The diffusion of the Web 2.0 has made it possible for patients to exchange on online health communities, defined as computer-mediated communities dedicated to health topics, wherein members can build relationships with other members. It is now acknowledged that online health communities provide users not only with medical information but also with social support with no time or geographical boundaries. However, in spite of their considerable interest, there is still a paucity of research as to how online health communities alter the patient-physician relationship. This research aims at filling this gap and examines how online health communities, while providing users with computer-mediated social support and empowerment, impact the patient-physician relationship. Six hypotheses are proposed and tested. A survey was developed and 328 responses were collected from online patient groups in Canada in 2016. The data were analysed using structural equation modelling. All but one hypothesis are validated. The results show that user computer-mediated social support positively influences user empowerment and participation during the consultation, which in turn determines user commitment to the relationship with the physician. Importantly and contrary to our expectations, user empowerment is found to be significantly but negatively related to user commitment with the physician.

BackgroundOver the past 50 years, patient noncompliance has appeared as a major public health concern and focus of a great deal of research because it endangers patient recovery and imposes a considerable financial burden on health care systems. Meanwhile, online health communities (OHCs) are becoming more common and are commonly used by individuals with health problems, and they may have a role in facilitating compliance. Despite this growing popularity, little is known about patient compliance predictors for OHCs’ users.ObjectiveThis study aimed to investigate the extent to which participating in OHCs may trigger higher levels of compliance. It identified 3 interrelated predictors that may affect patient compliance: patient empowerment gained through peer-to-peer OHCs, satisfaction with the physician, and commitment to the physician.MethodsA Web-based survey tested the conceptual model and assessed the effects of patient empowerment gained through OHCs on patient satisfaction and commitment to the physician, as well as the effects of these 3 predictors on patient compliance with the proposed treatment. Members of peer-to-peer OHCs were asked to answer an online questionnaire. A convenience sample of 420 patients experiencing chronic illness and using peer-to-peer OHCs was surveyed in August 2018 in Québec, Canada. A path analysis using structural equation modeling tested the proposed relationships between the predictors and their respective paths on patient compliance. The mediation effects of these predictor variables on patient compliance were estimated with the PROCESS macro in SPSS.ResultsThe findings indicated that patient empowerment gained through OHCs was positively related to patient commitment to the physician (beta=.69; P<.001) and patient compliance with the proposed treatment (beta=.35; P<.001). Patient commitment also positively influenced patient compliance (beta=.74; P<.001). Patient empowerment did not exert a significant influence on patient satisfaction with the physician (beta=.02; P=.76), and satisfaction did not affect compliance (beta=−.07; P=.05); however, patient satisfaction was positively related to patient commitment to the physician (beta=.14; P<.01). The impact of empowerment on compliance was partially mediated by commitment to the physician (beta=.32; 95% CI 0.22-0.44) but not by satisfaction.ConclusionsThis study highlights the importance of peer-to-peer OHCs for two main reasons. The primary reason is that patient empowerment gained through peer-to-peer OHCs both directly and indirectly enhances patient compliance with the proposed treatment. The underlying mechanisms of these effects were shown. Second, commitment to the physician was found to play a more critical role than satisfaction with the physician in determining patient-physician relationship quality. Overall, our findings support the assumption that health care stakeholders should encourage the use of peer-to-peer OHCs to favor patient empowerment and patient commitment to the physician to increase patient compliance w...

Purpose – The present study aims to use the qualitative approach of soft laddering to gather insight into both risk perception and subsequent marketing strategies of medical tourism. Medical tourism has recently started to spark interest of marketing researchers and has been a frequently discussed topic by both journalists and physicians. Nevertheless, there are only few marketing studies offering in-depth research on the phenomenon of medical tourism. In the present article, we will concentrate on the central notion of risk inherent to any medical procedure and a fortiori to surgery in the so-called Third World countries. Because medical tourism is a product to be sold to costumers, the perceived risk needs to be dealt with on the marketing level. Design/methodology/approach – In the present study, the qualitative approach of soft laddering was used with 23 participants from France and 22 participants from Quebec to gather insight into both risk perception and subsequent marketing strategies of medical tourism. Findings – The results show significant differences in consumer behavior between the two nationalities involved. We will see how these differences are related to underlying values as well as different reasons and constraints to purchase. Practical implications – The results could help developed countries’ government to implement health policy. Originality/value – Qualitative research does not often use soft laddering, which was used in this paper. Moreover, this qualitative approach has some advantages as the number of chains, as well as the frequencies of selection and the diversity of elements quoted by consumers (kinds of risks, values and consequences of the choices made).

This research highlights the importance of OHCs, which can be seen as valuable instruments for enhancing patient-physician relationships. It shows that healthcare managers should seek to enhance interpersonal trust among OHC users, because this trust has a positive influence on patient satisfaction with, trust in and attitude toward the physician.

Background: The restrictions implemented around the world to contain the spread of the coronavirus disease 2019 (COVID-19) impact workers. Emotional distress and maladaptive behaviors such as alcohol misuse are expected, particularly in vulnerable groups such as front-line health workers. In the present study, we examined if alcohol consumption behaviors in Quebec workers changed during confinement of the COVID-19 pandemic, and whether healthcare workers reported specific patterns of changes. Methods: Data were obtained from an anonymous online survey conducted among adult workers aged ⩾18 years in the province of Quebec, Canada, between May 25, 2020 and June 26, 2020. Participants provided self-reported data regarding sociodemographic including field of work, as well as mental health disorders, alcohol use, alcohol craving, and type of alcohol consumed. Changes in alcohol behaviors were assessed using Wilcoxon signed rank test for categorial variables and paired- t tests for continuous variables. Results: The survey was completed by 847 participants (77.8% women), with 42.5% healthcare workers. Participants reported increased daily alcohol use ( Z = −10.60; P < .001, r = −.372) and alcohol craving ( P < .001, d = 0.485) during the confinement. Only the type of alcohol consumed during the confinement differed between health care workers and other workers (OR = 0.45, P = .003). Health care workers used less high alcohol products during the confinement. Conclusion: Our results show a significant increase in daily alcohol consumption and in alcohol craving during the confinement in the Quebec working population.