A SURVEY OF PATIENT FACTORSIMPACTING ACQUISITION OF HEALTH INFORMATION ABOUT PELVIC FLOORDISORDERS
A. BAIN1, M.HYAKUTAKE 2, M. YASKINA 1, J. A. SCHULZ 2;
1Women and Children's Health Research Institute, LoisHole Hosp. for Women, Dept. of Obstet, Edmonton, Canada, 2Obstetricsand Gynecology, Lois Hole Hosp. for Women, Dept. of Obstet, Edmonton,Canada.
Introduction: Pelvic floorDisorders (PFDs), including pelvic organ prolapse, urinaryincontinence, and fecal incontinence, are highly prevalent, but stillnot widely discussed. Approximately one in four women over age twentywill experience at least one PFD, increasing to one in two women bythe age of fifty1. Despite this high prevalence, manywomen do not seek medical help due to embarrassment, myths regardingcause, and uncertainty about treatment options. The use of theinternet, twitter, You Tube, and apps in health education forpatients has been increasing over the past decade. However, there islittle literature regarding comfort level of different populationswith health information technologies.
Objective: Our studyobjectives were to assess patient ability to access technology, andto determine the preferred medium for providing health informationand education regarding PFDs to a urogynecology patientpopulation.
Methods: We developed and distributed a surveyto women attending a tertiary care urogynecology clinic. The surveyenquired about their current sources of health information, theircomfort level using electronic health information tools, and theirpreferences for various health information delivery methods,including face-to-face encounters, and online tools such as vodcasts.Study data were collected and managed through RedCap2, andanalyzed by a biostatistician.
Results: The survey responserate was 84.7% (269 surveys were distributed, of which 228 werecompleted). 46.5% and 53.5% survey participants were new patients andreturning patients, respectively. Median patient age was 60 years(range 19-90, SD 15.35); 51% of women were age 60 or older. Patientshad had their urogynecologic concern for a median of 3 years. It wasdetermined that a patient’s age, level of education, and whetherthey owned a computer, were statistically significant variables indetermining whether they accessed healthcare information online.Native language and distance to travel to the clinic were notstatistically significant. As a patient’s age increased, thepercentage that accessed health information online decreased (meanage 55 vs. 68 years for accessing health information online). Womenin the age group 70-79 years had 0.083 times lower odds (95%confidence interval from 0.008 to 0.876) of looking up the healthinformation on the internet than women 29 years or younger. Women inthe age group 80 years or older had 0.068 times lower odds (95%confidence interval from 0.005 to 0.937) of looking up the healthinformation on the internet than women of 29 years or younger. As apatient’s level of education increased, the percentage thataccessed health information online increased. Patients withuniversity or college education had 8.069 times higher odds (95%confidence interval from 1.429 to 45.551) of looking up the healthinformation on the internet than patients with high school education.Patients with postgraduate education had 38.599 times higher odds(95% confidence interval from 2.483 to 599.978) of looking up thehealth information on the internet than patients with high schooleducation. Out of the 228 surveys completed, it was determined that85% of patients own a computer and 73% of patients access theinternet daily via their electronic source of choice. Patients whoown computer had 8.148 times higher odds (95% confidence intervalfrom 2.949 to 22.514) of looking up the health information on theinternet than patients who does not own a computer. Patients who owna technology device (computer, smartphone, or tablet) had 7.401 timeshigher odds (95% confidence interval from 1.692 to 32.367) of lookingup the health information on the internet than patients who does nothave a technology device. Although 75% of patients access healthinformation online, only 21% of patients were familiar with the localhealth authority website promoted as a reliable electronic resourcefor health information. 79% of patients said they would find ituseful to have online health information provided by theirurogynecology clinic. The preferred modes of health informationdelivery included one-on-one sessions with a health professional, anonline vodcast accessible at any time, and printedhandouts.
Conclusions: These results suggest that thepatient population accessing the urogynecology clinic for PFDs wouldbenefit from more innovative and accessible health informationregarding their gynecological concerns. A significant proportion haveaccess to computers or technology devices. Novel educationaltechnologies may improve patient education and access tocare.
References: 1. JAMA 2008; 300: 1311 - 1316. 2. JBiomed Inform. 2009 Apr;42(2):377-81.