Why Do Patients Seek an Alternative Channel? The Effects of Unmet Needs on Patients' Health-Related Internet Use

Abstract

Breast cancer is the most common form of cancer found among women in the United States. During the course of the illness, women diagnosed with breast cancer need information and support to cope with the illness. To understand what leads women with breast cancer to consult the Internet for health-related information, we examined how unmet needs—needs that have not been satisfied—in regards to information and emotional support determine patterns of cancer patients' health-related Internet use. Using data collected from 122 women diagnosed with breast cancer, we found that the higher the unmet need for information was, the more likely individuals were to spend time in specialized health information. Likewise, the higher the unmet need for emotional support was, the more likely individuals were to spend time in social support services such as discussion groups. Implications for future research on unmet needs and the use of the Internet were discussed.

Notes

¹CHESS (Comprehensive Health Enhancement Support Studies) is a nonprofit eHealth system providing more limited content based on needs identified in studies of women with breast cancer, their partners, and adult children. It is designed to be attractive and easy to use, with 12 integrated services in four main categories to improve breast cancer patients' quality of life: (1) Information Services, consisting of Questions and Answers, Instant Library, Personal Stories, Consumer Guide, Referral Directory, and the Dictionary; (2) Problem Solving Services, including Decisions Aid and Action Plan; (3) Self-Monitoring and Guidance Services, including Personal Profiles and Assessments; and (4) Support Services, consisting of Ask an Expert and Discussion Group.

²The specific health issue we studied was breast cancer. Breast cancer is the most common cancer found among women in the United States. In 2008, it is estimated that 182,460 women will be diagnosed with breast cancer, and 40,480 will die from the disease. As of 2008, there would be more than 2.5 million breast cancer survivors in the United States. According to the American Cancer Society, death rates from breast cancer have been declining because of earlier detection and improved treatment. It means that many women are living substantial numbers of years with the aftermath of illness and its treatment.

³The sites included National Cancer Institute (NCI), American Cancer Society (ACS), Komen, Celebrating Life Foundation (for African Americans), Y-Me, and Oncolink.

⁴The data from the only CHESS group allow us to track detailed categories about health-related information, such as Information Services and Support Services.

⁵Upper outliers who were extremely heavy users of health information were replaced by their nearest neighbors, using the Winsorization technique (Barnett & Lewis, 1994). This technique provides a way of preventing a number of suspect data points from potentially influencing the results without changing the median.

⁶We believe this will help to ensure that none of these factors will be confounded with an experimental condition by chance, and will limit the potential influence of these extraneous factors on the observed differences.

Note. Entries are standardized final betas.

∗p < .05, ∗∗p < .01.

⁷ http://www.hon.ch/Survey/Survey2005/res.html.