中国的儿科肿瘤患者通常在疾病晚期才就诊，导致生存率较低和健康结果较差。研究提出的一个可能导致儿科肿瘤就诊延迟的因素是照顾者的在线健康信息寻求行为。本研究旨在采用混合方法，考察中国儿科肿瘤患者的在线健康信息寻求行为与延迟之间的关联。本研究采用混合方法，具体而言是顺序解释性设计。照顾者的在线健康信息寻求行为被定义为照顾者通过互联网获取与子女健康相关信息的方式。儿科肿瘤的延迟被定义为以下三种类型之一的延迟：患者延迟、诊断延迟或治疗延迟。定量分析方法包括描述性分析、学生t检验、Pearson卡方检验和二元logistic回归分析，均使用Stata软件进行。定性分析方法包括概念内容分析和Colaizzi法。总共有303对儿科肿瘤患者和照顾者参与了定量调查，其中29名照顾者完成了定性访谈。定量分析结果显示，近一半（151/303，49.8%）的患者出现了儿科肿瘤的延迟，主要延迟类型是诊断延迟（113/303，37.3%），其次是患者延迟（50/303，16.5%）和治疗延迟（24/303，7.9%）。在该研究中，303名照顾者参与者中有232人（76.6%）表现出在线健康信息寻求行为。与未参与在线健康信息寻求行为的照顾者相比，参与者更有可能出现患者延迟（患者延迟的比值比=2.21；95% CI 1.03-4.75）。定性分析结果显示，照顾者的在线健康信息寻求行为通过影响照顾者第一次就医前的症状评估和照顾者对医疗提供者的诊断和治疗决策的接受，影响了肿瘤护理路径。我们的研究结果表明，中国儿科照顾者的在线健康信息寻求行为可能是患者延迟的一个危险因素。我们的政府和社会应该共同努力，规范在线健康信息并提高其质量。通过在线健康信息平台提供的专业免费咨询服务对缩短照顾者第一次就医前的肿瘤症状评估时间至关重要。 ©Jiamin Wang, Xuemei Zhen, Peter C Coyte, Di Shao, Ni Zhao, Lele Chang, Yujia Feng, Xiaojie Sun. 本文最初发表于《医学互联网研究》杂志（https://www.jmir.org），16.08.2023。

Pediatric cancer patients in China often present at an advanced stage of disease resulting in lower survival and poorer health outcomes. One factor hypothesized to contribute to delays in pediatric cancer has been the online health information-seeking (OHIS) behaviors by caregivers.This study aims to examine the association between OHIS behaviors by caregivers and delays for Chinese pediatric cancer patients using a mixed methods approach.This study used a mixed methods approach, specifically a sequential explanatory design. OHIS behavior by the caregiver was defined as the way caregivers access information relevant to their children's health via the Internet. Delays in pediatric cancer were defined as any one of the following 3 types of delay: patient delay, diagnosis delay, or treatment delay. The quantitative analysis methods included descriptive analyses, Student t tests, Pearson chi-square test, and binary logistic regression analysis, all performed using Stata. The qualitative analysis methods included conceptual content analysis and the Colaizzi method.A total of 303 pediatric cancer patient-caregiver dyads was included in the quantitative survey, and 29 caregivers completed the qualitative interview. Quantitative analysis results revealed that nearly one-half (151/303, 49.8%) of patients experienced delays in pediatric cancer, and the primary type of delay was diagnosis delay (113/303, 37.3%), followed by patient delay (50/303, 16.5%) and treatment delay (24/303, 7.9%). In this study, 232 of the 303 (76.6%) caregiver participants demonstrated OHIS behaviors. When those engaged in OHIS behaviors were compared with their counterparts, the likelihood of patient delay more than doubled (odds ratio=2.21; 95% CI 1.03-4.75). Qualitative analysis results showed that caregivers' OHIS behaviors impacted the cancer care pathway by influencing caregivers' symptom appraisal before the first medical contact and caregivers' acceptance of health care providers' diagnostic and treatment decisions.Our findings suggest that OHIS among Chinese pediatric caregivers may be a risk factor for increasing the likelihood of patient delay. Our government and society should make a concerted effort to regulate online health information and improve its quality. Specialized freemium consultations provided by health care providers via online health informatic platforms are needed to shorten the time for caregivers' cancer symptom appraisal before the first medical contact.©Jiamin Wang, Xuemei Zhen, Peter C Coyte, Di Shao, Ni Zhao, Lele Chang, Yujia Feng, Xiaojie Sun. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.08.2023.