (OMSs) Single Platform in China?

(1) Background: Word-of-mouth (WOM) can influence patients' choice of doctors in online medical services (OMSs). Previous studies have explored the relationship between internal WOM in online healthcare communities (OHCs) and patients' choice of doctors. There is a lack of research on external WOM and position ranking in OMSs. (2) Methods: We develop an empirical model based on the data of 4435 doctors from a leading online healthcare community in China. We discuss the influence of internal and external WOM on patients' choice of doctors in OMSs, exploring the interaction between internal and external WOM and the moderation of doctor position ranking. (3) Results: Both internal and external WOM had a positive impact on patients' choice of doctors; there was a significant positive interaction between internal and third-party generated WOM, but the interaction between internal and relative-generated WOM, and the interaction between internal and doctor-generated WOM were both nonsignificant. The position ranking of doctors significantly enhanced the impact of internal WOM, whereas it weakened the impact of doctor recommendations on patients' choice of doctors. (4) The results emphasize the importance of the research on external WOM in OMSs, and suggest that the moderation of internal WOM may be related to the credibility and accessibility of external WOM, and the impact of doctor position ranking can be explained by information search costs.

How older adults’ health beliefs affect intention to perform COVID-19 self-examination: A reasoned action approach

BACKGROUND: COVID-19 self-examination is a significant part of the national recovery plan against the virus. Although it is easier to perform COVID-19 self-examination (CSE), only a small percentage of people prefer it. There are no precise statistics on CSE in Malaysia, but informal data from news agencies imply low CSE. Lack of awareness and conflicting information about the reliability of CSE results may have raised concerns about CSE’s efficacy and effectiveness. OBJECTIVE: This study investigates how Malaysian older adults’ health beliefs influence their intention to perform CSE. The study developed a framework combining illness threats (ITH), perceived barriers (PBA), medical motivations (MMO), and control over illness (COI) from the Health Belief Model (HBM) with the Reasoned-Action Approach’s attitude (ATT), perceived control (PCO), and intention (INT). METHODS: Structural Equation Modelling (SEM) analyses were conducted with AMOS 26 software to determine the influence of HBM on older adults’ attitude, perceived control, and intention. The study collected 200 data for the pilot study and 400 data for hypotheses testing. RESULTS: ITH, MMO, and COI have positive effects, whilst PBA affects ATT negatively. ITH and COI positively impact PCO, and PCO has a greater significant effect on INT than ATT. CONCLUSION: Given the HBM’s role in influencing older adults’ intention to perform COVID-19 self-examination, providing different levels of care and emphasising the perception of knowledge of illness are especially beneficial. Several recommendations are made to ensure that CSE remains relevant for older adults’ well-being, although COVID-19’s impact has become more stabilised.

Patient's behavior of selection physician in online health communities: Based on an Elaboration likelihood model

Background

With the rapid development of "Internet + medicine" and the impact of the COVID-19 epidemic, online health communities have become an important way for patients to seek medical treatment. However, the mistrust between physicians and patients in online health communities has long existed and continues to impact the decision-making behavior of patients. The purpose of this article is to explore the influencing factors of patient decision-making in online health communities by identifying the relationship between physicians' online information and patients' selection behavior.

Methods

In this study, we selected China's Good Doctor (www.haodf.com) as the source of data, scrapped 10,446 physician data from December 2020 to June 2021 to construct a logit model of online patients' selection behavior, and used regression analysis to test the hypotheses.

Results

The number of types of services, number of scientific articles, and avatar in physicians' personal information all has a positive effect on patients' selection behavior, while the title and personal introduction hurt patients' selection behavior. Online word-of-mouth positively affected patients' selection behavior and disease risk had a moderating effect.

Conclusion

Focusing on physician-presented information, this article organically combines the Elaboration likelihood model with trust source theory and online word-of-mouth from the perspective of the trusted party-physician, providing new ideas for the study of factors influencing patients' selection behavior in online health communities. The findings provide useful insights for patients, physicians, and community managers about the relationship between physician information and patients' selection behavior.

Patient distrust toward doctors in online health communities: integrating distrust construct model and social-technical systems theory

Purpose

This article aims to explore the factors influencing patients' distrust toward doctors in online health community.

Design/methodology/approach

This study leveraged the distrust construct model and socio-technical systems theory to establish a research model. The authors used the survey method to validate the research model by developing and distributing questionnaires to online health community users. 518 valid responses were collected.

