Navigating the ethical landscape of healthcare professionals in social networks: Reflections to avoid shipwrecks.

Mention ‘social network’ and most people's thoughts turn to Facebook, Myspace, or LinkedIn. We imagine social networks to be engaging, intrusive, and invariably electronic. I am a member of two social networking websites, one of which I find to be fun and the other functional. My enthusiasm for reviving old friendships and retaining newer ones via social networking waned when managing information about other people's socializing became harder work than my day job. The great benefit of social networking websites, though, is that they allow users to form communities unbounded by geography. Yet this lust for electronic handholding – fun as it can be – encourages us to ignore the social networks that form in our non-virtual communities. Social networks can bring together people separated by time and distance, but the time we spend socializing electronically separates us from our physical networks. Additionally, the Internet and social networks have offered patients an easy route to medical information. Health professionals view this information revolution as potentially beneficial and harmful. How can the quality of medical information be guaranteed? Does it even matter? Is there really any evidence of harm as a result of people using medical information from the Internet? And why is using an untrustworthy website more bothersome than reading an ill-informed newspaper or journal article, listening to a badly researched radio programme, or watching pop science on television? All of these media have been used to further the case for a link between the MMR vaccine and autism. Indeed, the Internet has been a prominent tool for campaigners against the vaccine to share concerns across geographical boundaries and voice their concern to media outlets that have been unsympathetic to their cause. In many ways, the MMR controversy has been accelerated by the speed of distribution of modern media. Yet word of mouth has also played an important part. An understanding of physical social networks is fundamental to the interpretation of the perceptions of childhood immunization, especially in some minority communities. The legacy of Andrew Wakefield's criticism of the MMR vaccine is not just that he finds his integrity being questioned, but that the re-emergence of certain childhood infections is attributed to the decline in vaccination rates associated with his work. Orthodox Jewish families in North East London, for example, have low uptake of immunization, and a qualitative study in this issue examines the reasons for that low uptake (JRSM 2008;101:244–51). Lesley Henderson and colleagues find that in a community thought to be relatively insulated from direct influence, word of mouth is nevertheless a potent source of rumours about vaccination dangers, the origin of which may lie in media scares. The researchers conclude that assumptions concerning the role of religious beliefs should not act as an obstacle for providing clear messages concerning immunization, and community norms may be challenged by using social networks to communicate more positive messages about immunization. The study also underscores the importance of communication in healthcare. Whether healthcare professionals are communicating with peers or patients, communication skills are an essential tool for modern healthcare professionals, who are faced with new challenges created by our information-rich society. But fundamentally it reminds us that the convenience of pointing patients to electronic information is not a substitute for influencing physical social networks that are connected by word of mouth.

Objective: To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status. Design: Multicentre study with a prospective short-term follow-up design. Setting: A university hospital, a central hospital and a district hospital in southern Sweden. Subjects: Consecutive sample of 246 patients with a suspect or manifest myocardial infarction. Main measures: The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables. Results: Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence. Conclusions: Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.

