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Abstract：
Pediatric cancer patients in China often present at an advanced stage of disease resulting in lower survival and poorer health outcomes. One factor hypothesized to contribute to delays in pediatric cancer has been the online health information-seeking (OHIS) behaviors by caregivers.
This study aims to examine the association between OHIS behaviors by caregivers and delays for Chinese pediatric cancer patients using a mixed methods approach.
This study used a mixed methods approach, specifically a sequential explanatory design. OHIS behavior by the caregiver was defined as the way caregivers access information relevant to their children\'s health via the Internet. Delays in pediatric cancer were defined as any one of the following 3 types of delay: patient delay, diagnosis delay, or treatment delay. The quantitative analysis methods included descriptive analyses, Student t tests, Pearson chi-square test, and binary logistic regression analysis, all performed using Stata. The qualitative analysis methods included conceptual content analysis and the Colaizzi method.
A total of 303 pediatric cancer patient-caregiver dyads was included in the quantitative survey, and 29 caregivers completed the qualitative interview. Quantitative analysis results revealed that nearly one-half (151/303, 49.8%) of patients experienced delays in pediatric cancer, and the primary type of delay was diagnosis delay (113/303, 37.3%), followed by patient delay (50/303, 16.5%) and treatment delay (24/303, 7.9%). In this study, 232 of the 303 (76.6%) caregiver participants demonstrated OHIS behaviors. When those engaged in OHIS behaviors were compared with their counterparts, the likelihood of patient delay more than doubled (odds ratio=2.21; 95% CI 1.03-4.75). Qualitative analysis results showed that caregivers\' OHIS behaviors impacted the cancer care pathway by influencing caregivers\' symptom appraisal before the first medical contact and caregivers\' acceptance of health care providers\' diagnostic and treatment decisions.
Our findings suggest that OHIS among Chinese pediatric caregivers may be a risk factor for increasing the likelihood of patient delay. Our government and society should make a concerted effort to regulate online health information and improve its quality. Specialized freemium consultations provided by health care providers via online health informatic platforms are needed to shorten the time for caregivers\' cancer symptom appraisal before the first medical contact.
This study aims to examine the association between OHIS behaviors by caregivers and delays for Chinese pediatric cancer patients using a mixed methods approach.
This study used a mixed methods approach, specifically a sequential explanatory design. OHIS behavior by the caregiver was defined as the way caregivers access information relevant to their children\'s health via the Internet. Delays in pediatric cancer were defined as any one of the following 3 types of delay: patient delay, diagnosis delay, or treatment delay. The quantitative analysis methods included descriptive analyses, Student t tests, Pearson chi-square test, and binary logistic regression analysis, all performed using Stata. The qualitative analysis methods included conceptual content analysis and the Colaizzi method.
A total of 303 pediatric cancer patient-caregiver dyads was included in the quantitative survey, and 29 caregivers completed the qualitative interview. Quantitative analysis results revealed that nearly one-half (151/303, 49.8%) of patients experienced delays in pediatric cancer, and the primary type of delay was diagnosis delay (113/303, 37.3%), followed by patient delay (50/303, 16.5%) and treatment delay (24/303, 7.9%). In this study, 232 of the 303 (76.6%) caregiver participants demonstrated OHIS behaviors. When those engaged in OHIS behaviors were compared with their counterparts, the likelihood of patient delay more than doubled (odds ratio=2.21; 95% CI 1.03-4.75). Qualitative analysis results showed that caregivers\' OHIS behaviors impacted the cancer care pathway by influencing caregivers\' symptom appraisal before the first medical contact and caregivers\' acceptance of health care providers\' diagnostic and treatment decisions.
Our findings suggest that OHIS among Chinese pediatric caregivers may be a risk factor for increasing the likelihood of patient delay. Our government and society should make a concerted effort to regulate online health information and improve its quality. Specialized freemium consultations provided by health care providers via online health informatic platforms are needed to shorten the time for caregivers\' cancer symptom appraisal before the first medical contact.
