Information seeking behavior of patients with diabetes mellitus: a cross-sectional study in an outpatient clinic of a university-affiliated hospital in Athens, Greece

Knowledge level and health information-seeking behavior of people with diabetes in rural areas: a multicenter cross-sectional study

Introduction

There is a lack of research on the current level of diabetes knowledge and health information-seeking behaviors among patients with diabetes in rural areas of China's economically underdeveloped regions during COVID-19, as well as a lack of up-to-date evidence on glycemic control and the incidence of complications among rural patients with diabetes.

Objectives

To investigate the prevalence of glycemic control and complications among patients with diabetes in rural areas, to explore the current status and correlation of diabetes knowledge level and health information-seeking behavior, and to analyze the factors affecting diabetes knowledge level.

Methods

From January 2022 to July 2022, we conducted a screening on diabetic complications and a questionnaire survey among 2,178 patients with diabetes in 15 county hospitals in rural areas of Guangxi Zhuang Autonomous Region. The patients' knowledge level and health information-seeking behavior were investigated. Spearman correlation analysis was used to assess the correlation between diabetes knowledge and health information-seeking behavior. Multiple linear regression analysis was used to test how demographic information and health information-seeking behavior influenced the level of diabetes knowledge.

Results

Of 2,178 patients with diabetes in rural areas, 1,684 (77.32%) had poor glycemic control, and the prevalence of diabetic complications was estimated to be 72.13%. Patients with diabetes had poor diabetes knowledge and health information-seeking behavior, and there is a strong positive correlation between them. Diabetes knowledge level was influenced by per capita household disposable income, occupational status, gender, age, ethnicity, family history of diabetes, insulin use, glycated hemoglobin, education level, number of complications and health information-seeking behavior.

Conclusion

Patients with diabetes in rural areas have poor glycemic control and a high incidence of diabetic complications. Patients with diabetes in rural areas have poor knowledge and inadequate health information-seeking behavior. Systematic and standardized education should be provided to improve patients' diabetes knowledge and thus improve their self-management ability.

Knowledge Regarding Hypoglycemia and Its Management Among Patients With Insulin-Requiring Diabetes Mellitus in Al-Ahsa, Saudi Arabia

BACKGROUND

Hypoglycemia has a negative influence on patients with diabetes mellitus (DM) using insulin, and a lack of knowledge about hypoglycemia is one of the main causes of hypoglycemia. We aim to assess the level of knowledge about hypoglycemia and its management among insulin-requiring DM patients in Al-Ahsa, Saudi Arabia.

METHODS

A cross-sectional study was conducted on patients with insulin-requiring DM in Al-Ahsa, Saudi Arabia, from November 2021 to March 2022. A questionnaire was filled out by the participants to assess their level of knowledge about hypoglycemia, which was categorized as good, fair, or poor if participants scored >7, 6-7, or <6, respectively.

RESULTS

A total of 238 participants were recruited. Among participants, 55% were males, mainly in the age group of 40-65 years, and had higher education degrees. Doctors were the main source of information among participants. Most patients had no chronic illnesses other than DM or DM-related complications, although hypertension was reported in 37% of patients. The majority of participants had a good level of knowledge regarding hypoglycemia, and the main factors that increased it were getting information from doctors, social media, or a booklet or pamphlet (p-value <0.05).

CONCLUSION

Our participants generally had a good level of knowledge about hypoglycemia, and doctors delivering information about hypoglycemia contributed significantly to this knowledge level.

Design, development, and usability evaluation of a smartphone-based application for nutrition management in patients with type II diabetes

Purpose

Information technology (IT)-based interventions, especially mobile health (mHealth), possess a great potential for promoting self-management in patients with chronic diseases, including diabetes type II. The present study was aimed to design and develop a smartphone-based application (app) for nutrition management in patients with type II diabetes and evaluation of its usability.

Methods

In this study, a three-phase research approach was followed; (1) To determine the information content and functionalities of the app, a five-point Likert scale checklist including six parts was developed based on reviews of clinical practice guidelines and specialized databases. The checklist was then given to ten experts in endocrinology and metabolism, internal medicine, and nutrition, and those items with a mean score higher than 3.75 were approved. (2) In Android Studio, the app was designed and developed using Java language. (3) The Questionnaire for User Interaction Satisfaction (QUIS) was used to assess the app's usability by 21 patients with type II diabetes, ten IT experts, and seven endocrinologists, internal medicine practitioners, and nutritionists over one month. Mean scores were divided into three levels: weak (0-3), average (3-6), and good (6-9).

Results

According to experts' view, 17 out of 22 educational content and 17 out of 27 functionalities were approved. The app's most important educational content was the timing of meals for insulin patients and the definition of diabetes and its complications. The designed app had the following functionalities: providing educational information, recording information, performing calculations, representing data graphically, setting reminders, and communicating with physicians. The most important features of the app were the insulin dose calculation, reminders for doctors' appointments, setting times for tests and blood glucose measurements, and also tracking weight, blood glucose levels, and blood pressure. In terms of usability evaluation, the app was rated "good" level by diabetic patients (7.83 ± 0.74), IT experts (8.1 ± 0.66), and physicians (8.03 ± 0.95).

