scholarly journals Does Internet Use Affect Medical Decisions among Older Adults in China? Evidence from CHARLS

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 60
Author(s):  
Gan Li ◽  
Chuanfeng Han ◽  
Pihui Liu
Keyword(s):  
Older Adults ◽  
Internet Use ◽  
Positive Impact ◽  
Medical Institution ◽  
The Internet ◽  
Cluster Sampling ◽  
Fe Model ◽  
Medical Decisions ◽  
Common Diseases ◽  
Medical Institutions

Background: The rapid growth of the elderly population poses a huge challenge for people to access medical services. The key to get rid of the dilemma is for patients to go firstly to primary medical institutions. Existing studies have identified numerous factors that can affect patients’ health institution choice. However, we currently know little about the role of Internet use in the patients’ medical decisions. The objective of this study is to explore health-seeking behavior and institution choice under the background of the Internet era from the perspective of older adults, and to analyze whether the Internet could guide patients to the appropriate medical institution so as to accomplish hierarchical treatment. Methods: The dataset comprises 9416 people aged 45 or above from the China Health and Retirement Longitudinal Survey (CHARLS), which, through multistage cluster sampling, was conducted in 2011, 2013, and 2015. Logistic regression, PSM, and FE model are used to estimate the influence of Internet use on the health care decision-making behavior. Results: Internet use has a significant positive impact on the self-treatment of common diseases (β = 0.05, p < 0.05). In terms of medical institution choices, those who use Internet are more inclined to choose top-level hospitals than community health service institutions to treat common diseases (β = 0.06, p < 0.01). Conclusions: The Internet has lowered the obstacles to learning about common ailments, resulting in a substitution impact of self-treatment for hospital care. However, Internet use may aggravate older adults’ perception of the risk of disease, which exacerbates the tendency of going to higher-level medical institutions for medical treatment. The finding of the study is useful for further rational planning and utilization of the Internet in order to guide patients to appropriate medical institution, which helps to improve the efficiency of the overall medical and health services.

scholarly journals Impact of the Internet on Medical Decisions of Chinese Adults: Longitudinal Data Analysis (Preprint)

2020 ◽  
Author(s):  
Qianqian Ma ◽  
Dongxu Sun ◽  
Fangfang Cui ◽  
Yunkai Zhai ◽  
Jie Zhao ◽  
...  
Keyword(s):  
Longitudinal Data ◽  
Medical Treatment ◽  
Hospital Care ◽  
Medical Information ◽  
Self Care ◽  
Medical Institution ◽  
The Internet ◽  
Chinese Adults ◽  
Medical Decisions ◽  
Common Diseases

BACKGROUND The internet has caused the explosive growth of medical information and has greatly improved the availability of medical knowledge. This makes the internet one of the main ways for residents to obtain medical information and knowledge before seeking medical treatment. However, little has been researched on how the internet affects medical decisions. OBJECTIVE The purpose of this study was to explore the associations between internet behaviors and medical decisions among Chinese adults aged 18 or over, including whether to go to the hospital and which level of medical institution to choose. METHODS With the adult residents (≥18 years old) in 12 regions including urban and rural areas taken as the research objects, the differences in medical choices of adults with various characteristics were analyzed, and generalized linear mixed models were adopted to analyze the longitudinal data of the China Health Nutrition Survey from 2006 to 2015. RESULTS Adult groups with different ages, genders, education levels, regions, places of residence, severities of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse medical decisions, and the differences were statistically significant (<i>P</i>&lt;.05). After controlling for these potential confounding factors and taking self-care as the reference, the probability of Chinese adults who participated in online browsing activities selecting hospital care was 0.82 (95% CI 0.69-0.98; <i>P</i>=.03) times that of residents who did not participate in online browsing activities. In terms of medical institution choices, adults who participated in online browsing activities were 1.86 (95% CI 1.35-2.58; <i>P</i>&lt;.001) times more likely to opt for municipal medical treatment than primary care. However, the effect of online browsing on the selection probability of county-level hospitals was not significant compared with primary hospitals (<i>P</i>=.59). Robust analysis verified that accessing the internet had a similar effect on Chinese adults’ medical decisions. CONCLUSIONS Chinese adults who use the internet are a little less likely to go to the hospital than self-care. The internet has broken down the barriers to obtain knowledge of common diseases and thus has a slight substitution effect of self-care on hospital care. Internet use may increase the probability of adults going to municipal hospitals. The rising tendency of visiting high-level medical institutions may be consequently exacerbated due to knowledge monopoly of severe and complicated diseases that is difficult to eliminate, and the increase in inconsistent and incomplete medical information online will blur the residents’ cognitive boundary of common diseases and severe diseases. Exploring the substantive impact of the internet on medical decision making is of great significance for further rational planning and utilization of the internet, in order to guide patients to appropriate medical institution.

