Escolar Documentos
Profissional Documentos
Cultura Documentos
Genevieve Hewson
Groups to Consider
AIDS Patients
Hypochondriacs
Cancer Patients
Nurses / Clinicians
Caregivers
Parents
Diabetics
Physicians
The Elderly
Ethnic Groups
Socio-economic groups
Expectant First-Time
Mothers (and Fathers)
Young Adults
Areas of Focus
HIB of Doctors
Information seeking of professionals (Leckie/Pettigrew/Sylvain)
o Information needs in practice/pre-internet (Covell)
o Information-seeking behavior relative to EBM/evidence-based medicine (Davies)
o Curbside Consultation (Perley)
o
Two Models
It is a flow chart depicting the sequence of events during health information seeking
It identifies factors that lead to particular outcomes
Can be used to illustrate active and passive information seeking
(Loo 2007)
6.
Stimulus Gap in
Knowledge
Information Goals
Seekers decide urgency
Cost Benefit- Is it
worth seeking
information?
Search Behaviors - The
extent (scope) of search
is considered
Information Evaluation
Have I found what Im
looking for?, What are
my information goals ?
Decision Point- Seeker
is subjective, Have I
found it, or do I keep
searching (Loo, 1997)
(Freimuth et al)
Health Information
Acquisition Model
1989
(Loo 2007)
A.
1.
2.
3.
4.
a)
b)
B.
1.
2.
C.
Breast
Cancer
Patients
life.
They must choose from complete treatment
options that yield different morbidities but equal
odds of survival.
(Radina et al. 2011)
beliefs.
A plethora of information on breast cancer has
emerged in both scientific and popular media.
There is unprecedented and growing access to
health information, making it essential for health
care providers and others to better understand
the health seeking behaviors of patients.
(Radina et al. 2011)
(Williamson 2006)
Levels of information
needs throughout the
cancer trajectory
(Van Der Molen 2000)
For Consideration
o The role fear of knowing
or anxiety plays in a
patients search for
information.
o The role information
overload has on a
patients ability to cope.
MBSS
(Miller Behavioural Style Scale) AKA (Miller Blunter Style Scale)
In 1987, Suzanne M. Miller developed a 32-item questionnaire to evaluate a
person's means of coping with stress. (ie: Discovering the presence of
breast cancer)
This questionnaire is useful in determining whether a patient wants more or
less information when confronted with his/her diagnosis.
This scale is used to identify:
Monitors Active seekers of information
Blunters Distracted seekers of information
Monitors and blunters are quantified by the terms - high and low.
MBSS
(Miller Behavioral Style Scale) AKA (Miller Blunter Style Scale) (cont.)
MBSS (Cont.)
(Miller Behavioral Style Scale) AKA (Miller Blunter Style Scale)
(Miller 1987)
Models to Explain
Monitoring and Blunting Theory
Krikelass (1983)
Information
Seeking Model
includes both
immediate and
deferred seeking.
It also illustrates the
collecting of
information to
satisfy deferred
Information needs.
(Baker 2005)
Models to Explain
Monitoring and Blunting Theory
Dervins (1992) Sense Making Model
Illustrates both monitors and blunters informationseeking styles. Both seek information, but do so in
different time frames.
(Baker 2005)
Models to Explain
Monitoring and Blunting Theory
Lazarus & Folkmans
(1984) Transactional
Model of Stress and
Coping
Identifies information
seeking as the most frequent
method used to cope with a
stressful event when
information is limited.
(Van Der Molen 1999)
Facilitate coping
Regain a sense of control
Increase confidence and security
Help with (participate in) the decision making process
(Rees & Bath 2001)
Sources of Information
for Breast Cancer Patients
Internet
Primary Literature
Supplemental Literature (booklets and pamphlets from the
physician)
Verbal Interactions with Health Care Professionals
(Williamson & Manaszewicz 2002)
Library
Written Information from Breast Cancer Organizations
Verbal Interactions with other breast cancer survivors
Support Groups
(Rees & Bath 2001)
Sources of Information
for Breast Cancer Patients (Cont.)
Hospital leaflets
Specialist Nurses
Medical Books and Journals
Non-medical sources
Family members
Friends
Coworkers
Telephone hotlines
Television or radio
(Nagler et al 2010)
Information Disparities
In Patient Education Materials
Materials should be aimed at 8th grade levels
Conclusion
When it comes to health every one is different.
When a person discovers that they have cancer their innate
coping skills range from I need to know everything Right
Now! to If I dont think about it, it isnt real. Eventually,
people at both ends of the cancer spectrum come to accept
the reality of their situation. When they are ready, they
seek health/medical information in order to make the best
decision possible. When this happens, libraries need to be
equipped with all the latest materials/resources/databases to
provide the user with the highest quality information.
Recommendations
People in need of health information do not always seek
that which they need. For those that do, information
specialists should make the information session as easy as
possible.
Health Information-giving requires:
Sensitivity to each individuals needs
Flexibility on behalf of the people providing the information
Effective communication skills (Van Der Molen 1999)
Written information needs to be supported with verbal
explanations (Van Der Molen 2000)
Recommendations (Cont.)
Health information-giving requires:
Reliable information sources
Accessibility to the Internet (for valid web-based information)
Proxies (intermediaries) have a full understanding of material
provided (Nagler et al 2009)
Access to On-line Databases that contain relevant data from
medical books/ journals, newspapers and magazines (Cowan
et al 2007)
Accessibility to multi-media enhancements, to assist those
seekers, with low literacy skills or those who do not speak
English (Williamson & Manaszewicz 2002)
Language barriers
Cultural beliefs
(Jenkins et al. 1996; Remennick 1999; Meana et al. 2001; Bernstein et al. 2002;
Salant & Lauderdale 2003; Scarinci et al. 2003)
Information Blunting
Information blunting- According to Miller (1991) ,
Sources of Information
Doctors trust differs by
demographic characteristics
Religious organizations or
leaders
Newspapers or magazines
Television
Charitable organizations
Government health agencies
Internet
INFORMATION-SEEKING BEHAVIOR
OF
DOCTORS
These factors act as a filter in the information seeking process. Once process
begins, factors which affect success or failure include:
David Covell M.D (1985) Physicians have a need for highly specific non-recurrent
points of information related to an individual patients problem. Pedagogic
continuing medical education (CME) cannot affect problem solving at this level
and fails to improve patient care practices.
Covell (cont.)
Covell calls for medical educators to develop and test models that can
efficiently provide for information needs of physicians including:
Doctors search efficiency is very good only 18% of time; fair 52% and poor 30%
of time.
When information is not located in a database, it is assumed by doctor not to
exist.
Doctors believe search failed because of lack of relevant evidence rather than
realizing errors in their search strategy
Do not have skill to convert clinical question to a searchable strategy for an
information resource
Question formulation does not improve as doctors progress through their
clinical training
62% cite lack of training as the most common barrier to using databases
Only 34 % had availed themselves of the opportunity for on-site training
Underserved
Journal of Personality and Social Psychology
Journal of the Medical Library Association
New Review of Information Behavior Research
Oncology Nursing Forum
Patient Education and Counseling
Discussion Question 1
Monitoring and Blunting are information-seeking
Discussion Question 2
From the Covell study in 1985 to the Davies review of
2007 one consistent factor in the information
behavior of physicians is their preference to utilize
other physicians as a primary information source. In
the age of evidence-based medicine, how can
medical librarians promote the usage of electronic
databases such as MEDLINE to inform practice given a
physician preference for oral construction?