Qualitative Health Research

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Health Information−−Seeking Behavior

Sylvie D. Lambert and Carmen G. Loiselle
Qual Health Res 2007 17: 1006
DOI: 10.1177/1049732307305199

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 Qualitative Health Research
Volume 17 Number 8
October 2007 1006-1019

Health Information–Seeking Behavior © 2007 Sage Publications

10.1177/1049732307305199
http://qhr.sagepub.com
hosted at
Sylvie D. Lambert http://online.sagepub.com

Carmen G. Loiselle
McGill University

Seeking information about one’s health is increasingly documented as a key coping strategy in health-promotive activities
and psychosocial adjustment to illness. In this article, the authors critically examine the scientific literature from 1982 to
2006 on the concept of health information–seeking behavior (HISB) to determine its level of maturity and clarify the con-
cept’s essential characteristics. A principle-based method of concept analysis provides the framework for exploring the
nature of HISB. The authors reviewed approximately 100 published articles and five books reporting on HISB. Although
HISB is a popular concept used in various contexts, most HISB definitions provide little insight into the concept’s specific
meanings. The authors describe the concept’s characteristics, contributing to a clearer understanding of HISB, and discuss
operationalizations, antecedents, and outcomes of HISB. Such an analysis of HISB might guide further theorizing on this
highly relevant concept and assist health care providers in designing optimal informational interventions.

Keywords: concept analysis; information seeking; health information

F rom the late 1980s to mid-1990s, only a few

seminal works addressed the concept of health
information–seeking behavior (HISB) (e.g., Lenz,
From Wilson (1963) to the Present
One challenging and critical issue in concept analy-
1984; Loiselle, 1995; Miller, 1987). However, the sis is the selection of the most appropriate analytical
advent of the information age and related increase in method. Traditionally, concept analysis has been
the amount of information potentially available (Vakkari, addressed primarily through Wilsonian-derived meth-
Savolainen, & Dervin, 1996), and an enhanced focus on ods introduced mainly by Walker and Avant (1995) and
self-monitoring and self-care, as well as renewed Chinn and Jacobs (1987). These methods are widely
interest in predictors of health promotion and illness used, as they offer structure and guidance for concept
prevention activities, contributed to HISB’s taking analysis. However, the end product of such analysis
center stage (Johnson, 2003; Loiselle & Dubois, often lacks depth, with resulting concept attributes that
2003). Since the mid-1990s, studies examining HISB are vague and of limited utility. An additional criticism
abound in the health-related scientific literature. is that these methods are based on demised positivist
Researchers and clinicians, alike, are interested in philosophy (Hupcey, Morse, Lenz, & Tason, 1996;
understanding how and why individuals obtain health Morse, Hupcey, Mitcham, & Lenz, 1996). For these
information, where they go to retrieve such informa- reasons, authors have recommended alternate meth-
tion, what particular types of information they prefer, ods, such as critical analysis of the literature and the
and how the health information sought is used. At first use of qualitative approaches (Hupcey, Morse, et al.,
glance, the concept of HISB appears to be well devel- 1996; Morse, Hupcey, et al., 1996; Rodgers, 1989;
oped and used without apparent controversies or Schwartz-Barcott, 2003).
debate about its meaning. However, on closer exami- Rodgers (1989) proposed an evolutionary method
nation, the concept affords multiple understandings. for concept analysis that moves away from a static
Despite the abundant theoretical and empirical litera- view of concepts to a more fluid one and overcomes
ture on HISB, no article reviewed to date critically some of the aforementioned weaknesses (Hupcey,
examines the concept. Such an analysis might further Morse, et al., 1996; Morse, Hupcey, et al., 1996).
clarify the concept and contribute to a more fully However, certain aspects of the evolutionary method
developed concept and more accurate assessments of remain disputable. The analysis still focuses mainly on
HISB. Hence, the purpose of the present article is to the linguistic aspect of the concept (Morse, Hupcey,
present a comprehensive analysis of the concept of et al., 1996) and is often limited to a single exemplar
HISB. (limiting the richness of the data obtained) (Hupcey,
1006

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 Lambert, Loiselle / Health Information–Seeking Behavior 1007

Morse, et al., 1996; Morse, 1995; Morse, Hupcey, literature were (a) works written in English or French,
et al., 1996). Furthermore, the selection of one exemplar (b) those with a focus on actual behaviors of individu-
that encompasses all contexts contradicts Rodgers’s als when seeking health-related information, (c) the
statement that concepts are context bound. In addition, inclusion of “information seeking” in the title or the text,
Rodgers’s recommendation that data analysis be and (d) scholarly works published in a peer-reviewed
delayed until last violates standards of qualitative journal. A computer-generated search was performed
inquiry (Hupcey, Morse, et al., 1996). using OVID software, accessing the Medline, CINAHL,
Morse and colleagues have contributed a criteria- or psychINFO, HEALTHSTAR, Web of Science, and
principle-based method to concept analysis (Morse, Health and Psychosocial Instruments databases. The
1995; Morse, Hupcey, et al., 1996; Morse, Mitcham, search was conducted in various disciplines to obtain a
Hupcey, & Tason, 1996; Penrod & Hupcey, 2005). broad perspective on the concept (Morse, 2000; Penrod
Morse et al.’s (Morse, Hupcey, et al., 1996; Morse, & Hupcey, 2005). The period from 1982 to 2006 was
Mitcham, et al., 1996) method is selected for the pre- retained, as it represents a period long enough to detect
sent analysis, as it promotes the use of rich data sources seminal work undertaken on HISB. Examples of terms
and provides clear criteria on which to base the analy- (used alone or in combination) included information-
sis and it is more flexible and less decontextualizing seeking behavior, information needs, health informa-
than the abovementioned methods (Penrod & Hupcey, tion, coping, decision making, information services
2005). According to Morse, Hupcey, et al. (1996), con- (use), and health education (use). In addition, a perusal
cept analysis “refers to a process of inquiry that of the reference lists of each article was conducted to
explores concepts for their level of development or retrieve potentially relevant work not initially identi-
maturity as revealed by their internal structure, use, fied. Five books and approximately 100 published arti-
representativeness, and/or relations to other concepts” cles were reviewed. Of the articles, approximately 60%
(p. 255). The initial phase focuses on analyzing extant were quantitative studies (e.g., information-seeking
literature on the concept and determining its level of styles, correlates of information seeking), 15% were
maturity. Maturity is a criteria-based determination of qualitative studies (e.g., type and sources of informa-
the concept’s clarity from epistemological (i.e., defini- tion preferred), 15% were reviews (e.g., information
tions), linguistic (i.e., contexts within which the con- needs), and 10% were theoretical papers (e.g., model or
cept is used), logical (i.e., boundaries and theoretical theories of information-seeking behavior). The refer-
integration with other concepts), and pragmatic (i.e., ences were organized using Reference Manager.
operationalization) perspectives (Hupcey, Penrod,
Morse, & Mitcham, 2001; Morse, Hupcey, et al., 1996; Data Analysis
Morse, Mitcham, et al., 1996; Penrod & Hupcey, 2005).
Analysis was carried out according to an in-depth
Each criterion “contributes to an understanding of
content analysis of each source (Morse, 2000). First,
the strengths and limitations of the present state of the
we read each article and book chapter two to three
concept in the scientific literature” (Penrod & Hupcey,
times to identify general content and to gain a sense of
2005, p. 403). A concept is mature if it is well defined;
the overall meaning given to HISB. Analysis then pro-
it has distinct characteristics, delineated boundaries,
ceeded inductively; within each article, statements or
and well-described preconditions and outcomes; and a
paragraphs providing information on some aspect of
consensus exists on its use (Morse, Mitcham, et al.,
the concept (i.e., components, maturity) were identi-
1996). For the concept of HISB, an exploration of the
fied and noted. The following questions guided the
literature reveals that the concept is partially developed.
analysis: Is the concept clearly defined? Is the concept
The second part of the analysis clarifies HISB by delin-
used consistently and appropriately within context?
eating its conceptual components, including its
Does the concept hold its boundaries? Has the concept
antecedents, characteristics, and outcomes.
been theoretically integrated with other concepts? Has
the concept been appropriately operationalized? What
Sample for Data Collection are the key characteristics of HISB? What are the rela-
The literature reviewed for this analysis includes tionships among the characteristics? Is HISB treated as
book chapters, theoretical and empirical articles on a fixed personality characteristic or as a behavioral,
HISB, instruments that attempt to measure the concept, context-bound strategy? What are the antecedents to
and review articles. The inclusion criteria for the chosen HISB (e.g., is an information need sufficient to enact

