Emotional and informational support messages in an online hospice support community

Sex Differences in the Relationship Between Emotional Support and Self-rated Health among Chinese Elderly

PURPOSE

This study aimed to explore sex differences in the association between emotional support and self-rated health among the elderly.

DESIGN

This was a cross-sectional survey based on the sub-project of China's National Basic Public Health Service Project-Health Management Services for the Elderly.

SETTING

Participants were recruited from ten rural townships in Jingyuan County, Gansu Province, Northwestern China.

SUBJECTS

1405 subjects aged 60 or above.

METHODS

Emotional support (consisting of 5 items) and self-rated health (evaluated by EQ-VAS) were investigated in this study. Multiple linear regression was conducted to consider the potential relationship.

RESULTS

The frequency of children visit and the number of providers of emotional support were positively associated with self-rated health among older women (β = 1.13, 95%CI = 0.25-2.02; β = 1.80, 95%CI = 1.01-2.58), whereas the number of close friends had a positive association with self-rated health among older men (β = 1.11, 95%CI = 0.20-2.01). The number of close relatives and the frequency of seeking emotional support were not found to be associated with self-rated health among both older men and older women.

CONCLUSION

The study has found that the relationship between emotional support and self-rated health was differed by sex, calling attention to the need for sex-specific interventions.

Reciprocal association between social support and psychological distress in chronic physical health conditions: A random intercept cross-lagged panel model

The onset of a chronic physical health condition (CHC) can highly impact individuals' well-being and mental health. Social support has been shown to help people rebound after the onset of a CHC. Nonetheless, little is known about the longitudinal pattern of social support and its reciprocal association with mental health in CHC. This study aimed to illustrate the longitudinal pattern of perceived social support and to examine the reciprocal association between perceived social support and psychological distress across 6 years. Two random intercept cross-lagged panel models were conducted, one for emotional and one for practical support, using yearly assessments of 582 Swiss Household Panel's participants reporting a CHC. A reciprocal association was found, with psychological distress 1 year after the onset being linked to less emotional support in the following year and vice versa, more emotional support being linked to less psychological distress the following year. A unidirectional association was found for practical support, with more psychological distress 1 year before the CHC onset being linked to more practical support at the onset year. This study underlines the importance of involving the social environment of individuals living with a CHC, especially around the first year after the onset.

Public Opinions About Palliative and End-of-Life Care During the COVID-19 Pandemic: Twitter-Based Content Analysis

BACKGROUND

Palliative and end-of-life care (PEoLC) played a critical role in relieving distress and providing grief support in response to the heavy toll caused by the COVID-19 pandemic. However, little is known about public opinions concerning PEoLC during the pandemic. Given that social media have the potential to collect real-time public opinions, an analysis of this evidence is vital to guide future policy-making.

OBJECTIVE

This study aimed to use social media data to investigate real-time public opinions regarding PEoLC during the COVID-19 crisis and explore the impact of vaccination programs on public opinions about PEoLC.

METHODS

This Twitter-based study explored tweets across 3 English-speaking countries: the United States, the United Kingdom, and Canada. From October 2020 to March 2021, a total of 7951 PEoLC-related tweets with geographic tags were retrieved and identified from a large-scale COVID-19 Twitter data set through the Twitter application programming interface. Topic modeling realized through a pointwise mutual information-based co-occurrence network and Louvain modularity was used to examine latent topics across the 3 countries and across 2 time periods (pre- and postvaccination program periods).

RESULTS

Commonalities and regional differences among PEoLC topics in the United States, the United Kingdom, and Canada were identified specifically: cancer care and care facilities were of common interest to the public across the 3 countries during the pandemic; the public expressed positive attitudes toward the COVID-19 vaccine and highlighted the protection it affords to PEoLC professionals; and although Twitter users shared their personal experiences about PEoLC in the web-based community during the pandemic, this was more prominent in the United States and Canada. The implementation of the vaccination programs raised the profile of the vaccine discussion; however, this did not influence public opinions about PEoLC.

CONCLUSIONS

Public opinions on Twitter reflected a need for enhanced PEoLC services during the COVID-19 pandemic. The insignificant impact of the vaccination program on public discussion on social media indicated that public concerns regarding PEoLC continued to persist even after the vaccination efforts. Insights gleaned from public opinions regarding PEoLC could provide some clues for policy makers on how to ensure high-quality PEoLC during public health emergencies. In this post-COVID-19 era, PEoLC professionals may wish to continue to examine social media and learn from web-based public discussion how to ease the long-lasting trauma caused by this crisis and prepare for public health emergencies in the future. Besides, our results showed social media's potential in acting as an effective tool to reflect public opinions in the context of PEoLC.

