Introduction: Internet has become an increasingly popular source of reference for patients to learn about their medical problems. It is easily accessible, and a large number of uncensored information is available online written from various sources and perspectives. However, the role of internet and its impact on patient’s care and understanding of the disease remains unclear. The purpose of this study is to evaluate the role and effect of internet use for patients seeking consultation for hip and knee arthritis. More specifically, the relationship between patient’s education level, internet use, motives for doing background readings, perception of internet information, and reactions to the available information will be studied. Method: Patients seeking orthopaedic consultation for knee or hip arthritis at the Toronto Western Hospital were identified and invited to fill out a questionnaire on their first visit. The questionnaire was designed to assess the patients’ pre-consultation reading habits, their use of internet, and their reaction to what they have read on the internet. The questionnaire also included questions about the respondent’s background.Results: In comparing patients holding college/university degree (CU) with patients having no college/university education (NoCU), the CU group were associated with increased internet use (CU vs. NoCU: 71.0% vs. 48.3%; p < 0.01) and background reading (CU vs. NoCU: 82.2% vs. 17.8%; p < 0.001) prior to consultation; fewer incidence of anxiety following internet use (CU vs. NoCU: 29.9% vs. 53.6%; p < 0.05); and higher rates of decisions influenced by internet use (CU vs. NoCU: 20.8% vs. 3.6%, p < 0.05). Internet users demonstrated a higher confidence in gathering and understanding medical information (Internet users vs. non-internet users: 6.59 ± 2.05 vs. 5.03 ± 2.78; p < 0.001) and rated the accuracy of information on internet at 7.18 ± 2.01 (max = 10). Conclusion: Internet use can influence patient’s treatment decision, anxiety level, and understanding of their disease. Caregivers must recognize the growing trend of internet use and should counsel and educate their patients appropriately based on what they have read to help them accurately appreciate the nature of their disease.
Cite this paper
K. Koo, C. Farlinger, S. Johnson and K. Syed, "Patient Education Level and Utilization of Internet Resources by Patients in Orthopedic Hip and Knee Consultations," Open Journal of Medical Psychology
, Vol. 2 No. 1, 2013, pp. 54-60. doi: 10.4236/ojmp.2013.21009
 A. Boker, L. Brownell and N. Donen, “The Amsterdam Preoperative Anxiety and Information Scale Provides a Simple and Reliable Measure of Preoperative Anxiety,” Canadian Journal of Anesthesia, Vol. 49, No. 8, 2002, pp. 792-798. doi:10.1007/BF03017410
 D. Fell, D. R. Derbyshire, C. J. Maile, I. M. Larsson, R. Ellis, K. J. Achola and G. Smith, “Measurement of Plasma Catecholamine Concentrations. An Assessment of Anxiety,” British Journal of Anaesthesia, Vol. 57, No. 8, 1985, pp. 770-774. doi:10.1093/bja/57.8.770
 C. Weissman, “The Metabolic Response to Stress: An Overview and Update,” Anesthesiology, Vol. 73, No. 2, 1990, pp. 308-327.
 T. M. Osborn, and N. A. Sandler, “The Effects of Preoperative Anxiety on Intravenous Sedation,” Anesthesia Progress, Vol. 51, No. 2, 2004, pp. 46-51.
 I. Maranets and Z. N. Kain, “Preoperative Anxiety and Intraoperative Anesthetic Requirements,” Anesthesia & Analgesia, Vol. 89, No. 6, 1999, pp. 1346-1351.
 C. J. Eloise, V. N. Thomas and J. Wilson-Barnet, “Patient Experiences of Anxiety, Depression and Acute Pain after Surgery: A Longitudinal Perspective,” International Journal of Nursing Studies, Vol. 42, No. 5, 2005, pp. 521-530. doi:10.1016/j.ijnurstu.2004.09.014
 J. Heine, S. Koch and P. Goldie, “Patients’ Experiences of Readiness for Discharge Following a Total Hip Replacement,” Australian Journal of Physiotherapy, Vol. 50, No. 4, 2004, pp. 227-233.
 A. K. Madan, C. T. Frantzides and C. E. Pesce, “The Quality of Information about Laparoscopic Bariatric Surgery on the Internet,” Surgical Endoscopy, Vol. 17, No. 5, 2003, pp. 685-687.
 L. C. Soot, G. L. Moneta and J. M. Edwards, “Vascular Surgery and the Internet: A Poor Source of Patient-Orientated Information,” Journal of Vascular Surgery, Vol. 30, No. 1, 1999, pp. 84-91.
 N. Aslam, D. Bowyer, A. Wainwright, T. Theologis and M.Benson, “Evaluation of Internet Use by Paediatric Orthopaedic Outpatients and the Quality of Information Available,” Journal of Pediatric Orthopaedics B, Vol. 4, No. 2, 2005, pp. 129-133.
 P. K. Beredjiklian, D. J. Bozentka, D. R.Steinberg and J. Bernstein, “Evaluating the Source and Content of Orthopaedic Information on the Internet: The Case of Carpal Tunnel Syndrome,” Journal of Bone and Joint Surgery, Vol. 82A, No. 11, 2000, pp. 1540-1543.
 SEO Consultants, “Top Ten Search Engines—Top 10 SEs,” 2010.
 Internet World Stats, “Internet Usage Statistics for all the Americas,” 2010.
 G. O. Hellawell, K. J. Turner, K. J. Le Monnier and S. F. Brewster, “Urology and the Internet: An Evaluation of Internetuse by Urology Patients and of Information Available on Urological Topics,” BJU International, Vol. 86, No. 3, 2000, pp. 191-194.
 S. B.McPherson, S. M.Beall, M. L.Greenfield and J. S. Biermann, “Patient Internet Use in a Community Outpatient Orthopaedic Practice,” The Iowa Orthopaedic Journal, 2002, Vol. 22, pp. 103-107.
 S. B.McPherson, G. J. Gergory, M. L. Greenfield, R. N. Hesinger and J. S. Biermann, “Use of the Internet by Pediatric Orthopaedic Outpatients,” Journal of Pediatric Orthopaedics, Vol. 22, No. 2, 2002, pp. 261-264.
 B. Makar, D. Quilliot, R. Zarnegar, T. Levan, A. Ayav, L. Bresler, P. Boissel and L. Brunaud, “What Is the Quality of Information about Bariatric Surgery on the Internet?” Obesity Surgery, Vol. 18, No. 11, 2008, pp. 1455-1459.
 M.l Droomers and G. P. Westert, “Do Lower Socioeconomic Groups Use More Health Services, because They Suffer from More Illnesses?” European Journal of Public Health, Vol. 14, No. 3, 2004, pp. 311-313.
 R. L. Sudore, et al., “Limited Literacy in Older people and Disparities in Health and Healthcare access,” Journal of the American Geriatrics Society, Vol. 54, No. 5, 2006, pp. 770-776. doi:10.1111/j.1532-5415.2006.00691.x