The role of the Internet in patient-practitioner relationships: findings from a qualitative research study.
BACKGROUND
Studies suggest that there has been an increase in the use of the Internet by patients in many Western societies. However, despite the many texts available on health and the Internet, not much is known about how much patients actually use the Internet to look up health information in their daily lives. We know little about what meaning this activity has for their experience of health and illness, and for their relationship with health-care practitioners.


OBJECTIVE
To explore patients' and practitioners' use of the Internet and to consider whether use of the Internet is changing relationships between patients and health-care practitioners.


METHODS
The study used qualitative interviews and observations of patient-practitioner interaction. Our purposive sample of 47 patients (32 women and 15 men) had all had contact with the health services for information/treatment in relation to hormone replacement therapy (HRT)/menopause and Viagra/erectile dysfunction. The setting for the research was in general practitioners' surgeries, specialist clinics and patients' homes in the United Kingdom. Participants reflected a wide range of socio-economic groups, but most were white and British born, which, given the ethnic make-up of the town in which we conducted the research, was not surprising. In addition to patients, we interviewed 10 health-care practitioners (4 consultant doctors, 3 GPs, 2 specialist nurses, and a psychologist) about their own health information seeking practices (HISPs) and those of their patients.


RESULTS
Use of the Internet can increase patients' knowledge about their health conditions, although patients in our study were often too overwhelmed by the information available on the Internet to make an informed decision about their own care. Patients have a great deal of trust in their health-care practitioners. Health-care practitioners need to improve their own skills in Internet use. Hype around Internet use by patients appears to exceed the reality of Internet use.


CONCLUSIONS
Our qualitative study suggests that use of the Internet is contributing to subtle changes in the relationship between health-care practitioners and their patients, rather than effecting the dramatic transformation some people envisage for it.
Centre for Nursing and Midwifery Research, University of Brighton, UK. a.hart@brighton.ac.uk <a.hart@brighton.ac.uk>
Angie
A
Hart
Flis
F
Henwood
Sally
S
Wyatt
D000328:Adult; D000368:Aged; D003197:Computer Literacy; D007172:Erectile Dysfunction / Q000188:drug therapy; D005260:Female; D006296:Health Services / Q000639:trends; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D007255:Information Services / Q000639:trends*; D020407:Internet / Q000639:trends*; D008297:Male; D008593:Menopause / Q000187:drug effects; D008875:Middle Aged; D010817:Physician-Patient Relations; D010879:Piperazines / Q000627:therapeutic use; D011687:Purines; D036301:Qualitative Research; D000068677:Sildenafil Citrate; D013450:Sulfones; D006113:United Kingdom
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate