Digital divide in health information across Korea, Japan and USA

JaeHee Jeong 부산대학교 2018 국내석사

이 연구의 목적은 전세계 건강정보격차에 대한 현황을 살펴보고, 한국, 일본, 미국의 사례를 중심으로 대안을 제시하고자 한다. 디지털 시대에 인터넷을 통해 날씨, 교육, 주식, 건강 등의 모든 정보를 이용할 수 있다. 하지만 이런 혜택을 누리지 못하는 집단이 발생하게 되었고 이를 정보격차라고 부른다. 건강격차의 여러 원인 중 하나는 바로 신뢰할 수 있는 건강정보에 대한 접근과 이를 뒷받침하는 네트워크 인프라의 문제에서 기인한다. 즉, 건강정보의 정보격차가 건강격차를 만드는 하나의 원인이다. 이 논문에서 실제 건강정보 격차가 존재하는지, 건강정보 격차의 원인은 무엇이고 어떻게 해결할 수 있는지 국제전기통신연합의 정보격차 지수를 이용하여 글로벌 레벨에서 살펴본다. 그리고 건강정보격차가 건강한 삶과의 영향관계를 살펴보기 위해 세계보건기구의 기대수명 지표로 ANOVA 분석을 통해 확인한다. 정보격차가 낮으면서 기대수명이 높은 한국, 일본, 미국의 사례를 분석한 결과, 이들은 정부차원에서 신뢰할 수 있는 건강정보유통을 위한 노력과 이를 명시한 건강증진법이 있었고 협회 혹은 병원과 같은 전문가들이 올바른 건강정보유통을 위한 노력을 찾아볼 수 있었다. 그리고 더 나아가 이 논문은 건강정보격차를 줄이고, 디지털 시대 공신력 있는 건강정보를 얻고, 건강증진을 추구하기 위해 디지털 리터러시, 헬스 리터러시 강화를 대안으로 제시한다. 키워드: 건강정보, 정보격차, 헬스 리터러시, 건강격차, 건강증진 The purpose of this paper is to examine the current states on the digital divide in health information, figure out the current problems, suggest recommendations. One of the reasons causing health disparities is the lack of health information in the context of the digital divide. Nowadays, Humans are easy to access to the internet able to get any information including health. But there must be someone who doesn’t get access information, which is called the digital divide. This paper wants to examine the reason of the digital divide in health information and figure out the solutions. This paper investigated the digital divide by ITU’s IDI worldwide. In order to examine the relationship between the digital divide in health information and healthy life, this paper analyzed the data based on the life expectancy using ANOVA. From the cases of Korea, Japan and USA where they have the low level of the digital divide, and the high level of health expectancy, the elements were revealed that they set a portal for health information in the national level and it is based on the policies of health promotion. Furthermore, associations or hospitals have performed a role of health information distribution in the private level. In the digital era, this paper wants to suggest digital literacy and health literacy in order to bridge the digital divide in health information, to get reliable health information, seek health promotion.

Geographical disparities in health information competence and behaviors in Korea

서혜연 Graduate School, Yonsei University 2019 국내석사

Access to health information that affects one’s health competence and behavior is vulnerable in some regions, which may lead to a low level of health status. Even though South Korean has been developed in health care system, there is still a long way to reduce social and geographical disparities in one nation. This study attempted to discover whether geographical disparities in health information competence and health behaviors still exist. Analyses of covariance were conducted to examine whether health information competence and behaviors were differed by region. The results showed that geographic location significantly affects individual health information competence such as health literacy, health information self-efficacy, and online health information self-efficacy. The present study also revealed that geographic location significantly affects individual health information behaviors. In addition to geographical factors, education and age appear to be prominent indicators of acquiring health information.

A Randomized Study on the Effectiveness of the Geo-visualized Health Information of Air Pollution

