Use of the internet by Italian pediatricians: habits, impact on clinical practice and expectations

High-Quality eHealth Websites for Information on Endometriosis: Systematic Search

BACKGROUND

eHealth websites are increasingly being used by community members to obtain information about endometriosis. Additionally, clinicians can use these websites to enhance their understanding of the condition and refer patients to these websites. However, poor-quality information can adversely impact users. Therefore, a critical evaluation is needed to assess and recommend high-quality endometriosis websites.

OBJECTIVE

This study aimed to evaluate the quality and provide recommendations for high-quality endometriosis eHealth websites for the community and clinicians.

METHODS

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines informed 2 Google searches of international and Australian eHealth websites. The first search string used the terms "endometriosis," "adenomyosis," or "pelvic pain," whereas "Australia" was added to the second search string. Only free eHealth websites in English were included. ENLIGHT, a validated tool, was used to assess the quality across 7 domains such as usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. Websites with a total score of 3.5 or more were classified as "good" according to the ENLIGHT scoring system and are recommended as high-quality eHealth websites for information on endometriosis.

RESULTS

In total, 117 eHealth websites were screened, and 80 were included in the quality assessment. Four high-quality eHealth websites (ie, those that scored 3.5 or more) were identified (Endometriosis Australia Facebook Page, Endometriosis UK, National Action Plan for Endometriosis on EndoActive, and Adenomyosis by the Medical Republic). These websites provided easily understood, engaging, and accurate information. Adenomyosis by the Medical Republic can be used as a resource in clinical practice. Most eHealth websites scored well, 3.5 or more in the domains of usability (n=76, 95%), visual design (n=64, 80%), and content (n=63, 79%). However, of the 63 websites, only 25 provided references and 26 provided authorship details. Few eHealth websites scored well on user engagement (n=18, 23%), therapeutic persuasiveness (n=2, 3%), and therapeutic alliance (n=22, 28%). In total, 30 (38%) eHealth websites scored well on general subjective evaluation.

CONCLUSIONS

Although geographical location can influence the search results, we identified 4 high-quality endometriosis eHealth websites that can be recommended to the endometriosis community and clinicians. To improve quality, eHealth websites must provide evidence-based information with appropriate referencing and authorship. Factors that enhance usability, visual design, user engagement, therapeutic persuasiveness, and therapeutic alliance can lead to the successful and long-term uptake of eHealth websites. User engagement, therapeutic persuasiveness, and therapeutic alliance can be strengthened by sharing lived experiences and personal stories and by cocreating meaningful content for both the community and clinicians. Reach and discoverability can be improved by leveraging search engine optimization tools.

TRIAL REGISTRATION

PROSPERO CRD42020185475; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=185475&VersionID=2124365.

Elective oocyte cryopreservation for age-related fertility decline

PURPOSE

Women who pursue fertility at an advanced age are increasingly common. Family planning and sexual education have traditionally focused on contraception and prevention of sexually transmitted diseases. A focus should now also be placed on fertility awareness and fertility preservation. This manuscript aims to give an update on the existing evidence around elective oocyte cryopreservation, also highlighting the need for fertility education and evidence-based, individualized counselling.

METHODS

A thorough electronic search was performed from the start of databases to March 2020 aiming to summarize the existing evidence around elective egg freezing, the logic behind its use, patient counselling and education, success rates and risks involved, regulation, cost-effectiveness, current status and future perspectives.

RESULTS

Clinician-led counselling regarding reproductive aging and fertility preservation is often overlooked. Elective oocyte cryopreservation is not a guarantee of live birth, and the answer regarding cost-effectiveness needs to be individualized. The existing studies on obstetric and perinatal outcomes following the use of egg freezing are, until now, reassuring. Constant monitoring of short-term and long-term outcomes, uniform regulation and evidence-based, individualized counselling is of paramount importance.

