JMIR Publications

ABSTRACT

Background:

Pediatric cancer patients in China often present at an advanced stage of disease resulting in lower survival and poorer health outcomes. One factor hypothesized to contribute to delays of pediatric cancer has been the online health information seeking (OHIS) behaviors by caregivers.

Objective:

This study aims to quantitatively and qualitatively examine the association between OHIS behaviors by caregivers and delays for Chinese pediatric cancer patients.

Methods:

This study employed a mixed methods approach, specifically a sequential explanatory design. OHIS behavior by caregiver was defined as the way caregivers access information relevant to their children’s health via the Internet. Delays of pediatric cancer was defined as the length of time between biological initiation of the disease and the cancer treatment, which could be divided as total delay, patient delay, diagnosis delay ,and treatment delay. The quantitative analysis included descriptive analyses, Student’s t-tests, Pearson's chi squared test, and Binary logistic regression all performed by Stata. Qualitative analysis included conceptual content analysis and Colaizzi’s method.

Results:

A total of 303 pediatric cancer patient-caregiver dyads were included in the quantitative survey and 29 caregivers accepted the qualitative interview. Quantitative analysis revealed that the prevalence of total delay, patient delay, diagnostic delay, and treatment delay was 61.71%, 16.50%, 37.29% and 7.92%, respectively. In this study, 232 (76.57%) caregiver participants undertook OHIS behaviors. When those who engaged in OHIS behaviors were compared with their counterparts, the likelihood of patient delay more than doubled (OR=2.21; 95% CI: 1.03, 4.75). Qualitative analysis showed that caregivers’ OHIS behaviors impacted the cancer care pathway by influencing caregivers’ symptoms appraisal before the first medical contacts and caregiver’s acceptance of health care provider’s diagnostic and treatment decision.

Conclusions:

Our findings suggest that OHIS by caregivers may be a risk factor in increasing the likelihood of patient delay among Chinese pediatric caregivers. Online health science popularization of pediatric cancer is needed to shorten Chinese caregivers’ cancer symptoms appraisal before the first medical contact, and online health information needs to be regulated to improve the quality of online health information in China.