摘要：
背景：中国的儿童癌症患者通常处于疾病的晚期，从而导致较低的生存率和较差的健康状况。假设导致儿科癌症延误的一个因素是护理人员的在线健康信息寻求（OHIS）行为。
目的：本研究旨在使用混合方法研究中国儿科癌症患者照顾者的OHIS行为与延误之间的关系。
方法：本研究采用混合方法，特别是一个顺序的解释性设计。护理人员的OHIS行为被定义为护理人员通过互联网访问与子女健康相关的信息的方式。儿科癌症的延迟定义为以下3种类型的延迟中的任何一种：患者延迟，诊断延迟,或治疗延迟。定量分析方法包括描述性分析，学生t测试，皮尔逊卡方检验，和二元逻辑回归分析，都是用Stata表演的.定性分析方法包括概念内容分析和Colaizzi方法。
结果：共有303名儿科癌症患者-看护者被纳入定量调查，29名护理人员完成了定性访谈。定量分析结果显示，近一半(151/303，49.8%)的患者出现儿科癌症延迟，延迟的主要类型是诊断延迟（113/303，37.3%），其次是患者延迟（50/303，16.5%）和治疗延迟（24/303，7.9%）。在这项研究中,303名(76.6%)护理人员参与者中有232人表现出OHIS行为。当那些从事OHIS行为的人与他们的同行进行比较时，患者延迟的可能性增加了一倍以上(比值比=2.21;95%CI1.03-4.75).定性分析结果表明，照顾者的OHIS行为通过影响照顾者在首次医疗接触之前的症状评估和照顾者对医疗保健提供者的接受诊断和治疗决策来影响癌症护理途径。
结论：我们的研究表明，中国儿科护理人员的OHIS可能是增加患者延误可能性的危险因素。我国政府和社会应该共同努力，规范在线健康信息，提高其质量。需要医疗保健提供者通过在线健康信息平台提供的专业免费咨询，以缩短护理人员在首次医疗联系之前进行癌症症状评估的时间。
目的：本研究旨在使用混合方法研究中国儿科癌症患者照顾者的OHIS行为与延误之间的关系。
方法：本研究采用混合方法，特别是一个顺序的解释性设计。护理人员的OHIS行为被定义为护理人员通过互联网访问与子女健康相关的信息的方式。儿科癌症的延迟定义为以下3种类型的延迟中的任何一种：患者延迟，诊断延迟,或治疗延迟。定量分析方法包括描述性分析，学生t测试，皮尔逊卡方检验，和二元逻辑回归分析，都是用Stata表演的.定性分析方法包括概念内容分析和Colaizzi方法。
结果：共有303名儿科癌症患者-看护者被纳入定量调查，29名护理人员完成了定性访谈。定量分析结果显示，近一半(151/303，49.8%)的患者出现儿科癌症延迟，延迟的主要类型是诊断延迟（113/303，37.3%），其次是患者延迟（50/303，16.5%）和治疗延迟（24/303，7.9%）。在这项研究中,303名(76.6%)护理人员参与者中有232人表现出OHIS行为。当那些从事OHIS行为的人与他们的同行进行比较时，患者延迟的可能性增加了一倍以上(比值比=2.21;95%CI1.03-4.75).定性分析结果表明，照顾者的OHIS行为通过影响照顾者在首次医疗接触之前的症状评估和照顾者对医疗保健提供者的接受诊断和治疗决策来影响癌症护理途径。
结论：我们的研究表明，中国儿科护理人员的OHIS可能是增加患者延误可能性的危险因素。我国政府和社会应该共同努力，规范在线健康信息，提高其质量。需要医疗保健提供者通过在线健康信息平台提供的专业免费咨询，以缩短护理人员在首次医疗联系之前进行癌症症状评估的时间。
