Women's Use of the Internet: What Nurses Need to Know

How People with Physical Disabilities Can Obtain Social Support through Online Videos: A Qualitative Study in China

BACKGROUND

Online video creation is becoming an option for many people with physical disabilities in China. However, few studies have considered how physically disabled individuals access social support through online video creation.

METHODS

For this qualitative study, semi-structured interviews were conducted with 18 online video creators with physical disabilities. The starting point of this study was video creation by people with physical disabilities, with a focus on the social interactions between creators, online video platforms, followers, viewers and sponsors, as well as the perceived social support in the process.

RESULTS

Thematic analysis was used to identify six social support themes: (i) meeting emotional needs; (ii) obtaining informational support; (iii) obtaining creative benefits; (iv) constructing identity; (v) reconstructing social relationships; and (vi) discovering self-worth. Four risk-related themes were identified: (i) online language violence; (ii) invasion of commercial capital; (iii) online video addiction; and (iv) fragile social support.

CONCLUSIONS

The findings indicate that, although people with physical disabilities can obtain effective social support through creating online videos, it is accompanied by many risks. In addition, the social support gained through creating online videos differs from traditional online social support (e.g., changes in online support groups, emphasis on creative gain).

PROSPECT

Future research should perform more detailed analyses of different types of social support and specific risks of creation, while taking into account individual differences and sociodemographic backgrounds.

Development of Social Support Networks by Patients With Depression Through Online Health Communities: Social Network Analysis

Background

In recent years, people with mental health problems are increasingly using online social networks to receive social support. For example, in online depression communities, patients can share their experiences, exchange valuable information, and receive emotional support to help them cope with their disease. Therefore, it is critical to understand how patients with depression develop online social support networks to exchange informational and emotional support.

Objective

Our aim in this study was to investigate which user attributes have significant effects on the formation of informational and emotional support networks in online depression communities and to further examine whether there is an association between the two social networks.

Methods

We used social network theory and constructed exponential random graph models to help understand the informational and emotional support networks in online depression communities. A total of 74,986 original posts were retrieved from 1077 members in an online depression community in China from April 2003 to September 2017 and the available data were extracted. An informational support network of 1077 participant nodes and 6557 arcs and an emotional support network of 1077 participant nodes and 6430 arcs were constructed to examine the endogenous (purely structural) effects and exogenous (actor-relation) effects on each support network separately, as well as the cross-network effects between the two networks.

Results

We found significant effects of two important structural features, reciprocity and transitivity, on the formation of both the informational support network (r=3.6247, P<.001, and r=1.6232, P<.001, respectively) and the emotional support network (r=4.4111, P<.001, and r=0.0177, P<.001, respectively). The results also showed significant effects of some individual factors on the formation of the two networks. No significant effects of homophily were found for gender (r=0.0783, P=.20, and r=0.1122, P=.25, respectively) in the informational or emotional support networks. There was no tendency for users who had great influence (r=0.3253, P=.05) or wrote more posts (r=0.3896, P=.07) or newcomers (r=–0.0452, P=.66) to form informational support ties more easily. However, users who spent more time online (r=0.6680, P<.001) or provided more replies to other posts (r=0.5026, P<.001) were more likely to form informational support ties. Users who had a big influence (r=0.8325, P<.001), spent more time online (r=0.5839, P<.001), wrote more posts (r=2.4025, P<.001), or provided more replies to other posts (r=0.2259, P<.001) were more likely to form emotional support ties, and newcomers (r=–0.4224, P<.001) were less likely than old-timers to receive emotional support. In addition, we found that there was a significant entrainment effect (r=0.7834, P<.001) and a nonsignificant exchange effect (r=–0.2757, P=.32) between the two networks.

Conclusions

This study makes several important theoretical contributions to the research on online depression communities and has important practical implications for the managers of online depression communities and the users involved in these communities.

Exploring the role of online health information and social media in the illness experience of arthritis-related fatigue: A focus group study

PURPOSE

Online health information (OHI) and social media have become prominent health resources for people with arthritis-related fatigue. More research is needed to understand how OHI and online social support may influence illness experiences and patient-practitioner relationships in people with arthritis-related fatigue. The present study aimed to explore how OHI and social media shape these experiences by using an inductive qualitative analysis.