Findings

The data analysis results showed that patients' distrusting beliefs were significantly related to their distrust toward doctors in online health communities. Meanwhile, social factors included perceived egoism and lack of expertise; whereas technical factors included no structural assurance, and lack of third-party recognition.

Originality/value

This study not only provides a solid and comprehensive theoretical understanding of patient distrust toward doctors in online health communities but also could serve as the basis to relieve the distrust between patients and doctors in online health communities, or even in the offline environment.

How to Maintain a Sustainable Doctor-Patient Relationship in Healthcare in China: A Structural Equation Modeling Approach

It is important to identify means of improving and maintaining a sustainable doctor-patient relationship to address current healthcare issues. Although many studies have made outstanding contributions to the healthcare doctor-patient relationship literature, little work has been done to explore the influencing elements of the doctor-patient relationship in relation to expectation confirmation theory. To fill this gap, this study produced a theoretical framework model of the influencing factors of the doctor-patient relationship according to the expectation confirmation theory. Data from 335 Chinese patients were analyzed using a structural equation modeling method, and the results showed that patient satisfaction and patient trust are the most important factors in building a good relationship between doctor and patient. Furthermore, three components of postdiagnosis patient's perception, namely, perceived service quality, perceived communication quality, and perceived service attitude, are examined. These have a significant impact on patient confirmation. These three components ultimately affect the doctor-patient relationship. This study will be helpful for doctors to understand patients' service demands and their future diagnosis behavior. The proposals of this study may lead to optimization of the process of diagnosis and improvements in the quality of clinic services.

Qualitative and quantitative analysis of doctor-patient interactions during andrological consultations

INTRODUCTION

Although a trustworthy connection between doctor and patient is crucial in clinical practice, it could be hindered by different cultural and linguistic backgrounds. Moreover, an effective doctor-patient interaction could be even more challenging in andrological fields, in which psychological and social components are predominant.

AIM

To analyse the doctor-patient relationship in the andrological field, applying both qualitative and quantitative analyses.

METHODS

monocentric, cross-sectional, observational study was performed between May and December 2018. During the study, all patients aged >18 years attending the Modena Andrology Unit for couple infertility or erectile dysfunction were enrolled and the doctor-patients interaction recorded. Patients were divided into two groups depending on their medical seeking and were further divided between native and non-native speakers of Italian. All patients underwent a routine andrological examination. Every first medical consultation was audio-recorded and transcribed using "ELAN" software for socio-linguistic analysis. Transcriptions underwent qualitative analysis through conversation analysis. Then, quantitative analyses were performed, and interaction parameters underwent correlation analyses.

RESULTS

Twenty-five patients were enrolled. The analysis of the andrological interview allowed to recognize five consecutive phases, following a semi-standardized pattern. Patients without linguistic barriers and with infertility problems showed more autonomous contribution during the consultation. No difference arose in sexual dysfunctions group. Doctor's explanations were frequent, but when linguistic barrier was present or Italian patients seemed less talkative, explanations were shorter, and doctors tried to use other conversational mechanisms to promote understanding. Patient's variables were significantly lower compared to the doctor, considering the number of turns (p = 0.025) and their minimum (p = 0.032), maximum (p<0.001), and average durations (p<0.001). Only patient's latency was significantly higher than the doctor's (p = 0.001).

CONCLUSION

This is the first attempt to analyse the doctor-patient relationship in andrology using authentic audio-recorded consultations. The results confirmed that a patient-centred communication must be applied also in andrological consultations. However, the topics discussed may require more "medical formulation" to be acceptable to the participants in this context. This article is protected by copyright. All rights reserved.

Patient Acceptance and Intention to Use e-Consultations During the COVID-19 Pandemic in the Eastern Province of Saudi Arabia

Background

Over the last decade, the use of digital technology has increased immeasurably and transformed both our personal and professional lives. The medical profession quickly embraced this development, especially after the spread of the COVID-19 pandemic. Medical consultations were transitioned to online settings as a substitute for face-to-face consultations. This exponential acceleration of the use of remote online consultations (e-consultations) was deemed necessary to respond to the impact of the global pandemic. This study identifies the factors that influence actual patient use and the intention to use e-consultations in Saudi Arabia.

