Evidence-based medicine

Use of the Internet can increase patients' understanding about their medical conditions and offers opportunities to strengthen the patient-physician relationship, increase patient satisfaction, and improve health outcomes. However, physicians vary widely in the extent to which they accept patient online medical information seeking and make it part of the patient-physician relationship. This paper explores factors impacting the extent to which physicians advocate (encourage, speak in favor, or are supportive of) patient internet use. Specifically, using social cognitive theory as a theoretical base, this study develops a model of the determinants of physician advocation of patient use of the internet for information about medical conditions and treatments. Survey data collected from a random sample of 179 physicians licensed to practice medicine in Florida is used to test the proposed model. Proxy efficacy for patient internet use, social efficacy for enlisting patient internet use, performance outcomes expectations, and personal outcome expectations are shown to be significant determinants of physician professional advocation of patient internet use. In addition to its direct impact, proxy efficacy is shown to influence intention to advocate patient internet use indirectly thru social efficacy and outcome expectations, demonstrating the key role of this construct in the proxy agency model. Self-efficacy, in contrast, is not found to be a significant factor. Overall, the results support the proposed model of technology use.

Difficulty in communicating internal states may interfere with medical assessment of pain conditions. Individuals who score high on an assessment measure of a construct called alexithymia have difficulty in describing and/or identifying emotions. Both diffuse and low verbal communication styles have been related to alexithymia in chronic pain patients. Alexithymia has also been linked with pain intensity and various chronic pain conditions. As yet, research has not examined whether alexithymia and acute pain are related. The current research examined high-functioning individuals with chronic, acute, or no pain. No difference in alexithymia levels was found between the groups. However, pain intensity was related to difficulty in identifying feelings, and participants who scored high in alexithymia produced a low number of words per sentence in pain descriptions.