METHOD

Seven focus groups were conducted with 21 participants aged 28-77 diagnosed with a range of rheumatic diseases. Within the focus groups, participants were asked questions about OHI, online social support and the role of OHI in their health care. The focus groups were recorded, transcribed and analysed using a combination of interpretative phenomenological analysis (IPA) and thematic analysis.

RESULTS

The analysis resulted in three themes: (a) how online social support changes illness experiences, (b) communicating fatigue to health professionals using OHI and (c) health care experiences online. These themes provide insight into the ways people with arthritis-related fatigue benefit from online social support, use OHI to support communication with health professionals and how they share health care for arthritis in online spaces.

CONCLUSION

This research expanded on previous literature addressing the role of OHI and social media in the illness experience of arthritis-related fatigue. As technology use is increasing, particularly in the current extraordinary environment of social distancing, it is critical to address the role of OHI and social media in health care. In this study, OHI and social media played a prevalent role in the health care of many participants.

What Drives Patients Affected by Depression to Share in Online Depression Communities? A Social Capital Perspective

Online depression communities give people additional opportunities to share their experiences and exchange social support to care for themselves in fighting against depression. We aimed to explore what drives patients to share in online depression communities. We used three dimensions of social capital (structural, relational, and cognitive) to explain their sharing behaviors. We further proposed that five factors (social interaction ties, a sense of shared identity, trust, expertise, and a sense of shared values) will have significant, positive effects on sharing behaviors and that there are differences among patients who have spent different lengths of time participating in online depression communities. We then chose a popular online depression community in China as our data source and obtained a dataset consisting of 31,440 posts from 197 members. Then, we employed panel data regression analyses to test all six hypotheses. The results revealed that all five factors had significant, positive effects (p < 0.01) on patients' sharing behaviors, and the effects were significantly different across groups. Our empirical results help designers and managers of online depression communities take specific measures to facilitate community members' access to social capital resources. Meanwhile, our results have implications for existing health management and e-health literature.

Understanding the Chinese Hui Ethnic Minority's Information Seeking on Cardiovascular Diseases: A Focus Group Study

The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) than most other ethnic groups. Therefore, the availability of health information relating to these factors is especially important for the Hui minority’s preventive healthcare. They do, however, experience difficulties in obtaining health-related information. The current research aims to identify the needs of the Hui people on where and how they obtain cardiovascular disease (CVD) related information from the media and other sources. Six focus groups were conducted in Shenyang City. The results revealed that the participants relied on different sources to get advice about CVDs, of which the internet and television were the most prominent ones. The participants expressed a desire for credible and professional information from different sources and asked for mediated health communication programs specifically targeted at the Hui. In addition, the participants felt ignored by the Chinese mainstream media at large, which created barriers for them to get health information.

Students Seeking Health-related Information over Internet

The use of Internet to search information related to health has become a common phenomenon. This article investigates the seeking of health-related information of the college going students over the Internet. The researchers have tested the technology acceptance model (TAM) to determine the behavioural intention of the students to seek health-related information over the Internet. A self-administered questionnaire was distributed among the students who were involved in Internet use. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to the responded data. The results showed that it is the perceived usefulness (PU) which has a direct impact on the behavioural intention of the Internet users to search health-related information over the Internet.

Information Management in New Motherhood: Does the Internet Help or Hinder?

BACKGROUND

Women are faced with the task of gathering information and making subsequent decisions for themselves and their families as they are often the primary caregivers.

OBJECTIVE

The purpose of this study was to elucidate prominent themes related to information management and Internet usage in new motherhood. While the advantages to online support have been explored, triggered anxiety has not been a focus of the literature.

DESIGN

A focus group study of 31 adult, postpartum women was held at a large, urban medical center in the Northeastern United States. Data related to information management were extracted and analyzed thematically.

RESULTS

Women reported experiencing (a) a forcible, internal drive for information related to family health and (b) a high level of anxiety surrounding health-related Internet searches.

CONCLUSIONS

Health care providers must be aware that women will consult the Internet for information and that at least a portion of those individuals will experience anxiety as a result.