Methods

A cross-sectional survey was distributed online via social media platforms targeting the population living in Saudi Arabia from August to December 2020. The questionnaire measured patient perceptions of and attitudes toward utilizing e-consultations using a validated questionnaire informed by the technology acceptance model (TAM). Analyses were performed in SPSS to identify the external factors that influence patients' actual use of e-consultations and to assess the TAM factors (usefulness, social influence, and ease of use) that influence the intention to use e-consultations across both actual users and never-users.

Results

A total of 150 participants completed the questionnaire; the average age was 38 years old, 85% of the participants were females, and 67% reported never using e-consultations. Additionally, motivation, trust, attitude, and social influence were significantly related to participants' intention to use e-consultations.

Conclusion

Participants' trust in and perception of the usefulness of e-consultations were significant factors in their intention to use e-consultation services. Policymakers' attention to those factors could play a role in increasing public acceptance and the use of e-consultations to improve distance medical care.

Evolutionary Game—Theoretic Approach for Analyzing User Privacy Disclosure Behavior in Online Health Communities

Privacy disclosure is one of the most common user information behaviors in online health communities. Under the premise of implementing privacy protection strategies in online health communities, promoting user privacy disclosure behavior can result in a “win–win” scenario for users and online health communities. Combining the real situation and evolutionary game theory, in this study, we first constructed an evolutionary game model of privacy disclosure behavior with users and online health communities as the main participants. Then, we solved the replication dynamic equations for both parties and analyzed the evolutionary stable strategies (ESSs) in different scenarios. Finally, we adopted MATLAB for numerical simulations to verify the accuracy of the model. Studies show that: (1) factors such as medical service support and community rewards that users receive after disclosing their private personal information affect user game strategy; and (2) the additional costs of the online health communities implementing the “positive protection” strategy and the expected loss related to the privacy leakage risk affect the online health communities’ game strategy. In this regard, this paper puts forward the following suggestions in order to optimize the benefits of both sets of participants: the explicit benefits of users should be improved, the internal environment of the communities should be optimized, the additional costs of the “positive protection” strategy should be reduced, and penalties for privacy leakages should be increased.

Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Google Trends Analysis

INTRODUCTION

The internet has revolutionized health information delivery. With instantaneous and widespread access to electronic sources, patients have countless options with regard to where and how they acquire medical information. Although this enables patients to feel informed, uncontextualized misinformation can derail patients as much as accurate information can empower them. To better understand the sources of information available, a Google Trends analysis was performed.

METHODS

Search volume data were collected for the terms "ALCL," "textured implants," "Anaplastic Large Cell Lymphoma," "breast implant illness," and "breast implant cancer." Data were collected for 1- and 5-year search periods ending on May 1, 2020. Peaks were correlated to relevant news articles or FDA statements.

RESULTS

Results uncovered that news platforms like the New York Times (NYT) and The Guardian had greater public visibility when compared to official announcements through the FDA or pharmaceutical companies. During these peaks in public interest, search results on Google were dominated by information from media sources, highlighting a weakness in the general public's access to credible online health information.

CONCLUSIONS

Online search volume and regional data obtained from Google Trends can serve to strategize timely and targeted dissemination of important medical announcements to the public. Evidence from this study reveals pitfalls of the current model for dissemination of information and provides valuable, actionable methods for improved patient outreach for future communications.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Does Internet Use Aggravate Public Distrust of Doctors? Evidence from China

The internet has exacerbated the spillover of medical information, and changes in the quantity, quality, and scope of information supply also affect public trust in doctors, which is of great significance to the construction of a harmonious physician–patient relationship. The objective of this study is to explore the relationship between internet use and residents’ trust in doctors using data from the China Family Panel Studies for 2018. The empirical investigation utilizes an endogenous switching regression model (ESR) to overcome the endogeneity bias. Our results indicate that internet use is negatively associated with residents’ trust in doctors (β = 0.07, p < 0.05). Specifically, the patient trust of internet users is nearly 7 percent less than that of non-internet users. Nevertheless, residents with higher dependence on traditional media such as television, newspapers, magazines and radio as an information channel show stronger patient trust. Finally, the results of the subsample analysis indicate a need to focus on older and less-educated residents, who are more vulnerable and more likely to be affected.

Psychological impacts and online interventions of social isolation amongst older adults during COVID-19 pandemic: A scoping review

AIM

To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation.

DESIGN

A scoping review was performed.

DATA SOURCES

A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar.