How Do Team-Level and Individual-Level Linguistic Styles Affect Patients' Emotional Well-Being-Evidence from Online Doctor Teams

BACKGROUND

In the post-epidemic era, online medical care is developing rapidly, and online doctor teams are attracting attention as a high-quality online medical service model that can provide more social support for patients.

METHODS

Using online doctor teams on the Haodf.com platform as the research subject, this study investigates the key factors in the process of doctor-patient communication, which affects patients' emotional well-being. We also explore the different roles played by doctors as leaders and non-leaders in doctor-patient communication. From the perspective of language style, we select representative factors in the process of doctor-patient communication, namely the richness of health vocabulary, the expression of emotions, and the use of health-related terms (including perceptual words and biological words). We extract both team-level and individual-level linguistic communication styles through textual and sentiment analysis methods and empirically analyze their effects on patients' emotional well-being using multiple linear regression models.

RESULTS

The results show that the expression of positive emotions by the team and attention to patients' perceptions and biological conditions benefit patients' emotional well-being. Leaders should focus on the emotional expression, whereas non-leaders should focus on the use of perceptual and biological words.

CONCLUSIONS

This study expands the application of linguistic styles in the medical field and provides a practical basis for improving patients' emotional well-being.

Social Support and Aggressive Communication on Social Network Sites during the COVID-19 Pandemic

During the COVID-19 pandemic, use of social networking sites (SNSs) surged in many countries, including the United States. This content analysis of a convenience sample of English language conversations examined how users sought and provided social support on three Western-dominated SNSs, Reddit (N = 100), YouTube (N = 100), and Facebook (N = 100), during the week following the declaration of COVID-19 as a pandemic. In addition to analyzing social support, this study examined aggressive communication, which often leads to undesirable mental health outcomes, on Reddit, YouTube, and Facebook during this period. According to the Social Identity Model of Individuation Effects (SIDE), anonymous environments which codify civil communication norms are more likely to yield prosocial behavior. Results indicate that Reddit, YouTube, and Facebook varied significantly in supportive and aggressive communication prevalence. Reddit users more frequently provided social support than did YouTube and Facebook users. Additionally, Reddit users engaged in aggressive communication significantly less than both YouTube and Facebook users. These findings support predictions from the SIDE model, as Reddit both offers users greater anonymity than YouTube and Facebook and codifies supportive, civil communication norms in a rules system called, "Reddiquette."

Comparative Analysis of Social Support in Online Health Communities Using a Word Co-Occurrence Network Analysis Approach

Online health communities (OHCs) have become a major source of social support for people with health problems. Members of OHCs interact online with others facing similar health problems and receive multiple types of social support, including but not limited to informational support, emotional support, and companionship. The aim of this study is to examine the differences in social support communication among people with different types of cancers. A novel approach is developed to better understand the types of social support embedded in OHC posts. Our approach, based on the word co-occurrence network analysis, preserves the semantic structures of the texts. Information extraction from the semantic structures is supported by the interplay of quantitative and qualitative analyses of the network structures. Our analysis shows that significant differences in social support exist across cancer types, and evidence for the differences across diseases in terms of communication preferences and language use is also identified. Overall, this study can establish a new venue for extracting and analyzing information, so as to inform social support for clinical care.

Paying attention to relatives of cancer patients: What can we learn from their online writings?

OBJECTIVE

Relatives of cancer patients often play a crucial role in care, while their own needs generally receive scant attention. We investigate those topics on which relatives share information online.

METHODS

We coded user-generated content written by 185 relatives on a major Dutch cancer site (kanker.nl), into three main categories: 'Disease', 'Well-being' and 'Other subjects'. In addition, we analysed five websites (from five countries) for which content they provide that is relevant for relatives.

RESULTS

Our analysis showed that across cancer types, relatives share online information and emotions. Quantitative analysis showed that they mainly write about topics related to their own well-being (blog posters: 45% of the posts and group posters 64%). Blog posters found the disease-related topics more important than the group posters (45% and 29%).

