title: The effects of online self-diagnosis and health information seeking on the patient-healthcare professional relationship
Creators: name: Farnood, Annabel
Publisher: name: University of Glasgow
Year: 2021

description: Background: Internet connectivity is spreading around the globe, and in some countries, connectivity is almost universal. When connected, the internet user has before them, an unparalleled information resource. Among the billions of web pages, are many devoted to health information, from academic resources to patient online health forums. In increasing numbers, patients are turning to these resources for information. Healthcare professionals including nurses, find themselves relating to increasingly knowledgeable patients and the very nature of the relationship is changing. Understanding this change and its consequences is an important research task and as part of this endeavour, this thesis reports on the effects of patient online self-diagnosis and health information-seeking on the patient-healthcare professional relationship and medical authority. Methods: First, a mixed methods systematic review examines and synthesises the current literature on the effects of patient online self-diagnosis on the patient-healthcare professional relationship. Second, a qualitative descriptive method was adopted for investigating heart failure online health forums. Finally, online semi-structured interviews were conducted with a sample of 16 patients and 15 healthcare professionals, to gain their perceptions of the use of the internet for seeking online health information. Data were analysed thematically, and Normalization Process Theory provided the underlying conceptual lens to inform analysis. Findings: The findings indicated that patients found the internet to be a complementary information source alongside healthcare professionals. Healthcare professionals were perceived to be the most reliable and valued information source. The most common reason to use online health forums was to plug information gaps surrounding diagnosis or treatments. Forums were used to aid decision-making such as whether to seek further medical attention, and to source information on lifestyle choices, medications and other advice. Forum responses were analysed for diagnostic accuracy and only a small minority were found to be evidence based. Signposting to other sources and responses containing unsubstantiated advice were far more common. The interview study found similarities and differences in public and healthcare professional perceptions. Healthcare professionals had hesitancies and were cautious of patient’s using the internet for health information but were in favour of patients becoming more knowledgeable and working together to make informed decisions. Likewise, public participants searched online to understand information gained from their healthcare professional and hoped to work in a professional partnership and become more involved in the decision-making process. Conclusion and Implications: Rather than online health information seeking inevitably undermining the patient-healthcare professional relationship, using a broad and triangulated research design, this study provides evidence that potentially beneficial outcomes may result from this growing phenomenon. The research offers insights into peer-focused resources such as online health forums and the perceptions of the public and healthcare professionals. Recommendations relate to the adapting of behavioural and communicative approaches appropriate for internet-informed patients. The nursing profession should recognise the significance of the phenomenon and incorporate it into education and development programmes.