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1008 Qualitative Health Research

Table 1
Definitions of Health Information–Seeking Behavior
Author(s) Definition

Lenz (1984) Series of interrelated behaviors that can vary along two main dimensions: (a) extent and
(b) method (p. 63)
Barsevick & Johnson (1990) “Actions used to obtain knowledge of a specific event or situation” (pp. 3-4)
Corbo-Richert, Caty, & “Verbal or nonverbal behavior seeking to attain, clarify, or confirm information” (p. 30)
Barnes (1993)
Baker & Connor (1994) “Any activity undertaken to satisfy a query” (p.38)
Loiselle (1995) “A self-regulatory strategy that patients use to organize transactions between the self and health-related
settings with the goal of balancing instrumental benefits and subjective costs stemming from
informational outcome” (p. 9)
Johnson (1997) “Purposive acquisition of information from selected information carriers” (p. 4)
Conley (1998) “Verbal or nonverbal behavior used to obtain, clarify, or confirm knowledge or information about a
specific event or situation” (p. 132)
van der Molen (1999) Strategy use as a means of coping with, and reducing, stress
Rees and Bath (2000) “Problem-focused coping strategy sometimes adopted by individuals as a response to a threatening
situations” (p. 72)
Rees and Bath (2001) Monitoring: “the urge to confront oneself with the threatening situation by means of seeking more
information about it” (p. 900). Blunting: “tendency to distract from threat-relevant information”
(p. 900).
Czaja, Manfredi, and Number of sources from whom an individual sought information
Price (2003)

HISB)? What are some of the outcomes or conse- go about obtaining information, including information
quences of HISB? Detailed analysis and interpretation about their health, health promotion activities, risks to
of notes resulted in our identifying main themes related one’s health, and illness.
to HISB. We described each aspect of the concept fur- Few authors use the complete label health information–
ther by continually organizing and reorganizing key seeking behavior (e.g., Baker & Pettigrew, 1999;
points in the literature until cohesive and comprehen- Gollop, 1997; N. Gray, Klein, Noyce, Sesselberg, &
sive descriptions were obtained. Articles reviewed Cantrill, 2005; Kakai, Maskarinec, Shumay, Tatsumura,
were constantly compared and contrasted with each & Tasaki, 2003). Most authors of articles reviewed use
other, and similarities and differences among authors the term information seeking behavior. The word health
were identified. Rigor was supported by our reviewing is implied by the type of information sought (i.e., indi-
a large amount of the literature on HISB from the viduals seek “health”-related information) and/or the
various disciplines (Morse, 2000; Penrod & Hupcey, context (i.e., information sought within a health-related
2005). In addition, findings were discussed between context) (e.g., Beisecker & Beisecker, 1990; Borgers
the authors until a consensus was reached. et al., 1993; Czaja et al., 2003; Szwajcer, Hiddink,
Koelen, & Van Woerkum, 2005). Others use the term
health information seeking or simply information seek-
Findings ing. Authors imply that “behaviors” or “actions” to
obtain information are an inherent component of infor-
Maturity of the Concept mation seeking (e.g., Meischke, Eisenberg, Rowe, &
Cagle, 2005; Shi, Nakamura, & Takano, 2004). For
Is the Concept Clearly Defined?
the purpose of the present analysis, the comprehensive
Explicit definitions of HISB are difficult to locate, label of health information–seeking behavior (HISB) is
and there is no apparent dominant definition. Typically, used.
definitions are inferred by the purpose or focus of the Various definitions of HISB found in the literature
article. The meaning of HISB is often thought to be are presented in Table 1. Most authors have proposed
obvious, and what individuals do to obtain information that HISB entails the use of specific actions and/or
taken for granted (Case, 2002). The broad sense attrib- strategies by individuals to acquire information.
uted to HISB relates to the ways in which individuals However, little insight or description is provided as to

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 Lambert, Loiselle / Health Information–Seeking Behavior 1009

