BackgroundThere has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced.ObjectiveThe aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives.MethodsThis included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis.ResultsWe found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating consumers on how to assess OCHI websites, and helping consumers present and discuss the OCHI they find with a health professional in their social network or a librarian for instance.ConclusionsWe examined negative outcomes associated with using OCHI from five complementary perspectives (consumers, family physicians, pharmacists, nurses, and health librarians). We identified a construct of OCHI use–related tension that included and framed all negative outcomes. This construct has three dimensions (three interdependent levels): internal, interpersonal, and service-related tensions. Future research can focus on the implementation and effectiveness of the proposed strategies, which might contribute to reducing these tensions.
YouTube is the preferred online platform for today’s teenagers. As such, this article explores the relationship between socialization processes in adolescent peer culture and the meanings behind the production and reception of YouTube videos by teenage audiences. Two fields of enquiry comprise the data analyzed in this article. First, through content analysis, we studied the production of videos on YouTube by teenagers between the ages of 14 and 18. The discursive construction of an audience is expressed by YouTubers through intimate identity performances using specific, dialogical, and conversational modes. The second study investigated the reception of these videos by teenagers between the ages of 12 and 19 through the use of focus groups and in-depth interviews. The results explained the way young people develop a sense of closeness with YouTubers. When examined collectively, our studies reveal how teenage YouTube practices, both as production and reception of content, constitute a twofold social recognition process that incorporates a capacity to recognize oneself in others—like figures with whom one can identify with—and a need to be recognized by others as beings of value. The “intimate confessional production format,” as we have termed it, reinforces this bond.
La progression de l’utilisation « non médicale » des médicaments, que ceux-ci soient disponibles avec ou sans ordonnance, apparaît aujourd’hui comme une préoccupation d’importance croissante dans le champ de la santé publique. Cette tendance, qui touche particulièrement les adolescents et les jeunes adultes, englobe une multitude de pratiques, allant du détournement à l’automédication en passant par « l’abus » et le dopage, pratiques qui seront définies ici et qui peuvent conduire au développement d’une dépendance au médicament. S’appuyant sur une revue de la littérature en sciences sociales et en santé publique, cet article met en évidence les problèmes que soulève la catégorisation des pratiques, notamment parce que les frontières entre les usages licites et illicites du médicament semblent de plus en plus brouillées dans les sociétés contemporaines. L’utilisation « non médicale » du médicament s’inscrit dans un contexte social marqué par un plus grand accès aux produits pharmaceutiques et aux savoirs qui s’y rapportent ainsi que par une tendance à la banalisation du recours chimique dans la vie quotidienne. Cet usage de l’assistance chimique à la vie quotidienne soulève la question de l’autonomie du sujet en santé et du rapport des individus à l’expertise médicale.The increase in non-medical use of prescription drugs and OTCs is becoming a serious public health issue. Non-medical use of medicines is more common among adolescents and young adults and includes practices such as drug diversion, self-medication, drug abuse, and doping. Using the literature published in public health and social sciences, this paper shows that categorizing drug-taking practices can be problematic as the distinction between illicit and licit use of medicines is becoming blurred in contemporary societies. Non medical use of prescription drugs is situated within a broader social context where greater access to prescription drugs and health information is provided and where the use of medicines is integrated into everyday life. It raises issues related to autonomy in healthcare and to the lay-expert relationship.La progresión del uso “no médico” de los medicamentos, ya sea que estén disponibles con o sin receta, constituye en la actualidad un problema cada vez más importante en el campo de la salud pública. Esta tendencia, que toca particularmente a los adolescentes y los adultos jóvenes, engloba una cantidad de prácticas que van de la utilización indebida a la automedicación, pasando por “el abuso” y el dopaje, prácticas que se definirán aquí y que pueden conducir al desarrollo de una dependencia al medicamento. Apoyándose en una revisión de la bibliografía de las ciencias sociales y la salud pública, este artículo pone en evidencia los problemas que representa la categorización de las prácticas, principalmente porque las fronteras entre los usos lícitos e ilícitos del medicamento parecen ser cada vez menos claras en las sociedades contemporáneas. El uso “no médico” del medicamento se inscribe en un contexto social marcado por un mayor...
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