정소화 서울대학교 대학원 2019 국내석사

2013년부터 대기오염 위험에 관한 기사가 쏟아지기 시작했으며 대기 오염의 건강 위험에 대한 우려 또한 증가하였다. 시민들의 우려가 증가하면서 정부의 위험 커뮤니케이션의 중요성이 부각되었다. 본 연구에서는 효과적인 위험 소통을 위한 효율적인 의사 소통 수단으로 잘 알려진 시각화에 초점을 맞추어 위험 소통 측면에서 대기 오염으로 인한 건강 정보의 시각화 효과를 확인하고자 한다. 179명이 참여한 2×3형태의 무작위 배정 연구이다. 건강 정보 제공 여부와 텍스트, 인포그래픽, 맞춤형 3가지 모델에 따른 결과(정보의 유용성, 쉬운이해정도, 정보탐색 동기 정도, 대처 실천 정도, 위험 심각성 인지 정도, 주관적 위험 인지 정도)를 확인할 것이다. 순위형 자료를 이용한 2요인 분석방법(two-way ordinal analysis)으로 분석하였다. 정보의 유용성, 쉬운이해정도, 정보탐색 동기 정도, 대처 실천 정도, 주관적 위험 인지 정도에서 모델별로 유의한 차이가 나타났다. 유용성, 심각성, 위험 심각성인지, 예방 동기 측면에서, 건강 정보 제공에 따라 모델별로 유의한 차이가 있었다. 하지만, 모델과 건강 정보 제공 유무에 따른 인터렉션 효과는 나타나지 않았다. 본 연구는 정보의 유용성, 쉬운이해정도, 정보탐색 동기정도, 대처실천정도, 위험심각성 인지, 주관적 위험인지 정도에 대한 응답을 통해 대기오염으로인한 건강정보를 지도시각화한 효과를 확인하였다. 또한 건강 정보 제공 유무에 따른 효과를 확인하였다. 본 연구는 무작위배정의 강점을 가지고 있지만, 실험적 연구이기 대문에 내적 타당성의 한계가 있다. 또한 주관적 측정방법인 설문 연구를 수행하여 객관적 측정 지표가 아니라는 한계가 있으므로 시선추적(eye-tracking)과 같은 객관적인 측정방법을 사용한 연구가 필요하다. 하지만, 본 연구를 통해 시각화 또는 맞춤형 자료일수록, 건강정보를 포함할 수록 위험소통에 효과적임을 알 수 있었다. 위험소통시 정보전달에 시각화와 맞춤화를 사용한다면 유용성, 정보탐색 동기정도, 위험 심각성 인지, 대처실천 동기 정도를 효과적으로 높일 수 있을 것이다. 또한 위험소통에 건강 정보를 포함한다면, 위험에 대한 심각성, 위험 인지, 대처 실천 정도가 증가할 것이다. 하지만, 더욱 효과적인 건강정보의 리터러시 향상 측면에서, 상세한 시각화, 맞춤화 방법과 건강 정보 표현, 제공 방법에 대한 논의가 필요하다. From 2013, as the articles about the risk of air pollution have been flooded, the concerns on the health risk of air pollution have been increasing. As rises the worrying, the importance of the government’s risk communication arises, too. In this study, we identified the effectiveness of visualized health information on air pollution, which is well-known as an effective way of communication to efficient communication. It is Randomized study with 179 participants. It is 2 × 3 study design with two steps: first is the availability of the information about health information, second is model: text, infographic, tailored. We analyzed the outcome with two-way ordinal analysis with CLM. In usefulness, ease, motivation to search for information, the severity of the risk, and motivation for taking action of prevention, there is a significant difference by models. In the severity of the risk, perception of the risk, and the motivation for taking action of prevention, there is a significant difference by the availability of health information. However, there is no interaction effect by model and availability of health information in all questions. Through the scores of the usefulness of information, ease of information, motivation to search for the information, the severity of the risk, perception of the risk, and motivation for taking action of prevention, this study explored to find out the effectiveness of the geo-visualized health information of air pollution, also, the effectiveness of the availability of health information. This explorative study has a strength of randomized comparison and tried to minimize the biases (e.g., allocation, confounding), but there is a limitation of internal validity. Also, this study has a limitation in objectives because of using the questionnaire. The questionnaire is a subjective measuring tool, so there is a need to study in an objective approach like eye-tracking. Through this study, we could identify that it is the more visualized or tailored (personalized) or including the health information, it is more effective in risk communication. If using the visualized or the tailored (personalized) method to risk communication, then communicate more efficient in usefulness, motivating to search for information, risk severity, motivating for taking action of prevention. If using the health information in risk communication, then the severity of the risk, the perception of the risk, and the motivation for taking action of prevention are increasing. However, for improving the literacy of health information, details of visualization or personalization methods, and the way of providing the health information (for example, using the plain words) are needs more discussion to apply in practice.

(A) study on the source and truthfulness of user-generated content of health information on social media : a case for colorectal cancer on twitter