Background: Multiple studies indicate that the choice of contralateral prophylactic mastectomy (CPM) is increasing, predominantly in women younger than 50. This is despite the lack of demonstrated survival advantage for removing the non-cancerous breast, and contradicts expert medical recommendations, such as those of The National Comprehensive Cancer Network, that discourage CPM unless the patient is at elevated risk for breast cancer (e.g., BRCA1/2 mutation). An underexplored area with regard to selection of CPM is the influence of patients' social and support networks. Breast cancer patients typically involve one or more intimates in their treatment decisions. Further, breast cancer is rarely stigmatized, making it acceptable to disclose the condition, even to non-intimates. Thus, others, in person or using social media, are likely to know when patients are making treatment choices, and may provide information, opinions, or advice that affects these choices. The scope and strength of social network influence on CPM decision-making remains unexplored to date. Methods: Potential participants for this study were identified from Indiana University and Wishard Health Services billing records using the procedure code for bilateral mastectomy during the years 2007-2012. The lists were then curated to identify patients who had undergone CPM. These patients were mailed an introductory letter and study information sheet, after which they were contacted by telephone and the questionnaire administered to those who agreed. Questions focused on the people with whom participants discussed the CPM decision. Results: 117 women of 326 invited agreed to participate. 88% of participants were Caucasian and 11% African-American. The mean age at diagnosis was 50. Most respondents (97%) discussed their surgical options with at least one person other than their surgeons (median = 3, mean = 6.7). The individuals most frequently consulted were spouses/partners, and friends or relatives who had experienced breast cancer. Children, relatives and friends who had not experienced breast cancer, and health care providers or counseling professionals were also engaged in discussion. Most respondents (92%) reported that at least one of the people they talked with (median = 2, mean = 2.6) had some degree of influence on the CPM decision. The average influence of these individuals was 3.2 on a 5-point scale (5 = played a strong role in the decision). Children had the strongest average influence (3.7/5), followed by spouses, and friends or relatives who had experienced breast cancer. Consistent with the sample (all respondents had elected CPM), most people who influenced the respondents were reported to be positive or neutral toward CPM. In the few instances in which the advisor was negative with regard to CPM, respondents reported that this person did not influence their decision. Conclusion: The current study corroborates prior research indicating that breast cancer patients discuss their treatment options with others, and underscores the potential for social and support networks to influence CPM decisions. To reduce the incidence of CPM, it may be necessary for health care professionals to educate and inform large segments of the lay public about the actual benefits and risks of CPM. Citation Format: Baptiste D, Venetis MK, MacGeorge EL, Lagoon J, Mouton A, Pastor R, Friley LB, Clare SE, Bowling MW. Social networks and the decision to undergo contralateral prophylactic mastectomy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-23.

Background. Mothers often look to family members and friends (ie, their social network) for advice and support regarding infant care decisions. However, little is known about the process by which mothers' social networks are established and how mothers use these networks to make decisions regarding infant care. We thus conducted a qualitative analysis to explore how mothers choose individuals for their social networks, and how they use these for decision-making. Methods. Focus groups or individual interviews were conducted with 28 mothers. We asked probing questions about whom mothers turned to for advice and support, and how they made infant care decisions. Data were coded and analyzed iteratively for emerging themes. Results. Themes that emerged were changes in social networks once children are born, reasons for being in the mother's social network, importance of the pediatrician as a trusted source, and process of making infant care decisions. After an infant is born, mothers gravitate toward friends with children; trustworthiness of those whom mothers turn to is based on their perceived experience and knowledge. Pediatricians are valued for their professional and personal experience with children. Mothers use consensus and/or instinct to make infant care decisions, but continually seek reassurance that these decisions are correct. Conclusion. Mothers' social networks are important sources of infant care information. Because mothers rely on consensus and continued reassurance when making decisions, health care professionals have many opportunities to influence decision-making. Consistent health care messaging can enhance mothers' perceptions that there is consensus of opinion from trusted sources.

Using Digital Media to Promote Kidney Disease Education

Background/Introduction After the pandemic, there has been a significant rise in the time people dedicate to social networks. Throughout periods of local and international lockdowns, these platforms became recognized as quicker and more effective tools for communication across various fields. Purpose We aimed to conduct a study to assess the effectiveness of deploying an information system to improve the communication process between patients and healthcare specialists. Methods A questionnaire consisting of 20 questions was utilized, completed by 43 patients or their relatives admitted between January 1, 2024, and January 31, 2024 in a cardiology ward of a tertiary centre. Results Among all participants, a proportion of 65% was represented by middle-aged women from urban areas, with 68.4% holding higher education degrees and 31.6% with secondary education. A vast majority (98%) reported using at least one social network daily for both professional and personal reasons. Eighty-three percent believe that doctor-patient interactions on social networks are ethical and regard it as a secure and effective method for communicating with healthcare professionals. Feedback from social networks did not significantly influence the selection of doctors or medical institutions. However, social network advertising notably affects the choice of medical specialists or institutions, with 48% of respondents indicating they sought out the most prominently featured hospitals or doctors on these platforms. Despite this, 72% of respondents were unaware of personalized advertising strategies or that such messages are often crafted by public relations firms. Most found social network communication with medical staff suitable for follow-ups (92%) but not for initial assessments or determining diagnostic procedures (81%). Still, there was reluctance to rely exclusively on social networks for choosing medical services. Conclusions Patients and their families are open to receiving medical information and communicating with healthcare providers through social networks. However, a limited understanding of the technologies employed to boost the visibility of specific content or endorse procedures on social media could expose patients to skewed information. Responsible regulation of medical information and advertising is imperiously needed.