Sources of information on Gestational Diabetes Mellitus, satisfaction with diagnostic process and information provision

Background

This study aimed to investigate the percentage of the needs and expectations of pregnant women with Gestational Diabetes Mellitus (GDM) about the best sources of information on GDM, their satisfaction with the diagnostic process and information provision.

Methods

Questionnaires were completed by 116 pregnant women aged 18–45 years, diagnosed with GDM and recruited from maternity diabetes clinic. Eligible women were invited to participate in the study and informed consent was obtained from each participant prior to enrolment. Descriptive statistics, Kruskal-Wallis test, t-test and chi-square test were used to analyse data.

Results

Most women (64.2 %) expected general practitioners (GPs) to be the best source of GDM information, following by diabetes educator nurses (45.9 %), diabetes support groups (33.9 %) and internet (32.1 %). However, women found that diabetes educator nurses were more helpful than GPs (32.6 and 20.2 %, respectively). Participants’ age and country of birth were statistically significant. For women aged over 30 years and women born overseas the internet was the most useful information source (68.9 and 77.1 % respectively). Overall, women were very satisfied (33.0 %) or satisfied (45.0 %) with how they were informed of the GDM diagnosis, although 26.0 % were informed by telephone and 16.0 % by text message. More than one-third (39.0 %) of women were not referred to sources of information by GPs at time of diagnosis of GDM (p <0.0001). Women who were referred reported that they were very satisfied (40.0 %) or satisfied (44.0 %) with information they received. Only 8.0 % of women reported dissatisfaction with the manner of health professionals.

Conclusion

The results suggest that health professionals should be aware of the needs and expectations of women who have been diagnosed with GDM, with most women expecting to receive information on GDM from their GPs and diabetes educator nurses. The findings suggest that there is scope for improving how women are informed of the GDM diagnosis and given information, and in clinicians’ manner.

Use of the internet as a health information resource among French young adults: results from a nationally representative survey

BACKGROUND

The Internet is one of the main resources of health information especially for young adults, but website content is not always trustworthy or validated. Little is known about this specific population and the importance of online health searches for use and impact. It is fundamental to assess behaviors and attitudes of young people looking for online health-related information and their level of trust in such information.

OBJECTIVE

The objective is to describe the characteristics of Internet users aged 15-30 years who use the Web as a health information resource and their trust in it, and to define the context and the effect of such use on French young adults' behavior in relation to their medical consultations.

METHODS

We used the French Health Barometer 2010, a nationally representative survey of 27,653 individuals that investigates population health behaviors and concerns. Multivariate logistic regressions were performed using a subsample of 1052 young adults aged 15-30 years to estimate associations between demographics, socioeconomic, and health status and (1) the use of the Internet to search for health information, and (2) its impact on health behaviors and the physician-patient relationship.

RESULTS

In 2010, 48.5% (474/977) of Web users aged 15-30 years used the Internet for health purposes. Those who did not use the Internet for health purposes reported being informed enough by other sources (75.0%, 377/503), stated they preferred seeing a doctor (74.1%, 373/503) or did not trust the information on the Internet (67.2%, 338/503). However, approximately 80% (371/474) of young online health seekers considered the information found online reliable. Women (P<.001) and people with higher sociocultural positions (OR 0.5, 95% CI 0.3-0.9 and OR 0.4, 95% CI 0.2-0.7 for employees and manual workers, respectively, vs individuals with executive or manager positions) were more likely to use the Internet for health purposes. For a subsample of women only, online health seeking was more likely among those having a child (OR 1.8, 95% CI 1.1-2.7) and experiencing psychological distress (OR 2.0, 95% CI 1.0-4.0). Finally, for online health seekers aged 15-30 years, one-third (33.3%, 157/474) reported they changed their health behaviors (eg, frequency of medical consultations, way of taking care of one's own health) because of their online searches. Different factors were associated with different outcomes of change, but psychological distress, poor quality of life, and low income were the most common.

CONCLUSIONS

The Internet is a useful tool to spread health information and prevention campaigns, especially to target young adults. Young adults trust online information and consider the Internet as a valid source of health advice. Health agencies should ensure the improvement of online health information quality and the creation of health-related websites and programs dedicated to young adults.