박소현 서울대학교 융합과학기술대학원 2015 국내석사

In this tech-savvy era, people consult their well-being to Dr. Google and hashtags (#). They can almost self-diagnose themselves using a search engine, and micro-posts on Twitter can predict influenza outbreaks. If any misinformation is found in this vein, its impact can be fatal. This necessitates an in-depth analysis of consumer health information online, with a particular focus on its quality. This study analyzes the source and truthfulness of user-generated content of health information on Twitter, one of the most popular social networking services since its inception in 2006. Particularly, it explores who says what on Twitter about colorectal cancer, the third leading cause of cancer deaths worldwide. Using Twitter’s Public Streaming API, all tweets containing colorectal cancer-related keywords were collected from August 1st, 2014 to October 31st, 2014. The tweets were classified by their content and user, and the quality of informative content was assessed. Notable findings of this study include: 1) the tweets included approximately twice more informative content (65.20%) than communicative content; 2) a significant number of tweets (90.62%) were written by individual users; 3) though smaller in tweet count, organizations showed a tendency to tweet information more; 4) most tweets (73.40%) included URLs to external websites such as news articles and medical information resources; and finally 5) sampled informative tweets were mostly medically correct information (84.52%), reviewed by board-certified physicians. This study makes the following contributions. First, it has quantitatively analyzed the content and source of colorectal cancer information delivered on Twitter, with a focus on assessing its quality. Second, it has shown that Twitter can potentially aid social health information seeking, narrowing the gap between doctors and patients. Third, this study has suggested that more popular retweets may filter medically correct information, hinting a possibility for collective intelligence in information sharing on Twitter. Yet one needs much caution subscribing to health information online, as its quality is hard to assess without a trained eye. Lastly, this study has confirmed the need for future system features to be equipped with a sanity check on the quality of any health information. In sum, this study concludes that using Twitter for seeking and sharing health information is both an opportunity and a risk. While a well-structured piece of health information in tweets may foster better informed public, it is often vague whether tweets, limited to 140 characters, are telling accurate, up-to-date health information. Future research opportunities are bountiful, such as detecting fraud in health information and automatically identifying information sources.

한국 거주 이민자의 건강정보 이용 현황

장선미 서울대학교 대학원 2013 국내석사

Purpose: Health information is essential to live a healthy life. Racial and ethnic disparities are well known in healthcare and occur when using health information. How immigrants use health information is unknown in Korea. Thus, in this paper, the use of health information by immigrants in Korea and the effect factors that could influence the use of health information were examined. Methods: A survey tool was developed based on the Andersen Behavioral Health Model. The use of health information and the effect factors were explained by using 3 factors: the predisposition factors, enabling factors and needs factors. The questionnaire was served in four languages including Korean, English, Mongolian and Vietnamese. The survey was conducted in clinics that give free medical services to immigrants, and 170 adult immigrants from 19 nations participated in total. Data was analyzed by correlation analysis and regression analysis. Results: The results of the correlation analysis between the sufficient use of health information and the three factors showed that the highest correlation was found in the education level of the predisposition factors, health information capacity of the enabling factors and health status of the needs factors. These variables were designated as representative variables for each factor. Regression analysis showed that the needs factor did not have a significant effect on the sufficient use of health information but that the predisposition and enabling factors had a significant main effect on the sufficient use of health information. Among the predictors, the enabling factor had the strongest effect on the sufficient use of health information. The predisposition factor did not have a significant effect on the needs factor; however, the enabling factor had a significant effect on the needs factor. The predisposition factor had a significant effect on the enabling factor. Conclusion: In this study, the predisposition and enabling factors significantly affected the sufficient use of health information by immigrants living in Korea. Thus, concern and focus on increasing enabling factors are needed to improve the sufficient use of health information. Furthermore, social supports and policies are important to access health information easily and for its sufficient use.

Effect of Online Health Information Quality on Consumers’ Health Literacy and Health Behavioral Intention

