Table 3.
Procedures and strategies for dealing with Internet-related health anxieties/cyberchondria
| Perceived cause of (emerging) cyberchondria | Implication from the GP’s standpoint | Specific approach | Focus | Percentage share in the sample (N = 38) |
|---|---|---|---|---|
| Disorientation and uncertainty due to the lack of a serious, competent medical authority guiding the patient and giving trustworthy information | The doctor should eliminate other sources of information that (potentially) conflict with his/her advice; the patient should be directed to the physician as a “decision-making and instructing authority” (I-23, male) | Actively discourage the patient from (further) health-related Internet investigations (for example, in case of uncertainty the GP can be contacted at short notice in order to prevent further rampant online searches and to strengthen the doctor–patient relationship) | Stabilization | 21% (8) |
| Patients have a lack of understandable, transparent explanation as well as an insufficient overview of their treatment situation (for example, diseases, diagnoses, therapies, etc.) | The doctor can prevent a growing feeling of uncertainty and edginess in the patient by focusing on providing detailed information and clarifying questions | Detailed explanation of the diagnosis and therapy to prevent a patient from having an expansive or aimless internet research (provided that considerably more consultation time is granted) | Prevention/stabilization | 63% (24) |
| Patients have a lack of serious, correct sources of information and advice; they are misinformed and misguided by the results of their health-related research | Physicians can correct patients’ false assumptions by providing the patient with alternative sources of information that are reputable and reliable; the patients’ aim to do independent research can be prevented | a) The patients are given recommendations to reputable health information sources on the Internet by the doctor (for example, certain health portals) | Prevention/stabilization | 32% (12) |
| b) The doctor refers to other information materials or hands them over (such as medical brochures, journal articles) | 11% (4) | |||
| Patients wish to be taken seriously in their online research by the doctor and want their findings to be taken into account; if this is not the case, the patient turns (even more) to online research and becomes independent | In order to strengthen the doctor–patient relationship, the doctor should actively ask for and react to the patient’s Internet searches. This gives the patient appreciation and his/her research can ideally be used for further care | a) Joint examination and discussion of the health-related online information and health websites sought by the patient | Prevention/stabilization | 26% (10) |
| b) The doctor checks the information sought by the patient and tries to classify, correct, and clarify | 13% (5) | |||
| In the early stages of cyberchondria, patients are often on their own and, in the course of their Internet searches, become nervous and panic-stricken, without the doctor being aware of it. If the tipping point is exceeded and health fears have become entrenched, it is often difficult to manage cyberchondria | Early detection of patients who do intensive health searches on the Internet with the doctor responding, if necessary, in order to prevent cyberchondria | a) Extension of the common medical history questionnaire in order to record the frequency of Internet research on health and illness on the part of the patient | Prevention | 11% (4) |
| b) For certain groups of patients, the doctor asks in principle whether previous health-related searches have been conducted on the Internet | 18% (7) | |||
| c) Fundamental thematization of chances and risks of online research during the consultation | 11% (4) | |||
| Cyberchondria arises in a complex process of development and dynamization in which various psychosocial factors, personality traits, and experiences interact with each other | The doctor can only respond effectively to Internet-related health anxieties if he/she has the necessary background knowledge to influence affected patients competently; this is all the more important given the lack of psychotherapeutic care capacities | Doctors complete further psychosocial training (such as psychotherapy, psychoanalysis, social medicine) | Prevention/stabilization | 11% (4) |
GP general practitioner