scholarly journals Impact of the Internet on Medical Decisions of Chinese Adults: Longitudinal Data Analysis

10.2196/18481 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18481
Author(s):  
Qianqian Ma ◽  
Dongxu Sun ◽  
Fangfang Cui ◽  
Yunkai Zhai ◽  
Jie Zhao ◽  
...  
Keyword(s):  
Longitudinal Data ◽  
Medical Treatment ◽  
Hospital Care ◽  
Medical Information ◽  
Self Care ◽  
Medical Institution ◽  
The Internet ◽  
Chinese Adults ◽  
Medical Decisions ◽  
Common Diseases

Background The internet has caused the explosive growth of medical information and has greatly improved the availability of medical knowledge. This makes the internet one of the main ways for residents to obtain medical information and knowledge before seeking medical treatment. However, little has been researched on how the internet affects medical decisions. Objective The purpose of this study was to explore the associations between internet behaviors and medical decisions among Chinese adults aged 18 or over, including whether to go to the hospital and which level of medical institution to choose. Methods With the adult residents (≥18 years old) in 12 regions including urban and rural areas taken as the research objects, the differences in medical choices of adults with various characteristics were analyzed, and generalized linear mixed models were adopted to analyze the longitudinal data of the China Health Nutrition Survey from 2006 to 2015. Results Adult groups with different ages, genders, education levels, regions, places of residence, severities of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse medical decisions, and the differences were statistically significant (P<.05). After controlling for these potential confounding factors and taking self-care as the reference, the probability of Chinese adults who participated in online browsing activities selecting hospital care was 0.82 (95% CI 0.69-0.98; P=.03) times that of residents who did not participate in online browsing activities. In terms of medical institution choices, adults who participated in online browsing activities were 1.86 (95% CI 1.35-2.58; P<.001) times more likely to opt for municipal medical treatment than primary care. However, the effect of online browsing on the selection probability of county-level hospitals was not significant compared with primary hospitals (P=.59). Robust analysis verified that accessing the internet had a similar effect on Chinese adults’ medical decisions. Conclusions Chinese adults who use the internet are a little less likely to go to the hospital than self-care. The internet has broken down the barriers to obtain knowledge of common diseases and thus has a slight substitution effect of self-care on hospital care. Internet use may increase the probability of adults going to municipal hospitals. The rising tendency of visiting high-level medical institutions may be consequently exacerbated due to knowledge monopoly of severe and complicated diseases that is difficult to eliminate, and the increase in inconsistent and incomplete medical information online will blur the residents’ cognitive boundary of common diseases and severe diseases. Exploring the substantive impact of the internet on medical decision making is of great significance for further rational planning and utilization of the internet, in order to guide patients to appropriate medical institution.

scholarly journals Lifestyle Segmentation to Explain the Online Health Information–Seeking Behavior of Older Adults: Representative Telephone Survey

10.2196/15099 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15099 ◽  
Author(s):  
Winja Weber ◽  
Anne Reinhardt ◽  
Constanze Rossmann
Keyword(s):  
Older Adults ◽  
Health Information ◽  
Information Seeking ◽  
Internet Use ◽  
Information Seeking Behavior ◽  
The Internet ◽  
Online Health Information ◽  
Sociodemographic Variables ◽  
Seeking Behavior ◽  
Health Related

Background As a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information–seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context. Objective The aim of this study was to examine older people’s health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults’ internet use for health information. Methods A telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence. Results The results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes. Conclusions Our findings indicate that the internet still plays only a minor role in the health information–seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.