박유진 서울대학교 대학원 2022 국내박사

요근래 유튜브는 건강정보 공유 플랫폼으로서의 역할을 톡톡히 하고 있다. 유튜브를 통해 소비자들은 의료정보와 건강 상식들을 손쉽게 접하며 건강 문해력을 높이는 기회가 될 수도 있지만, 이와 동시에 정보의 질과 정확도 문제가 꾸준히 지적되고 있다. 건강정보의 질적 이슈는 소비자의 건강과 직결되는 중요한 문제인 만큼, 의료 전문가의 질 평가를 통해 정보의 신뢰도를 검증하고, 온라인 건강정보가 소비자의 건강 행동에 긍정적인 영향을 미칠 수 있도록 노력이 필요하다. 본 연구의 목적은 현재 유통되고 있는 건강정보 유튜브 영상의 질을 점검하고, 질 평가된 건강정보 유튜브가 소비자의 건강 문해력 향상 정도와 건강 행동 의도에 미치는 영향을 파악하고자 함에 있다. 이를 확인하기 위한 본 연구의 연구 가설은 다음과 같다. 첫째, 전문가에게 높은 질 평가를 받은 건강정보는 소비자의 건강 문해력을 향상시킬 것이다. 둘째, 전문가에게 높은 질 평가를 받은 건강정보는 소비자의 건강 행동 의도를 향상시킬 것이다. 셋째, 전문가에게 높은 질 평가를 받은 건강정보에 대한 소비자의 신뢰도는 건강 행동 의도에 긍정적인 영향을 미칠 것이다. 연구 가설 검증을 위해 본 연구에서는 총 2 단계 실험이 진행되었다. 1단계에서는, GQS와 DISCERN 질 평가 도구를 이용하여 유튜브 건강정보 영상에 대한 전문가 질 평가를 실시하였다. GQS 평가를 기반으로 건강검진-eGFR 결과 해석에 관한 영상 20개와 만성 장 질환에 관한 영상 20개를 선별하였다. 총 영상 40개에 대한 간호사 62인의 DISCERN 질 평가가 시행되었고, 영상의 길이에 따라 간호사 1인 당 1~3개의 영상을 배정하여 한 영상 당 총 3번의 평가가 이루어질 수 있도록 조정하였다. 2단계에서는, 건강검진-eGFR 결과 해석 분야에서 가장 높은 DISCERN 평가를 받은 영상 시청 그룹 (Group 1-1, 127명), 건강검진-eGFR 결과 해석 분야에서 가장 낮은 DISCERN 평가를 받은 영상 시청 그룹 (Group 1-2, 125명), 만성 장 질환 분야에서 가장 높은 DISCERN 평가를 받은 영상 시청 그룹 (Group 2-1, 128명), 만성 장 질환 분야에서 가장 낮은 DISCERN 평가를 받은 영상 시청 그룹 (Group 2-2, 125명) 총 네 실험 그룹 (505명)을 설정하였으며, 실험은 온라인 서베이 형식으로 진행되었다. 네 그룹 중 한 실험 그룹에 무작위 배정된 피실험자들은 각 그룹에 할당된 영상을 시청하기 전 건강 문해력을 측정한 후 건강 행동 의도에 대해 응답하였고, 영상을 시청한 후 해당 영상에 대한 신뢰도 및 건강 문해력과 건강 행동 의도에 대해 다시 측정 및 응답하는 순서로 실험이 진행되었다. 연구 결과는 다음과 같다. 첫째, 높은 전문가 질 평가를 받은 건강정보는 소비자의 건강 문해력을 향상시켰다. 전문가에게 가장 높은 질 평가를 받은 영상을 시청한 Group 1-1, 2-1 두 그룹의 건강 문해력은 영상을 시청하기 전 35.30 ± 5.45, 35.62 ± 5.32 에서 영상을 시청한 후 40.22 ± 5.13, 39.38 ± 4.44 로 향상되었다. 그룹 내 영상 시청 전후 차이 비교를 위해 실시한 대응 표본 t 검정 결과, 전문가에게 높은 질 평가를 받은 영상을 시청한 두 그룹인 Group 1-1 (t=-10.539, p<0.0001), Group 2-1 (t=-7.973, p<0.0001) 모두 유의수준 p<0.0001 으로 통계적으로 유의한 차이가 있는 것으로 나타났다. 또한 시청한 영상에 따라 건강 문해력에 차이가 생기는지 알아보기 위해 실시한 독립 표본 t 검정 결과, 건강검진에서의 eGFR 검사 결과 해석 관련 영상을 시청한 실험 그룹인 Group 1-1, 1-2는 영상 시청 전 그룹 간 건강 문해력에 차이가 없었으나 (t=0.279, p=0.439), 영상 시청 후 그룹 간 차이가 생겼다 (t=7.634, p<0.0001). 만성 장 질환 관련 영상을 시청한 실험 그룹인 Group 2-1, 2-2 또한 영상 시청 전 그룹 간 건강 문해력에 차이가 없었으나 (t=-0.228, p=0.819), 영상 시청 후 그룹 간 차이가 생겼다 (t=6.355, p<0.0001). 둘째, 매개변수 회귀분석 결과, 전문가 질 평가를 받은 건강정보에 대한 소비자의 신뢰도는 건강 행동 의도에 긍정적인 영향을 미치는 것으로 나타났다. 이 때, 건강 문해력의 향상 정도가 부분 매개 효과를 가졌다. 즉, 소비자의 건강정보에 대한 신뢰도가 높을수록 건강 문해력 향상 정도와 건강 행동 의도가 높아지며, 이 때 건강 문해력 향상 정도가 높을수록 건강 행동 의도가 높아지는 것으로 나타났다. 본 연구는 전문가 질 평가된 온라인 건강정보가 소비자의 건강 문해력 및 향후 건강 행동 의도에 미치는 영향을 살펴본 거의 유일한 연구이다. 기존 연구들은 온라인 건강정보에 대한 질 평가 및 평가 결과 해석에 집중하였다면, 본 연구는 더 나아가 전문가에게 질적 검증을 받은 건강정보가 실제로 의료정보 소비자의 건강 문해력 및 향후 건강 행동 의도에 영향을 주는지 평가하여 그 인과관계를 밝혔다는 점에서 의의가 있다. 객관적인 도구로 질 평가한 건강정보를 제공하여 소비자들이 양질의 건강정보를 습득하고 건강 문해력 향상 및 자신의 건강 행동에 긍정적인 영향을 미칠 수 있는 환경을 꾸준히 마련할 필요가 있다. YouTube serves as a major health information-sharing platform these days. Consumers can easily access medical knowledge and health information on the site; thus, YouTube provides the opportunity to improve one’s health literacy. However, the quality and reliability of YouTube health information has been constantly debated. Quality of health information may be directly related to the health of consumers; therefore, efforts should be made to verify the reliability of health information through quality evaluation by medical professionals so that online health information can positively influence consumer health literacy and health behavior. The purpose of this study was to examine the quality of health information on YouTube videos and to identify its effect on the level of improvement in consumer health literacy and health behavioral intention. The study hypotheses were as follows: First, health information that has been evaluated as being of high quality by medical professionals will aid in improving consumer health literacy. Second, health information that has been evaluated