Heed or disregard a cancer patient’s critical blogging? An experimental study of two different framing strategies

Abstract

BackgroundWe have examined healthcare staff attitudes of toward a blogging cancer patient who publishes critical posts about her treatment and their possible effect on patient-staff relationships and treatment decisions.MethodsWe used two versions of a questionnaire containing a vignette based on a modified real case involving a 39-year-old cancer patient who complained on her blog about how she was encountered and the treatment she received. Initially she was not offered a new, and expensive treatment, which might have influenced her perception of further encounters. In one version of the vignette, the team decides to put extra effort into both encounters and offers the expensive new cancer treatment. In the other version, the team decides to follow the clinic’s routine to the letter. Subsequently, blog postings became either positive or negative in tone. We also divided participants into value-neutral and value-influenced groups (regarding personal values) by asking how their trust in healthcare would be affected if the team’s suggestion were followed.ResultsA total of 56 % (95 % CI: 51–61) of the respondents faced with a team decision to ‘do something-extra’ in encounters would act in accordance with this ambition. Concerning treatment, 32 % (95 % CI: 28–38) would follow the team’s decision to offer a new and expensive treatment. A large majority of those who received the “follow-routine” version agreed to do so in encountering [94 % (95 % CI: 91–97)]. Similar proportions were found regarding treatment [86 % (95 % CI: 82–90)].A total of 83 % (95 % CI: 76–91) of the value-neutral participants who received the “do-something-extra” version stated that they would act as the team suggested regarding encounters, while 57 % (95 % CI: 47–67) would do so in regard to treatment. Among the value-influenced participants who received the “do-something-extra” version, 45 % (95 % CI: 38–51) stated that they would make an extra effort to accommodate the patient and her needs, while the proportion for treatment was 22 % (95 % CI: 16–27). Among those who had received the “follow-routine” version, a large majority agreed, and no difference was indicated between the value-neutral and the value-influenced participants.ConclusionThe present study indicates that healthcare staff is indeed influenced by reading a patient’s critical blog entries, largely regarding encounters, but also concerning treatment is concerned. Value-neutral healthcare personnel seem to exhibit a pragmatic attitude and be more inclined to heed and respond to a patient whose criticism may well be warranted. The study also indicates that healthcare staff is partly positive or negative to future blogging patients depending on how the issue has been framed.For future research we suggest as a bold hypothesis that the phrase “clinical routine” might conceal power aspects masquerading as adopted ethical principles.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0115-3) contains supplementary material, which is available to ...

Influence of Internet and Social Media in the Promotion of Alternative Oncology, Cancer Quackery, and the Predatory Publishing Phenomenon

“…However, information posted on blogs and discussion forums, especially anonymous posts, showed significantly lower levels of scientific accuracy compared to other electronic resources. According to a Swedish study [ 26 ], the healthcare personnel can also be subjectively influenced by the reading of a patient’s critical blog. In this study, the authors showed that staff exhibiting a neutral, professional and pragmatic attitude is more inclined to heed and respond to critic patients [ 26 ].…”

Respectful encounters from healthcare professionals and return to work among 9032 long-term sick-listed due to cancer or due to other diagnoses: results from a Swedish population-based survey

“…In this context, the quality of the cancer patients’ encounters with healthcare professionals might be considered as of relatively minor importance [6]. Nevertheless, several studies indicate that experiences of respectful encounters with healthcare professionals may result in patients feeling strengthened and encouraged, both among cancer patients and others [7–9], and patients’ experiences of disrespectful or wrongful encounters may have negative consequences for their health and their trust in the healthcare system [9–11].…”

Is healthcare providers’ value-neutrality depending on how controversial a medical intervention is? Analysis of 10 more or less controversial interventions

“…Previously conducted studies have, however, indicated that Swedish physicians actually hold values that are in conflict with official values. [9][10][11][12][13][14][15][16][17][18] By official values in health care, we mean the values expressed in health care law and regulations. However, personal values that are at odds with the official values are seldom openly declared by the physician.…”

“…The simple idea is that the physician's personal values remain tacit while affecting factual judgements, so that the practical conclusion about what to do as a health care professional is informed by these values. [9][10][11][12][13][14][15][16][17][18][19] Value impregnation of factual aspects is not a phenomenon unique to Sweden or Swedish health care. In a Swiss study, Hermann et al investigate physicians' decision-making process regarding assisted suicide, claiming that physicians' personal values enter 'through the back-door' as they colour the assessment of patients' decision-making capacity.…”

“…The method has been applied in six different vignette-based studies including 10 more or less controversial health care interventions. [10][11][12][13][14][15][16][17][18] The aim of the present article is to examine whether the proportions of value-influenced and value-neutral participants vary depending on how controversial the issue is.…”