Conclusion

Given the desirable evaluation of the app by patients, physicians, and IT experts, it can be concluded that the developed app has the required functionalities for nutrition management of patients with type II diabetes. Smartphone-based apps appear to be able to improve self-management, the quality of care and health in patients with diabetes, and reduce many of their unnecessary visits to healthcare centers, and costs.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-022-01140-x.

Dengue-Related Information Needs and Information-Seeking Behavior in Pakistan

This present study aims to examine the information needs and information-seeking behavior of Dengue-affected and non-affected people by exploring their information needs, resources used, and obstacles encountered. A structured questionnaire was used to collect data from 100 Dengue patients and 200 non-patients. The collected data were analyzed by applying descriptive and inferential statistics. The findings revealed that a majority of the respondents had information needs regarding nutritional options, best approaches to treatment, and expected benefits of treatment. They mostly sought information to keep themselves up-to-date and to prevent the disease. Television, Internet search engines, and social media outlets were frequently used information sources along with information-seeking from family and friends. Respondents with higher academic qualifications reported comparatively higher Dengue-related information needs. Moreover, age was a positive predictor of both their information needs and frequency of using health information sources. The findings will be helpful for healthcare providers to tailor Dengue awareness campaigns and prevention strategies according to the public needs and preferences.

U-shaped association between online information exchange and app usage frequency: a large-scale survey of China 's online young and middle-aged people with pre diabetes and diabetes

Background

China has the world's largest diabetic population, and the cost of caring for all these people every day is substantial. Online information exchange and app usage frequency have been demonstrated to play a significant influence in the management of blood glucose and enhancement of diabetes-related quality of life. However, the association between online information exchange and app usage frequency among actual online populations remains unclear and deserves additional study. Therefore, we evaluated the factors affecting the frequency of app usage in the online glucose management population, with a particular emphasis on the connection between online information exchange and app use frequency, contributing to the expansion of the research of diabetes management models.

Method

This cross-sectional study was conducted by disseminating questionnaires in blood glucose management-related forums and WeChat groups and included 1586 online users concerned about blood glucose management. Information exchange and app usage frequency were considered as independent and dependent variables, respectively. We performed stratified and single factor analysis, multiple equation regression analysis, smooth curve fitting, and threshold effect and saturation effect analysis. R (version 4.1.3, http://www.Rproject.org) and EmpowerStats were used for data analysis.

Result

After adjusting for other covariates, information exchange was independently and positively associated with app use frequency (β = 8.6, 95% CI: 6.5 to 11.2, p < 0.001). Through interaction analysis, the most significant interaction factors influencing the relationship between information exchange and app usage frequency were identified as health insurance status, whether living with parents, glycated hemoglobin status in the previous month, and self-monitoring of blood glucose (SMBG). The association between information exchange and app usage frequency is U-shaped, with information exchange inflection points of 3.0 and 4.2. Information exchange and app usage frequency are negatively correlated when the average information exchange score is less than 3.0, and for every point increase in the average information exchange score, the likelihood of the app high usage frequency group compared to the app low usage frequency group decreases by 70%. The relationship between information exchange and app usage frequency is strongest when it is greater than or equal to 3.0 and less than or equal to 4.2. The probability of the app high usage frequency group occurring compared to the app low usage frequency group rises 17.3 times for every 1 point increase in the average information exchange score. The probability of the app high usage frequency group occurring in comparison to the app low usage frequency group increased by 1.8 times for every 1 point rise in information exchange when the average information exchange score was higher than 4.2.

Conclusion

Age, body mass index, married, living with parents, hemoglobin level, SMBG, and information exchange were positively connected with app usage frequency in our study of online blood glucose management population. The link between information exchange and app use frequency was significantly U-shaped. The app usage frequency changed the most with the rise in information exchange when the information exchange score was greater than or equal to 3.0 and less than or equal to 4.2. Therefore, we ought to offer effort to concentrate on and increase the health-related behaviors and activities of those in this score interval.

The processes of engagement in information-seeking behavior for individuals with diabetes who developed diabetic foot ulcer: A constructivist grounded theory study

To describe the process of engagement in information seeking behavior for individuals with type 1 and type 2 diabetes.

Methodology

Constructivist grounded theory. The data was gathered through thirty semi-structured interviews of participants attending a wound care clinic in Southeast, Ontario, Canada. The waiting period taken to seek appropriate help varied from weeks to months.

Results

"The processes of engagement in information-seeking behavior about diabetes" are organized as follows: 1) discovering diabetes, 2) reactions to the diagnosis, and 3) engaging in self-directed learning. For most participants, the diagnosis of diabetes was unexpected and usually confirmed after a long period of experiencing a diversity of symptoms. The terms used mostly by participants were "I started to wonder" and "Something was wrong with me." After being diagnosed with diabetes, participants sought information to learn about it. Most of them engaged in self-directed learning to acquire knowledge about their illness.

