Social Positioning Theory as a Lens for Exploring Health Information Seeking and Decision Making

218 Background: Increasing emphasis on patient-centered care has led to shared decision making, which better aligns medical decisions with patient preferences for care. In its 2004 report, Health Literacy: A Prescription to End Confusion, the US Institute of Medicine defines health literacy as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. However, little is known about the confluent role of patient health information seeking patterns and physician trust in the decision-making process. Therefore, we assessed perspectives of metastatic breast cancer (MBC) patients and health care professionals regarding how health information seeking and physician trust influence decision making. Methods: Qualitative interviews with 26 MBC patients and 6 community oncologists, as well as 3 separate focus groups involving lay navigators, nurses, and academic oncologists, were recorded and transcribed. Qualitative data analysis was conducted using a content analysis approach that included a constant comparative method to generate themes from the transcribed textual data. Results: Five prominent themes emerged from these responses. (1) Patients’ primary source of treatment information were physicians. (2) Patients differed in their approach to seeking further health information regarding the discussed treatment options (e.g. internet websites, family and friends, support groups). (3) Patients trusted their physician’s recommendations to achieve their goals of care. (4) Oncologists were cognizant of their fundamental role in facilitating informed decision making (5) Patient and physician discordant perspectives on shared decision making were apparent. Conclusions: Patient procurement of health information and their capacity to use it effectively to make informed decisions in conjunction with their trust in physicians, may play an important role in shared decision making.

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Impact of Education on Health Information Seeking and Decision-making among Rural Women

SRELS Journal of Information Management ◽

10.17821/srels/2020/v57i6/152320 ◽

2020 ◽

Vol 57 (6) ◽

pp. 327

Author(s):

Florence Guite ◽

P. Hangsing

Keyword(s):

Decision Making ◽

Health Information ◽

Rural Women ◽

Information Seeking ◽

Health Information Seeking

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Exploring Health Information-Seeking Preferences of Older Adults With Hypertension: Quasi-Experimental Design (Preprint)

10.2196/preprints.8903 ◽

2017 ◽

Author(s):

Gabriele Sak ◽

Peter Johannes Schulz

Keyword(s):

Older Adults ◽

Health Care ◽

Decision Making ◽

Health Information ◽

Information Seeking ◽

Self Efficacy ◽

Intervention Group ◽

The Internet ◽

Health Information Seeking ◽

Additional Information

BACKGROUND Patients’ engagement in health care decision making is constituted by at least two behaviors: health information seeking and active involvement in medical decisions. Previous research reported that older adults desire a lot of information, but want to participate in decision making to a lesser degree. However, there is only limited evidence on the effect of desire for health information on seniors’ perceived confidence in making an informed choice (ie, decision self-efficacy). OBJECTIVE The goal of this study was to investigate the role desire for health information has for older patients. More specifically, it tested whether decision self-efficacy increases as a function of an assisted computer-based information search. Additionally, the study allowed insights into the sources seniors with hypertension prefer to consult. METHODS A sample of 101 senior citizens (aged ≥60 years) with high blood pressure in the Italian-speaking part of Switzerland answered a questionnaire before and after an informational intervention was applied. The intervention consisted of offering additional information on hypertension from five different sources and of providing the information the participant desired. Preference for receiving this information was the major independent variable. The main outcome measure was decision self-efficacy (assessed at baseline and posttest). Analyses of covariance were conducted to detect differences between and within who desired additional hypertension-related content (intervention group) and “information avoiders” (control group). RESULTS Health care professionals firmly remain the preferred and most trusted source of health information for senior patients. The second most consulted source was the internet (intervention group only). However, among the total sample, the internet obtained the lowest credibility score. A significant increase in decision self-efficacy occurred in seniors consulting additional information compared to information avoiders (F1,93=28.25, P<.001). CONCLUSIONS Consulting health information on a computer screen, and assistance by a computer-savvy person, may be a helpful activity to increase perceived confidence in making treatment decisions in seniors with hypertension.

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“What's wrong with that woman?” – Positioning Theory and Information-Seeking Behaviour

Proceedings of the Annual Conference of CAIS / Actes du congrès annuel de l'ACSI ◽

10.29173/cais20 ◽

2013 ◽

Author(s):

Pamela J. McKenzie ◽

Robert F. Carey

Keyword(s):

Health Status ◽

Lupus Erythematosus ◽

Information Seeking ◽

Positioning Theory ◽

Discursive Practices ◽

Structured Interviews ◽

Systematic Lupus Erythematosus ◽

Information Seeking Behaviour ◽

Social Positioning ◽

Social Positioning Theory

We offer social positioning theory (Davies and Harre 1990) as a framework for exploring the ways in which the visibility of an individual’s health status is linked to socially constructed subjectivities that can affect the individual’s information-seeking behaviour. Qualitative analysis of data from two doctoral studies (collected through participant observation and 40 semi-structured interviews) illustrates the utility of social positioning theory as a framework for studying two specific health contexts: systematic lupus erythematosus, and twin pregnancy. Adopting a ‘position’ involves the use of discursive practices which define the relations between self and others. Such practices frequently draw upon common social representations of particular phenomena (Van Langehove and Harre 1994). Our findings indicate that the visibility of health status is related to subject positioning, and that positioning theory offers insight into the mutually specifying correspondence between local discursive practices and styles of information behavior. The pregnant woman’s expanding abdomen makes her health status evident to others, often positioning her as a willing recipient of advice and information (Browner and Press 1997). Cultural assumptions associated with “twins” can both facilitate and constrain the woman’s information seeking (“Better you than me.”). However, the stock of shared cultural understandings associated with lupus is comparatively sparse (Senecal 1991). Symptoms such as hair loss, skin rash, and weight gain may therefore lead to positions which are experienced by novice patients as stigmatizing (“What’s wrong with that woman?”). Even when evident symptoms disappear, the stigmatized position can be maintained through secrecy (“No one can tell I have lupus.”). In these situations, information-seeking is relegated to the confidential encounters characteristic of expert disciplinary regimes. As a heuristic tool, then, positioning theory provides an opportunity for analysis of the means by which the information-seeking subject is configured through discursive encounters.

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