as being of high quality by medical professionals will aid in improving consumer health behavioral intention. Third, the reliability of the consumer health information and the improvement of consumer health literacy will have a positive effect on health behavioral intention. A two-step experimental design was used to verify the study hypotheses. In the first step, a quality evaluation of YouTube health information videos was conducted using the Global Quality Scale and DISCERN evaluation. Based on the Global Quality Scale score, 20 videos on interpreting estimated glomerular filtration rate (eGFR) test results from health checkups and 20 videos on IBD were selected. The DISCERN quality evaluation of the 40 videos was performed by 62 nurses. One to three videos were assigned to each nurse according to video length; therefore, a total of three evaluations were made per video. In the second step, four groups were organized as follows: The first group watched the highest DISCERN evaluated video on interpreting eGFR test results of a health checkup (Group 1-1). The second group watched the lowest DISCERN evaluated video on interpreting eGFR test results of a health checkup (Group 1-2). The third group watched the highest DISCERN evaluated video on IBD (Group 2-1). The fourth group watched the lowest DISCERN evaluated video on IBD (Group 2-2). A total of 505 participants were randomly assigned to one of the four groups and were administered the eHealth Literacy Scale and a health behavioral intention assessment, before watching the videos assigned to each group. After watching the videos, they were administered the eHealth Literacy Scale and health behavioral intention assessment again, and also completed a health information reliability questionnaire. The results were as follows: First, health literacy was improved in both Groups 1-1 and 2-1 (those with the highest quality evaluation) from 35.30 ± 5.45 and 35.62 ± 5.32 to 40.22 ± 5.13 and 39.38 ± 4.44, respectively, after watching the videos. Paired t-tests were conducted to measure the change within the groups, and it was found that both Groups 1-1 (t = -10.539, p < 0.0001) and 2-1 (t = -7.973, p < 0.0001) had a statistically significant difference. In addition, the results of independent sample t-tests showed that there were no health literacy differences before watching the videos (Group 1: t = 0.279, p = 0.781 and Group 2: t = -0.228, p = 0.819); however, statistically significant differences were found after watching the videos (Group 1: t = 7.634, p < 0.0001 and Group 2: t = 6.355, p < 0.0001). Second, through mediator variable regression, it was found that health information reliability determined by expert quality evaluation had a positive effect on health behavioral intention. The improved health literacy had a partial mediating effect. In other words, the higher the health information reliability, the higher the improvement in health literacy and health behavioral intention. Moreover, the higher the improvement in health literacy, the better the health behavioral intention. This study is one of the few to examine the effect of expert quality evaluation of online health information on consumer health literacy and their future health behavior. While existing studies have focused mainly on evaluating and interpreting the quality of online health information, this study is noteworthy in that it further assesses whether the health information verified by medical professionals truly affects consumer health literacy and health behavioral intentions. It is necessary to continuously provide opportunities and platforms for health information consumers to access high-quality health information that can have a decisive effect on their health.