Introduction:Social network is a social structure made up of individuals and organizations that represent “nodes”, and they are associated with one or more types of interdependency; such as: friendship, common interests, work, knowledge, prestige and many other interests. Beginning with the late twentieth and early twenty-first century, the Internet was a significant additional tool in the education of teenagers. Later, it takes more and more significant role in educating students and professionals.Goal:The aim of this paper is to investigate, to what extent and how effectively the Internet is used today. In addition, more specifically, this paper will research the implications of the well-known social networks in education of students and health professionals in Bosnia and Herzegovina (B&H).Material and methods:We compared the ratio of using Medline, as the largest biomedical data base system for spreading medical information, as basics for health education at biomedical faculties at five universities in B&H.Results and discussion:According to data from the CRA (i.e. Communications Regulatory Agency) in B&H, in 2010, there were 522,364 internet access accounts, with about 2 million Internet users, representing about 52% of the total population. The Internet users’ preference is dominated by the users of fast broadband access (e.g. xDSL) with 42.8%, and elsewhere, still with dialup access, with 25.2%. The results showed that only 11.6% of professors use Facebook type of social network, 49.3% of them have a profile on BiomedExperts scientific social network and 79% have available articles in the largest biomedical literature database MEDLINE. Students are also frequent users of general social networks and educational clips from You Tube, which they prefer to utilize considerably more than the other types of professionals. Students rarely use the facilities of professional social networks, because they contain mainly data and information needed for further, postgraduate professional education. In our research, we analized cited published papers in the journal Medical Archives, the oldest medical journal in B&H (established in 1947) of randomly included 151 full and part time professors, authors from five medical faculties in B&H and B&H authors who currently work in the EU and USA.. ANOVA showed that there was no significant difference in the number of articles published between the Universities in Bosnia, but there was significant difference in the number of articles published on MEDLINE, between all faculties in B&H and a group of scientists who work around the world. Students’ tests showed that there was a statistically significant difference in the average number of papers published on Medline, between groups of part-time and full time professors. However, there were no statistically significant differences, between the professors for preclinical and clinical subjects.Conclusion:In B&H there are decent conditions for the use of online social networks in the education of health professionals. While students enthusiastically embraced these opportunities, this is not so much a case with health care professionals in practice; while scientific health care workers have not shown greater interest in the use of social networks, both for purposes of scientific research and in terms of self-education and training of students. There is much more use of the advantages offered by online social networks, both in education and in support of the scientific research.

BackgroundSystematic reviews summarize and evaluate relevant studies to contribute to evidence-based practice. Internationally, researchers have reached a consensus that the active involvement of the public leads to better research. Despite this agreement, there are many reviews of research concerning healthcare interventions intended to promote the care of people living with dementia and those from their social network (e.g., close contacts, both family and non-family members) primarily involve only healthcare professionals and other experts. Due to the lack of a dementia-sensitive framework to actively involve people living with dementia and those from their social network, and healthcare professionals as co-researchers in systematic reviews, it is important to develop a framework to inform practice.MethodsFor this framework development process, we will recruit four people living with dementia and a total of four people from their social network, and three healthcare professionals working in acute or long-term care settings. We will conduct regular meetings with these groups of the public and healthcare professionals to include them in all stages of the systematic review. We will also identify and develop methods necessary to ensure meaningful involvement. The results will be documented and analyzed for the development of a framework. For the planning and preparation for these meetings, as well as the conduct of the meetings themselves, we will be guided by the principles of the INVOLVE approach. In addition, the ACTIVE framework will be used to guide the degree of involvement and the stage in the review process.DiscussionWe assume that our transparent approach to the development of a framework to support the active involvement of people living with dementia and those from their social network, and healthcare professionals in systematic reviews will serve as an impetus for and provide guidance to other researchers with the goal of increasing researchers’ focus on this topic and facilitating systematic reviews that apply participatory approaches.Trial registration: Trial registration is unnecessary as no intervention study will be conducted.