what those behaviors or actions consist of (circular def- Molen, 1999), contribute to attaching appropriate mean-
initions). Lenz (1984) appears most informative in her ings to events (Rees & Bath, 2001; Rees, Sheard, &
treatment of the concept by specifying that HISB varies Echlin, 2003; Shiloh, Mahlev, Dar, & Ben-Rafael,
along two main dimensions: extent (scope and depth of 1998), help individuals rehearse or work through their
search) and method (information source used). Czaja experiences (Rees, Sheard, et al., 2003), provide ways of
et al. (2003) and Johnson (1997) have focused primarily managing the stressors (Davison et al., 2002; Feltwell &
on the method dimension of HISB in their definition. Rees, 2004; Huber & Cruz, 2000), determine what
The definitions proposed by van der Molen (1999) resources are available to manage the stressors (van der
and Rees and Bath (2000, 2001) suggest an antecedent, Molen, 1999) and make informed decisions (Henman
or cause (i.e., stress or threat), and/or a purpose (i.e., et al., 2002; Loiselle, 1995; Rees & Bath, 2001), and
coping) to HISB. These definitions limit HISB to situa- increase predictability and feelings of control over situ-
tions of threat; one of several possible situations where ations (Andreassen, Randers, Naslund, Stockeld, &
individuals would seek health-related information. Mattiasson, 2005; Case, Andrews, Johnson, & Allard,
Other authors are less prescriptive and more general 2005; Flattery et al., 2005; Henman et al., 2002; Rees,
about the situations in which the information is sought Sheard, et al., 2003). HISB is also argued to have
(e.g., Barsevick & Johnson, 1990; Conley, 1998; emotion-focused coping functions, in that information
Loiselle, 1995) or the antecedents to HISB (e.g., Baker reduces negative reactions linked to uncertainty (e.g.,
& Connor, 1994). anxiety) and provides reassurance, which might account
for the observation that information seeking is often pos-
Is the Concept Used Consistently and Appropriately itively related to both problem-focused and emotion-
Within the Context? focused coping (Shiloh, Sinai, et al., 1999). Overall,
Overall, HISB is studied within the context of (a) information seeking efforts serve to manage or alter the
coping with a health-threatening situation, (b) partici- relationship between an individual and the source of
pation and involvement in medical decision making, stress, potentially contributing to positive health out-
and (c) behavior change and preventive behavior. Each comes and psychosocial adjustment (van der Molen,
context as related to HISB is reviewed in turn. 1999). Although, many individuals choose to cope
with a health-related threat by seeking information,
HISB in the context of coping with a health-threatening others are found to purposefully avoid such information.
situation. Processes related to HISB are becoming Information avoidance, also referred broadly as denial,
increasingly central to how individuals cope with health- blunting, or repression, emphasizes that some individu-
threatening situations (Davison et al., 2002; Garvin als choose to divert their attention from the perceived
et al., 2003; Hoskins & Haber, 2000; Ransom, Jacobsen, threat (Feltwell & Rees, 2004; Livneh, 2000; Loiselle,
Schmidt, & Andrykowski, 2005; Rees & Bath, 2000). 1995).
Within this context, researchers have identified the type
of information individuals seek to cope with stressful HISB in the context of participation and involvement
situations, the amount of information sought, how the in medical decision making. As the trend toward shared
information is obtained, and when or under what cir- or collaborative medical decision making between health
cumstances the information is needed (Loiselle, 1995; care professionals and patients continues (Warner &
Rees & Bath, 2001; van der Molen, 1999). HISB is typ- Procaccino, 2004), much attention is given to individu-
ically referred to as a problem-focused coping strategy als’ preferred role in medical decision making (Beaver
(or monitoring) and implies that individuals focus their et al., 1996; Davison et al., 2002; Hack, Degner, & Dyck,
attention on the threatening situation and direct their 1994; Hashimoto & Fukuhara, 2004). Individuals’ pref-
efforts at becoming more engaged with and aware of erences for medical decision making range from wanting
stressors (Livneh, 2000; Rees & Bath, 2001; Shiloh, to be able to understand health care professionals’ deci-
Sinai, & Keinan, 1999). Information seeking is sug- sions about care, to wanting their views to be heard and
gested to enhance coping by helping individuals under- considered, to making the final decision (Beaver et al.,
stand the health threat and the associated challenges that 1996; Hack, Degner, Watson, & Sinha, 2006; Henman
it brings (Clark, 2005; Davison et al., 2002; Flattery, et al., 2002). HISB is conceptualized as a means of
Pinson, Savage, Salyer, & Virginia, 2005; Henman, obtaining the type and amount of information needed to
Butow, Brown, Boyle, & Tattersall, 2002), help to eval- participate in medical decision making. In general, stud-
uate what is at stake (Flattery et al., 2005; van der ies have shown that individuals who prefer an active or

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1010 Qualitative Health Research

collaborative role when making decisions with health Does the Concept Hold Its Boundaries, and Has it
professionals are also more active in their search for Been Theoretically Integrated With Other Concepts?
health-related information (Davison et al., 2002; Hack,
The boundaries of a concept are traditionally identi-
Degner, & Dyck, 1994). Seeking information con-
fied by what is and what is not part of the concept
tributes to participation in medical decision making by
(Morse, Mitcham, et al., 1996). One commonality
helping individuals identify possible options, weigh and
across several authors is that HISB is an intentional,
evaluate the different options, reduce uncertainty and
overt action; individuals make a conscious choice to
doubt about alternatives, and decide whether a particular
seek health-related information (Case, 2002; Johnson,
option is appropriate (J. Brown, Carroll, Boon, &
1997; Lenz, 1984; Longo, 2005; Rees & Bath, 2001;
Marmoreo, 2002; Budden, Pierce, Hayes, & Buettner,
Warner & Procaccino, 2004). This intentionality is
2003; Huber & Cruz, 2000; Johnson, 1997). The
suggested to be related to the accomplishment of some
assumption is that individuals who seek out information
particular information-related goal (Johnson, 1997).
might be better prepared to engage in medical decision
HISB does not include instances in which individuals
making (Beaver et al., 1996; J. Brown et al., 2002;
are being exposed to health-related information with-
Hashimoto & Fukuhara, 2004; Radecki & Jaccard, 1995;
out a specific request (passive receipt of information)
Shuyler & Knight, 2003). However, individuals seeking
(Barsevick & Johnson, 1990; Lenz, 1984; Loiselle,
large amounts of health-related information do not con-
1995; Longo, 2005) or when information is retrieved
sistently play an active role in decision making (Czaja
from memory (Johnson, 1997). For instance, if infor-
et al., 2003; Hashimoto & Fukuhara, 2004; Henman
mation is acquired, but not purposefully sought, while
et al., 2002). Here, information might be sought for other
the individual is engaging in another activity such as
purposes, such as anticipating the sequence of events or
watching television, this is not considered to be HISB
evaluating appropriateness of treatment proposed (Czaja
(Lenz, 1984). Furthermore, HISB does not include
et al., 2003; Hashimoto & Fukuhara, 2004).
information received from health professionals unless
HISB in the context of behavior change and preven- this information was specifically requested (Barsevick
tive behavior. HISB is often perceived as a crucial step & Johnson, 1990). However, passive acquisition of
in the enactment of discretionary health-related and information can occur during active information seek-
preventive behaviors (Budden et al., 2003; Fahrenwald ing (Lenz, 1984; Longo, 2005). Case (2002) has used
& Walker, 2003; Shi et al., 2004; Shuyler & Knight, the term information behavior to encompass informa-
2003; Warner & Procaccino, 2004; Yu & Wu, 2005). tion seeking or avoidance as well as unintentional or
Theoretically and empirically, information seeking is passive behaviors.
identified as a significant factor influencing the extent A concept often found to be used interchangeably
to which individuals decide to engage in healthy with HISB is preference for information within
lifestyles and/or preventive behaviors (e.g., Burbank, health-related contexts. A review of authors using this
Reibe, Padula, & Nigg, 2002; Fahrenwald & Walker, term revealed that it is most often used to emphasize
2003; Yu & Wu, 2005). Although information alone the extent to which an individual reports a desire,
does not guarantee healthy behaviors, acquiring ade- from an affective perspective, to seek or receive spe-
quate information might motivate individuals to make cific types of health information (e.g., Garvin, Moser,
positive changes in their health practices (Loiselle & et al., 2003; Hack, Degner, & Dyck, 1994; Loiselle,
Delvigne-Jean, 1998; Meischke et al., 2005; Shi et al., 1995). Individuals with high preference for informa-
2004; Szwacjer et al., 2005). Individuals’ specific tion wish to seek or receive as much health informa-
HISB might influence the scope and nature of the tion as possible; however, this high preference does
information on which judgments, beliefs, and attitudes not ensure that they will subsequently carry out their
toward the health behavior are based, the number of information search (Garvin & Kim, 2000; Loiselle,
alternative courses of action known to individuals, and 1995). Other factors, such as the complexity of the
knowledge about the pros and cons of different actions situation or individuals’ physical or psychological
(risk perception) and resources available to carry out health, might influence whether a high preference for
the different behaviors (Burbank et al., 2002; Griffin, information will translate into actual behavior
Dunwoody, & Neuwirth, 1999; Holmes & Lenz, 1997; (Harrison, Galloway, Graydon, Palmer-Wickham, &
Huber & Cruz, 2000; Johnson, 1997). Rich-Van, 1999).