The Repercussion of the Internet on Psychological Wellbeing

2019 ◽  
pp. 101-117
Author(s):  
Shilpa Suresh Bisen ◽  
Yogesh Deshpande
Keyword(s):  
Mental Health Professionals ◽  
Internet Use ◽  
Positive Impact ◽  
Psychological Disorders ◽  
Theoretical Background ◽  
Online Gambling ◽  
Problematic Internet Use ◽  
The Internet ◽  
Human Beings ◽  
New Concepts

The internet is an essential and integral part of our lives, whether it's about looking for a meaning of a word, searching for a journal, shopping, or connecting to others. Human beings cannot think of life without the internet. Although it's having a positive impact, the negative side is there. Problematic internet use is defined as non-chemical or behavioral addictions, which involve human-machine interactions and can be harmful as it leads to numerous forms of psychological disorders. The chapter addresses various psychopathologies arising due to excessive internet use (e.g., problematic internet use, online gaming, online gambling, and compulsive cybersex). The chapter frames a strong theoretical background along with recent controversial issues related to the disorder. The chapter is delineated to acquaint readers with new concepts arising in clinical psychology that will help mental health professionals to be well equipped with skills required for the prevention and treatment of internet-related psychological disorders.

Internet Use among Older Adults

2013 ◽  
pp. 124-141 ◽  
Author(s):  
Yiwei Chen ◽  
Bob Lee ◽  
Robert M. Kirk
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Internet Use ◽  
The Internet ◽  
Emotional Needs ◽  
Cognitive Limitations ◽  
Selective Optimization With Compensation ◽  
Emotional Processes ◽  
Age Related

Older adults (65 and above) are the fastest growing population to use computers and the Internet in their everyday lives. The primary purpose of this chapter is to use a Lifespan Developmental Perspective to examine both the constraints and the opportunities of Internet use among older adults. Given age-related changes in physical, cognitive, and socio-emotional processes, older adults may encounter different constraints in Internet use from younger adults. The Selective Optimization with Compensation model is used to explore opportunities for older adults in using the Internet to improve quality of life. Future product designs and training programs should take into account older adults’ physical and cognitive limitations, as well as their socio-emotional needs. It is also recommended that social policies should help older adults overcome these constraints in order to reduce age-related digital divide and promote quality of life for older adults.

scholarly journals DOES CHANGE IN INTERNET USE PREDICT PSYCHOLOGICAL WELL-BEING AMONG OLDER ADULTS?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S326-S326
Author(s):  
Ronald W Berkowsky
Keyword(s):  
Older Adults ◽  
Personal Growth ◽  
Internet Use ◽  
Well Being ◽  
Future Research ◽  
The Internet ◽  
Psychological Well Being ◽  
Internet Users ◽  
Additional Control ◽  
The Relationship