Online support for parents of preterm infants: a qualitative and content analysis of Facebook 'preemie' groups

OBJECTIVE

To qualitatively evaluate the content of communication in Facebook communities dedicated to preterm infants.

DESIGN

The 25 largest public English-language Facebook groups focusing on preterm infants were identified. For each group, the 20 most recent wallposts and a maximum of the 15 first comments to these wallposts, and the 15 most recent discussion topics were analysed according to a thematic coding scheme. The purpose of each group was determined and personal characteristics of administrators and active posters were analysed.

RESULTS

1497 individual Facebook groups focusing on preterm infants were found, wherein the 25 largest had between 391 and 14 986 members. Non-profit fundraising groups comprised 48% of analysed groups and had the greatest number of members (median 1450, IQR 548-5435), followed by general awareness (24% of all groups, members: median 1183, IQR 658-2116) and interpersonal support groups (28% of all groups, members: median 823, IQR 484-1022). 85.0% of administrators and 91.5% of posters were women, and two-thirds of posts had been written by mothers of preterm infants. The analysis of posts, comments and discussion topics (n=1054) showed that 'information sharing' (31%) and 'interpersonal support' (53%) were the most common purposes.

CONCLUSIONS

Facebook groups related to preterm birth have become a popular tool for fundraising and awareness-raising. However, most group members use these forums for information sharing and interpersonal support. Given their popularity and reach, further research is warranted to understand the motivations, implications and risks of dynamic online communication among parents of preterm infants.

A Changing Landscape: Implications of Pregnant Women's Internet Use for Childbirth Educators

Internet use among pregnant women is common and frequent, while attendance at childbirth education classes appears to be on the decline. This article explores why women turn to the Internet in pregnancy and how Internet use may affect their knowledge, attitudes, and behaviors. It suggests strategies for engaging women's interest in the Internet and describes how doing so may help increase the effectiveness of "traditional" childbirth education while mitigating the potentially overwhelming and confusing aspects of Internet use.

Social support and online postpartum depression discussion groups: a content analysis

OBJECTIVE

Social support has a positive influence on women's childbearing experience and is shown to be a preventive factor in postpartum depression. This study examined the perceived value and types of social supports that characterize the discussions of women who participate in postpartum depression online discussion groups.

METHODS

A directed content analysis was used to examine 512 messages posted on a postpartum depression online support group over six months.

RESULTS

The majority of the women's postings illustrated emotional support followed by informational and instrumental support.

CONCLUSIONS

Online support groups provide women experiencing postpartum depression a safe place to connect with others and receive information, encouragement and hope.

PRACTICE IMPLICATIONS

Education strategies are needed to address the many questions regarding PPD medical treatment. Recommending vetted links to PPD online support groups will create opportunities for women to share their experiences and obtain support.

Impact of electronic messaging on the patient-physician interaction

Patients are interested in secure electronic communication with their health-care providers, but physicians have been slow to adopt the technique into their practice. We have therefore reviewed the literature on secure patient messaging. Relevant studies were identified by Medline search which produced 1065 publications. Of these, 71 relevant articles were read independently by two reviewers. Currently available messaging systems allow for asynchronous communication, physician reimbursement and automated supporting functions such as triaging of patient messages and integration of messaging into medical records. The review showed that patients are satisfied with the use of secure physician messaging systems and find such services to be convenient, time-saving and useful. Physicians do not report adverse effects from their use. Legal concerns with electronic messaging include compliance with privacy standards. The economic benefits of secure messaging systems are most immediately apparent for larger health-care groups and hospitals, although smaller practices will also benefit in the long run. Secure patient-physician messaging is a convenient and useful addition to the health-care infrastructure. It can be expected that the identification of secure providers, integration with reimbursement systems and initial uptake by larger health-care organizations will speed up the adoption into routine health care.

