|Year : 2015 | Volume
| Issue : 4 | Page : 160-164
Knowledge, attitude, and use of internet for medical information by patients attending specialist clinics in ABUTH Zaria-Nigeria
Abbas A Yusuf1, Aliyu A Alhaji2
1 Nigerian Army Reference Hospital, Kaduna, Nigeria
2 Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
|Date of Submission||16-Jan-2015|
|Date of Acceptance||03-Dec-2015|
|Date of Web Publication||22-Dec-2015|
Aliyu A Alhaji
Department of Community Medicine, Ahmadu Bello University, Zaria
Background: Internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information among patients have mainly been done in developed countries, and very few studies have been carried out in developing world. Objectives: These were to determine the percentage of patients attending specialist clinics that use Internet for health information, describe types of information sought and if patients share the information with their physicians. Materials and Methods: This was a cross-sectional descriptive study. Stratified sampling with equal allocation was done from four specialist clinics and respondents were then selected by simple random sampling. Results: One hundred and ninety-four respondents participated in the study. The mean age of respondents was 31.24 ± 1.0 years. Majority were computer-literate 135 (69.60%) and had tertiary education 108 (55.70%). Sources of access to Internet and search engines used were phone set 167 (86.10%) and Google 147 (75.90%). Types of information sought on the Internet were on disease condition 55 (39.86%) and drug treatment 22 (15.94%); majority of respondents found the information useful 125 (64%) and shared it with their physicians. Educational status and not the age of respondents was significantly associated with computer literacy and Internet use (x2 = 46.03, df = 5, P = 0.001). Conclusion: The study revealed that respondents are knowledgeable on the use of Internet, how to search for information and a high proportion of the patients use it. With increasing access to mobile phones, Internet users will continue to rise overtime and so will demand for seeking medical information. Practical Implications: Health care professionals must acknowledge the use of Internet by their patients in search for knowledge, be ready to discuss such information and provide reliable guide to useful health websites.
Keywords: Internet use, medical information, patients
|How to cite this article:|
Yusuf AA, Alhaji AA. Knowledge, attitude, and use of internet for medical information by patients attending specialist clinics in ABUTH Zaria-Nigeria. Sub-Saharan Afr J Med 2015;2:160-4
|How to cite this URL:|
Yusuf AA, Alhaji AA. Knowledge, attitude, and use of internet for medical information by patients attending specialist clinics in ABUTH Zaria-Nigeria. Sub-Saharan Afr J Med [serial online] 2015 [cited 2020 May 28];2:160-4. Available from: http://www.ssajm.org/text.asp?2015/2/4/160/172435
| Introduction|| |
In the last two decades, the use of mobile phones and thus Internet has grown exponentially all over the African continent. The use of Internet has not only become an easy access to this "global village," but most importantly it has become increasingly popular as a ready source of medical information as patients go online. Using the Internet provide both the health care providers and patients free access to an expanding volume of health information that was previously inaccessible. Globally, it has been reported that over one hundred million people use the Internet for healthcare information, health-related products and to communicate with health care providers. , Access to large amounts of medical information is available through an estimated 20,000-100,000 health-related websites. , Thus on any given day, more people go online for medical advice and or information than actually visit health professionals in the world.  The era in which physicians monopolize medical information and, therefore, determine physician-patients interactions are gone. The Internet has begun to play a critical role in health care by providing a large, early, easily accessible database of health information and enabling patients to take an active part in their own care and management. For patients, parents/guardians, relatives and/or close friends, especially in cases of newly diagnosed (life-threatening) diseases, electronic mailing lists, online support groups and websites devoted to their particular disease can provide valuable information and emotional support. ,,,
Studies in developed societies have shown that a good number of patients use the Internet to find information related to their disease or health-related condition. In the USA and Sydney, Australia, 43% and 64% of parents respectively use the Internet to seek health-related information about the conditions of their children. , Furthermore, 50% of patients attending a pain center hospital in the Netherlands and 43% of patients in a cancer care center in Canada used the Internet to seek health information related to their disease condition. , Thus, the access to information provided by the Internet is likely to improve consumers' sense of control as well as their ability to participate actively in health care decisions with potentially better psychological outcomes. ,, The use of keywords "Internet, health information and UK " generated well over 500 results while the same yielded very few results for Nigeria. Generally, even though, the information is available on the use of Internet for health information, few studies have specifically examined Internet use among patients ,,,, and to the best of our knowledge no study of its kind has been conducted in Northern Nigeria. The dearth of literature in this area in Africa in general and Nigeria, in particular, prompted this study. The objectives of this study were to determine the proportion of patients attending specialist clinics that use Internet for health information, describe types of information sought and determine if patients who use the Internet discuss and or share the information with their physicians.
| Materials And Methods|| |
This was a cross-sectional study of patients attending specialist clinics of ABUTH, Zaria-Nigeria.
This constituted respondents who were attending specialist clinics. The clinics were broadly grouped into the four clinical Departments of Medicine, Surgery, Obstetrics, and Gynecology and Pediatrics; a clinic was randomly selected by ballot from the list of specialist clinics from each department. The specialist clinics were respectively medicine (cardiology), surgery (gastroenterology), pediatrics (infectious diseases), and O and G (infertility).
Sample and Sample Size
The sample size was computed using the usual formula  for sample size determination. A total of 218 participants were recruited for the study and respondents were equally (54) selected from the specialist clinics randomly by balloting using the clinic register.
