title: Does information overload prevent chronic patients from reading self-management educational materials?
abstract: BACKGROUND
  Self-care management is becoming an important part of care for chronic patients. However, various kinds of self-management educational materials which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients' use intention could be patients' perceived information overload regarding the self-management educational materials.
  
  
  OBJECTIVE
  This study proposed an extended model of the Theory of Planned Behavior (TPB), which incorporated perceived information overload, to explore if information overload will prevent chronic patients from reading educational materials for self-care management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the self-management educational materials. Perceived information overload is also referred to as an antecedent variable which may has impacts on attitude and perceived behavior control.
  
  
  METHODS
  The cross-sectional study interviewed newly diagnosed chronic patients with coronary artery disease, who are the potential users of the self-management educational materials, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the respondents, and structural equation modeling to study the reliability and validity for testing hypotheses.
  
  
  RESULTS
  A total of 110 respondents were enrolled in this study and successful interview data were collected from 106 respondents. The result indicates that the patients' perceived information overload of self-management educational materials was validated to have impacts on attitude and perceived behavioral control constructs of the TPB as well as contributing a direct impact on patients' intentions to use self-management educational materials. Besides, subjective norm and perceived behavioral control constructs were validated to have significant impacts on behavioral intentions, whereas the attitude construct was not. Finally, the relationships between information overload and attitude, information overload and intention, subjective norm and intention, as well as perceived behavioral control and intention varied significantly between highly- and less-educated respondents. Differing self-management educational materials for respondents of various educational levels could be formulated to substantially boost the use of self-management educational materials.
  
  
  CONCLUSIONS
  This study demonstrated a comprehensive framework, which extended perceived information overload into the TPB model, to predict patients' behavioral intention of using self-management educational materials. We expect the results of this study will provide useful insights for studying self-management educational materials usage and information overload from the perspectives of academia, governments, and healthcare providers.
authors.affiliation: Department of Information Management, Chia-Nan University of Pharmacy and Science, No.60, Erh-Jen Rd., Sec.1, Jen-Te District, Tainan City 71710, Taiwan, ROC. Electronic address: fredliu@mail.cnu.edu.tw.
authors.forename: Chung-Feng
authors.initials: CF
authors.lastname: Liu
authors.affiliation: Department of Healthcare Administration, I-Shou University, No.8, Yida Rd., Yanchao District, Kaohsiung City 82445, Taiwan, ROC. Electronic address: kuangmingkuo@gmail.com.
authors.forename: Kuang-Ming
authors.initials: KM
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000517:prevention & control / Q000523:psychology*; D003324:Coronary Artery Disease / Q000517:prevention & control / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D063025:Health Information Management / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards*; D010465:Perception; D012648:Self Care / Q000379:methods*; D013624:Taiwan
keywords: Chronic disease; Consumer health information; Information overload; Self-care