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 Lambert, Loiselle / Health Information–Seeking Behavior 1011

Theoretical Underpinnings of HISB recognized information need in initiating HISB is

empirically reported by several authors (e.g., Griffin
Although the majority of empirical studies reviewed
et al., 1999; Szwajcer et al., 2005; Warner & Procaccino,
do not specify a formal model or theoretical framework
2004). Johnson (1997) acknowledged the critical role of
for HISB, six models or theories related to HISB are
a stimulus; however, this variable is not explicitly
found in the health-related literature. These include (a)
depicted in the model. Lenz and Freimuth et al. also
Lazarus and Folkman’s (1984) stress, appraisal, and
called attention to intermediary steps following the
coping theory; (b) Miller’s (1987, 1989) monitoring
stimulus, particularly the perception of a positive cost-
and blunting hypothesis; (c) Lenz’s (1984) information-
benefit ratio, which influence an individual’s search for
seeking model; (d) the health information acquisition
information.
model (Freimuth, Stein, & Kean, 1989); (e) the com-
Although these models move away from conceptu-
prehensive model of information seeking (Johnson, 1997,
alizing HISB as a simple stimulus-response reaction
2003); and (f) the expanded model of health informa-
and include cognitive activities, the need for a positive
tion–seeking behaviors (Longo, 2005). Lazarus and
cost-benefit ratio can be challenged. Some authors
Folkman’s (1984) theory and Miller’s (1987) frame-
have contended that most individuals seek information
work are most frequently referenced. Both authors
that is relevant to them regardless of the potentially
focus primarily on individuals’ differential responses to
negative or positive implications (Dauenheimer,
stress. Although, Lazarus and Folkman (1984) did not
Stahlberg, Spreeman, & Sedikides, 2002). Lenz (1984)
expand on HISB, Miller (1987) provided specific char-
and Freimuth et al. (1989) also provided the most com-
acteristics that differentiate an information seeker (i.e.,
prehensive understanding of the different dimensions
monitor) from an information avoider (i.e., blunter).
of HISB: extent and method, as defined earlier. Longo
Although the concept of monitoring/blunting is popu-
(2005) and Johnson (1997) focused primarily on the
lar, it is suggested that this concept is not specific to
method dimension. Johnson provided an extensive
information seeking and, rather, mingles different types
description of the method dimension and emphasized
of coping strategies (Ransom et al., 2005). Therefore,
that information sources are selected on the basis of
the concept of monitoring/blunting may not best cap-
their match with individuals’ information needs.
ture individuals’ HISB. Neither of these specifically
Although Johnson did not exclude the extent dimen-
describes the process of HISB.
sion, it is not explicitly depicted in the model (Johnson,
The other four models are, in essence, flowcharts
Andrews, & Allard, 2001). Most models or theories
that describe a series of steps through which individu-
reviewed focus merely on whether individuals seek
als progress to seek information (information-seeking
information or not and do not take into consideration
process) and identify the underlying factors that might
the possible variability contained within these extreme
explain HISB. One appealing aspect of these models
HISB. Longo’s (2005) is the only model reviewed that
is their simplicity. However, some models appear to
considers different information-seeking outcomes
oversimplify HISB and represent the information-
(e.g., a patient might access the information but be
seeking process as linear (e.g., Johnson, 1997); no
unable to use it). Together, all models provide impor-
feedback loops are included, overlooking the iterative
tant insights into the study of HISB and increase our
nature of HISB. A more fluid and nonlinear model
understanding of why certain individuals might choose
(e.g., Freimuth et al., 1989) is suggested to be more
to seek available information whereas others do not to
appropriate (Case, 2002; Foster, 2004). Although
the same extent.
most models have some theoretical and/or empirical
justifications, some provide little evidence to support
their depiction of HISB and the associated variables.
Has the Concept Been Appropriately
Typically, the models or theories reviewed specify Operationalized?
several background, personal, and/or contextual factors Most often, authors operationalize the concept of
that motivate a person to seek information (or not) and HISB in terms of (a) type of health-related information
attempt to predict HISB (Case, 2002). Some authors, sought, (b) amount of health-related information sought,
particularly Lenz (1984) and Freimuth et al. (1989), (c) information sources used, or (d) discrete actions
have focused on a conception of HISB as a process implemented (e.g. Loiselle, 1995). Some authors have
initiated by a stimulus. The key role of a stimulus or a captured HISB by examining the specific kinds of

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1012 Qualitative Health Research

