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Purpose – This chapter examines medical consumerism and the changing relations between patients as consumers and the medical system across two women's health contexts, breast cancer and infertility.

Methodology/approach – The analysis draws on two qualitative studies: The first explores the experiences of 60 breast cancer survivors through in-depth interviews and participant observation (Sulik, 2005), and the second uses in-depth interviews to analyze 18 women's experiences with infertility (Eich-Krohm, 2000).

Findings – The medical consumer is an individualized role that shifts attention away from the quality problem in health care and toward the quality of the person as a medical consumer who is characterized to be optimistic, proactive, rational, responsible, and informed.

Research limitations/implications – As medicine has become a form of mass consumption, the category of medical consumer has elevated the individual in medical decision-making. The shift from patient to medical consumer is an ongoing process that is grounded in a tension between medical control and individual agency, and is exacerbated by the intensity and incomprehensibility of modern medicine.

Practical implications – The proliferation of medical information and personal illness narratives through the Internet, advice books, and self-help groups have advanced lay knowledge about preventive medicine and medical treatment while simultaneously introducing new fears and anxiety about the multitude of options and outcomes.

Originality/value of chapter – This study contributes to our knowledge on medical consumerism and its impact on illness experience and the synthesis of lay and professional knowledge.

This study proposes targeted modernization of the Department of Defense (DoD's) Joint Forces Ammunition Logistics information system by implementing the optimized innovative information technology open architecture design and integrating Radio Frequency Identification Device data technologies and real-time optimization and control mechanisms as the critical technology components of the solution. The innovative information technology, which pursues the focused logistics, will be deployed in 36 months at the estimated cost of $568 million in constant dollars. We estimate that the Systems, Applications, Products (SAP)-based enterprise integration solution that the Army currently pursues will cost another $1.5 billion through the year 2014; however, it is unlikely to deliver the intended technical capabilities.

As biomedicine becomes increasingly enmeshed in modern life, biomedicalization processes have implications for reproductive policy, including abortion policy. Informed consent provisions have been a prominent trend in state-level abortion lawmaking in the United States in recent years. Modeled on the practice of securing informed consent for medical procedures, informed consent provisions stipulate the information a person must receive before they can consent to an abortion. Informed consent provisions purportedly require that this information be objective, scientifically accurate, and non-judgmental. Through an analysis of informed consent provisions in Texas abortion legislation from 1993 to 2015, this chapter explores how such provisions employ medical and biomedical tropes to frame regulations that restrict access to abortion care as ostensibly protecting women’s health and safety. I find that informed consent legislation in Texas selectively borrows from medical and biomedical lexicons, cites strategic empirical evidence, and co-opts medical techniques and experts in ways that encumber abortion access.

The University of Tennessee Medical Center in Knoxville (UTMC) Preston Medical Library (PML) and Health Information Center (HIC) has provided a novel contribution to increasing consumer health literacy and reducing health disparities in a unique variety of ways. UTMC librarians have used qualitative, quantitative, and practice-based methodology and research to demonstrate what a regional medical library working with internal and community partners can accomplish. At UTMC, there has been a focus on the value of health literacy for the patient, the clinician, and the health care system itself. In 1993, the UTMC PML began a consumer and patient health information service, which was the foundation for increasing consumer health literacy. In 2014, UTMC took a leading role in advancing consumer health literacy through the opening of the HIC, a patient- and family-focused library inside of UTMC. This chapter will focus on the PML’s history as a reliable resource in providing patients, family members, and the community with accurate and trustworthy health information, as well as the librarians’ role related to health literacy and health disparities through various initiatives and projects. Additionally, this chapter will highlight specific suggestions for libraries interested in starting similar initiatives, such as obtaining support from leadership, opportunities for funding, and how to address roadblocks.

This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) populations face when accessing healthcare information and resources. Historically, information about queer and trans identities has been suppressed in the United States, reflecting dominant social values that pathologize queer identities. Using health-related zines housed at the Queer Zine Archive Project as a case study, this project investigates how queer and trans zines about healthcare have resisted these homophobic and transphobic ideologies. The analysis reveals that queer and trans zinesters use their feelings of impatience with the medical industry to fuel communal solutions to accessing and providing health care information.