Abstract Previous work focusing on the relationship between Internet use and quality of life among older adults (aged 65+) has found evidence of various positive impacts. This project expands upon this work by examining the relationship between Internet use and measures of psychological well-being (PWB) including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. The analytic sample is derived from two waves of data (Time 1 = 2004, Time 2 = 2011) taken from the Wisconsin Longitudinal Study and includes a sample of older adults aged~65 at Time 1 (N = 4943). Participants were separated into four categories: those who did not use the Internet at Time 1 or 2, those who used the Internet at Time 1 only, those who used the Internet at Time 2 only, and those who used the Internet at both Time 1 and 2. Regression analyses were performed with the Time 2 PWB measures as the outcomes and the Internet use categories as the primary predictors. Results indicate that while continuous Internet users typically reported higher PWB scores compared to non-users, those who stopped use between Time 1 and 2 also reported higher scores and those who started use between Time 1 and 2 reported lower scores. These results generally held when introducing Time 1 PWB measures as controls, suggesting changes in Internet use may affect PWB but not necessarily in the predicted directions. Additional control variables, potential explanations, and implications for future research are discussed.

scholarly journals INTERNET USE AND LONELINESS: CURE OR CAUSE? LONGITUDINAL ANALYSIS OF OLDER ADULTS’ INTERNET USE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S14-S14
Author(s):  
Elena Hees ◽  
Clemens Tesch-Römer ◽  
Oliver Huxhold
Keyword(s):  
Older Adults ◽  
Structural Equation ◽  
Internet Use ◽  
Age Groups ◽  
The Internet ◽  
Equation Modelling ◽  
Younger Age ◽  
Using Data ◽  
German Ageing Survey ◽  
Two Age Groups

Abstract The internet provides an indispensable platform for social interaction, entertainment and everyday tasks. Especially older adults might benefit from staying engaged online to counteract loneliness. Yet, current research on how internet use effects loneliness still paints a contradictory picture. The current study investigates the longitudinal influence of social internet use forms as opposed to general internet use on loneliness across three years (2014-2017) separately in two age groups (pre-retirement: 40-64 years and post-retirement: 65-85 years), using data from the German Ageing Survey (DEAS). Structural equation modelling shows, that general web use predicts an increase in loneliness in both age-groups. However, contacting friends and family online seems to protect against loneliness over and above the effect of overall internet use, at least for the younger age-group. Therefore, the current study underlines the importance of investigating what exactly people do online instead of seeing the internet as a homogenous tool.

scholarly journals Technology Adaptivity Mediates the Effect of Technology Biography on Internet Use Variability

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Alexander Seifert ◽  
Stefan T Kamin ◽  
Frieder R Lang
Keyword(s):  
Older Adults ◽  
Internet Use ◽  
Personal Characteristics ◽  
Positive Association ◽  
Subjective Health ◽  
Community Dwelling ◽  
Path Model ◽  
The Internet ◽  
Online Activities ◽  
Past Experiences

Abstract Background and Objectives Increasing numbers of older adults use the internet, but relatively little is known about the range and determinants of different online activities among older internet users. This study explores the interplay between technology-related biographical experiences and subjective technology adaptivity to explain the variability of internet use. Older adults who report having had more biographical experiences with technologies were expected to use a greater range of online activities. In addition, subjective technology adaptivity was expected to serve as a mediator of this relationship. Research Design and Methods The analyses are based on a sample of 707 community-dwelling older participants of the University of the Third Age between 60 and 95 years of age (mean age = 72.49 years; 48% female) who use the internet. The measures include self-reports of online activities, technology-related biographical experiences, subjective technology adaptivity, and personal characteristics (age, gender, education, income, living-together status, and subjective health). Correlations and a path model with mediator effects were used to explore the research hypothesis. Results The bivariate effects on the variability of internet use showed that study subjects participated in a greater range of online activities when they lived together with other people and were male, younger, and had higher levels of subjective technology adaptivity, technology-related biographical experiences, and educational level. The direct effects on the mediator show higher levels of subjective technology adaptivity for people who reported greater technology-related biographical experiences and for those who reported higher levels of subjective health. Discussion and Implications The results show that the positive association between people’s past experiences with and stances toward technology in their own lifetimes and their range of diverse internet activities is mediated by subjective technology adaptivity. The findings also help to illustrate which biographical factors and which current individual factors explain differences in actual online behavior.