Conclusion

Although the Internet is often used to seek information, healthcare providers and support network also played an important role in supporting participants information-seeking behavior learn about diabetes. The unique needs of people with diabetes must be taken into consideration during their diabetes care journey. These findings call for the need to provide education about diabetes from the time they are diagnosed and direct them to reliable resources of information.

Sources of information on diabetes and its demographic correlates: a nationwide survey among Singapore residents

Diabetes is a major public health concern in Singapore, and the Singapore Government declared a ‘War on Diabetes’, which included a nationwide public health campaign. It is important to identify what sources of diabetes information reach the general population, whether this differs by socio-demographic characteristics and if the sources of information influence knowledge of diabetes to aid the successful dissemination of health information. Two thousand eight hundred ninety-five respondents were part of a population-based cross-sectional study conducted from February 2019 to September 2020. Respondents rated on a five-point scale whether they had obtained information on diabetes from eight different information sources, and responses were dichotomized into ‘endorsed receiving information’ or ‘not endorsed receiving information’. Poisson regression models were conducted with the ‘endorsement of receiving information’ from each source as the outcome and socio-demographic variables as predictors. 95.9% of the study population had received information on diabetes from at least one source, and the mean number of sources was 4.2 ± 2.0. The leading source was media articles (82.1%), followed by health promotion videos/advertisements (77.9%), online websites (58.5%), books (56.5%), healthcare professionals (55.0%), radio (54.4%), public forums (27.7%) and support groups (15.5%). Endorsing a greater number of informational sources was associated with being younger, belonging to Malay or Indian instead of Chinese ethnicity, and having diabetes. An intensive nationwide diabetes awareness campaign successfully reached the public in Singapore with specific sources of information depending on socio-demographic characteristics. Findings suggest that diabetes information campaigns should utilize multiple channels for dissemination considering the different socio-demographic subgroups.

Potential of UK and US newspapers for shaping patients' knowledge and perceptions about antidiabetic medicines: a content analysis

Background

Information about how newspapers portray antidiabetic medicines to readers is lacking. This study investigated the reporting on antidiabetic medicines in the most widely circulated newspapers published in the United Kingdom (UK) and the United States (US) over a 10-year period.

Methods

The Nexis UK database was used to identify and select relevant articles. Systematic content analysis of the articles which met the inclusion criteria (articles of any format that contained reference to antidiabetic medicines) within the highest circulated newspapers in the UK and US between 2009 and 2018 was conducted. Inter-rater reliability of coding was established using a 10% sample of the identified articles.

Results

A total of 560 (369 UK and 191 US) relevant newspaper articles were retrieved. In the UK, the number of relevant articles showed a slightly increasing trend over the study period, while in the US, article numbers declined over the study period. Safety/risk of antidiabetic medicines was the most frequent theme covered by the articles (34.6%). Over one-third of the newspaper articles were written from a clinical perspective (37.7%). Insulin was the most commonly discussed class of antidiabetic medicine (23.1%). Control of blood sugar levels (53.1%) and side effects/toxicity (92.7%) were the most frequently reported benefit and risk of antidiabetic medicines, respectively. The most frequently reported organ systems harmed by antidiabetic medicines were the cardiovascular, endocrine and gastrointestinal systems. The UK newspapers were more likely to report the benefits of antidiabetic medicines (p = 0.005), while the US articles were more likely to report on harms/risks (p = 0.001). The majority of relevant articles (91.8%) were judged as having a balanced judgement, while 8.2% of the articles were rated as exaggerated.

Conclusions

This study has revealed that antidiabetic medicines are indeed reported on by UK and US newspapers. As media portrayal has the potential to negatively or positively influence patients’ views of their medication for diabetes, healthcare professionals should check on patients’ beliefs and knowledge about their medication and proactively provide objective and balanced information (including promotion of medication adherence).