만성질환 유무에 따른 인터넷 건강정보 이용행태 및 관련요인 비교 : 고혈압.당뇨를 중심으로

이현주 고려대학교 보건대학원 2005 국내석사

연구배경 및 목적 : 인터넷 건강정보란 보건의료서비스 제공자, 보험자, 관련 기관 및 산업체, 개인 등이 전문적인 지식에서부터 건강증진 및 질병예방, 질병관리, 관련기관 등에 대한 단순정보까지 인터넷을 통하여 제공하는 정보를 말한다. 인터넷이 대중화되면서 소비자들은 의료정보를 손쉽게 얻을 수 있게 되었고 다양한 내용을 요구하고 있으며 기존의 환자-의사관계를 바꿀 만큼 영향력이 커지고 있다. 그러나 아직 인터넷 건강정보 이용에 대한 계량적 연구성과는 적다. 본 연구는 고혈압, 당뇨 등의 만성 질환자와 비질환자들에서 인터넷 건강정보 이용행태와 관련요인을 파악하였다. 연구방법 : 서울의 2,200병상 규모의 종합병원 건강증진센터에서 2004년 8월 20일부터 9월 24일까지 내원하여 건강검진을 받은 수진자를 연구대상으로 하였다. 설문은 선행 연구와 건강정보사이트를 조사하여 선정한 항목으로 구조화시킨 후 예비조사를 통하여 완성하였다. 최종설문에는 인터넷 이용특성 9문항, 인터넷 건강정보 이용관련 17문항, 질병과 개인특성 11항목 등이 포함되었다. 문진표를 이용하여 고혈압과 당뇨가 있는 환자를 만성질환자로 구분하였고, 아무런 만성질환도 없는 사람을 비질환자로 하였다. 연구결과 : 비질환자 312명 중 남성은 68.3%이었고 고혈압ㆍ당뇨가 있는 환자 77명 중 남성이 83.1%이었다(p=0.01). 환자군의 평균 연령은 49.5±7.5세로 비질환자의 40.2±9.0보다 높았다(p<0.001). 건강정보의 주된 습득경로로 인터넷을 꼽은 비율은 21.3%와 22.8%로 유사하였으나, 주로 이용하는 인터넷 정보로 건강/의학정보를 선택한 비율은 환자군에서 24.7%로 비질환자의 10.3%보다 높았다(p=0.009). 이용하는 건강정보는 의료기관이 제일 많았으며 제공된 건강정보 내용에 대한 만족도에서 5점 만점에 약품정보, 커뮤니티, e-mail 건강상담, 구매정보 등에서는 3점 미만이었다. 의료진과 e-mail 소통경험은 환자군에서 5.3%로 적었으나 e-mail을 통한 상담을 제공하는 의료진으로 교체할 의향이 있는가에 대해서 70.2%가 그렇다고 응답하였으며, 의료진이나 기관선택 시 인터넷 정보가 영향을 주는가에 대하여도 54.6%가 그렇다고 응답하였다. 결론 : 환자와 소비자들의 인터넷을 통한 건강의료정보의 수요, 특히 쌍방향 의사 소통의 요구가 높고, 의료이용에도 영향을 주고 있으나, 제공되는 정보의 만족도는 낮았다. Background and purpose : Internet health information means the professional and general knowledge, and the information on the health development, prevention and management of disease, and related medical institution which are provided through the internet by the health and medical service team, insurers, related institutions, industrial organizations and individuals. With the popularization of the internet, consumers can easily acquire medical information and the influence of internet power is growing. The internet has even changed the relationship between doctors and patients as consumers are demanding more information. However, no in-depth study about health information acquisition by internet has been conducted yet. The study participants were patients with chronic disease, such as high blood pressure and diabetes, and healthy controls. I focused on their internet information using behavior type and factors relevant to the subjects. Method : The subject group was the people who had undergone a health check in the health development centers in general hospitals (2200 beds) in Seoul during Aug. 20th to Sep. 24th, 2004. A questionnaire was made by selecting items from prior studies and the health related sites on the internet, as completed by a pilot test. The final questionnaire included 9 questions of internet use pattern, 17 of health information obtained through the internet, and 11 of disease and characteristics of the individual. The subject group was classified by questionnaire into the patient group who had high blood pressure and diabetes and the non-patient group who had no chronic disease. Results : The men''s rate of internet usage was 68.3% out of 321 in the non-patient group and 83.1% out of 77 in the high blood pressure and diabetes group(p=0.01). The mean age of the patient group was 49.57.5 years, which was higher than the non-patient group of 40.29.0 years(p<0.001). A similar rate of 21.3% out of the patient group and 22.8% out of the non-patient group answered that their major acquisition channel of health information was the internet. However, the major search theme through the internet was for medical information at 24.7% in the patient group compared to 10.3% in the non-patient group(p=0.009). The major channel of medical information was from medical institutions and the level of satisfaction at the contents of the health information, such as medicine, communities, health counseling by e-mail and purchasing route, was under 60%. The ratio of subjects who had been in e-mail communication with medical personnel was 5.3% in the patient group. Nevertheless, 70.2% answered that they wanted to substitute the present medical personnel with medical personnel who are able to provide a counseling service with e-mail. The rate of subjects who were positive about the influence of internet power for selecting medical personnel and medical institution was 54.6%. Conclusion : The demand by patients and consumers to be able to obtain health information through the internet, especially the demand for multi communication, is rising. However, the degree of satisfaction in the medical information and its value was low.