Introduction:Beginning with the late twentieth and early twenty-first century, the Internet was a significant additional tool in the education of teenagers. Later, it takes more and more significant role in educating students and professionals.Goal:The aim of this paper is to investigate, to what extent and how effectively the Internet is used today by students of biomedical faculties in Bosnia and Herzegovina. In addition, more specifically, this paper will research the implications of the well-known social networks in education of students and health professionals in Bosnia and Herzegovina. We compared the ratio of using Social networks by students for spreading medical information as basics for health education at medical faculties at 3 universities in Bosnia and Herzegovina (B&H).Results and discussion:The results showed that only 11.6% of professors use Facebook type of social network, 49.3% of them have a profile on BiomedExperts scientific social network and 79% have available articles in the largest biomedical literature database MEDLINE. Students are also frequent users of general social networks and educational clips from You Tube, which they prefer to utilize considerably more than the other types of professionals. Students rarely use the facilities of professional social networks, because they contain mainly data and information needed for further, postgraduate professional education.Conclusion:In B&H there are decent conditions for the use of online social networks in the education of health professionals. While students enthusiastically embraced these opportunities, this is not so much a case with health care professionals in practice; while scientific health care workers have not shown greater interest in the use of social networks, both for purposes of scientific research and in terms of self-education and training of students.

BackgroundIndividuals’ social networks and social support are fundamental determinants of self-management and self-efficacy. In chronic respiratory conditions, social support can be promoted and optimized to facilitate the self-management of breathlessness.ObjectiveThis study aimed to identify how online and offline social networks play a role in the health management of older patients with chronic respiratory conditions, explore the role of support from online peers in patients’ self-management, and understand the barriers to and potential benefits of digital social interventions.MethodsWe recruited participants from a hospital-run singing group to a workshop in London, the United Kingdom, and adapted PERSNET, a quantitative social network assessment tool. The second workshop was replaced by telephone interviews because of the COVID-19 lockdown. The transcripts were analyzed using thematic analysis.ResultsA total of 7 participants (2/7, 29%, men and 5/7, 71%, women), with an age range of 64 to 81 years, produced network maps that comprised between 5 and 10 individuals, including family members, health care professionals, colleagues, activity groups, offline and online friends, and peers. The visual maps facilitated reflections and enhanced participants’ understanding of the role of offline and online social networks in the management of chronic respiratory conditions. It also highlighted the work undertaken by the networks themselves in the self-management support. Participants with small, close-knit networks received physical, health, and emotional support, whereas those with more diverse and large networks benefited from accessing alternative and complementary sources of information. Participants in the latter type of network tended to communicate more openly and comfortably about their illness, shared the impact of their illness on their day-to-day life, and demonstrated distinct traits in terms of identity and perception of chronic disease. Participants described the potential benefits of expanding their networks to include online peers as sources of novel information, motivation, and access to supportive environments. Lack of technological skills, fear of being scammed, or preference for keeping illness-related problems for themselves and immediate family were reported by some as barriers to engaging with online peer support.ConclusionsIn this small-scale study, the social network assessment tool proved feasible and acceptable. These data show the value of using a social network tool as a research tool that can help assess and understand network structure and engagement in the self-management support and could be developed into an intervention to support self-management. Patients’ preferences to share illness experiences with their online peers, as well as the contexts in which this can be acceptable, should be considered when developing and offering digital social interventions. Future studies can explore the evolution of the social networks of older people with chronic illnesses to understand whether their willingness to engage with online peers can change over time.

Social Networking Among Upper Extremity Patients

We used a systematic search and selection process to assess the scope of the literature along with a narrative synthesis of recent high-quality reviews. The original studies were mainly observational studies of patients and, to a lesser extent, of carers. There were few interventional studies, mainly of patients. There were very few studies of any type on wellbeing in their wider social network or in healthcare professionals. All the review literature looked at MND patient or carer wellbeing, with some covering both. No reviews were found of wellbeing in other family members, patients' social networks, or their healthcare professionals. The reviews demonstrated wellbeing problems for patients linked to psychosocial issues. Carer wellbeing is also compromised. Psychotherapies, social supports, improved decision supports, and changes to healthcare delivery are among the suggested strategies for improved patient and carer wellbeing, but no proven interventions were identified for either. Early access to palliative care, also not well-tested but recommended, is poorly implemented. Work on interventions to deal with well-established wellbeing problems for patients and carers is now a research priority. Explicit use of current methods for patient and public involvement and for design and testing of interventions provide a toolkit for this research. Observational research is needed in other groups. There is a potential in considering needs across patients' social networks rather than looking individually at particular groups.