Main Aspects of Preparing Diabetic Patients in Poland for Self-Care

Diabetes is a lifestyle disease which can cause many complications and organ-related disorders. The aim of the study was to analyze selected aspects of preparing patients with diabetes for self-care. The study group consisted of 190 people diagnosed with type 1 and type 2 diabetes, including 101 women and 89 men. The mean age of the respondents was 42.2 ± 13.4 years. The study was conducted using an anonymous self-designed questionnaire containing 50 questions. Among the respondents, 23.2% did not control their glucose levels at home. The respondents most often measured glucose once a day (33.6%) or three times a day (26.7%). A total of 64.7% of the respondents declared that they kept a self-monitoring diary. The knowledge of the symptoms of hypoglycemia and the ability to properly manage it was declared by 64.8% of the respondents. A total of 52.1% of the patients did not undertake any activity lasting more than 30 min at least 3 times a week, and 75.2% described their condition as very good and good. Independent participation in therapy, i.e., taking hypoglycemic drugs or insulin, was declared by 63.7% of the respondents. Despite undergoing therapeutic education, the study population diagnosed with diabetes still shows deficiencies in terms of awareness of proper health behaviors. Objective results showed that the patients had insufficient knowledge and skills in terms of self-care and self-observation, blood glucose and blood pressure measurements, physical activity, diet therapy as well as adherence to pharmacotherapy recommendations. Despite the good general preparation for self-care as declared by the respondents, these patients require further systematic, individual educational activities. The results of the present study have implications for nursing practice, patient therapeutic education, and the functioning of the public health and healthcare systems. The number of diabetic patients is constantly increasing. Patients require coordinated care and individualized therapeutic education in order to be prepared for self-care and self-management, thus reducing the risk of complications. Delaying the occurrence of potential complications provides patients with a chance to live an active private and professional life, and protects the health care system from carrying the cost burden of expensive highly specialized services.

Structured diabetes self-management education and its association with perceived diabetes knowledge, information, and disease distress: Results of a nationwide population-based study

OBJECTIVE

To evaluate, how participation in structured diabetes self-management education (DSME) programs is associated with perceived level of knowledge about diabetes, information needs, information sources and disease distress.

METHODS

We included 796 ever- and 277 never-DSME participants of the population-based survey "Disease knowledge and information needs - Diabetes mellitus (2017)" from Germany. Data on perceived level of diabetes knowledge (12 items), information needs (11 items), information sources (13 items) and disease distress (2 indices) were collected. Multiple logistic regression analyses were used to examine the association of DSME-participation with these outcomes.

RESULTS

DSME-participants showed a higher level of diabetes knowledge compared to never-DSME participants, particularly in aspects concerning diabetes in general (odds ratio 2.53; 95% confidence intervals 1.48-4.33), treatment (2.41; 1.36-4.26), acute complications (1.91; 1.07-3.41) and diabetes in everyday life (1.83; 1.04-3.22). DSME-participants showed higher information needs regarding late complications (1.51; 1.04-2.18) and acute complications (1.71; 1.71-2.48) than DSME never participants. DSME-participants more frequently consulted diabetologists (5.54; 3.56-8.60) and diabetes care specialists (5.62; 3.61-8.75) as information sources. DSME participation was not associated with disease distress.

CONCLUSION

DSME is a valuable tool for improving individual knowledge about diabetes. However, DSME should focus more on psychosocial aspects to reduce the disease burden.

Disparity and Factors Associated With Internet Health Information Seeking Among US Adults Living With Diabetes Mellitus: Cross-sectional Study

Background

Many patients with chronic medical conditions search the internet to obtain medical advice and health information to improve their health condition and quality of life. Diabetes is a common chronic disease that disproportionately affects different race and ethnicity groups in the United States. In the existing literature on the popularity of internet health information seeking among persons with a chronic medical condition, there are limited data on US adults living with diabetes.

Objective

This study aims to examine the factors associated with internet health information seeking among US adults living with diabetes and whether there is a disparity in internet health information seeking stratified by race and ethnicity.

Methods

We conducted a cross-sectional study using the Health Information National Trends Survey data from 2017 to 2020. We selected our study sample based on respondents’ reports on whether they were told they had diabetes, and our primary outcome was internet health information–seeking behavior. We used 2 multivariable logistic regression models to examine the effects of sociodemographic factors and other covariates on the internet health information–seeking behavior of adults with diabetes. Jackknife replicate weights were used to provide bias-corrected variance estimates.

Results

Our study sample included 2903 adults who self-reported that they had diabetes. In total, 60.08% (1744/2903) were non-Hispanic White individuals, 46.88% (1336/2850) were men, and 64% (1812/2831) had some college or graduate education. The prevalence of internet health information seeking in this population was 64.49% (1872/2903), and the main factors associated with internet health information seeking included education level (some college vs less than high school: odds ratio [OR] 1.42, 95% CI 1.44-1.88; and college graduate or higher vs less than high school: OR 2.50, 95% CI 1.79-3.50), age (age group ≥65 years vs age group 18-44 years: OR 0.46, 95% CI 0.34-0.63), and household income level (P<.001). In addition, we found significant differences in the effects of predictors stratified by race.

Conclusions

The findings from this study suggest that internet health information seeking is common among US adults living with diabetes. Internet health information could influence the relationship between health care providers and adults living with diabetes and improve their self-management and quality of life.