Since 2000, there has been a dramatic increase in the number of individuals using the Internet, including for health purposes. Internet usage has increased from 46% of adults in 2000 to 79% in 2010. The purpose of this chapter is to examine changes in one type of Internet usage: online health searching. We examine the impact of traditional digital inequality factors on online health searching, and whether these patterns have changed over time.

Using data from five surveys ranging from 2002 to 2010 (n = 5,967 for all five surveys combined), we examine changing patterns of online health searching over the past decade.

Effects vary by inequality factor and time period examined. Despite the diffusion of the Internet, most of these gaps persist, and even strengthen, over time. Gender, age, and education gaps persist over time and appear to be increasing. An exception to this is the importance of broadband connection.

Since these data were collected, the use of mobile devices to access the Internet has increased. Research is needed on types of access and devices used for online health activities.

Larger scale inequalities play important roles in online health searching. Providing access and skills in evaluating online health information is needed for older and less educated groups. The results of this study have implications for the de-professionalization of medical knowledge.

This is the first study to examine digital inequality factors in online health information seeking over the breadth of this time period.

This paper reports on part of a dissertation project on the relationships between learning methods and students’ information behavior in Finland. In this qualitative study, information behavior is studied in the contexts of a problem-based learning curriculum and a traditional curriculum. In 1998, 16 theme interviews were conducted at the Tampere University Medical School, which applied the problem-based learning curriculum and 15 interviews at the Turku University Medical School, in which the traditional curriculum with an early patient contact program was implemented. The focus of this paper is on the concept of information literacy as a part of the students’ information behavior and its relationships with students’ conceptions of learning. The findings indicate that students’ information literacy is developed, on the one hand, through active use of information and sources in connection with real information needs, and, on the other hand, through an educational context which offers opportunities to get different viewpoints on issues. Following the same tendency, the more developed conceptions of learning were mostly held by the students belonging to the problem-based group with simple or developed skills in information literacy, although there were exceptions from this pattern.

Prior studies have shown that terminology support can improve health information retrieval but have not taken into account the characteristics of the user performing the search. In this chapter, the impact of translating queries’ terms between lay and medico-scientific terminology, in users with different levels of health literacy and topic familiarity, is evaluated. Findings demonstrate that medico-scientific queries demand more from the users and are mostly aimed at health professionals. In addition, these queries retrieve documents that are less readable and less well understood by users. Despite this, medico-scientific queries are associated with higher precision in the top-10 retrieved documents results and tend slightly to generate knowledge with less incorrect contents, the researchers concluded that search engines should provide query suggestions with medico-scientific terminology, whenever the user is able to digest it, that is, in users above the lowest levels of health literacy and topic familiarity. On the other hand, retrieval systems should provide lay alternative queries in users with inadequate health literacy or in those unfamiliar with a topic. In fact, the quantity of incorrect contents in the knowledge that emerges from a medico-scientific session tends to decrease with topic familiarity and health literacy. In terms of topic familiarity, the opposite happens with Graded Average Precision. Moreover, users most familiar with a topic tend to have higher motivational relevance with medico-scientific queries than with lay queries. This work is the first to consider user context features while studying the impact of a query processing technique in several aspects of the retrieval process, including the medical accuracy of the acquired knowledge.

This study illustrates that differences across health-related websites, as well as different Internet usage patterns, have significant implications for how individuals view and interact with their health care providers.

We rely on a qualitative study of three health-related websites and an ordinary least squares regression analysis of survey data to explore how websites with different organizational motives frame health-related issues and how variations in Internet usage patterns affect patients’ perceptions of the patient-doctor interaction.

Results reveal differences across three health-related websites and show that both the number and the type of websites patients visit affect their perceptions of physicians’ responses. Specifically, visiting multiple websites decreased perceptions of how well doctors listened to or answered patients’ questions, whereas using nonprofit or government health-related websites increased evaluations of how well doctors listened to and answered questions.

This study suggests that practitioners and scholars should look more closely at how patients use the Internet to understand how it affects doctor-patient interactions. Future research could expand the analysis of website framing or use methods such as in-depth interviewing to more fully understand on-the-ground processes and mechanisms.

This study highlights the importance of fleshing out nuances about what it means to be an Internet-informed patient given that varying patterns of Internet use may affect how patients perceive their physicians.