IntroductionAttention to the needs of the elderly is a social necessity, and it seems that evaluating the social network and quality of life of the elderly can be useful in a better understanding of their needs. This study was performed to determine the relationship between the social network and the quality of life of the elderly in the city of Bojnoord in Iran.MethodsIn this cross-sectional study, 201 elderly people aged 60 years or more were selected by continuous and consecutive sampling method in Bojnoord, Iran in 2014. Data were collected using demographic questionnaire, Lubben social network scale and LEIPAD elderly quality of life questionnaire. Data were analyzed by SPSS 16 and using descriptive statistics and independent-samples t-test, ANOVA and Pearson product-moment coefficient.ResultsThe results showed that 30.3% of elderly people studied, were subjected to a high risk of isolation. The highest mean in social network dimensions was in the family (19.68%), friends (12.01%) and the neighbors (9.90%), respectively. The mean score for quality of life of the elderly was as moderate to high (63.90±13.73), and among the quality of life dimensions, the highest mean was related to the self-care dimension (15.59%), and the lowest mean was related to the sexual functioning dimension (1.53%). The findings suggested a positive and significant relationship between social network and quality of life in the elderly who were studied (p<0.000, r=0.468).ConclusionThis study was a step toward understanding the social network status and quality of life of the elderly. It is necessary to say that health care professionals, especially nurses, display a significant role in the community to help people in this regard.

Social support is an important component of recovery-based interventions for individuals living with severe mental illness (IWSMI). Clubhouses are local community centers that facilitate the development of meaningful relationships among IWSMI through an empowering structure and engagement with the work-ordered day. This review synthesizes research on social networks in Clubhouses to provide insights on the role of supportive relationships in mental illness recovery, including the size and features of social networks of Clubhouse members, methodological trends and gaps, and the associations between social networks and demographic variables, recovery, health, and perceived social support. Research on social networks within Clubhouses were identified and analyzed following a systematic six-stage scoping review design. Twelve articles across six studies were included. Results revealed considerable variation in social network interview methods and network size and features. Overall findings suggest that network size is not consistently associated with reported loneliness, social support, recovery, or quality of life. A deep relationship with at least one supportive person, level of perceived affiliation with Clubhouses, or positive comments from network members may be more or equally valuable than a larger network. Some studies found that types of relationships were associated with unique benefits. Stronger peer networks were associated with relationship satisfaction, while increased connections with health care professionals and family were associated with reduced hospitalizations. Future research should diversify research designs, expand the use of social network analysis and visualization, measure additional outcomes including recovery and health, and increase sample diversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Purpose In this study, we investigate the nature and strength of the social relations of working-age individuals who have survived a severe traumatic brain injury. Materials and methods Fifty-three survivors diagnosed with severe traumatic brain injury completed the social network analysis questionnaire, enabling us to map their social networks using the software program EgoNet.QF. This was combined with interviews with four survivors and their significant members of their network and constructed narrative cases of the resources gained from their network. Results Half the survivors lost friends because of the brain injury. The most common social network post injury comprised parents followed by spouses. Close relatives experienced a dramatic change in the nature of their relationships with the survivor. They also struggled greatly with the rehabilitation health system, which in many cases affected their own careers. Conclusion Persons with severe traumatic brain injury and their close relatives predominantly learn to manage the new situation, with functionality driving social interaction. However, as social networks often are limited to the close family, these individuals are placed in a vulnerable position. IMPLICATIONS FOR REHABILITATION Existing networks (whether few or many) are of major importance for individuals with traumatic brain injury in the rehabilitation process. Close social relations possess knowledge about the survivor with traumatic brain injury that is important for the rehabilitation process. To support individuals and their families who lack strong resources and social networks, health care professionals should systematically identify these persons from admission to hospital and primary care. When these persons have been identified, individual plans for how to strengthen their network can be developed in collaboration with the individuals and their existing social network.