health-related information sought (e.g., information others should provide them with in terms of health-
about disease and disease process, information on self- related information rather than the actual search for
care and self-management strategies) (e.g., Borgers information. One of the most significant criticisms of
et al., 1993; Butow, Maclean, Dunn, Tattersall, & the scales reviewed is that HISB is conceptualized pri-
Boyer, 1997; Szwajcer et al., 2005). Individuals have marily as an all-or-nothing phenomenon; that is, indi-
also been asked about the general type of information viduals either seek or avoid health-related information.
sought. For example, are individuals seeking all possi- Such a dichotomous operationalization of the concept
ble information, most pertinent information, or only has often been identified as insufficient; individuals’
“good news” or “bad news”? Amount of information HISB are actually found to be more variable on a con-
sought is most often documented by asking individuals tinuum from avoidance and selectivity to complete
about the extent of details sought (e.g., Butow et al., search (Johnson, 1997; Loiselle, 1995; Szwajcer et al.,
1997; Hack et al., 1994; Loiselle, 1995). HISB is also 2005).
frequently operationalized through descriptions of
sources used (type and number, frequency of use) (e.g.,
Gollop, 1997; Loiselle, Edgar, & Batist, 2002;
Concept Clarification: Key
McGuffin & Wright, 2004; Rees & Bath, 2001). Some Components of HISB
authors have focused on surveying individuals’ discrete
behaviors when seeking information, such as how fre- Based on the above analysis of the concept’s maturity,
quently they ask questions to HCPs or initiate discus- HISB is partially developed, and further concept clarifi-
sions about specific issues (e.g., Borgers et al., 1993). cation is needed. One of the main weaknesses of the con-
Authors have also used various scales to measure cept is that its essential characteristics are not clearly
HISB. Four relevant published scales have been identi- delineated. Despite the popularity of the concept and its
fied: (a) the Miller Behavioral Style Scale (MBSS) extensive use, much about the essence of HISB remains
(Miller, 1987), (b) the Threatening Medical Situation implicit. Based on the literature reviewed, key compo-
Inventory (TMSI) (van Zuuren, deGroot, Mulder, & nents of HISB were extracted. These include the con-
Muris, 1996), (c) the Krantz Health Opinion Survey cept’s characteristics, antecedents, and consequences.
(KHOS) (Krantz, Baum, & Wideman, 1980), and (d)
the Autonomy Preference Index (API) (Ende, Kazis,
Characteristics of HISB
Ash, & Moskowitz, 1989). Although most of these Essential characteristics of HISB are those that are
scales have been used in several studies for their ease of present in all instances in which the concept appears,
administration and acceptable reliability and validity, but they can vary in strength of association and be
several shortcomings are noted. For instance, the present in different forms (Morse, Mitcham, et al.,
MBSS measures individuals’ tendency either to seek or 1996). Throughout the literature, two main dimen-
to avoid information within hypothetical threatening sions of HISB emerge: (a) the information dimen-
situations; the MBSS items are not specific to health- sion, and (b) the method dimension. The information
related contexts (Garvin & Kim, 2000). In an effort to dimension emphasizes the characteristics of the
design a scale that would be more relevant to health information sought, particularly in terms of type and
contexts, van Zuuren et al., inspired by the MBSS, amount. The type refers to the content and diversity
designed the TMSI and included health-related hypo- of the search. The amount refers to how much infor-
thetical scenarios. The use of hypothetical scenarios, by mation (details) about a given topic one seeks, under-
both the MBSS and TMSI, might lead to discrepancies lining the depth of the search. Individuals have been
between how individuals think they might behave in a found to vary greatly along this dimension: Some
particular situation and their actual HISB (Garvin & might search a lot of health-related information on a
Kim, 2000; Loiselle, 1995). As such, the MBSS and wide array of topics (Clark, 2005; Echlin & Rees,
TMSI appear to be measuring preference for informa- 2002; Leydon et al., 2000; Szwajcer et al., 2005);
tion rather than HISB. The KHOS focuses mainly on whereas others might choose to seek little or no
individuals’ preferences for asking questions directed at health-related information (Case et al., 2005; Echlin
health professionals when undergoing medical treat- & Rees, 2002; Longo, 2005; Szwajcer et al., 2005).
ments but provides little information on the type or Some individuals might seek health-related informa-
amount of health-related information individuals seek. tion only on a particular issue but avoid other types of
The API appears to measure what individuals think health-related information (Friis, Elverdam, &

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 Lambert, Loiselle / Health Information–Seeking Behavior 1013

Schmidt, 2003; Leydon et al., 2000; Loiselle, 1995), or Johnson, 1997; Szwajcer et al., 2005). General prop-
some might seek general information, whereas others erties of information sources that influence their use
prefer details or specifics (Ford, Wilson, Foster, Ellis, & include accessibility, credibility, and accuracy of the
Spink, 2002). source (N. Gray et al., 2005; Johnson, 1997), and the
The method dimension of HISB focuses on the style and comprehension of information presented
discretionary actions individual use to obtain health- (Johnson, 1997; Szwajcer et al., 2005). Other fre-
related information and sources of information used. quently stated sources of information are television
Discrete information seeking activities or strategies (e.g., Carlsson, 2000; McGuffin & Wright, 2004),
include direct and indirect questioning (e.g., Borgers magazines or newspapers (e.g., Andreassen et al.,
et al., 1993; Brashers, Goldsmith, & Hsieh, 2002; 2005; Feltwell & Rees, 2004; McGuffin & Wright,
Feltwell & Rees, 2004; Johnson, 1997), asking for clar- 2004; Shi et al., 2004), pamphlets and/or books (e.g.,
ifications (e.g., Beisecker & Beisecker, 1990), discussing Loiselle, Edgar, et al., 2002; Szwajcer et al., 2005;
and exchanging information with others (e.g., Beisecker Warner & Procaccino, 2004), and support groups (e.g.,
& Beisecker, 1990; Friis et al., 2003; Matthews, Rees & Bath, 2001).
Sellergren, Manfredi, & Williams, 2002), reading (e.g., In sum, HISB is characterized by the type and
Brereton & Nolan, 2002; Feltwell & Rees, 2004), amount of health-related information sought, the spe-
observing (e.g., Brereton & Nolan, 2002), use of a third cific actions implemented to obtain the information,
party (e.g., Johnson, 1997), browsing (e.g., Johnson, and the sources individuals use. Although authors
1997), and listening (e.g., Brereton & Nolan, 2002). have reported that individuals might have a general or
Most often, individuals seek health-related infor- stable tendency to either seek or avoid information
mation, at any given time, from a combination of per- (Butow et al., 1997; Echlin & Rees, 2002; Garvin &
sonal (e.g., self, friends, family) and impersonal (e.g., Kim, 2000), actual HISB are dynamic and might be
book, Internet) sources. The use of multiple sources expected to vary according to changing personal and
might reflect individuals’ desire to acquire as much contextual variables and time (Garvin & Kim, 2000;
information as possible (J. Brown et al., 2002; Szwajcer et al., 2005).
Shuyler & Knight, 2003) and/or to validate (R. Gray
et al., 1998; Muha, Smith, Baum, Maat, & Ward,
Antecedents
1998) or complement information received from a
prior source (Brereton & Nolan, 2002; Fleming, Typically, individuals’ HISB are recognized as
Goodman, Geraghty, West, & Lancaster, 2002; Muha initially motivated by an information need (Dunne,
et al., 1998). Johnson (1997) referred to the sources 2002; Griffin et al., 1999; Holmes & Lenz, 1997;
of information an individual consults to obtain infor- Johnson, 1997; Szwajcer et al., 2005; Warner &
mation as their information field. Most individuals Procaccino, 2004), generally defined as a perceived
indicate a preference for health professionals when gap between what an individual knows and what he
seeking medical facts (Andreassen et al., 2005; or she wants to know to achieve a certain goal (Case,
J. Brown et al., 2002; Johnson, 1997; Loiselle, 2002; Griffin et al., 1999; Johnson, 1997; Loiselle,
Semenic, Côté, Lapointe, & Gendron, 2001; Warner 1995; Szwajcer et al., 2005). However, several
& Procaccino, 2004). This might reflect individuals’ authors have reported that even if an individual has a
belief that professionals can provide unbiased, reli- need for information, he or she might not actually
able information that is in their best interest (J. Brown seek the information (Loiselle, 1995; Matthews et al.,
et al., 2002; Gollop, 1997; James, James, Davies, 2002; Rees & Bath, 2001; Szwajcer et al., 2005).
Harvey, & Tweddle, 1999). Individuals also report a Although significant, an information need is not suf-
preference for other sources of information, such as ficient to prompt HISB; rather, several personal and
friends or others experiencing the same health issue, contextual factors influence whether and how an indi-
when seeking psychosocial information (Beresford & vidual responds to an information need (Allen, 1996;
Sloper, 2003; Dunne, 2002) or the Internet when Case et al., 2005; Czaja et al., 2003; Loiselle, 2001;
seeking sensitive information (anonymity provided) Loiselle & Delvigne-Jean, 1998; Shiloh, Sinai, et al.,
(N. Gray et al., 2005). As such, the type and amount 1999). Personal and situational factors are reported to
of information desired influence which source(s) of influence what type of and how much information is
information one will consult (Beresford & Sloper, sought, what sources are used, and how the informa-
2003; N. Gray et al., 2005; Griffin et al., 1999; tion is obtained. Personal factors include individuals’