Why Does Health Information Acquisition Increase Physician Visits? : The Role of Hypochondriasis

석인희 서울대학교 대학원 2018 국내석사

Hypochondriasis refers to the overwhelming fear of having a serious illness despite the absence of an actual medical condition. Hypochondriasis is also considered as a health anxiety. Hypochondriasis in South Korea is of particular concern in public health due to general population’s high consciousness in health. However, compared to Western countries, a few studies have addressed hypochondriasis in South Korea. This study focused on health information acquisition as one cause of hypochondriasis. In the information age, people often obtain health information not only from online sources but also from different information sources (television, print media, interpersonal communication). If people whom acquire health information are more likely to be concerned about their health status, then the relationship between health information acquisition and hypochondriasis should be examined. The effects of health information acquisition from the internet on hypochondriasis have been well studied, but the effects of health information acquisition from various information sources on hypochondriasis have been under researched. Thus, this study aimed to answer the following question: Does health information acquired through various information sources influence hypochondriasis? Furthermore, understanding both health information acquisition and hypochondriasis is imperative because they are both correlated with medical costs. Due to the fact that the health information acquired from non-physician sources is uncertain, it may increase the frequency of physician visits. Also, hypochondriasis is one of the main causes of increased medical costs worldwide. Therefore, this study is aimed to empirically test the relationships among health information acquisition, hypochondriasis, and physician visits by conducting a nationally representative survey in South Korea. South Korean population between 19 and 59 years of age participated in a two-wave longitudinal survey (N = 2,000 at Wave 1 and N = 1,300 at Wave 2). The results indicated that health information acquisition at Wave 1 predicted hypochondriasis at Wave 1, which in turn increased physician visits at Wave 2, after controlling for Wave 1 physician visits and other potential confounders. This result suggested that people who acquire health information from numerous information sources are more likely to suffer from hypochondriasis, which results in increased physician visits. Also, hypochondriasis is a mediator of the relationship between health information acquisition and physician visits.