A pretested, structured, close-ended, and interviewer-administered questionnaire was used to collected data on knowledge, attitude, perception and Internet use for medical information among respondents. In Nigeria, generally, most hospitals do not have fixed appointment schedule with a specific time for patients to see specialist physicians. Thus, there is significant waiting time before consultation. Questionnaires were administered to study participants either before or after specialist consultations at each clinic as the schedule and convenience of the respondents permits. Data collected were checked for completeness and accuracy, cleaned, coded, and entered into computer software. Data were collected from January to June 2014 and were analyzed using IBM, SPSS version 20.0. Results were presented in tables along with the output of their analyses. Tests of associations were done and the level of significance for all analyses was a P = 0.05. Simple descriptive analysis was performed to compare Internet usage with age, sex, educational status, and clinic attendance among respondents.
Permission for the study was sought and obtained from Research and Ethics Committee of ABUTH and verbal informed consent from study participants who were assured of confidentiality of information collected.
| Results|| |
A total of 218 questionnaires were distributed, but only 194 were returned for analysis giving a response rate of 88.9%. Mean age of respondents was 31.24 ± 1.0 years. Majority were Muslim 134 (69.10%), computer-literate 135 (69.60%), civil servant 58 (29.90%) and had tertiary education 108 (55.70%), respectively [Table 1]. Sources of access to Internet and search engine used were respectively mobile phone set 167 (86.10%), modem 21 (10.30%), Google 147 (75.90%) and Yahoo 29 (14.90%) [Table 2]. Majority of respondents 98 (55.10%) accessed the Internet on a daily basis. Types of information sought on the net were on disease condition 55 (39.86%), diets 50 (36.23%), and drug treatments 22 (15.94%) [Table 3]. Majority of respondents 125 (64.00%) found the information useful and even share 107 (55.00%) it with their physicians. Problems associated with Internet use were slow connection 113 (58.20%), cost 22 (11.30%), and information overload 17 (8.80%) [Figure 1]. Educational status and not the age of respondents was significantly associated with computer literacy and Internet use (χ2 = 46.03, df = 5, P = 0.001). Respondents who were engaged in business 41 (21.13%) and civil servants 52 (26.80%) were noted to have greater access to the Internet than other occupations (P = 0.056).
|Table 2: Sources of access to Internet and search engine used by respondents |
Click here to view
| Discussion|| |
Health care delivery system is being transformed by advances in e-health and computer-literate public (that is ready to become an equal partner in it's own health). The Internet has obvious potential benefits to it's users. For patients, it can be an invaluable medium for detailed information on ill-health, disease and self-care or management and a constantly growing source of new information. , This is already changing and re-shaping patient-provider relationships and has strengthened communication between physicians and patients.  In this study, more than 50% of respondents reported Internet use on a daily basis which is consistent with previous studies where 78% and 77% reported Internet use in the previous month. , The reasons cited for using the Internet includes; disease condition (39.86%), dietary information (36.23%), and medications (15.9%), respectively. These reasons are not universal and varied between study settings and patients. A study  in Detroit, USA reported the following reasons: Information on specific medications, disease prevention and alternative therapies while another study in Saudi Arabia  reported; re-assurance and clarification, obtaining new information on new management schemes. On the other hand, rheumatology patients in a UK study  reported as follows; looking for relevant information, drug treatments, and alternative therapies. The implications of above findings was reported by McMullan that the Internet is used by the patients before the clinical encounter to seek information to manage the patients' own health care independently and/or decide whether they need professional help; however, after clinical encounter, it is done for re-assurance because of dissatisfaction with the information provided by the health professional.  Majority of respondents (64%) who used the Internet find the information useful and even shared it with their physicians, this was higher than 20% reported in an earlier study.  This is a positive attitude that will also encourage their doctors to be current and up to date to be able to address adequately questions that patients may raise during clinic visits. However, in another study, patients did not share the information with their doctors.  The reasons given why patients did not share the web information with physicians is that the doctors did not ask and or uncertain whether the doctor will entertain any such discussion. The effect of meeting the physician with information might be welcomed as long as the physician is well-informed and had adequate communication skills and did not appear threatened by the patient bringing in the information. However, as the use of Internet increases, it will become pertinent for physicians to identify patients who use the net and to understand how they use it as a source of medical information. The Internet has the potential to change critically the doctor-patient relationship in that it offers an opportunity for patients to increase their knowledge, become more informed and increase their involvement in their health care decision-making process. In this regard, physicians may best assist their patients by acknowledging patients' use of Internet and by serving as guides to help them navigate and find reliable and useful materials. Indeed as part of medical history, physicians should routinely enquire about their patients' use of the Internet to obtain medical information.  In this study, significant predictors to Internet use were; educational status and computer literacy. Respondents who were in business and civil servants have greater access to Internet than other occupations. This is consistent with report of an earlier study  in which education and income of patients were significantly associated with Internet use. This is not surprising, as education is crucial and a key determinant to health (access to information, health seeking behavior and income, etc.). Furthermore, as most information on health and health-related conditions are in English, understanding English language coupled with being computer-literate is a necessary ingredient for the respondents to be able to navigate in the web to search for and comprehend the information been sought.
| Conclusion|| |
This study revealed that study participants are knowledgeable on the use of Internet, how to search for information and a high proportion of the patients are Internet users. With increasing access to mobile phones, Internet users will continue to rise overtime and so will demand for seeking medical information. This is re-shaping doctor-patient relationship in health care decision-making process. Thus, physicians will need to be up to date and ready to face the challenges of Internet use by their patients and be ready to provide reliable guide to useful health websites.
Financial Support and Sponsorship
Conflicts of Interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]