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1014 Qualitative Health Research

sociodemographic characteristics as well as psy- it with their partners, whereas partners might decide to
chosocial variables such as personality traits and indi- avoid discussion on information-related issues; this
viduals’ expectations, goals, beliefs, values, attitudes, pattern of communication might, in turn, lead indi-
emotions and moods, skills, and/or resources viduals to refrain from seeking and/or disclosing fur-
(Borgers et al., 1993; Loiselle, 2001; Matthews et al., ther information (Brashers et al., 2002; Loiselle,
2002). For example, women (Czaja et al., 2003; Lambert, & Cooke, 2006).
Johnson, 1997) and educated and younger individuals Findings from these studies particularly emphasize
(Czaja et al., 2003; Johnson, 1997; Muha et al., 1998) the importance of considering the interaction among
are often reported to be active information seekers. personal (i.e., individual information preference) and
Personality characteristics such as high internal locus situational factors (i.e., family members’ HISB) in pre-
of control (Hashimoto & Fukuhara, 2004; Johnson, dicting individuals’ HISB (Loiselle, 2001; Loiselle &
1997), self-esteem (Radecki & Jaccard, 1995), a pref- Delvigne-Jean, 1998). In most studies reviewed, the
erence for involvement in health-related decision influences of personal and contextual factors were
making (Czaja et al., 2003; Davison et al., 2002), and analyzed independently, and the main effect of each
self-efficacy (Brown, Ganesan, & Challagalla, 2001; variable on HISB was determined separately. An inter-
Griffin et al., 1999; Johnson, 1997) are shown to con- actional approach (“person × context”) focuses on rela-
tribute positively to information seeking. Other indi- tionships among personal and contextual factors and
viduals’ reactions are found to limit HISB, such as how these, together, determine HISB (Loiselle, 2001).
feelings of guilt (Dunne, 2002), fear of social stigma Although few researchers have carried out interactional
regarding certain type of information (Matthews et analyses, this approach is suggested as most promising
al., 2002), and concern that information will con- to evaluate the predictive value of specific personal and
tribute to more worry and anxiety (Borgers et al., contextual antecedents on individuals’ HISB (Loiselle,
1993; Case et al., 2005). 2001).
Contextual or situational factors emphasize the
characteristics of individuals’ environment, source of
Outcomes
information, and information seeking context (Allen,
1996; Czaja et al., 2003; Dunne, 2002; Loiselle, Several studies reviewed measured the influence
2001; Matthews et al., 2002). For example, an acces- of HISB on individuals’ health-related outcomes.
sible information source might be more likely to be Commonly, outcomes or consequences of seeking
used than one perceived to be difficult to access information include (a) cognitive outcomes, such as
(Gollop, 1997). Furthermore, trust in HCPs is shown increase knowledge (Andreassen et al., 2005; Muha
to contribute to asking questions and seeking more et al., 1998), informed decision making (Davison et al.,
information from HCPs (Borgers et al., 1993; Czaja 2002; Muha et al., 1998; Warner & Procaccino, 2004),
et al., 2003). Individuals’ social network and the increase perception of control (Echlin & Rees, 2002),
informational support received from family and and coping (Edgar, Remmer, Rosberger, & Fournier,
friends are also found to affect their HISB (Brashers 2000); (b) behavioral outcomes, including discussing
et al., 2002; Czaja et al., 2003; Johnson, 1997; Loiselle, information obtained with health care professional
Lambert, & Cooke, 2006). Family members and part- (Andreassen et al., 2005; Czaja et al., 2003; Muha et al.,
ners’ contribution to individuals’ HISB appear depen- 1998), increased self-care abilities and adherence to
dent on whether the information needs coincide with treatment (N. Gray et al., 2005), and change in health
those of their family members (Brashers et al., 2002; behavior (Shi et al., 2004; Szwajcer et al., 2005; Warner
Loiselle, Lambert, & Cooke, 2006). For example, if & Procaccino, 2004); (c) physical outcomes, such as
both family members and individuals desire informa- increase physical quality of life (Ransom et al., 2005);
tion, family members are often found to aid individuals and/or (d) affective outcomes, including decrease anx-
in their search (Brashers et al., 2002; Echlin & Rees, iety, fear, and distress (Brereton & Nolan, 2002; Huber
2002; Johnson, 1997; Loiselle, Lambert, & Cooke, & Cruz, 2000) and increase hope (Huber & Cruz, 2000)
2006). Conversely, a “mismatch” between individuals’ and empowerment (N. Gray et al., 2005).
HISB and those of their family members is shown to Although outcomes of seeking information are gen-
limit individuals’ HISB. For example, individuals might erally reported as positive, in some instances informa-
seek as much information as possible and wish to share tion seekers experience more negative outcomes (e.g.,

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 Lambert, Loiselle / Health Information–Seeking Behavior 1015

