Date of Award

2-4-2025

Thesis Type

Masters

Document Type

Dissertation

Divisions

Faculty of Medicine

Department

Department of Primary Care Medicine

Institution

Universiti Malaya

Abstract

More patients are turning to the Internet to understand their health and make health decisions. However, the quality of online health information (OHI) is highly variable, and it may contain misinformation. Patients who lack the necessary skills to appraise OHI may trust poor-quality OHI. Thus, this study aims to examine the association between OHI characteristics and appropriate trust in patients with high cardiovascular (CV) risk. This is a secondary analysis from a quantitative cohort study of 270 patients from a primary care clinic in Kuala Lumpur, Malaysia. Patients recorded each OHI encountered over two months in a digital information diary tool between October 2022 and January 2023. A total of 1194 entries were included for analysis. Entries were categorised by four information characteristics: (1) conduit, (2) commercial status, (3) content focus, and (4) presence of misinformation. Patients rated their trust level of each OHI using a 5-point Likert scale. The quality of each OHI was scored using the DISCERN tool. The presence of misinformation was determined using Wardle’s taxonomy. Appropriate trust was defined as trusting good-quality information or distrusting poor-quality information. Descriptive analysis was conducted on patients’ sociodemographic profiles, eHealth literacy scale (eHEALS), trust level, information quality, and information characteristics. The association between information characteristics and appropriate trust was analysed using multiple logistic regression. A total of 128 patients were included in this study, with a mean age of 60.2±10.05. The majority were Chinese (45.3%) and Malay (41.4%), and 44.5% had tertiary education. The eHEALS score was 29.2±4.79. Patients accessed more websites compared to social media (62% vs 38%) (conduit), and non-commercial sources compared to commercial (88.2% vs 11.8%) (commercial status). Information regarding

igeneral well-being and condition-related topics was evenly distributed (51.3% vs 48.7%) (content focus). 23.3% of entries contained misinformation (presence of misinformation). In terms of the DISCERN quality score categories, 30.8% of OHI was rated as Good/Excellent, 32.2% as Fair, and 37.1% as Poor/Very Poor. Despite the entries being categorised as Poor/Very Poor-quality, the level of trust rated by patients was high, with 64% expressing Trust or Complete Trust. When analysing the relationship between OHI quality and level of trust, 51.5% of entries were trusted appropriately. Information from websites (vs social media) exhibited higher appropriate trust (AOR 4.31, 95% CI 3.14-5.91, p< 0.001). Non-commercial information (vs commercial) demonstrated higher appropriate trust (AOR 1.59, 95% CI 1.01-2.50, p=0.047). Information without misinformation has a higher appropriate trust than those with misinformation (AOR 2.11, 95% CI 1.40-3.20, p< 0.001). In conclusion, this study revealed that the level of appropriate trust based on the quality of OHI was 51.5% in patients with high CV risks. Information characteristics such as the conduit, commercial status, and the presence of misinformation were significantly associated with appropriate trust in OHI quality. This study emphasised the need for good quality OHI and dissemination through reliable sources.

Initial

khm

Additional Information

Dissertation (M.A.) – Faculty of Medicine, Universiti Malaya, 2024.

Download

Share

COinS