The Role of Patient Satisfaction in Online Health Information Seeking

Abstract

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.

Notes

¹In the U&G perspective, when two media fulfill the same communication needs, they are regarded as functional alternatives.

²Specific examples come from qualitative studies such as Nettleton and Colleagues' 2004 study of families with children who had chronic illnesses, Chen and Siu's (2001) study of Canadian cancer patients, Williamson's (2005) study of Australian breast cancer patients and Bass and colleagues (2006) study of patients newly diagnosed with cancer. These studies provide an indication of patient needs as do online discussion boards on Association of Cancer Online Resources (ACOR) and pediatric cancer sites like http://www.curesearch.org

³Caregivers' responses were not excluded from the analysis, but their small number precluded an analysis of differences, if any, between their information-seeking behaviors and that of patients and survivors.

⁺ p < .10; ∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

⁴The dependent variable for Hypothesis One was computed by subtracting average scores for the evaluation of the cancer specialist from average scores evaluating the internet and online support groups, respectively. Thus, a positive result indicates the Internet or online support groups were rated more highly, while a negative result indicates that the cancer specialist was rated more highly.

⁵Mean scores on the patient satisfaction scale were computed. Scores between 1.00 and 3.56 signified dissatisfaction, scores between 3.57 and 4.56 signified a neutral rating of the provider, and scores between 4.57 and 6.00 signified satisfaction.

⁶Computed in a manner similar to the diference in evaluation between the Internet and the cancer specialist, with a positive rating signifying a more positive evaluation of the online support group.

⁺ p < .10; ∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

⁷Satisfaction with quality of time and empathy were calculated in the same way as satisfaction with diagnosis. Scores between 1.00 and 2.59 denoted dissatisfaction, scores between 2.60 and 3.59 denoted a neutral rating, while scores between 3.60 and 5.00 signified satisfaction.

⁸Dummy variables were used for choosing the Internet as the first port of information and for choosing the oncologist as the preferred source of information.

⁺ p < .10; ∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

⁺ p < .10; ∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

⁹Extent of Internet use was measured as an average of six items measuring extent of Internet use for health purposes such as seeking an explanation of symptoms, verifying information provided by the oncologist and soon. The Methods section has more specific details.

¹⁰Dissatisfaction was expressed at the physician who provided an initial diagnosis or the first oncologist consulted.