Journal of Modern Medical

1. Introduction
One of the most important needs of humans is information needs. Informational need refers to people’s desire to have more knowledge and information to satisfy their needs. In the field of health care, quality information is necessary for more patient participation in health care. Patients need general information that is timely, relevant, reliable and easy to understand. This health information is part of the necessities of each health center in order to promote patients’ self-care, patients’ ability to choose the type of treatment, patient’s participation in clinical decision-making, ability to manage chronic diseases, and improve patients’ health literacy.
Organ transplantation is a life-saving treatment for patients in the final stage of their disease and life. It has become an extremely effective method in controlling the terminal failures of some organs and tissues. In previous studies, it has been shown that the physicians do not encourage patients to search for more information regarding their disease. This may be due to the fact that physicians are not aware of the information needs of patients or lack of familiarity with appropriate information sources for patients. By collecting information needs of organ transplant patients and analyzing them, the quality of educational interventions for these patients can be improved. This study aims to investigate the information sources of patients receiving organ transplants in Mashhad, Iran.
Methods
The is an analytical cross-sectional study that was conducted from December 2017 to May 2018. The study population includes all patients who received liver and kidney transplants in Montaseriyeh Hospital in Mashhad, Iran (n=115). The data collection tool was a researcher-made questionnaire, whose validity was confirmed by experts’ opinion and its reliability by test-retest method. It surveys demographic and transplantation-related information, general questions about searching for information about the disease (3 questions), sources of medical information used by patients (20 questions), level of confidence in these information sources (20 questions), reasons for using information sources (6 questions), problems of accessing information sources (6 questions), educational methods for better learning of information acquisition (6 questions). The term are rated on a scale from 1= very low to 10= very high. After designing and approving the questionnaire, the data was collected in the hospital. Descriptive statistics such as mean and standard deviation were used for describing data. Due to the non-normality of the data distribution according to the Kolmogorov-Smirnov test results, non-parametric tests were used for analysis of the study hypotheses. The significance level was set at 0.5. Data analysis was carried out in SPSS software version 16.
3. Results
The Mean age of the participants was 35.7±11 years. Most of them had desire to receive more information about their disease (93%). On average, 36 months had passed since the participants were transplanted. The most sources of information used by them were the attending physician (Mean=8.91 out of 10), nurses (Mean=7.38) and other transplant patients (Mean=6.80). The most important reasons for patients’ use of information sources were the better understanding of the disease (Mean=8.32) and curiosity to learn more (Mean=7.73). The most important problems of patients in obtaining information were the lack of familiarity with medical terms (Mean=7.32) and information sources (Mean=7.16) and lack of access to information in Persian language (Mean=7.14). Regarding the best type of educational methods for acquiring information, verbal/face-to-face learning method got the most points (Mean=9.05). There was a significant relationship between age and the desire to receive information (P<0.001). With increasing age, the desire to receive information decreased. The findings showed that 81% of patients searched for information about their disease. There was a significant relationship between age and searching for information about the disease (P=0.003) (Table 1).


With increasing age, their tendency to search information decreased.
Discussion
The results of the study showed that the most important reason for organ transplant patients to receive information about their disease was to understand better and more about the disease. There was a significant relationship between the patient’s age and information-seeking behavior; with the increase of age, their information-seeking behavior was declined. Since patients often get disease information from other patients and social media, it is necessary to provide them with informed people and reliable, correct and accurate information in the Internet and social networks. Considering the awareness of the doctors about the importance of the internet as an important tool in accessing information and the preference of patients to search online, it is recommended to design appropriate health literacy-related websites based on the needs of organ transplant patients. Tools and software developed in the field of telemedicine and teleconsultation can be used for their education. On the other hand, considering the preference of the patients living in rural areas to obtain information related to their disease verbally, and their high level of trust in doctors in order to receive information about their disease, it is recommended that doctors and nurses provide the necessary information to this group of patients verbally and face to face. Overall, it seems that a proper and codified program for finding information should be provided to organ transplant patients to increase their health literacy, as one of the undeniable rights of these patients.

Ethical Considerations
Compliance with ethical guidelines
This study approved by the ethics committee of the Mashhad University of Medical Sciences (Code: IR.MUMS.REC.1397.032).

Funding
This research was derived from the master's thesis, which was carried out with the financial support of the research assistant of Mashhad University of Medical Sciences (Grant No.: 9617 86).

Authors' contributions
Conceptualization:  Masoumeh Sarbaz, Khalil Kimiafar; Methodology: Parviz Marouzi; Investigation: Safiyeh Sadeghian Roshanaei; Writing-original draft:  Seyyedeh Fatemeh Mousavi Baigi; Writing-review & editing: All author; Funding acquisition: Masoumeh Sarbaz, Khalil Kimiafar; Resources: Masoumeh Sarbaz, Khalil Kimiafar; Supervision: Masoumeh Sarbaz, Khalil Kimiafar.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
We hereby express our gratitude to the authorities of Mashhad's Mantasarih Hospital and the Student Research Committee of Mashhad University of Medical Sciences who helped us in conducting this research.


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