OBJECTIVE: This review aims to understand physicians\' perceptions of patients\' internet health information-seeking behavior as well as their communication strategies and the challenges and needs they face with internet-informed patients.
METHODS: An initial search in PubMed, Scopus, CINAHL, Communication and Mass Media Complete, and PsycINFO was conducted to collect studies published from January 1990 to August 1, 2022. A subsequent search on December 24, 2023, targeted recent studies published after the initial search cutoff date. Two reviewers independently performed title, abstract, and full-text screening, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Thematic analysis was then used to identify key themes and systematically categorize evidence from both qualitative and quantitative studies under these themes.
RESULTS: A total of 22 qualifying articles were identified after the search and screening process. Physicians were found to hold diverse views on patients\' internet searches, which can be viewed as a continuous spectrum of opinions ranging from positive to negative. While some physicians leaned distinctly toward either positive or negative perspectives, a significant number expressed more balanced views. These physicians recognized both the benefits, such as increased patient health knowledge and informed decision-making, and the potential harms, including misinformation and the triggering of negative emotions, such as patient anxiety or confusion, associated with patients\' internet health information seeking. Two communicative strategies were identified: the participative and defensive approaches. While the former seeks to guide internet-informed patients to use internet information with physicians\' expertise, the latter aims to discourage patients from using the internet to seek health information. Physicians\' perceptions were linked to their strategies: those holding positive views tended to adopt a participative approach, while those with negative views favored a defensive strategy. Some physicians claimed to shift between the 2 approaches depending on their interaction with a certain patient. We also identified several challenges and needs of physicians in dealing with internet-informed patients, including the time pressure to address internet-informed patient demands, a lack of structured training, and being uninformed about trustworthy internet sites that can be recommended to internet-informed patients.
CONCLUSIONS: This review highlights the diverse perceptions that physicians hold toward internet-informed patients, as well as the interplay between their perceptions, communication strategies, and their interactions with individual patients. Incorporating elements into the medical teaching curriculum that introduce physicians to reliable internet health resources for patient guidance, coupled with providing updates on technological advancements, could be instrumental in equipping physicians to more effectively manage internet-informed patients.
BACKGROUND: PROSPERO CRD42022356317; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=356317.
目的:这篇综述旨在了解医生对患者的看法,以及他们寻求互联网健康信息的行为,以及他们的沟通策略,以及他们面对互联网知情患者的挑战和需求。
方法:PubMed中的初始搜索,Scopus,CINAHL,通信和大众传媒完成,和PsycINFO进行了收集1990年1月至2022年8月1日发表的研究。2023年12月24日的后续搜索针对的是在最初的搜索截止日期之后发表的最新研究。两名审稿人独立表演标题,abstract,和全文筛选,遵守PRISMA(系统审查和荟萃分析的首选报告项目)声明指南。然后使用主题分析来确定关键主题,并系统地对这些主题下的定性和定量研究中的证据进行分类。
结果:在搜索和筛选过程之后,共确定了22篇合格文章。医生被发现对患者的互联网搜索持有不同的观点,这可以被视为从积极到消极的连续观点。虽然一些医生明显倾向于积极或消极的观点,相当多的人表达了更平衡的观点。这些医生认识到这两种好处,例如增加患者的健康知识和明智的决策,和潜在的危害,包括错误信息和负面情绪的触发,如患者焦虑或困惑,与患者相关的互联网健康信息寻求。确定了两种交际策略:参与和防御方法。虽然前者试图引导互联网知情患者使用互联网信息与医生的专业知识,后者旨在阻止患者使用互联网寻求健康信息。医生的看法与他们的策略有关:那些持有积极观点的人倾向于采用参与性方法,而那些持负面观点的人则倾向于采取防御策略。一些医生声称根据他们与特定患者的互动在两种方法之间进行转换。我们还确定了医生在处理互联网知情患者方面的一些挑战和需求,包括解决互联网知情患者需求的时间压力,缺乏结构化的培训,并且不了解可以推荐给互联网知情患者的值得信赖的互联网网站。
结论:这篇综述强调了医生对互联网知情患者的不同看法,以及他们的感知之间的相互作用,沟通策略,以及他们与个体患者的互动。将元素纳入医学教学课程,向医生介绍可靠的互联网健康资源以指导患者,加上提供技术进步的最新信息,可以帮助医生更有效地管理了解互联网的患者。
背景:PROSPEROCRD42022356317;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=356317。