CONCLUSIONS

This study has shown that relatives share different kinds of user-generatedcontent related to their own situation. This could be a valuable resource for further research into the needs of relatives, and a very useful source for identification of emotional and informational topics.

PRACTICE IMPLICATIONS

It is crucial that relatives are enabled to occupy their own space in the disease-and-treatment process appropriate to their needs and to help avoid caregiver burden.

From loquacious to reticent: understanding patient health information communication to guide consumer health IT design

Background and significance

It is increasingly recognized that some patients self-manage in the context of social networks rather than alone. Consumer health information technology (IT) designed to support socially embedded self-management must be responsive to patients' everyday communication practices. There is an opportunity to improve consumer health IT design by explicating how patients currently leverage social media to support health information communication.

Objective

The objective of this study was to determine types of health information communication patterns that typify Facebook users with chronic health conditions to guide consumer health IT design.

Materials and methods

Seven hundred participants with type 2 diabetes were recruited through a commercial survey access panel. Cluster analysis was used to identify distinct approaches to health information communication both on and off Facebook. Analysis of variance (ANOVA) methods were used to identify demographic and behavioral differences among profiles. Secondary analysis of qualitative interviews ( n  = 25) and analysis of open-ended survey questions were conducted to understand participant rationales for each profile.

Results

Our analysis yielded 7 distinct health information communication profiles. Five of 7 profiles had consistent patterns both on and off Facebook, while the remaining 2 demonstrated distinct practices, with no health information communication on Facebook but some off Facebook. One profile was distinct from all others in both health information communication practices and demographic composition. Rationales for following specific health information communication practices were categorized under 6 themes: altruism, instrumental support, social support, privacy and stigma, convenience, and Facebook knowledge.

Conclusion

Facebook has been widely adopted for health information communication; This study demonstrates that Facebook has been widely adopted for health information communication. It also shows that the ways in which patients communicate health information on and off Facebook are diverse.

Social Media Use by Transplant Recipients for Support and Healing

Transplant recipients use a diverse support network that now includes transplant-related social media support groups. The purpose of this study is to explore the use of social media sites by transplant recipients as a potential source of support and healing and the usefulness of Internet postings as a source of rich qualitative data. A qualitative descriptive design was used for the study. A total of 126 retrospective postings from 58 participants were analyzed as they existed on this open publically available Web site over a 20-month period from the selected discussion threads. Two major themes emerged from the data: sharing overwhelming gratitude and finding sanctuary. Sharing overwhelming gratitude was expressed in emotional postings about feelings and letters to donor families. Finding sanctuary described the recipients' perception of the online community as a safe and nonjudgmental environment to discuss sensitive issues and feelings. This study adds to what is known about the unique psychological and emotional needs of transplant recipients. Transplant-related support Web sites offer the opportunity to learn what matters most to transplant recipients and identify gaps in care related to calls for nursing.

Informational and emotional elements in online support groups: a Bayesian approach to large-scale content analysis

OBJECTIVE

This research examines the extent to which informational and emotional elements are employed in online support forums for 14 purposively sampled chronic medical conditions and the factors that influence whether posts are of a more informational or emotional nature.

METHODS

Large-scale qualitative data were obtained from Dailystrength.org. Based on a hand-coded training dataset, all posts were classified into informational or emotional using a Bayesian classification algorithm to generalize the findings. Posts that could not be classified with a probability of at least 75% were excluded.

RESULTS

The overall tendency toward emotional posts differs by condition: mental health (depression, schizophrenia) and Alzheimer's disease consist of more emotional posts, while informational posts relate more to nonterminal physical conditions (irritable bowel syndrome, diabetes, asthma). There is no gender difference across conditions, although prostate cancer forums are oriented toward informational support, whereas breast cancer forums rather feature emotional support. Across diseases, the best predictors for emotional content are lower age and a higher number of overall posts by the support group member.

DISCUSSION

The results are in line with previous empirical research and unify empirical findings from single/2-condition research. Limitations include the analytical restriction to predefined categories (informational, emotional) through the chosen machine-learning approach.

CONCLUSION

Our findings provide an empirical foundation for building theory on informational versus emotional support across conditions, give insights for practitioners to better understand the role of online support groups for different patients, and show the usefulness of machine-learning approaches to analyze large-scale qualitative health data from online settings.

Eliciting and receiving online support: using computer-aided content analysis to examine the dynamics of online social support

Background

Although many people with serious diseases participate in online support communities, little research has investigated how participants elicit and provide social support on these sites.