(Mis)Information, Fears and Preventative Health Behaviours Related to COVID-19

Social and mass media platforms (SMM) are essential tools for keeping people informed about health-promoting practices. However, the potential to spread misinformation or false rumors exists. These might influence preventive health behaviours and incite anxiety and/or fear among the population. A sample of 300 adults participated in a survey to understand information needs, fears and preventive health behaviours related to COVID-19 while analyzing differences in COVID-19 acceptance rates. Descriptive-correlational, between-group comparisons and regression analyses were applied. Most of the sample revealed a willingness to accept COVID-19 vaccines (65.4% vs. 34.5%) and was prone to use and trust different SMM without experiencing significant obstacles in managing COVID-19-related information except for the need to ration it from time to time (χ2(2, N = 298) = 6.654, p = 0.036). Preventive behaviours/measures carried out were similar among the people resistant, hesitant or willing to get vaccinated for COVID-19. However, higher self-efficacy was observed in resistant vaccine individuals (F(2) = 3.163, p = 0.044). Psychological impact (need for psychological support due to COVID-19 situation) in accepting (F(5, 189) = 17.539, p < 0.001, R2 = 0.317) and hesitant individuals (F(5, 77) = 17.080, p < 0.001, R2 = 0.526) was explained by female gender, younger age, threat susceptibility and differential characteristics in terms of psychological symptoms experienced and SMM trust. No explanatory model was obtained for the resistant individuals. SMM could be effective tools to promote COVID-19 health preventive behaviours. However, psychographic characteristics might modulate information-seeking and management as well as self-perceived threat susceptibility and severity. All these factors must be accurately considered when designing different health preventive campaigns for the general public.

Preferences and Experiences of People with Chronic Illness in Using Different Sources of Health Information: Results of a Mixed-Methods Study

Background: People with chronic illness are particularly dependent on adequate health literacy (HL), but often report difficulties in accessing, understanding, appraising, and applying health information. To strengthen the HL of people with chronic illness, in-depth knowledge about how they deal with health information is crucial. Methods: To this end, quantitative data from the Second Health Literacy Survey Germany (HLS-GER 2) and qualitative data from seven focus group discussions were used to examine the interest in health information, preferred sources of information as well as experiences and challenges with information management among people with chronic illness. Results: The results show that people with chronic illness have a great interest in health information and use very different sources of health information, preferring personal information from physicians most. The results also point to several challenges in health information management that seem to be influenced by the illness duration as well as by the experiences made with the respective sources. Conclusions: Overall, the study provides important starting points for intervention development for the provision and communication of health-related information, but also to research on health information behavior and HL.

Information-Seeking Behavior and Its Associated Factors Among Patients with Diabetes in a Resource-Limited Country: A Cross-Sectional Study

BACKGROUND

Diabetes mellitus is one of the most common chronic diseases in the world. The burden of diabetes mellitus is increasing rapidly in developing countries, including Ethiopia. Diabetes information seeking is essential for patients with diabetes to better manage and control their diabetes. However, information seeking about disease prevention and treatment is low in developing countries.

OBJECTIVE

This study aims to assess the diabetes information-seeking behavior and its associated factors among patients with diabetes in Debre Markos Referral Hospital, Amhara Region, Northwest Ethiopia.

METHODS

An institution-based cross-sectional quantitative study supplemented with a qualitative study was conducted among 423 subjects from March to April 2019. A structured questionnaire and in-depth interview were used to collect the required data from the study subjects. The data were entered using Epi Info version 7.2.2. Data processing and analysis were conducted using SPSS version 23. Descriptive statistics and a binary logistic regression model were used for the quantitative study, and thematic content analysis was used for the qualitative study. The significance test cut-off value for bivariate analysis was P<0.2 and the cut-off value for multivariate analysis was P<0.05. Adjusted odds ratios with 95% confidence intervals were used to interpret the results.

RESULTS

Out of 423 study participants, only 41.6% of patients with diabetes were diabetes information seekers. After adjusting all other factors in the final model, educational status, place of residence, comorbidity and health literacy were significantly associated with diabetes information seeking.

CONCLUSION

This study result indicates that the overall prevalence of information seeking among patients with diabetes toward diabetes was low. Having higher educational status, urban place of residence, the presence of comorbidity and adequate health literacy level increased the likelihood of diabetes information-seeking behavior among patients with diabetes.

Thirst for Information and Needs Reflections of Type 2 Diabetes Patients Receiving Insulin Treatment in North-East Ethiopia: A Qualitative Exploration

Objectives:

Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia.

Methods:

The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients’ registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies.

Results:

Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants’ recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions.

Conclusions:

Patients’ main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

The impact of health information needs' satisfaction of hypertensive patients on their clinical outcomes

Purpose

The ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical condition. The literature falls short of providing evidence on the interaction between patients' health information seeking behaviour and the successful management of a clinical condition. On the other hand, patient education and good information seeking practices are deemed necessary for hypertension management daily decisions.

Design/methodology/approach

A specially designed questionnaire study was developed: The survey design was informed by the information seeking behaviour model of Wilson for studying hypertension patients' information needs, information resources and obstacles patients face while seeking hypertension-related information. Moreover, clinical information was collected in order to make associations and inference on the impact of information seeking on patients' clinical outcomes.

