Investigating the Association Between Internet Health Information Use and Patient Willingness to Communicate with Health Care Providers

ABSTRACT

Communication between health professionals and patients is an intergroup phenomenon where the health professional has the most power and status. Over the past few decades, there has been a steady increase in the availability to patients of information about healthcare and specific diseases on the Internet. In this paper, we ask whether the use of Internet health information assists patients to manage their consultations with health professionals better and whether it alters the intergroup dynamic by providing a more equal status for patients. In this study 370 participants from Australia and Canada completed a survey that included a ‘willingness to communicate with health professionals’ scale. They also commented on their use and trust of Internet health information. Thematic analysis suggests that patients’ use of Internet health information serves as a broker between patients and their health provider in health consultations. We discuss the implications of these findings for health practitioners as they address how easier Internet access influences patient interactions with health professionals. We consider future research directions these finding provide in explaining communication behaviour in this context.     

美国的听力师教育

随着婴儿潮、人口老龄化及新技术的广泛应用，人们对听力保健的需求显著增加。在美国，听力保健服务由助听设备专员、耳鼻喉科医生和听力师3类人员提供，其中听力师提供除医疗、手术外宽泛的听力保健服务。美国的听力保健服务体系及听力师教育体系经历了一个渐进的过程：20年前对从业人员的学历要求是听力学硕士，随着对服务质量要求的提高和服务范围的扩大，美国听力师逐渐要求专业博士学位（Au.D），毕业后还需3～4年的专门教育才能成为一名听力师。听力师教育有统一的标准，大学课程要通过听力教育认证委员会（the Accreditation Commission for Audiology Education， ACAE）或学术认证委员会（the Council on Academic Accreditation，CAA）的多程序严格的认证才能被承认。美国听力师需求存在巨大缺口，但是各国听力学教育标准不统一及听力师收入与教育投资不匹配，阻碍了更多的人进入这一领域。美国试图通过改变教育模式，降低教育成本及革新教学方法等改善听力师教育状况，但是听力师教育体系远未完善。     

Racial matching and adolescent self-disclosure of substance use and mental health symptoms

Obtaining accurate assessment data from adolescents in treatment aids clinical decision making and facilitates more accurate outcome evaluations. However, findings could be biased due to underreported substance use and mental health symptoms. This article compares self-reports of youth in non-White matched client–assessor dyads and those in nonmatched dyads. There were no differences on self-reported substance use, but matched youth reported significantly fewer attention deficit/hyperactivity disorder symptoms versus the comparison group. One possible reason for these findings is the effect of in-group stereotype threat. Future studies should examine the potential effect that in-group stereotyping and perceived racism have on the therapeutic relationship.     

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital condition. It responds well to early diagnosis and treatment, but otherwise the prognosis is poor. We present our case series of 12 patients (mean age, 2 ± 2.58 yr; age range, 2 mo–8 yr), emphasizing the diagnostic process and discussing our surgical results. The diagnosis of ALCAPA should be suspected in infants who have dilated cardiomyopathy with electrocardiographic changes that suggest ischemia, and in older children who have isolated mitral regurgitation. When clinical suspicion is high, the results of 2-dimensional echocardiography combined with color-flow Doppler studies in expert hands can establish the diagnosis, thus avoiding angiography in critically ill infants. The treatment of choice in our patients was transfer and reimplantation of the left coronary artery onto the ascending aorta. There were 2 deaths: both were infants in extremis who underwent emergency surgery. An older child with severe ventricular dysfunction was given mechanical ventricular assistance and then heart transplantation. As of this report, all 10 survivors remained well and asymptomatic.