feeling overwhelmed, more worry) than information characteristics, and outcomes. Although HISB has
avoiders (Clark, 2005; Echlin & Rees, 2002; Feltwell & received considerable attention in the literature, there
Rees, 2003; Garvin et al., 2003; Loiselle, Lambert, & has been less focus on examining the concept’s key
Boisclair, 2003; Miller, 1995). It appears that when dimensions. Identification of the two main dimensions
determining outcomes of individuals’ HISB, the congru- of HISB (information and method dimension) clarifies
ence between the information individuals wanted and the core meaning of the concept. Using these key
what they obtained needs to be taken into consideration. dimensions affords a more throughout identification
In general, HISB outcomes are reported to be more and discussion of individuals’ actual HISB. The degree
positive when individuals sought or received the infor- to which emphasis has been put on each dimension of
mation desired (Butow et al., 1997; Garvin et al., 2003; HISB varies among authors. Most researchers have
Loiselle, 2001; Miller, 1995; Shiloh, Mahlev, et al., examined either dimension of HISB, but rarely have
1998). For example, information seekers who obtain the they attended to both despite suggestions that HISB is
information they want report less anxiety than those that best understood as a composite of information and
do not, and information avoiders who obtain more infor- method-related behaviors (Lenz, 1984). Therefore, a
mation than they desire report more anxiety than infor- more comprehensive understanding of HISB might lie
mation avoiders who do not receive voluminous amount in examining individuals’ patterns of HISB, that is, the
of information (Garvin et al., 2003; Miller, 1995). particular ways in which individuals sequence compo-
Therefore, empirical studies emphasize that an interac- nents of the information and method dimensions
tional analysis of the person and the context is also most within a given situation (and over time) to satisfy their
predictive for determining not only individuals’ HISB information needs (Dunne, 2002; Echlin & Rees,
but also its outcomes (Loiselle, 2001). 2002; Huber & Cruz, 2000; Szwajcer et al., 2005).
Patterns of HISB reflect individuals’ selectivity in the
Conclusion and Implications type and amount of information needed and sources
and actions used, and best capture the uniqueness of
Findings of this concept analysis provide up-to-date each individual search for information. As such, HISB
conceptual and operational foundations for clinicians, might best be reconceptualized from an either/or single
researchers, and theorists interested in the concept. behavior to an agglomeration of information and
To our knowledge, this is one of the first articles explor- method behaviors. Such a reconceptualization further
ing in such depth the concept of health information– challenges traditional operationalization of HISB as
seeking behavior (HISB). This analysis initially exam- categorically seekers or avoiders (Loiselle, Lambert, &
ined the definitions of and contexts related to HISB Dubois, 2006). General definitions of seekers and
and the concept’s boundaries and operationalizations. avoiders focus on whether the information is sought or
This section of the analysis was challenging primarily not, with little consideration of the individual’s overall
because of the large amount of literature available and information environment. Typical categorizations of
lack of clear definitions and/or theoretical frameworks, seekers or avoiders do not optimally capture differen-
and consensus on the meaning of HISB. It is apparent tial patterns of HISB and might contribute to the mis-
that the concept of HISB is used within many contexts, classification of individuals’ HISB. For example, if a
particularly in relation to illness-related coping, and has pregnant woman does not want to be told the sex of her
great appeal to multiple disciplines. Together, researchers fetus as it might appear on the ultrasound but might be
have attempted to understand, explain, or predict indi- opened to “folk” tales about how to tell whether the
viduals’ quests for health-related information, with an fetus is a girl or a boy (Loiselle, Lambert, & Dubois,
underlying assumption that seeking information is 2006), how should these HISB be categorized?
often desirable and central to health and illness behav- Findings from this concept analysis can be used to
iors. In addition, insights into whether HISB is a trait theorize on HISB. Particularly, a fine-grained analysis
(i.e., a relatively stable characteristic) or a state (i.e., of HISB requires attention to individuals’ patterns of
according to the particular circumstance) has been pro- HISB, its situational and personal antecedents, and their
vided, which, in turn, is important to consider when interaction effects. Some of the following questions
measuring HISB. could be considered: What differentiates individuals’
In the second part of the analysis, we focused on patterns of HISB? How do patterns of HISB vary across
clarifying and offering additional insights into the context and time? What are the consequences of differ-
concept’s key components, including its antecedents, ent patterns? Such an analysis would further document

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1016 Qualitative Health Research

individuals’ selectivity and variability when seeking Beaver, K., Luker, K. A., Owens, R. G., Leinster, S. J., Degner, L. F.,
information and can be integrated into current models & Sloan, J. A. (1996). Treatment decision making in women newly
diagnosed with breast cancer. Cancer Nursing, 19(1), 8-19.
to explain HISB beyond the mere seeker-versus-avoider
Beisecker, A. E., & Beisecker, T. D. (1990). Patient information-
dichotomy. In addition, much of the research on HISB seeking behaviours when communicating with doctors.
centers on illnesses, such as cancer, HIV, and heart dis- Medical Care, 28(1), 19-28.
ease, there is a need also to understand patterns of HISB Beresford, B. A., & Sloper, P. (2003). Chronically ill adolescents’
in a variety of other contexts and in various stages of experiences of communicating with doctors: A qualitative
health and illness. How patterns of HISB differ in dif- study. Journal of Adolescent Health, 33, 172-179.
Borgers, R., Mullen, P., Meertens, R., Rijken, M., Eussen, G.,
ferent groups, such as across cultures and within differ- Plagge, I., et al. (1993). The information-seeking behavior of
ent age groups, also needs to be explored further. All of cancer outpatients: A description of the situation. Patient
these questions indicate further areas in which to Education and Counseling, 22, 35-46.
develop and clarify the concept of HISB and demon- Brashers, D. E., Goldsmith, D. J., & Hsieh, E. (2002). Information
strate the need to collect new data using qualitative seeking and avoiding in health contexts. Human Communication
Research, 28(2), 258-271.
methods. We have recently undertaken a qualitative
Brereton, L., & Nolan, M. (2002). “Seeking”: A key activity for new
study to explore further patterns of HISB among indi- family carers of stroke survivors. Journal of Clinical Nursing,
viduals diagnosed with breast, prostate, or colorectal 11, 22-31.
cancer (Lambert & Loiselle, 2005). This exploration is Brown, J. B., Carroll, J., Boon, H., & Marmoreo, J. (2002).
contributing to a better understanding of the complexi- Women’s decision-making about their health care. Patient
ties and subtleties of HISB, such as the Differential Education and Counseling, 48, 225-231.
Brown, S. P., Ganesan, S., & Challagalla, G. (2001). Self-efficacy
Health Information Seeking Behavior (DHISB) scale as a moderator of information-seeking effectiveness. Journal
(Loiselle & Lambert, 2007). of Applied Psychology, 86(3), 1043-1051.
HISB is of interest to health professionals because Budden, L., Pierce, P., Hayes, B., & Buettner, P. (2003).
of its potential influence on the process and outcome Australian women’s prediagnostic decision-making styles,
related to psychosocial adjustment to illness. In addi- relating to treatment choices for early breast cancer treatment.
Research and Theory for Nursing Practice: An International
tion, the concept of HISB as presented herein might
Journal, 17(2), 117-136.
be most relevant to practice as key dimensions are Burbank, P., Reibe, D., Padula, C., & Nigg, C. (2002). Exercise
clearly outlined; making its assessment accessible and older adults: Changing behaviour with the transtheoretical
and comprehensive. Such a clear and precise defini- model. National Journal of Orthopaedic Nurses, 21(4), 51-63.
tion of HISB will also assist researchers and clini- Butow, P. N., Maclean, M., Dunn, S. M., Tattersall, M. H. N., &
cians in tailoring their informational interventions to Boyer, M. J. (1997). The dynamics of change: Cancer patients’
preferences for information, involvement and support. Annals of
individuals’ needs and preferences. Oncology, 8, 857-863.
Carlsson, M. (2000). Cancer patients seeking information from
sources outside the health care system. Support Care Cancer,
8, 453-457.
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1018 Qualitative Health Research