The association between Internet use and health outcomes in the population of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Szulc ◽  
M Duplaga
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Health Services ◽  
Health Outcomes ◽  
Internet Use ◽  
Health Behaviours ◽  
The Internet ◽  
Internet Users ◽  
Health Related ◽  
The Impact

Abstract Background The Internet has become one of the primary sources of health-related information. Less is known about the impact of Internet access and use on health-related outcomes in the older population, which frequently suffer from a digital divide. The main objective of this study was the assessment of the associations between Internet use and variables reflecting health status, the use of health services and health behaviours in the population at least 50 years old. Methods The analysis was carried out on the data set from the telephone-based survey in a sample of 1000 respondents representative for targeted age strata of Polish society. The effects of Internet use were assessed with logistic regression models after adjusting for key socioeconomic variables. Results Mean age (standard deviation) of respondents was 64.2 (9.6). In the study group, 51.1% respondents were Internet users, 19.4% - persons with disabilities, 21.2% were hospitalised at least once, and 51.0% visited health care facilities at least six times in preceding 12 months. The respondents being Internet users less frequently reported chronic diseases (OR, 95%CI: 0.21, 0.16-0.30), disability status (0.52, 0.37-0.72) and higher self-assessed health status (1.64, 1.24-2.16). They also less often used health services in the preceding 12 months (0.77, 0.60-0.99. Internet use was not associated with hospital admission in the preceding year (1.04, 0.76-1.41) and most of the health behaviours (smoking: 1.06, 0.77-1.45, physical activity: 0.85, 0.63-1.15, the consumption of fruits and vegetables: 0.73, 0.50-1.07). Interestingly, Internet users drunk more alcohol (1.52, 1.14-2.02). Conclusions In the population of older adults, the use of the Internet is associated with variables reflecting health status and the utilisation of health services. Higher health status and lower prevalence of chronic conditions among Internet users were found after adjusting for age and other socioeconomic factors. Key messages It was shown that Internet use may be related with more favourable health outcomes. The reported association should trigger further research on the impact of Internet in elderly persons.

scholarly journals Internet Addiction among Undergraduate Students: Evidence from a Malaysian Public University

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Rosliza A.M. ◽  
Ragubathi M.N. ◽  
Mohamad Yusoff M.K.A ◽  
Shaharuddin M.S.
Keyword(s):  
Undergraduate Students ◽  
Internet Addiction ◽  
Social Life ◽  
Internet Use ◽  
Public University ◽  
The Internet ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Online Activity ◽  
Internet Users

Introduction: Internet addiction is an increasingly worrying phenomena affecting people globally especially the youths. This study aimed to determine the prevalence of internet addiction among undergraduate students in a Malaysian public university and its associated factors. Materials and Methods: A cross-sectional study involving 322 undergraduate students, identified through cluster sampling was conducted using a pretested, self-administered questionnaire. The questionnaire includes socio-demography, use of information technology gadgets and internet usage. Internet Addiction test (IAT) was used to identify internet addiction. Data was analysed using SPSS version 22. Results: From 322 respondents, 25 (7.8%) were categorised as addictive internet users, while 182 (56.5%) were problematic internet users. The commonest online activity includes social networking (86.6%), entertainment (77.3%) and educational purposes (77.0%). From multivariate analysis, problematic and addictive internet use was significantly more common among male students (AOR=2.47, 95% CI [1.43, 4.26]), those who received study loan (AOR=1.93, 95% CI [1.10, 3.39]) and other types of funding (AOR=3.95, 95% CI [1.59, 9.80]) compared to those on scholarships, and those who spent between four to ten hours a day accessing the Internet (AOR=2.43, 95% CI [1.13, 5.23]) compared to those using the Internet for two hours or less a day. Conclusion: The prevalence of problematic and addictive internet use among respondents were higher compared to previous researches among Malaysian adolescents. It is recommended that an awareness programme on responsible use of the internet be conducted to prevent students from becoming addicted which may impact negatively on their educational performance and social life.

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