REVIEW METHODS

Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes.

RESULTS

Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention.

CONCLUSION

The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions.

IMPACT

With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis.

The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review

BACKGROUND

The internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors.

OBJECTIVE

This study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship.

METHODS

Literature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021.

RESULTS

We selected 53 target papers (42 [79%] English papers and 11 [21%] Chinese papers) that met the inclusion criteria. Of these, 31 (58%) papers believe that patients' OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11%) papers show that OHI reduces Chinese patients' trust in doctors.

CONCLUSIONS

Our main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China's internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship.

The Effect of Media Richness on the Stability of Physician-Patient Relationships on E-Consultation Platforms

Incorporating media richness theory, social presence theory, and apparatgeist theory, the authors used multiple linear regression to explore the effect of media richness on the stability of physician-patient relationships and the moderating effect of disease complexity and response timeliness on the relationship between media richness and relationship stability. The results showed that media richness had a positive effect on the stability of physician-patient relationships. Additionally, both disease complexity and response timeliness positively affect the relationship between media richness and the stability of physician-patient relationships. This research contributes to the literature concerning media selection, e-consultation platforms, and physician-patient relationships; and it provides practical guidance for online doctor teams on how to select appropriate media communication forms for patient consultations in different situations.

A fuzzy trust measurement method considering patients' trust opinions in Internet plus Healthcare

With the outbreak of COVID-19, Internet plus Healthcare has developed rapidly with a number of Internet plus Healthcare platforms emerging. The problem of doctor-patient trust is a key issue restricting the development of the Internet plus Healthcare, which has aroused extensive attention of scholars. The patient's perceived trust on the Internet plus Healthcare platform has the characteristics of subjectivity, ambiguity, and high perceived risk. Therefore, existing trust calculation method becomes inapplicable because these characteristics have not been considered. In order to solve this problem, this study extracts influencing factors of patient trust on the Internet plus Healthcare platform, gives a trust calculation method based on intuitionistic fuzzy set theory, and added a risk preference coefficient in order to integrate the characteristics of patients' high perceived risk into the proposed method. This method is conducive to the platform to provide patients with more accurate doctor recommendations

Global Public Interest and Seasonal Variations in Alzheimer's Disease: Evidence From Google Trends

Background: As the world's population ages, Alzheimer's disease (AD), a common neurodegenerative disease, is a major challenge to human health in the future. Understanding the information needs on AD of the global public can contribute to the prevention and control of AD. The purpose of this study was to explore global public interest and seasonal variations in AD using Google Trends (GT). Methods: GT was used to obtain relative search volume (RSV) of the keyword "Alzheimer's disease" in six English-speaking countries (Australia, New Zealand, the USA, the UK, Canada, and Ireland) and the world from January 2004 to December 2020. Cosinor analysis was applied to detect the seasonality of AD-related RSV. Time series plot was used to observe the trend of annual mean AD-related RSV. Globally, hot topics and top rising topics related to AD were also analyzed. In addition, we also explored the geographical distribution characteristics of AD-related RSV. Results: AD-related RSV declined steadily from January 2004 to December 2013 and rose steadily from January 2014 to December 2020. Search popularity of AD is low in the southern hemisphere, compared to the northern hemisphere. Cosinor analysis showed that there were significant seasonal variations in AD-related RSV in six English-speaking countries (all P < 0.05). Interestingly, regardless of the hemisphere, peaks were observed in the winter months and trough in the summer months. Topics related to the characteristics and etiology of AD, early onset AD, AD-related associations, care of AD patients, and diseases that can easily be confused with AD had received special attention. Conclusions: There is increasing global public interest for AD and a significant seasonal variation in AD. A better understanding of the seasonal variations and public interest of AD by governments, health workers and patients can contribute to the prevention, management, and treatment of AD.

Frequency of Online Health Information Seeking and Types of Information Sought Among the General Chinese Population: Cross-sectional Study

BACKGROUND

The internet is one of the most popular health information resources, and the Chinese constitute one-fifth of the online users worldwide. As internet penetration continues to rise, more details on the Chinese population seeking online health information need to be known based on the current literature.

OBJECTIVE

This study aims to explore the sociodemographic differences in online health information seeking (OHIS), including the frequency of OHIS and the types of online health information sought among the general Chinese population in mainland China.