진료정보 공동활용에 대한 의사들의 참여의사 및 필요성 인식도에 관한 연구

임수연 연세대학교 보건대학원 2003 국내석사

최근 의료분야 정보화 진행과 인터넷 확산에 따라 의료비용절감 및 진료의 질 향상을 도모하기 위하여 진료정보 공동활용의 필요성이 대두되고 있다. 이 연구는 각 의료기관의 진료정보 공동활용 현황 및 진료정보 공동활용에 대한 참여의사와 필요성에 대한 분석을 통해 진료정보 공동활용을 위한 기반조성 및 활성화 방안 구축을 목적으로 수행되었다. 분석결과는 다음과 같다. 첫째, 의료기관별 정보화 수준은 매우 다양하며 종합전문요양기관, 대규모 종합병원은 정보화 수준이 높은 편이며, 중소규모 병원의 정보화 수준이 상당히 낮은 것으로 나타났다. 대다수 의료기관에서 원무업무, 보험청구, 행정업무, 약제업무, 미수금관리, 외래 OCS 등의 순으로 전산화가 이루어지고 있었으며, 진료정보 공동활용이 되기 위한 전제조건이라 할 수 있는 전자의무기록(Electronic Medical Record: EMR)을 도입한 의료기관은 전체의 7.2%에 불과한 낮은 수준이었으나, 의료영상 저장 및 전달시스템(Picture Archiving & Communicating System: PACS)의 도입은 전체 의료기관의 43.2% 수준으로 2000년도 한국보건산업진흥원에서 조사한 자료인 6.9%와 비교하면 월등히 증가되었음을 알 수 있었다. 둘째, 타 의료기관의 진료정보 공동활용시 정보확보방법으로 환자에게 직접 요청하는 경우가 응답자의 과반수 이상이었으며, 진료정보 공유 방법으로는 대부분은 인편으로 문서의 전달과 회신이 이루어짐을 알 수 있었다. 그러나 향후 진료정보 공동활용시 사용방법으로는 인터넷상의 진료의뢰시스템, 인쇄된 문서의 교환, E-mail 순으로 선호함이 나타났다. 셋째, 진료정보 공동활용에 대한 참여의사에 대해 일반적 특성, 정보화 특성과 상관없이 97.6%가 참여의사를 보이고 있었다. 또한 의사들이 생각하고 있는 진료정보 공동활용을 위해서는 용어·서식·코드 등의 표준화 문제가 우선적으로 선결되어야 할 문제라고 응답하였다. 넷째, 향후 진료정보 공동활용시 사용방법으로 종합전문요양기관, 종합병원급에서는 인터넷상의 진료의뢰시스템이 가장 바람직한 방법이라고 응답하였으나 병원급에서는 인쇄된 문서의 교환이 향후 진료정보 공동활용시 바람직한 방법이라고 응답하였다. 다섯째, PACS 공동활용망 등록에 대한 의견에서는 PACS의 도입율이 높은 종합전문요양기관, 종합병원급에서는 병원급보다는 긍정적으로 생각하고 있었다. 여섯째, 진료정보 공동활용 필요성에 대한 인식도에 영향을 미치는 요인을 알아보기 위해 로지스틱 회귀분석을 시행한 결과, 진료의뢰서 및 소견서의 수정 필요성을 인식하는 의사가, 그렇지 않은 의사보다 진료정보 공동활용 필요성을 인식하는 경우가 3.409배 높게 나타났다. 이와 같은 진료정보 공동활용의 수용가능성을 토대로 다음과 같은 활성화 방안을 제시하고자 한다. 첫째, 전자의무기록 도입 등 병원내부 정보화를 위한 추가적인 인력, 시간, 비용 등의 투입이 예상되므로 정부의 적극적인 지원이 마련되어야 한다. 둘째, 의료기관간 정보 제공시 수가를 인정해 주는 등의 인센티브제도를 도입하여야 한다. 셋째, 만성질환의 체계적인 관리를 위한 진료정보 공동활용은 1차 진료가 이루어지는 병원급을 중심으로 활성화가 되어야 한다. 넷째, 진료정보 공동활용의 성공적인 추진을 위하여 국가적인 차원의 용어·서식·코드의 표준화가 선결되어야 한다. 마지막으로 프라이버시 원칙 등 보안시스템 적용에 대한 지침 설정 및 정보의 신뢰성 확보와 의료정보의 안전성을 보장하기 위한 공인 인증센터의 활용을 제언하는 바이다. Recently, the importance of sharing health information, as means to lower medical expenses and enhance the quality of medical examinations, is emerging with informatization of the medical sector and rapid spread of the Internet. The purpose of this study is to lay the foundation for sharing health information and come up with measures to promote it by examining the current state of health information sharing among medical institutions as well as analyzing doctors' willingness to participate and their perception of health information sharing. The results are as follows; First, the level of informatization amongst medical institutions varied. The tertiary hospitals and large-scale general hospitals showed high level of informatization, while the level of informatization was lower in smaller hospitals. In the majority of medical institutions, operations were being computerized in the order of hospital affairs, insurance claims, administration, pharmaceuticals, management of receivable accounts, and outpatient OCS, etc. Second, when asked how hospitals obtained health information of other medical institutions, more than half replied that they requested it directly from the patient, so it can be seen that most of the information was shared through the transfer of documents by people. However, in the future, health information is expected to be shared through the internet medical referral systems, exchange of printable documents, or e-mails. Third, when doctors were asked whether they would be willing to share health information, 97.6% showed a willingness to participate, regardless of the respondents' general characteristics or level of informatization of the institutions. Doctors also replied that standardization of terminology, format and code must be achieved firstly for health information to be shared efficiently. Fourth, when sharing health information in the future, the internet medical referral systems would be most appropriate for the tertiary hospitals and large general hospitals, while the exchange of printable documents would be most suitable for smaller hospitals. Fifth, general hospitals and specialized sanitariums, which are more likely to adopt PACS, responded more positively to the PACS information network than smaller hospitals. Sixth, a logistic regression analysis was used to analyze what factors affect doctors' perceptions of health information sharing. The results showed that 3.409 times doctors, who recognized the need to make revisions in referral form, replied that there was a need to share health information, than doctors who did not recognize the need to make revisions. Based on such results, this thesis aims to present ways to promote the sharing of health information. First, additional human resources, time, and cost is expected to accrue if electronic medical records are adopted and hospital affairs are computerized. Therefore, appropriate governmental funding should be provided. Second, various incentives, such as allowing charges for health information sharing, should be offered to medical institutions that share health information. Third, in order to systematically manage chronic diseases, health information sharing should be facilitated in smaller hospitals where primary health care is provided. Fourth, terminology, format and code must be standardized at the national level. Fifth, there must be guidelines on confidentiality and security systems. In addition, it is suggested that an official certification center be established to ensure the validity and confidentiality of the medical information being shared.

Searching from the heart: The interplay between emotions and customization in online health information seeking

Myrick, Jessica Gall The University of North Carolina at Chapel Hill 2013 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

The prospect of a threat to one's health or an opportunity for improved health can spark emotional reactions—the fear of an illness or the hope of a healthier life. People are increasingly turning to the Internet to search for information related to such health issues. However, the dizzying amount of online health information—some of it of dubious quality—makes the task of finding trustworthy and relevant health information difficult. One way to address this dilemma is to utilize technology's ability to provide users with customized content based on their unique desires and preferences. Grounded in the literatures on emotions, health information seeking, and customization, one approach to improving the efficiency and effectiveness of the health information seeking process would be to craft customized search engine results based on the user's situational emotion state. Further customizing of health search results based on dispositional aspects of the user's identity—in addition to the situational emotion—is a conceptually promising approach to improving the health information seeking process. This dissertation examined the relationship between types of emotional experiences and health information seeking as well as the interplay of emotion states and customization in the health information seeking process. The results revealed that discrete emotions have an important impact on multiple steps in the health information seeking process, from search query generation to post-search cognitions, attitudes, and behaviors. Additionally, the results indicate that customizing health-related search results based on situational factors may not be as effective as customizing search results based on dispositional aspects of a user's identity. Theoretical, methodological, and public health implications are discussed and directions for future research in this domain are offered.