Findings

The study included 111 patients submitted to the outpatient hypertension clinic of a university hospital in Athens for a 24-h ambulatory blood pressure measurement (ABPM). The analysis showed that those reporting higher satisfaction level of their information needs achieved lower values in ABPM (ABPM<130/80mmHg, p = 0.049). Stepwise the logistic regression analysis revealed three independent factors to predict the possibility of being optimally treated (ABPM<130/80mmHg). Dipping status (OR: 14.052, 95% CI: 4.229–46.688, p = 0.0001) patients with high satisfaction level of their disease (OR: 13.450, 95% CI: 1.364–132.627, p = 0.026) and interpersonal relationships were used as the main source of information (OR: 1.762, 95% CI: 1.024–3.031, p = 0.41).

Originality/value

Hypertensive patients with high satisfaction level of information achieve better disease control. Among different sources of information, interpersonal relationships emerge as the most appropriate factor for patients' disease control.

A cross-sectional survey interconnecting health information seeking behavior with clinical data of type 2 diabetes mellitus patients

Purpose

The purpose of this paper is the investigation of type 2 diabetes patients' information seeking behavior in terms of their information needs, sources and barriers faced by patients when seeking information. The information seeking behavior is associated with clinical patient data.

Design/methodology/approach

The relevant literature is reviewed, and the results of a cross-sectional survey informed by Wilson's macro-model of information seeking behavior are reported. The survey includes 106 outpatients from the diabetes clinic of a Greek major university hospital and includes information seeking behaviors and patient's clinical evidence.

Findings

The most important health information needs are related to the complications, symptoms and causes of diabetes, to the proper diet for diabetics and the measures adopted to avoid foot complications. Furthermore, the most important information resources were physicians, ophthalmologists, books, broadcast media and family members. Obstacles encountered during information seeking include the complicated nature of health information, which involves scientific terms as well as psychological issues. The diabetes stage is correlated with information needs for diabetes medication, while the years from the first diagnosis are negatively correlated with the use of informal sources.

Research limitations/implications

The information needs and sources of diabetic patients, as well as the main obstacles to this pursuit, could potentially have important implications in designing a future information campaign and information services for diabetes patients.

Originality/value

The Wilson's macro-model of information seeking has been applied to the diabetic patients' information seeking behavior; while information needs, information sources and information obstacles are correlated with clinical evidence from patients’ hospital records.

Status and influencing factors of diabetes information acquisition among rural elderly with pre-diabetes in Yiyang City, China: a cross-sectional study

OBJECTIVE

This study was designed to investigate the status of diabetes information acquisition and its influencing factors among patients, 60 years and older, with pre-diabetes in rural China.

DESIGN

This is a cross-sectional study.

SETTING

The survey was conducted in 42 rural communities in Yiyang City, Hunan Province, China.

PARTICIPANTS

A total of 461 elderly with pre-diabetes participated in this study, and 434 of them completed the survey (434/461, 94.1%).

OUTCOME MEASURES

Information on sociodemographic and diabetic information-seeking behaviours were assessed through the structured questionnaires and described by percentages, mean±SD. The influencing factors of diabetes information acquisition were analysed using multiple linear regression analysis.

RESULTS

The average score of diabetes information acquisition in the subjects was 8.39±11.28. The most popular and trusted source of diabetes information for the subjects was doctors. The level of information acquisition not only declined as the age progressed (95% CI -3.754 to -0.143) but also proved lowest among subjects with less than 1 year of education (95% CI 0.756 to 4.326). In addition, the level of information acquisition among elderly individuals with pre-diabetes, but with no history of hyperglycaemia, was lower than among those with a history of hyperglycaemia (95% CI 3.398 to 11.945).

CONCLUSIONS

These data indicated that the lack of ability to acquire diabetes information in elderly with pre-diabetes was common in rural China. Improving the ability of rural residents to access information should be incorporated into rural diabetes prevention efforts, especially for the elderly with pre-diabetes with low education and no history of hyperglycaemia.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-15007033; Pre-results.

Cross-sectional study about the use of telemedicine for type 2 diabetes mellitus management in Spain: patient's perspective. The EnREDa2 Study

OBJECTIVES

The usefulness of telemedicine (TM) in type 2 diabetes mellitus (T2DM) has been discussed in recent years. The aim of this study is to describe patients' perceptions about TM and to identify preferences on TM resources, in Spain.

DESIGN

An observational, cross-sectional study was conducted using a structured questionnaire.

PARTICIPANTS

1036 patients with T2DM accepted to participate in the study (response rate: 68%).

RESULTS

Blood glucose values were recorded by 85.9% of the patients while data such as lifestyle habits were only recorded by 14.4% of the patients. Previous experience in TM was reported by 9.8% of the patients, out of which 70.5% were satisfied with its service and 73.5% considered that the use of TM had optimised their T2DM management. However, most of these patients noted aspects to be improved such as user-friendliness (81.4%), interaction with the medical team (78.4%) and time required for recording/transferring data (78.4%). Experienced patients had better perception about TM usefulness than naïve patients for all listed aspects (p<0.05). Among naïve patients, 38.2% expressed their willingness to participate in TM programmes, but only 4.7% were invited to do so. Patients considered that physicians' (77.5%) and pharmacists' (75.5%) encouragement can boost the use of TM.