CONCLUSIONS

Elective oocyte cryopreservation is one of the most controversial aspects of the world of assisted reproduction, and a lot of questions remain unanswered. However, women today do have this option which was not available in the past. Elective oocyte cryopreservation for age-related fertility decline should be incorporated in women's reproductive options to ensure informed decisions and reproductive autonomy.

Internet access, usage and trust among medical professionals in China: A web-based survey

OBJECTIVES

Social media has changed methods of communication in the medical profession. As part of a "doctor as communicator" strategy, Chinese medical professionals are actively embracing social media, which may have an impact on tense physician-patient relationships in China. This paper aims to examine a pattern of Internet access, Internet usage, and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level.

DESIGNS

A web-based questionnaire was designed, based on a media literacy model, and was divided into 3 dimensions: public information, general medical information, and specialty information. After a two-round pilot study, 1001 physicians were included. Additionally, 4 interviewees were chosen to participate in in-depth interviews and content analysis was performed. Data were analyzed using SPSS 25.0.

RESULTS

Findings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information. However, they still trust traditional media (n = 1001, P < 0.01) and professional journals more (n = 1001, P < 0.01). Internet access, usage, and trust were positively correlated (r = 0.185-0.344, P < 0.01). Regarding usage habits, 47.66% of the participating physicians would practice science popularization through their new media accounts and 71.23% would forward approved health information within their professional realm. A validated instrument can be provided for further related studies.

CONCLUSIONS

Science popularization is a specific usage of new media among Chinese medical professionals, through which they have achieved new authority and empowered communication because of self-media. To some extent, physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.

A cross-sectional survey among physicians on internet use for epilepsy-related information

OBJECTIVE

We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to identify factors associated with the attitude of being influenced by information found on the Internet.

METHODS

This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018.

RESULTS

184 questionnaires were analyzed. 97.8 % of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9 %) or to confirm a diagnostic or therapeutic decision (37.3 %). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95 %CI: 1.28-6.76; p = 0.011), higher frequency of Internet use (OR: 3.66; 95 %CI: 1.56-9.21; p = 0.006) and higher confidence in reliability of online information (OR: 2.61; 95 %CI: 1.09-6.26; p = 0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information.

CONCLUSION

Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

Evaluating the Quality and Reliability of Online Information on Social Fertility Preservation

OBJECTIVE

With the rising trend of postponing motherhood, there has been an increasing rate of infertility. Social fertility preservation offers the potential to overcome this age-related infertility, and many women are turning to the Internet to seek medical information. The aim of this study was to evaluate online information on social fertility preservation.

METHODS

This study used five search terms-"egg freezing," "fertility preservation," "social egg freezing," "social fertility preservation," and "oocyte cryopreservation"-to identify the most popular sites as rated by Google. Accuracy of information and quality of websites were rated on the basis of four categories: Silberg's accountability criteria, Abbott's aesthetic criteria, Flesch-Kincaid readability score, and the Canadian Fertility and Andrology Society (CFAS) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommendations (Canadian Task Force classification III).

RESULTS

Study investigators identified the 21 most used websites. The average Silberg score was 6.57, with 85.7% of websites meeting the criteria for adequate accountability. Only one website (4.8%) did not meet the criteria for appropriate aesthetic appeal. The average Flesch-Kincaid readability score was 11.39, equivalent to a grade 11 reading level, which is significantly higher than the reading level of the general population. A total of 57% of websites contained less than half of the evidence-based recommendations provided in CFAS and SOGC recommendations.

CONCLUSION

Online information on social fertility preservation is easily accessible and aesthetically pleasing, but information is not easily readable and does not reflect evidence-based recommendations. Hence, health care professionals must fill the knowledge gaps and adequately counsel their patients to optimize a woman's chance at a successful pregnancy.

Family physicians' utility of social media: a survey comparison among family medicine residents and physicians

Introduction

Social media has become ubiquitous and has brought a dramatic change in health services. Little is known about its use by family physicians and residents for personal or professional purpose. The aim of the current study was to evaluate the utility of social media among family medicine residents and consultants.

