線上健康社群社會資本之效應

Abstract

隨著網路資訊科技的發展與人民教育水準之提升，病患與照護者已越來越關注於醫療健康資訊的掌握，對於醫療相關知識的取得也漸趨積極主動。因此，建立線上健康社群，實施線上健康介入，以促進照護者之醫療知識，改善病患健康結果，進而減輕照護者之醫療照顧上的負擔，已被廣泛應用於解決健康問題之因應上。 但因一般線上社群資訊的公開性以及網路訊息的來源繁雜，而與需具有高度私密性與正確性要求的醫療健康資訊產生衝突，進而導致一般線上醫療資訊的濫用與誤解。導致許多醫療健康相關線上資訊的可信度與有效性遭受醫療人員，病患的照顧者與病患本人的質疑。因此，如何增加醫療健康資訊的可信度，有效性以及使用者參與，成為設計線上健康介入時的一大挑戰。 本研究為深入探討在線上健康社群中，針對ㄧ群有相同醫療健康需求的居家呼吸照護兒童家庭照顧者，透過社會資本的累積，與專業醫療人員以及家庭照顧者成員間擁有健康知識的轉換及累積和擴散、建立彼此信任與互惠互利的關係，可有效增加生活掌控度與改善憂鬱傾向，提升成員的生活品質，充份展現健康社群系統的優勢，以達成促進優質醫療照護資訊的分享，提升成員間長照知識與經驗的擴散轉換之效率及累積。 本研究希望驗證以下假設： (一)在線上健康社群中，社會資本（Social Capital）會正向影響生活掌控度（Perceived Life Control），改善憂鬱傾向（Improving Depression Status）與使用者參與（User Engagement）的關係自變數有：結構維度 (Structural Dimension)、關係維度（Relational Dimension）以及認知維度（Cognitive Dimension） (Nahapiet & Ghoshal, 1998)； (二)在線上健康社群中，使用者參與（User Engagement），對社會資本（Social Capital）正向影響生活掌控度（Perceived Life Control），改善憂鬱傾向（Improving Depression Status）和改善生活品質（Quality of Life）具有中介效應 ； (三)在線上健康社群中，生活掌控度（Perceived Life Control）和改善憂鬱傾向（Improving Depression Status ）會正向影響改善生活品質（Quality of Life）。

Online health interventions can lead to behavioral changes and improve health outcomes related to various health conditions. However, tensions between patients and physicians may discourage patients from seeking health information online. Furthermore, patients may make poor decisions about disease management even if the information they access is accurate because of a lack of understanding due to information asymmetry. Evidence suggests that in online communities, social ties can positively affect health outcomes and facilitate knowledge sharing through user engagement. However, the different types of resources embedded within, available through, and derived from networks of relationships require additional investigation. We hypothesized that in online health interventions, the social capital in terms of three distinct dimensions: structural, relational, and cognitive of the participants directly affects their sense of control in life, depressive tendencies, and user engagement, and indirectly affects quality of life (QOL). This study used a survey and conducted a 4-month health intervention in an online health community that provides physician-supervised knowledge content to participants on a daily basis. We recruited 81 family caregivers of children on home ventilation. These caregivers were selected because their capability of accessing modern information and communication technology was greater than that of people with other demographic characteristics. We conducted Internet-based surveys at the beginning and the end of this study, in which the participants shared their knowledge and experiences with other family caregivers and their user engagements in the online health community were monitored during the first and fourth months. The empirical results obtained from the partial least squares multi-group analysis algorithm show that measures of the relational dimension of social capital positively and significantly affected perceived life control and negatively and significantly affected depression status. Moreover, user engagement positively and significantly affected family caregivers’ QOL; however, family caregivers’ cognitive dimensional of social capital negatively and significantly affected their perceived life control.