Lambert, S. D., & Loiselle, C. G. (2005). For enquiring minds: Meischke, H., Eisenberg, M., Rowe, S., & Cagle, A. (2005). Do
Refinement of a questionnaire to assess individuals’ patterns older adults use the Internet for information on heart attacks?:
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Lenz, E. (1984). Information seeking: A component of client Journal of Personality and Social Psychology, 52(2), 345-353.
decisions and health behavior. ANS, 6(3), 59-71. Miller, S. (1989). Cognitive informational styles in the process of
Leydon, G., Boulton, M., Moynihan, C., Jones, A., Mossman, J., coping with threat and frustration. Advances in Behavioral
Boudioni, M., et al. (2000). Cancer patients’ information needs Therapy, 11, 223-234.
and information seeking behaviour: In depth interview study. Miller, S. (1995). Monitoring versus blunting styles of coping
BMJ, 320, 909-913. with cancer influence the information patients want and need
Livneh, H. (2000). Psychosocial adaptation to cancer: The role of about their disease. Cancer, 76(2), 167-177.
coping strategies. Journal of Rehabilitation, 66(2), 40-49. Morse, J. M. (1995). Exploring the theoretical basis of nursing using
Loiselle, C. G. (1995). Self-evaluation and health information- advanced techniques of concept analysis. ANS, 17(3), 31-46.
seeking: A study of self-assessment and self-protection. Morse, J. M. (2000). Exploring pragmatic utility: Concept analysis by
Unpublished doctoral dissertation, University of Wisconsin, critically appraising the literature. In B. Rodgers, & K. Knafl
Madison. (Eds.), Concept development in nursing: Foundations, techniques,
Loiselle, C. G. (2001). Les femmes et l’information sur le cancer and applications (pp. 333-352). Philadelphia: W. B. Saunders.
du sein: Le périlleux équilibre entre le droit, le besoin et la Morse, J., Hupcey, J., Mitcham, C., & Lenz, E. R. (1996). Concept
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Loiselle, C. G., & Delvigne-Jean, Y. (1998). L’éducation pour la Criteria for concept evaluation. Journal of Advanced Nursing,
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programs]. Canadian Nurse, 94(3), 42-46. Muha, C., Smith, K. S., Baum, S., Maat, J. T., & Ward, J. A.
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health communication. Canadian Nurse, 99(4), 22-26. ing: The cancer information service experience Part 8. Journal
Loiselle, C. G., Edgar, L., & Batist, G. (2002). The contribution of Health Communication, 3(Suppl.), 109-120.
of interactive health communication (IHC) to the health and Penrod, J., & Hupcey, J. E. (2005). Enhancing methodological
well being of oncology patients [Operating research grant]. clarity: Principle-based concept analysis. Journal of Advanced
Canadian Institutes of Health Research (MOP-57782). Nursing, 50(4), 403-409.
Unpublished manuscript. Radecki, C., & Jaccard, J. (1995). Perceptions of knowledge,
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health information-seeking behavior scale among women newly of Experimental Social Psychology, 31, 107-138.
diagnosed with breast cancer. Unpublished manuscript. Ransom, S., Jacobsen, P. B., Schmidt, J. E., & Andrykowski, M. A.
Loiselle, C. G., Lambert, S. D., & Boisclair, C. (2003). Preferences (2005). Relationship of problem-focused coping strategies to
in information-seeking about cancer: A new self-report instru- changes in quality of life following treatment for early stage
ment. Psycho-Oncology, 12(4 Suppl.), S232. breast cancer. Journal of Pain and Symptom Management,
Loiselle, C. G., Lambert, S. D., & Cooke, A. (2006). The search- 30(3), 243-253.
ing, processing, and sharing of breast cancer information by Rees, C., & Bath, P. (2000). The psychometric properties of the
women diagnosed with the illness. Canadian Journal of Miller Behavioural Style Scale with adult daughters of women
Nursing Research (CJNR), 38(3), 83-104. with early breast cancer. Journal of Advanced Nursing, 32(2),
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mere dichotomy of active search versus avoidance of infor- Rees, C. E., & Bath, P. A. (2001). Information-seeking behaviors
mation about the self [Letter to the editor]. Journal of the of women with breast cancer. ONF, 28(5), 899-907.
Medical Library Association, 94(4), 375. Rees, C. E., Sheard, C. E., & Echlin, K. (2003). The relationship
Loiselle, C. G., Semenic, S. E., Côté, B., Lapointe, M., & Gendron, R. between the information-seeking behaviours and information
(2001). Impressions of breastfeeding information and support needs of partners of men with prostate cancer: A pilot study.
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prehensive and integrated model. Health Expectations, 8, 189-194. Schwartz-Barcott, D. (2003). Response to “Concept advance-
Matthews, A. K., Sellergren, S. A., Manfredi, C., & Williams, M. ment: Enhancing inductive validity.” Research and Theory for
(2002). Factors influencing medical information-seeking Nursing Practice: An International Journal, 17(2), 160-174.
among African American cancer patients. Journal of Health Shi, H.-J., Nakamura, K., & Takano, T. (2004). Health values and
Communication, 7, 205-219. health information-seeking in relation to positive change of
McGuffin, M., &. Wright, J. (2004). Information-seeking behavior health practice among middle-aged urban men. Preventive
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 Lambert, Loiselle / Health Information–Seeking Behavior 1019

Shiloh, S., Mahlev, U., Dar, R., & Ben-Rafael, Z. (1998). Interactive Walker, L. O., & Avant, K. C. (1995). Strategies for theory con-
effects of viewing a contraction monitor and information-seeking struction in nursing. Norwalk, CT: Appleton.
on reported childbirth pain. Cognitive Therapy and Research, Warner, D., & Procaccino, J. D. (2004). Toward wellness: Women
22(5), 501-516. seeking health information. Journal of the American Society
Shiloh, S., Sinai, R. B., & Keinan, G. (1999). Effects of control- for Information Science and Technology, 55(8), 709-730.
lability, predictability, and information-seeking style on inter- Wilson, J. (1963). Thinking with concepts. Cambridge, UK:
est in predictive genetic testing. PSPB, 25(10), 1187-1195. University of Cambridge Press.
Shuyler, K. S., & Knight, K. M. (2003). What are patients seeking Yu, M.-Y., & Wu, T.-Y. (2005). Factors influencing mammogra-
when they turn to the Internet? Journal of Medical Research, phy screening of Chinese American women. JOGNN, 34(3),
5(4), e24. 386-394.
Szwajcer, E. M., Hiddink, G. J., Koelen, M. A., & Van Woerkum, C.
(2005). Nutrition-related information-seeking behaviours
before and throughout the course of pregnancy: Consequences Sylvie D. Lambert is a doctoral candidate at the School of
for nutrition communication. European Journal of Clinical Nursing, Faculty of Medicine, McGill University.
Nutrition, 59(Suppl. 1), s57-s65.
Vakkari, R., Savolainen, R., & Dervin, B. (Eds.). (1996). Information Carmen G. Loiselle is an assistant professor at the School of
seeking in context. London: Taylor Graham. Nursing, Faculty of Medicine, McGill University. She is also
van der Molen, B. (1999). Relating information needs to the cancer Director of the McGill University Oncology Nursing Program. She
experience: 1—Information as a key coping strategy. European is a Nurse Scientist at the Centre for Nursing Research/Lady Davis
Journal of Clinical Nutrition, 8, 238-244. Institute of the SMBD-Jewish General Hospital (Montreal) and the
van Zuuren, F., deGroot, K. I., Mulder, N. L., & Muris, P. (1996). McGill University Health Centre (MUHC) and is Program Leader
Coping with medical threat: An evaluation of the threatening for the CIHR/NCIC Psychosocial Oncology Research Training pro-
medical situations inventory (TMSI). Personality and Individual gram (PORT). Dr. Loiselle holds a career scientist award from the
Differences, 21, 21-31. Fonds de la Recherche en Santé du Québec (FRSQ).

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