Self-epistemic authority and nurses' reactions to medical information that is retrieved from Internet sites of different credibility

This cross-sectional study investigated nurses' reactions to Internet medical information that was retrieved from sources of different scientific credibility and the association between self-epistemic authority and these reactions. The participants filled in questionnaires on their reactions to Internet medical information and self-epistemic authority. The nurses' reactions to Internet medical information from a highly credible source (Medline) correlated positively with self-epistemic authority. However, no such correlation was found with Internet medical information from a less credible Internet source (Ynet). Compared with the nurses without an academic degree, the nurses with an academic degree had more positive reactions to the information that was retrieved from Medline. The reactions to the medical information that was retrieved from Ynet did not differ by the education of the nurses. This study shows that nurses' reactions to different sources of Internet information vary according to their level of self-epistemic authority and education. As patients' use of Internet medical information is increasing, nurses need to expand their expertise in the various professional and popular medical information sites. Such skills will help to reduce any negative feeling that might arise when they encounter patients who present medical information from the Internet.

Representations of hysterectomy as a transition process in Finnish women's and health magazines

Representations of hysterectomy as a transition process in Finnish women's and health magazines The purpose of this article was to describe representations of hysterectomy in Finnish women's and health magazines. The data used in the study were obtained from six Finnish women's and health magazines. Using content analysis, 42 articles were analysed. We identified two main categories, information about care and treatment and women's experiences. In the first category, there emerged six subcategories: role of uterus, indications for hysterectomy, operative techniques of hysterectomy, alternative methods of treatment, pros and cons of hysterectomy and patient guidance. The second category consisted of women's experiences of hysterectomy as a period of transition. The components of the transition theory were confirmed by the women's stories. We also wanted to highlight the fact that the result shows that nurses were missing from the media coverage regarding hysterectomy.

The role of patient satisfaction in online health information seeking

Studies of online health information seeking are beginning to address a basic question: why do people turn to the Internet? This study draws upon the Uses and Gratifications (U&G) and Media System Dependency (MSD) perspectives to examine in this process the role played by satisfaction with care. The sample comprised 178 cancer listserv users, of whom 35% chose the Internet as their preferred source of health information compared with 19% who named their oncologist. Dissatisfied patients were significantly more likely to rate the Internet as a better source of information than the provider (p = .001). The level of empathy shown by the provider and the quality of time spent with the patient had a significant negative association with choosing the Internet as a preferred source of information, and a significant positive association with choosing the oncologist as an information source. The results from this study emphasize the significance of the patient-provider interaction. Dissatisfied patients' tendency to seek and trust information sources other than their physician also may have implications for compliance with treatment.

Midwives' use of the Internet: an Australian study

OBJECTIVE

to report findings on midwives' use of the Internet drawn from a larger study that explored midwives' attitudes and experiences to online and computer-based learning.

DESIGN AND SETTING

a descriptive, quantitative design using anonymous questionnaires was employed to obtain information from a sample of midwives in Victoria, Australia.

PARTICIPANTS

questionnaires were forwarded by mail to a sample of 300 members of the Victorian branch of the Australian College of Midwives. A total of 169 questionnaires were returned by reply paid mail, representing a response rate of 56%.

FINDINGS

around 92.3% of respondents reported that they used the Internet. However, 31.5% did not find navigating it to be easy, 34.7% reported that finding information was not easy, and 27.2% were not confident using the Internet.

KEY CONCLUSIONS

many midwives have insufficient Internet competence to be able to access necessary evidence to support practice and to assist women with decision making.

IMPLICATIONS FOR PRACTICE

ongoing education and training is needed to ensure that midwives have the skills to source evidence to support practice, and are able to effectively critique Internet information.

Factors affecting nurses' attitudes in Israel toward patients who present them with Internet medical information

Nurses regularly encounter patients bringing with them medical data from the Internet. The purpose of the present study was to examine the prevalence of these encounters, nurses' attitudes to these patients, and the factors that might influence their attitudes. A cross-sectional study of a convenience sample of 110 nurses (32 practical nurses, 35 registered nurses and 43 academically trained nurses). The main variables measured were: attitudes toward patients presenting Internet information, professional self-esteem, and three indices of Internet use. The results show that most nurses had encountered patients presenting Internet medical information and held positive attitudes to them. Nurses with such experience had more positive attitudes than nurses with no such experience. Professional self-esteem and indices of Internet use were also positively correlated to favorable attitudes to these patients. Regression analysis showed that professional self-esteem and Internet self-efficacy predicted attitudes to these patients. Since the number of patients presenting Internet information can only multiply, there is a need to prepare and train nurses for encounters with such patients.