CONCLUSIONS

In Spain, nearly 10% of patients with T2DM have experience with TM and it is well accepted, especially one based on glucometers. Nevertheless, in order to promote TM use, easier and time-saving programmes for patient-physician interaction should be optimised.

Trends in the receipt of medicines information among Finnish adults in 1999-2014: a nationwide repeated cross-sectional survey

OBJECTIVE

The aim of this study was to examine long-term trends in the receipt of medicines information (MI) among adult medicine users from 1999 to 2014.

DESIGN

Repeated cross-sectional postal survey from the years 1999, 2002, 2005 and 2008-2014.

SETTING

Each study year, a new nationally representative sample of 5000 Finns aged 15-64 years was drawn from the Population Register Centre of Finland.

PARTICIPANTS

The range of annual respondents varied from 2545 to 3371 and response rates from 53% to 67%. Of the total responses (n=29 465), 64% were from medicine users (n=18 862, ranging by year from 58% to 68%).

OUTCOME MEASURES

Receipt of information on medicines in use within 12 months prior to the survey from a given list of consumer MI sources available in Finland.

RESULTS

Physicians, community pharmacists and package leaflets were the most common MI sources throughout the study period. Receipt of MI increased most from the Internet (from 1% in 1999 to 16% in 2014), while decreased most from physicians (62% to 47%) and package leaflets (44% to 34%), and remained stable from community pharmacists (46% to 45%) and nurses (14% to 14%). In 1999, of the medicine users 4% did not report receipt of MI from any of the sources listed in the survey, while this proportion had remarkably increased to 28% in 2014.

CONCLUSIONS

Healthcare professionals and package leaflets had still a dominating importance in 2014 despite the growing number of MI sources over time, but still a minority of adult medicine users reported receiving MI via the Internet in 2014. Worrying is that the proportion of adult medicine users who did not receive MI from any of the sources became seven fold during the study period.

Diabetes-related information-seeking behaviour: a systematic review

BACKGROUND

Information-seeking behaviour is necessary to improve knowledge on diabetes therapy and complications. Combined with other self-management skills and autonomous handling of the disease, it is essential for achieving treatment targets. However, a systematic review addressing this topic is lacking. The aims of this systematic review were to identify and analyse existing knowledge of information-seeking behaviour: (1) types information-seeking behaviour, (2) information sources, (3) the content of searched information, and (4) associated variables that may affect information-seeking behaviour.

METHODS

The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. MEDLINE, CINAHL, EMBASE, ScienceDirect, PsycInfo, Cochrane Library, Web of Science, CCMed, ERIC, Journals@OVID, Deutsches Ärzteblatt and Karlsruher virtueller Katalog (KvK) databases were searched. Publications dealing with information-seeking behaviour of people with diabetes mellitus published up to June 2015 were included. A forward citation tracking was performed in September 2016 and June 2017. Additionally, an update of the two main databases (MEDLINE, CINAHL) was conducted, considering studies published up to July 2017. Studies published in languages other than English or German were excluded, as well as letters, short reports, editorials, comments and discussion papers. A study selection and the critical appraisal of the selected studies were performed independently by two reviewers. A third reviewer was consulted if any disagreement was found. Data extraction and content analysis were performed using selected dimensions of Wilson's 'model of information behaviour'.

RESULTS

Twenty-six studies were included. Five 'types of information-seeking behaviour' were identified, e.g. passive and active search. The 'Internet' and 'healthcare professionals' were the most frequently reported sources. 'Diet', 'complications', 'exercise' and 'medications and pharmacological interactions' were the most frequently identified content of information. Seven main categories including associated variables were identified, e.g. 'socioeconomic', 'duration of DM', and 'lifestyle'.

CONCLUSION

The systematic review provides a valuable overview of available knowledge on the information-seeking behaviour of people with diabetes mellitus, although there are only a few studies. There was a high heterogeneity regarding the research question, design, methods and participants. Although the Internet is often used to seek information, health professionals still play an important role in supporting their patients' information-seeking behaviour. Specific needs of people with diabetes must be taken into consideration.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42016037312.

The Association Between Commonly Investigated User Factors and Various Types of eHealth Use for Self-Care of Type 2 Diabetes: Case of First-Generation Immigrants From Pakistan in the Oslo Area, Norway

Background

Sociodemographic and health-related factors are often investigated for their association with the active use of electronic health (eHealth). The importance of such factors has been found to vary, depending on the purpose or means of eHealth and the target user groups. Pakistanis are one of the biggest immigrant groups in the Oslo area, Norway. Due to an especially high risk of developing type 2 diabetes (T2D) among this population, knowledge about their use of eHealth for T2D self-management and prevention (self-care) will be valuable for both understanding this vulnerable group and for developing effective eHealth services.