METHODS

A cross-sectional study for assessing the residents' health care needs with self-administered questionnaires was implemented in 4 counties and districts in China from July 2018 to August 2018. Pearson's chi-square test was used to identify the sociodemographic differences between infrequent and frequent online health information seekers. We also performed binary logistic regression for the 4 types of online health information as the dependent variables and the sociodemographic factors as the independent variables.

RESULTS

Compared with infrequent online health information seekers, frequent seekers were more likely to be female (infrequent: 1654/3318; 49.85%; frequent: 1015/1831, 55.43%), older (over 60 years old; infrequent: 454/3318, 13.68%; frequent: 282/1831, 15.40%), married (infrequent: 2649/3318, 79.84%; frequent: 1537/1831, 83.94%), and better educated (bachelor's or above; infrequent: 834/3318, 25.14%; frequent: 566/1831, 30.91%). They were also more likely to earn a higher income (over RMB ¥50k [RMB ¥1=US $0.15641]; infrequent: 1139/3318, 34.33%; frequent: 710/1831, 34.78%), have commercial health insurance (infrequent: 628/3318, 18.93%; frequent: 470/1831, 25.67%), and have reported illness in the past 12 months (infrequent: 659/3318, 19.86%; frequent: 415/1831, 22.67%). Among the 4 health information types, health science popularization was the most searched for information by Chinese online health information seekers (3654/5149, 70.79%), followed by healthy behaviors (3567/5149, 69.28%), traditional Chinese medicine (1931/5149, 37.50%), and medical concerns (1703/5149, 33.07%). The binary logistic regression models showed that males were less likely to seek information on healthy behaviors (adjusted odds ratio [AOR] 0.69, 95% CI 0.61-0.78) and traditional Chinese medicine (AOR 0.64, 95% CI 0.57-0.73), and respondents who had at least 1 chronic disease were more likely to seek information on medical concerns (AOR 1.27, 95% CI 1.07-1.51) and traditional Chinese medicine (AOR 1.26, 95% CI 1.06-1.49).

CONCLUSIONS

Sociodemographic factors were associated with the frequency of OHIS and types of information sought among the general Chinese population. The results remind providers of online health information to consider the needs of specific population groups when tailoring and presenting health information to the target population.

Factors associated with using the internet for medical information based on the doctor-patient trust model: a cross-sectional study

Background

Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment.

Methods

A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson’s correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care.

Results

The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor’s credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients’ behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor’s credibility on the patient’s behavioural intention was 0.385; the total effect of the personal trust tendency on the patient’s behavioural intention was 0.296.

Conclusions

This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.

q-Rung orthopair fuzzy TOPSIS method and the application to information service quality evaluation in online health community

Since the information quality in the online health community is very important for users to obtain valuable health information, information quality evaluation is a necessary research that involves a multi-attribute decision-making (MADM) problem. However, few researches have been done to address both the construction of evaluation criteria and the expression and processing of fuzzy information, especially in online health community. This paper proposes a novel evaluation framework of information service quality combined principal component analysis (PCA) method with the TOPSIS method under q-rung orthopair fuzzy set (q-ROFS) environment. An accurate evaluation criteria system is optimized by the PCA method, and the q-ROF TOPSIS method is proposed to process larger space of fuzzy evaluation information and overcome information loss and information distortion, in which a new distance measure between q-ROFSs is defined and an entropy weight model is initiated to determine the unknown weight of attribute. Moreover, a numerical example is performed to prove the practicability and superiority of the method through comparative analysis, which gives clear results of information quality evaluation of four online health communities. This research ends with fuzzy decision-making theory and application, and provides references for standardizing and improving the information quality of online health communities.

Are Diverse Media Better than a Single Medium? The Relationship between Mixed Media and Perceived Effect from the Perspective of Online Psychological Counseling

The progress of new media has promoted the development of online health consultations. Previous research has investigated the impact of media richness on user satisfaction; however, little attention has been given to the mixed effects of the nesting of multiple media. The purpose of this study is to analyze the impact and differences of the use of single or mixed media on users' perceived effect from the perspectives of social support and satisfaction by mining user reviews on online health platforms. The data were collected from a professional online psychological counseling platform. We collected data on 48,807 reviews from 11,694 users. Text annotation and sentiment analysis were then used to extract variable eigenvalues from the reviews. One-way analysis of variance (ANOVA) and hierarchical regression analysis were used for statistical analysis. The results show that mixed media with different richness has a significant impact on the users' perceived effects. Among them, compared to "text + audio," using "text + audio + video/face to face" can significantly improve the users' perceived social support and satisfaction. However, compared to single medium, mixed media with higher richness may not necessarily achieve a better effect. We found that the inclusion of "video/face to face" mixed media significantly reduced the users' perceived social support and satisfaction compared to text or audio use alone. These research results complement the blank media richness theory in the field of online health care and provide guidance for improving the personalized customization of online psychological counseling platforms.

