Indiana University-Purdue University Indianapolis (IUPUI) / Atypical symptoms, multiple co-morbidities and a lack of public awareness make it difficult for older adults to know when to seek help for sepsis. Diagnosis delays contribute to older adults’ higher sepsis mortality rates. This research describes patients’ and caregivers’ experiences with the symptom appraisal process, self-management strategies, provider-nurse-patient interactions, and barriers when seeking sepsis care. Convenience and purposive stratified sampling were utilized on two data sources. A nurse-patient and nurse-family caregivers were interviewed. Online stories by older adult patient survivors or family members from the Faces of Sepsis ™ Sepsis Alliance website were analyzed. Emergent themes were identified using qualitative descriptive methods. Listlessness and fatigue were most bothersome symptoms for the nurse-family caregivers. Fever, pain and low blood pressure were most common complaints, followed by breathing difficulty, mental status changes and weakness. Patients expressed “excruciating pain” with abdominal and soft tissue sources of infection, and with post-operative sepsis. Concern was expressed that self-management strategies and medications create barriers by masking typical sepsis signs. Health care providers’ interpersonal interactions, lack of awareness of sepsis symptoms and guidelines, complacency towards older adults, and denial by patients were barriers. Further barriers were staff inexperience, delays, care omissions, and tension between health care providers, patients and caregivers—with emerging advocacy by patients and family. In conclusion, providers should assess previous self-management strategies when evaluating symptoms. At primary care visits or hospital discharge, older patients with risk factors need anticipatory guidance for sepsis symptoms and possible emergent infections--specifically patients with pre-existing risk factors such as urinary tract infections, pneumonia, or operative events. Public and professional education are needed to overcome a lack of urgency and understanding of symptoms for diagnosis, treatment and guideline adherence for inpatients and outpatient clinics. Further research on subjective sepsis symptoms may improve patient-clinician communications when evaluating sepsis in older adults.

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The present study was aimed at experimentally investigating effects of causal explanations for depression on treatment-seeking behavior and beliefs. Participants at a large Southern university (N = 139; 78% female; average age 19.77) received bogus screening results indicating high depression risk, then viewed an explanation of depression etiology (fixed biological vs. malleable) before receiving a treatment referral (antidepressant vs. psychotherapy). Participants accepted the cover story at face value, but some expressed doubts about the screening task’s ability to properly assess their individual depression. Within the skeptics, those given a fixed biological explanation for depression were relatively unwilling to accept either treatment, but those given a malleable explanation were much more willing to accept psychotherapy. Importantly, differences in skepticism were not due to levels of actual depressive symptoms. The present findings indicate that information about the malleability of depression may have a protective effect for persons who otherwise would not accept treatment.

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When people access online health information, unfortunately, they have access to both clinically accurate and inaccurate information that they may then utilize to make informed personal health decisions. This research fills a gap in the literature of online health communities as they relate to chronic obstructive pulmonary disease (COPD). The conduct of this research required a multi-phased and multi-method approach, best presented in three distinct essays. In Essays 1 and 2, data gathering within two online health communities specific to COPD allowed this study to address three research questions: (1) what are the information needs of COPD patients that result in their participation in online health communities; (2) what are the information sources offered to the participants in these online communities; and (3) is the information obtained via those communities credible. Essay 1 harvested data from a moderated website hosted by a non-profit organization for patients with COPD and Essay 2 harvested data from a non-moderated Facebook group also serving this unique group. Data Miner, a Chrome extension designed to extract data, was used to collect data, key words and themes which brought an understanding of the health information needs of participants and identified what health information sources were preferred. Using NIH guidelines, the credibility of sources exchanged were evaluated for both groups. The research presented in Essay 1 showed that COPD patients have health information needs and that a clinically monitored social health online community, that is available 24/7 to answer questions that arise at the time of need, provides much needed support. The research in Essay 2 illustrates the need for healthcare workers to be aware of unmoderated sites and promote these sites for the purpose of socialization only, and not for medical information. Building on the knowledge gained through the data analysis in Essays 1 and 2 and based on the theoretical frameworks established in the health belief model, social exchange theory, and the technology acceptance model, Essay 3 generated a new integrated model that seeks to understand information seeking effectiveness in online health communities was proposed. This model identifies the relationships between the types of disease specific information sought by members of 65 COPD Facebook groups, and member success in acquiring credible and clinically accurate health information to use in making health decisions related to disease management and the development of effective health management behaviors. Structural equation modeling was utilized to analyze survey responses and test the proposed model for statistical significance This study has important implications for health educators and medical professionals that will enhance their understanding of the benefits of online peer health communities and will guide them in providing their patients with an "information prescription" guiding them to clinically accurate and understandable, disease specific health information between office visits and at the patient's time of need.

This study explores ways of visualizing metadata in virtual reality through means other than text. Specifically, we focus on the metadata of a 3D object as a search result and how these visualizations can support understanding of the object. The study draws on research from the field of information science and is positioned in the domain of cultural heritage. There are few studies about human information interaction in virtual reality or metadata visualization in these environments. However, metadata can be a useful tool in the information seeking search process. Because its visualization should depend on purpose, ways of visualizing metadata other than through text are in need of exploration. This study answers the following question: How can descriptive metadata of a 3D search result object be visualized in VR to support users’ understanding of the object? A research through design approach was employed. Data was collected through interviews about objects with visitors at a museum. These interview data were analyzed using a thematic analysis, and the results of that analysis were triangulated with the objects’ metadata in a database. This triangulation resulted in sets of characteristics and techniques that, as expressed by interviewees, could help them gain an understanding of an object of historical and cultural significance. We then selected a smaller set of characteristics for implementation using a prioritization matrix, and an object to visualize metadata for. Brainstorming sessions generated ways of visualizing these characteristics using relevant techniques. The prototype is a virtual reality experience that allows the user to navigate three layers of information with visualizations of the 3D object’s characteristics. The prototype was interactively demonstrated with four participants and their feedback was documented. The discussion is about the definition of metadata, unforeseen designs, the search process, the role of virtual reality in information seeking, how metadata visualizations can support understanding of an object and whether our do, our choice of using research through design as the approach and the study’s ethical and societal implications and its limitations. We conclude that metadata of a search result as an object in VR can be visualized by segmenting the VR experience into different layers of information, specifying a sequence in which the layers are presented that builds a narrative and provides users with multisensory feedback. We encourage future evaluative and comparative studies.

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