How patient-centered communication shapes online health information seeking across different channels: The mediating role of uncertainty management.

Abstract

Patients increasingly rely on diverse online sources for health information. Although they place high trust in clinician-provided information, findings on how clinical communication relates to patients' online health information seeking (OHIS) remain inconsistent. Grounded in the Theory of Communication and Uncertainty Management (TCUM) and the Path Mediation Model, this study explores how patient-centered communication (PCC) is associated with patients' OHIS across different channel types and examines the mediating role of uncertainty management strategies. Online panel surveys were conducted in 2018-2019 across four European countries (Germany, Switzerland, Austria, and the Netherlands) with 4186 participants who had received healthcare in the past year. Multiple linear regression and PROCESS Model 4 assessed relationships among PCC, uncertainty management strategies (reduction, maintenance, increase), and five types of online health information channels. PCC was positively associated with professional websites and uncertainty reduction, but negatively associated with social media, uncertainty maintenance, and uncertainty increase. Uncertainty reduction predicted greater use of professional websites, online encyclopedias, and general social media platforms. Uncertainty maintenance predicted greater use of online pharmacies, general social media platforms, and online communities, while uncertainty increase predicted greater use of online pharmacies and online communities. Mediation analyses indicated that uncertainty management strategies partially explained the relationship between PCC and OHIS. PCC is associated with patients' OHIS both directly and indirectly through uncertainty management. Effective PCC can promote uncertainty reduction and professional source use while reducing uncertainty maintenance and peer platform reliance. These findings underscore the role of clinical communication in guiding patients' digital health information behavior. Clinicians should enhance PCC by discussing patients' information needs and understanding their uncertainty management goals. Greater oversight of online pharmacies and uncertainty management training in patient education programs are recommended to promote safer use of online health resources.