During client practice in third year, I had a senior client who preferred a naturopathic approach to meet her health care needs. While alternative methods of treatment are acceptable, the client was very resistant to change (low on the transtheoretical model of change) and proved to be challenging to oral health education.1,2 Educating the client on nutrition, self-diagnosis, dangers of online browsing, and evidence-based research were topics of discussion throughout appointments. To start, my client was very vocal on her methods of acquiring information from various online sources for a variety of vitamins, supplements, and therapies. Throughout every appointment, I was able to elicit information about the client’s oral health knowledge, beliefs, and attitudes regarding her personal self-care habits, diet, medications, and lifestyle.1 In clinic, I had the client participate in a food diary assessment, providing the client with nutritional counselling. From the results, it was evident the client was not receiving well-balanced nutrition with food variety as the client had designed a specific plant-based diet for themselves. The client also noted that her allergies were self-diagnosed, which affect her food choices; therefore, impacting her nutrition, dental, and overall health. Upon assessment, the client refused the recommendation of seeing a physician for allergy testing. Furthermore, while I was able to teach the client personal self-care through toothbrushing and flossing methods and techniques, the topic of working together to find credible sources for information was commonly discussed. At the end of the appointment, credible sources were provided to the client, such as Dieticians Canada, to provide her with more evidence-based information.1
Online research using unreliable online sources such as WebMD, Wikipedia, and eHow, can be dangerous if used incorrectly. Certain sources are unreliable if they have a lot of advertisements on their webpage, if directions and claims are unclear, if the website is out-of-date, if the site requires the entry of personal information, and if the site has an unreliable domain. Moreover, if a client does not understand the etiology of their medical conditions, and the required therapy needed to manage their condition(s), intake of unnecessary supplements and medications, inaccurate dose and frequency, and contraindications may surface and pose dangerous, if not deadly. Statistically, older adults, ages 65 years and older, are susceptible to complex health care needs, consequently, relying on past health experiences and medical knowledge to guide self-diagnosis.3 While commonly facing difficulty in navigating computer and Internet tools, one in five senior citizens use the Internet as a source for health information; however, many are misled to unreliable sources and misdiagnosis of themselves or others as 58% of seniors do not check sources for reliable information.3-5 Many individuals are drawn to online self-diagnosis as a form of relief.4 While there are a few benefits associated with this form of diagnosis, such as doctor appointment preparation, and understanding of symptoms and conditions, the risks of online diagnosis outweigh the benefits.4 Risks include misinterpretation of unreliable information, replacing the physician with the Internet, delay in seeking treatment, and inaccurate, incomplete, and harmful treatment facts and options suggested.4-6 A recommendation to all health care professionals is to recognize behaviours clients present; encourage client participation and autonomy for client’s health by providing credible sources and evidence-based information, while being receptive and aware of alternative medical approaches.4
References:
- Canadian Dental Hygiene Association. Entry-to-practice competencies and standards for Canadian dental hygienists [Online]. 2010 Jan [cited 2019 Apr 1]. Available from: https://www.cdha.ca/pdfs/Competencies_and_Standards.pdf
- Tillis TS, Stach DJ, Cross-Poline GN, Annan SD, Astroth DB, Wolfe P. The transtheoretical model applied to an oral self-care behavioral change: development and testing of instruments for stages of change and decisional balance. J Dent Hyg. 2003;77(1):16-25.
- Houston T, Suls J, Older adult experience of online diagnosis: results from a scenario-based think-aloud protocol. J Med Internet Res. 2014 Jan 16;16(1):16.
- Gass MA. Risks and benefits of self-diagnosis using the internet. Salem State University. 2016 May 1. Honors Theses. 96. http://digitalcommons.salemstate.edu/honors_theses/96
- Kaiser Family Foundation. e-Health and the elderly: how seniors use the internet for health information – key findings from a National Survey of Older Americans [Internet]. 2005 Jan [cited 2018 Apr 11]. Available from: https://kaiserfamilyfoundation.files.wordpress.com/2013/01/e-health-and-the-elderly-how-seniors-use-the-internet-for-health-information-key-findings-from-a-national-survey-of-older-americans-survey-report.pdf
- Oliveira M. More than half of Canadians use ‘doctor Google’ to self-diagnose. The Canadian Press. 2013 Jul 13 [cited 2018 Apr 2]. Available from: https://globalnews.ca/news/752415/more-than-half-of-canadians-use-doctor-google-to-self-diagnose/