NAKAYAMA, Kazuhiroa, NISHIO, Arisab, YOKOYAMA, Yukaric,SETOYAMA, Yokoa , TOGARI, Taisuked and YONEKURA, YukicaSt. Luke's college of Nursing, Nursing Informatics
bNagoya University,Fundermental Nursing

cThe University ofTokyo, Health Sociology
dYamaguchi University, Hygene, JAPAN1

Introduction More than 50% of Japanese choose the Internet overnewspaper, magazines, or television in order to search
information about health and illness.
 Since academic and research institutes have not yet
provided enough health-related information on theInternet, the information by patients and nonexperts
is needed.
 The number of access to Web2.0-based Q&A sites
such as Yahoo! Answers, which is called “Yahoo!
Chiebukuro” in Japan covering over 17 million
questions, and OKWave, which covers over 3.5 million
questions, is the most rapidly growing of all kinds ofwebsites in Japan.
 Such websites established a user rating system toreward user’s participation by utilizing user-generated
contents and information-sharing methods.
 We analyzed the questions and answers related tohealth issues posted on these websites.
2Method Since these websites have more than 0.1 million

questions, we especially focused on questions whichcame up after a questioner searched or looked athealth issues on the Internet as the second source.

 We searched the questions which contain “Internet,”“web,” “site,” “page,” “HP”, or “BBS” under the
category Conditions & Diseases of Health.

 Among these questions, we picked up some cases withwhich the questioner seemed to be troubled orconfused by searching or asking questions on theInternet.

 We analyzed when and how the problem had

happened and what kind of answers had beenevaluated high.

3Results
 The most frequently happened problem was that users

had been confused by new information (Figure1).

 Some people were confused because of discrepancies

in different information sources, including theirdoctor’s comments.

 Most of them seem not to have had enough time to

discuss their issues with their doctors or the other
health professionals, and therefore, they went onto
the Internet for the other credible sources.

 Another cause of user’s confusion is a lack oflegitimate websites written in Japanese. Commercial
websites come up first rather than academic ones
when people search health issues on the Internet. The
fact shows inadequate awareness of Japanese healthprofessionals about the health communication which isaimed at each level of health literacy.
4

Figure 1 Problems by searching or asking questions on the Internet（％）
0

10 20 30 40 50

Confused by new information
21.6
Unable to understand
17.3
Unable to find right information
13.9
Conflict with medical professionals
7.3
Difficulties in decision making
6.9
Anxiety about legitimacy
6.8
Wrongly apply information to one’s disease
Troubles with a respondent 3.6
Wrong answers in medical terms 3.42.8
Bias of information on the Internet
Troubles over Internet shopping 2.1
Wrong use of self-assessment tools 1.5
Uncommon treatment found on the Internet 1.1
Anxiety and trouble on vicious websites 0.9
Regret not searching information earlier 0.8

46.2

5

Discussion
 Adequate information supply by medical experts isneeded. Moreover, an improvement of health literacyof citizens and a supportive environment, which isdesigned to utilize citizens’ experiences andknowledge, are necessary.

 Web2.0-based Q&A sites seem to be effective.

Analyzing these questions and answers makes it clearthat what kinds of information were needed and whatkinds of answers a questioner gained.

 Therefore, we are making a list of sample cases whichshows troubles over information on the Internet, inorder to help people in all levels of health literacy.

 Items of the list contain when people used theInternet, the issues which arose after using theInternet and some good sample answers （Table 1）.
6

Table 1 Sample cases of troubles caused by information on the Internet
When theIssues after using the InternetInternet used
After a periodic Still unable to understand themedical
result of the examination after
examination
searching on the Internet

Good sample answers
Explain the result, especially focused on thequestioner’s age, symptoms and anxieties.

Provide more details of the disease shown on
Do not know if one’s symptom the Internet, explain a risk to diagnose one’s
can be applied to the one on the symptoms by using only the Internet source,
After noticing
Internet, if one should go to see show an importance of consulting a doctor andsymptoms
a doctor and which hospital one receiving an early treatment, talk aboutshould go
respondent’s experiences of the disease and how
to manage it
After aUnable to find website designed
Link to a website of a patient group or adiagnosis
to provide the information topatient’s diary of a struggle against the diseasestatedaccept diseases
Give an explanation about the case on theA doctor’s treatment and anInternet, point out the inadequate explanation by
After a medical
Internet-recommended treatment questioner’s doctor, recommend to consult thetreatment
are different, and do not know
doctor more precisely and to ask questioner’sshown
which treatment is betterfamily to stay in the consultation, give a
respondent’s story to choose a treatment
After a medical Do not know if the response to a
Support the response by respondent’streatment
family member found on theexperiences
7
startedInternet is rightConclusion
 We found that the people post questions in order toobtain the information about their health issues fromvarious sources and the validation of the information
provided by not only experts but also those who have
similar experiences.
 As well as providing more legitimate information, weshould focus on establishing a supportive environment
for Web2.0 where those who have similar experiences
participate and should find a role of experts on theenvironment.
 We are planning to develop a method to improvehealth literacy of patients and citizens by utilizing
Web2.0, which we believe that shows a direction ofNursing Informatics as Consumer Health Informatics.
This research was partially supported by the Ministry of Education, Science, Sports andCulture, Grant-in-Aid for Scientific Research(B), 2007-2010, 19390552
Email Address for Correspondence: nakayama@slcn.ac.jp8