Research Paper
How patients’ use of social media impacts their interactions with healthcare professionals

https://doi.org/10.1016/j.pec.2017.08.015Get rights and content

Highlights

  • Patients were empowered by using social media for health-related purposes.

  • Patients could participate more actively in the treatment decision-making processes.

  • The use of social media by patients improved their relationship with their healthcare professionals.

  • However overt or tacit opposition from healthcare professionals was reported.

Abstract

Introduction

Patients are increasingly accessing online health information and have become more participatory in their engagement with the advent of social media (SM). This study explored how patients’ use of SM impacted their interactions with healthcare professionals (HCPs).

Methods

Focus groups (n = 5) were conducted with 36 patients with chronic conditions and on medication who used SM for health-related purposes. The discussions lasted 60–90 min, were audio-recorded, transcribed verbatim, and thematically analysed.

Results

Participants did not interact with HCPs on SM and were not expecting to do so as they used SM exclusively for peer interactions. Most reported improvement in the patient-HCP relationship due to increased knowledge, better communication, and empowerment. Participants supplemented HCP-provided information with peer interactions on SM, and prepared themselves for consultations. They shared online health information with HCPs, during consultations, to validate it and to actively participate in the decision-making. Although some participants reported HCP support for their online activities, most perceived overt or tacit opposition.

Conclusion

Participants perceived that their SM use positively impacted relationships with HCPs. They felt empowered and were more assertive in participating in decision-making.

Practice implications

HCPs should be aware of patients’ activities and expectations, and support them in their online activities.

Introduction

The Internet has increased access to a range of health-related information, and its evolution to Web 2.0 has provided a more participatory environment where users develop and disseminate online content. Web 2.0 has provided the technological foundation for the appearance of social media platforms [1]. Web 2.0 has allowed the development of easy-to-use and interactive platforms where individuals and communities share, co-create, discuss, and modify user-generated content (e.g. texts, images, audios, videos, games) employing mobile and web-based technologies [2]. Social media (SM), dubbed the “participative Internet” [3], has therefore been enabled through the evolution of Web 2.0. Putting it simply, SM consists of a wide range of websites and applications whose content is created by Internet users [1]. It has provided a new venue for public communication, including health communication [4]. As a result, SM has turned out to be not only an emerging trend for patients seeking health information [5], but also a venue for them to interact with one another. Online communities of patients with a shared health problem have become common [6]. Popular topics discussed include disease symptoms, prognosis, examinations and procedures, and treatments [7]. Besides getting additional useful information directly from peers [8], online patients have also obtained social support for self-management of their chronic conditions [9].

It has been argued that patients’ access to online health information can impact their relationship with healthcare professionals (HCPs) [10]. As Web 2.0 and SM are dynamic communication technologies with increasing penetration in people’s daily lives, it is vital to keep abreast of changes in its use by patients. Additionally, it is important to fully comprehend how patients are accessing health services and interacting with their HCPs after engaging with peers on social media. Findings from the literature have revealed that patient participation in health-related discussions on SM and other online forums could have an impact on the patient-HCP relationship. Patients have felt empowered and confident with the knowledge and support obtained online [11], [12] and consequently have asked more relevant questions and communicated better with HCPs [11], [13], [14], [15], [16]. However, on the flip side, it has been claimed that patients’ active participation in online health activities with peers could threaten HCP expertise in some cases [17] leading them to negatively react to patients’ online autonomous health activities. This in turn could have a disempowering effect on patients [18]. Patients have ended up looking for other health providers in response to a physician’s negative attitude or due to the recommendation of “good doctors” from peers [15].

Chiu and Hsieh [13] investigated how cancer patients wrote (and read) blogs about their condition and the impact of such activity on their illness experience. Cancer patients reconstructed their life story in the blog, articulated their expected end of life and how they wished to be remembered after death [13]. Using in-person and virtual focus groups, Rupert et al. [18] found that patients used online health communities or support groups to obtain information not provided by HCPs and discussed information obtained online with their clinicians, positively impacting the patient-HCP relationship [11], [18]. An Australian study [17] employing interviews explored the use of online support groups by men with prostate cancer. It showed that the online environment allowed patients to share private information without the constraints imposed by face-to-face social interactions. However, medical specialists perceived this behaviour as a threat to their expert status and control over decision-making processes [17].

A recent review by Smailhodzic et al. [19] about the use of SM in healthcare incorporated studies dealing with patients’ use of SM and its influence on their relationship with HCPs. While recognizing the limited number of studies on this topic, the authors proposed that SM use by patients increased their empowerment leading to a more equalized power balance between patients and HCPs. Considering the relative novelty and relevance of the topic, further research is deemed necessary. A comprehensive understanding of patients’ use, perceptions, and opinions about the use of SM for health-related purposes is important in order to design services that meet their needs and expectations. Moreover, further research is necessary in order to better understand SM’s potential for supporting patient-HCP relationships [20]. Therefore, the aim of this research was to explore patients’ experiences, opinions and perceptions about their use of SM for health-related purposes. Specifically, the study objectives, reported here, were to determine the impact of these online activities on patients’ in-person healthcare services use and health decision-making behaviour; and its effect on patient-HCP relationships.

Section snippets

Focus groups

A qualitative approach was used to allow participants to articulate their experiences, and help elicit in-depth information from them [21]. Focus groups were chosen because they are an efficient way of gathering the views of several individuals simultaneously [22], uncovering important constructs that may not be tapped through individual interviews [23]. A focus group guide (Appendix 1 in Supplementary materials) was developed to address the broad research aims. Findings pertaining to the

Results

A total of 36 participants (Table 1) took part in the focus groups (n = 5). A wide range of chronic disease states (e.g. hypertension, depression, anxiety, cancer, arthritis, Crohn’s disease) was represented among the participants.

Three overarching themes related to the impact of SM in patients’ interactions with HCPs and health care services emerged from the analysis. Table 2 provides a sample of quotations illustrating such themes.

Discussion and conclusions

This study has demonstrated an overall positive impact on the patient-HCP relationship due to patients’ use of SM as clearly articulated by the participants, and has provided new insights into the specific aspects of patient-HCP relationship. This study also corroborated previous research indicating that patients’ use of SM for health-related purposes positively influenced their relationship with HCPs [11], [14], [18], [28].

Whilst previous research found that patients did not disclose their

Conflicts of interest

None.

I confirm that all participants’ personal identifiers have been removed or disguised so the persons described are not identifiable and cannot be identified through the details of the narrative.

Acknowledgements

The authors would like to thank all patients who participated in this study providing their valuable experiences and opinions.

This study was partially funded by a grant awarded to Arcelio Benetoli for Professional Innovation offered by the Young Pharmacist Group (YPG) – International Pharmaceutical Federation (FIP) and FIP Foundation for Education and Research at the 75th FIP World Congress of Pharmacy and Pharmaceutical Sciences. Dusseldorf, Germany 29 September – 3 October 2015.

Arcelio also

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