Methods

The collection of data was through the use of a five part questionnaire developed by researchers. The questionnaire was delivered to 70 physicians and 100 residents, out of which 132questionnaires were completed, representing a 78 percent response rate.

Results

Our findings demonstrate that there was an overall high use of social media. Females used social media more for general education and professional purposes. Men, by contrast, used it more frequently for personal purposes. The participants in this study appeared to consider social media as having several useful dimensions, such as: enabling them to accomplish job tasks, improve job performance, productivity and more effective patient care when using social media.

Conclusions

To date, limited studies have compared social media use among family physicians and residents. This study may serve as an initial step for future studies explaining the pattern of use among physicians.

Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health: A Cross-sectional Survey

BACKGROUND

To our knowledge, no evidence is available on health care professionals' use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses' personal use of ePHRs using a modified technology acceptance model.

OBJECTIVES

To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses' own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers' use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use.

METHODS

A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect.

RESULTS

Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses' own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses.

CONCLUSIONS

Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their individual patients.

Paediatricians' perceptions of a potential online psychosocial intervention for children with recurrent abdominal pain

AIMS

To evaluate paediatricians' perceived effectiveness of an online psychosocial intervention for children with recurrent abdominal pain (RAP). Also, to explore which elements of this intervention they would consider necessary when applied in the clinical context.

METHODS

A total of 131 paediatricians affiliated to Catalan and Balearic paediatric societies completed an online survey about how effective they would perceive an online psychosocial intervention for RAP (for reducing pain intensity, reducing disability and preventing chronicity) and how this intervention should be carried out. They were asked about the perceived effectiveness of the standard medical treatments they routinely applied for RAP and also their opinion of face-to-face psychosocial interventions.

RESULTS

A face-to face psychosocial intervention was considered better (to reduce pain intensity, reduce disability and prevent chronic pain) than an online psychological intervention and the standard medical treatment. Online and face-to-face psychosocial interventions are considered equally useful for children with mild disability, but a face-to-face psychosocial intervention is considered better for those with moderate and severe levels of disability. Paediatricians considered that an online psychosocial intervention for children with RAP should be simple and consistent; it should provide easy access for users; and its interface should be easy to use and attractive.

CONCLUSIONS

Paediatricians show a positive attitude towards a potential online psychosocial intervention for children and adolescents with RAP. However, they do not use the Internet for offering health care, and they would prefer a face-to-face psychosocial intervention.

Does googling for preconception care result in information consistent with international guidelines: a comparison of information found by Italian women of childbearing age and health professionals

Background

Preconception counseling is effective in reducing the risk of adverse pregnancy outcomes. The Internet is commonly used by women and health professionals to search for health information. We compared the consistency of preconception information found on the Internet with the recommendations published by American Journal of Obstetrics and Gynecology (AJOG) simulating a web search by women of childbearing age and health professionals.

Methods

We reviewed websites resulting from a Google search performed using search strings selected by Italian women of childbearing age and health professionals. We investigated if retrieved information was consistent with AJOG recommendations for preconception care. Logistic regression was used to compare presence of consistent recommendations between women and health professionals.

Results

The highest frequency of correct recommendations was found for folic acid supplementation (39.4% of websites). Consistency of preconception information did not significantly differ between search strategies except for folic acid supplementation. “Communities and blogs” website category provided less frequently correct recommendations compared with “Medical/Public Agency" category (i.e. folic acid supplementation (aOR 0.254; CI 0.098-0.664; p = <0.01). Commercial links, found in 60% of websites, were associated with presence of correct recommendations excepting few items (i.e. physical exercise (aOR 1.127; CI 0.331-3.840; p = 0.848).

Conclusions

Preconception information found is poor and inaccurate regardless of the search is performed by women or health professionals. It is unlikely that information found on the web have any positive impact among women and health professionals in our setting. Strategies to improve preconception information on the web and education of health professionals for web searching of health information should be considered.