Impact of Physicians' Competence and Warmth on Chronic Patients' Intention to Use Online Health Communities

In China, medical resources are unevenly distributed, and hospitals are very congested. Online health communities (OHCs) provide a new way for patients to communicate and obtain health-related information, thereby alleviating the pressure of treatment in hospitals. However, little is known about how to increase individuals’ use intention for OHCs from the perspective of physicians. This study aims to investigate the impact of physicians’ competence and warmth on chronic patients’ intention to use physician-centered OHCs based on the technology acceptance model. A formal investigation was anonymously conducted through a web-based questionnaire survey addressed to participants, and 710 valid responses were received. A research model was constructed and the hypotheses were tested by structural equation modeling. The findings suggest that competence and warmth positively affect chronic patients’ behavioral intention to use (BIU) OHCs through the mediation of perceived usefulness (PU) and perceived ease of use (PEOU). All hypotheses were supported at the 0.05 significant level. Compared with competence, warmth has a slightly stronger impact on PU and PEOU. PEOU has a stronger impact on chronic patients’ BIU OHCs than PU. This study provides a comprehensive understanding of the impacts of physicians’ characteristics in physician-driven OHCs. Compared with competence, physicians’ warmth should be paid more attention to motivate more chronic patients to use OHCs. Enhancing physicians’ warmth and the ease of use are the preferred ways to improve chronic patients’ intention to use OHCs.

Factors associated with intention to uptake pneumococcal vaccines among Chinese elderly aged 60 years and older during the early stage of COVID-19 pandemic

Innoculation of pneumococcal vaccines among the elderly is an effective public health policy to prevent pneumococcal diseases and it is widely promoted by many developed countries. The pneumococcal vaccination rate among the elderly in China was only 3.7% in 2019, it grew rapidly during the early stage of the COVID-19 pandemic. The purpose of this cross-sectional study was to investigate the psychological and demographic-economic factors related to the uptake behavior of pneumococcal vaccination among the Chinese elderly by using an integrated model based on the unified theory of acceptance and use of technology (UTAUT), and knowledge, attitudes and practices (KAP). The theoretical model was tested via structural equation modeling (SEM) with data collected from 516 Chinese older adults aged 60 years and older. Our results suggested that knowledge, performance expectancy, effort expectancy, attitude, and trust had a significant correlation with behavioral intention; behavioral intention and trust had a positive correlation with the uptake behavior, gender, and and education level and chronic obstructive pulmonary disease exerted significant moderating effects. To increase the coverage of pneumococcal vaccination among the elderly, it is necessary to provide effective health education by authoritative experts, thereby enhancing their knowledge and positive attitude towardthe vaccination.

Rebuild doctor-patient trust in medical service delivery in China

Doctor–patient trust is not strong in China, but studies examining this factor remain insufficient. The present study aimed to explore the effect of doctor–patient communication, medical service quality, and service satisfaction on patient trust in doctors. Five hundred sixty-four patients with tuberculosis participated in this cross-sectional study in Dalian, China. They completed questionnaires assessing socio-demographic characteristics, doctor–patient communication, medical service quality, service satisfaction and patient trust in medical staff. A structural equation model was applied to examine the hypotheses, and all the study hypotheses were supported: (1) doctor–patient communication, medical service quality and service satisfaction were positively associated with building doctor–patient trust; (2) service quality positively mediated the relationship between doctor–patient communication and trust; (3) medical service satisfaction positively mediated the relationship between doctor–patient communication and trust; (4) medical service satisfaction positively mediated the relationship between medical service quality and doctor–patient trust; and (5) medical service quality and service satisfaction were the positively sequential mediators between communication and doctor–patient trust. Based on these findings, improvements in doctor–patient communication, medical service quality, and service satisfaction are the important issues contributing to the rebuilding of doctor–patient trust in medical service delivery.