Objective

The aim of this study was to examine how commonly were the nine types of eHealth for T2D self-care being used among our target group, the first-generation Pakistani immigrants living in the Oslo area. The nine types of eHealth use are divided into three broad categories based on their purpose: information seeking, communication, and active self-care. We also aimed to investigate how sociodemographic factors, as well as self-assessment of health status and digital skills are associated with the use of eHealth in this group.

Methods

A survey was carried out in the form of individual structured interviews from September 2015 to January 2016 (N=176). For this study, dichotomous data about whether or not an informant had used each of the nine types of eHealth in the last 12 months and the total number of positive answers were used as dependent variables in a regression analysis. The independent variables were age, gender, total years of education, digital skills (represented by frequency of asking for help when using information and communication technology [ICT]), and self-assessment of health status. Principal component analyses were applied to make categories of independent variables to avoid multicollinearity.

Results

Principal component analysis yielded three components: knowledge, comprising total years of education and digital skills; health, comprising age and self-assessment of health status; and gender, as being a female. With the exception of closed conversation with a few specific acquaintances about self-care of T2D (negatively associated, P=.02) and the use of ICT for relevant information-seeking by using search engines (not associated, P=.18), the knowledge component was positively associated with all the other dependent variables. The health component was negatively associated with the use of ICT for closed conversation with a few specific acquaintances about self-care of T2D (P=.01) but not associated with the other dependent variables. Gender component showed no association with any of the dependent variables.

Conclusions

In our sample, knowledge, as a composite measure of education and digital skills, was found to be the main factor associated with eHealth use regarding T2D self-care. Enhancing digital skills would encourage and support more active use of eHealth for T2D self-care.

Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients' information needs

OBJECTIVE

The purpose of this study was to determine the information needs of primary care patients as they review clinic visit notes to inform information that should be contained in an after-visit summary (AVS).

METHOD

We collected data from 15 patients with an acute illness and 14 patients with a chronic disease using semi-structured interviews. The acute patients reviewed seven major sections, and chronic patients reviewed eight major sections of a simulated, but realistic visit note to identify relevant information needs for their AVS.

RESULTS

Patients in the acute illness group identified the Plan, Assessment and History of Present Illness the most as important note sections, while patients in the chronic care group identified Significant Lab Data, Plan, and Assessment the most as important note sections.

DISCUSSION

This study was able to identify primary care patients' information needs after clinic visit. Primary care patients have information needs pertaining to diagnosis and treatment, which may be the reason why both patient groups identified Plan and Assessment as important note sections. Future research should also develop and assess an AVS based on the information gathered in this study and evaluate its usefulness among primary care patients.

PRACTICE IMPLICATIONS

The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence.

Soliciting and Responding to Patients' Questions about Diabetes Through Online Sources

When patients cannot get answers from health professionals or retain the information given, increasingly they search online for answers, with limited success. Researchers from the United States, Ireland, and the United Kingdom explored this problem for patients with type 2 diabetes mellitus (T2DM). In 2014, patients attending an outpatient clinic (UK) were asked to submit questions about diabetes. Ten questions judged representative of different types of patient concerns were selected by the researchers and submitted to search engines within trusted and vetted websites in the United States, Ireland, and the United Kingdom. Two researchers independently assessed if answers could be found in the three top-ranked documents returned at each website. The 2014 search was repeated in June, 2016, examining the two top-ranked documents returned. One hundred and sixty-four questions were collected from 120 patients during 12 outpatient clinics. Most patients had T2DM (95%). Most questions were about diabetes (N = 155) with the remainder related to clinic operation (N = 9). Of the questions on diabetes, 152 were about T2DM. The 2014 assessment found no adequate answers to the questions in 90 documents (10 questions, 3 websites, 3 top documents). In the 2016 assessment, 1 document out of 60 (10 questions, 3 websites, 2 top documents) provided an adequate answer relating to 1 of the 10 questions. Available online sources of information do not provide answers to questions from patients with diabetes. Our results highlight the urgent need to develop novel ways of providing answers to patient questions about T2DM.

Health information needs, sources, and barriers of primary care patients to achieve patient-centered care: A literature review

To synthesize findings from previous studies assessing information needs of primary care patients on the Internet and other information sources in a primary care setting. A systematic review of studies was conducted with a comprehensive search in multiple databases including OVID MEDLINE, CINAHL, and Scopus. The most common information needs among patients were information about an illness or medical condition and treatment methods, while the most common information sources were the Internet and patients' physicians. Overall, patients tend to prefer the Internet for the ease of access to information, while they trust their physicians more for their clinical expertise and experience. Barriers to information access via the Internet include the following: socio-demographic variables such as age, ethnicity, income, education, and occupation; information search skills; and reliability of health information.

CONCLUSION

Further research is warranted to assess how to create accurate and reliable health information sources for both Internet and non-Internet users.