Objective

The first goal was to propose and test a model of the dynamic process through which participants in online support communities elicit and provide emotional and informational support. The second was to demonstrate the value of computer coding of conversational data using machine learning techniques (1) by replicating results derived from human-coded data about how people elicit support and (2) by answering questions that are intractable with small samples of human-coded data, namely how exposure to different types of social support predicts continued participation in online support communities. The third was to provide a detailed description of these machine learning techniques to enable other researchers to perform large-scale data analysis in these communities.

Methods

Communication among approximately 90,000 registered users of an online cancer support community was analyzed. The corpus comprised 1,562,459 messages organized into 68,158 discussion threads. Amazon Mechanical Turk workers coded (1) 1000 thread-starting messages on 5 attributes (positive and negative emotional self-disclosure, positive and negative informational self-disclosure, questions) and (2) 1000 replies on emotional and informational support. Their judgments were used to train machine learning models that automatically estimated the amount of these 7 attributes in the messages. Across attributes, the average Pearson correlation between human-based judgments and computer-based judgments was .65.

Results

Part 1 used human-coded data to investigate relationships between (1) 4 kinds of self-disclosure and question asking in thread-starting posts and (2) the amount of emotional and informational support in the first reply. Self-disclosure about negative emotions (beta=.24, P<.001), negative events (beta=.25, P<.001), and positive events (beta=.10, P=.02) increased emotional support. However, asking questions depressed emotional support (beta=–.21, P<.001). In contrast, asking questions increased informational support (beta=.38, P<.001), whereas positive informational self-disclosure depressed it (beta=–.09, P=.003). Self-disclosure led to the perception of emotional needs, which elicited emotional support, whereas asking questions led to the perception of informational needs, which elicited informational support. Part 2 used machine-coded data to replicate these results. Part 3 analyzed the machine-coded data and showed that exposure to more emotional support predicted staying in the group longer 33% (hazard ratio=0.67, P<.001), whereas exposure to more informational support predicted leaving the group sooner (hazard ratio=1.05, P<.001).

Conclusions

Self-disclosure is effective in eliciting emotional support, whereas question asking is effective in eliciting informational support. Moreover, perceptions that people desire particular kinds of support influence the support they receive. Finally, the type of support people receive affects the likelihood of their staying in or leaving the group. These results demonstrate the utility of machine learning methods for investigating the dynamics of social support exchange in online support communities.

Information and communication technologies for informal carers and paid assistants: benefits from micro-, meso-, and macro-levels

The aim of this study was to explore the benefits of information and communication technologies (ICT)-based services for informal carers and paid assistants of older people living in the community. We cross-case analysed the effects of twelve initiatives in the EU, the USA and Canada, based on their individual analysis documented through interviews with promoters and a literature review. We carried out the cross-case analysis following a variables-oriented strategy on seven dimensions of impact at micro-, meso- and macro-levels: the quality of life of informal carers and paid assistants, quality of life of care recipients, quality of care, care efficiency and sustainability, acceptability, and infrastructure and accessibility. ICT-based services for informal carers and paid assistants improve the quality of life of older people and their carers and access to qualified care. They also generate savings which contribute to the sustainability of the care systems. These findings constitute a first look at the benefits of the use of ICT-based services for informal carers and paid assistants. Nevertheless, more research using experimental methods is needed to demonstrate the impact of these ICT-based services at meso- and macro-levels. This would help to support policy-makers to deploy these technologies for long-term care delivery.

"It is the 'starting over' part that is so hard": Using an online group to support hospice bereavement

OBJECTIVE

Although hospice agencies are required to provide informal caregivers (family or friends of the patient) with formal bereavement support when their loved one passes, most bereavement interventions lack standardization and remain untested. We employed the Dual Processing Model of Bereavement as a theoretical framework for assessing the potential of a secret Facebook group for bereaved hospice caregivers.

METHOD

A mixed-methods approach was utilized to analyze online communication (posts and comments) in the secret Facebook group, and self-reported outcome measures on depression and anxiety were compared pre- and post-intervention.

RESULTS

Sixteen caregivers participated in the secret Facebook group over a period of nine months. The majority of online talk was oriented to restoration, revealing abrupt and anticipated triggers that evoked feelings of loss. Caregivers also shared loss orientation through storytelling, sharing and giving advice, and encouraging others to manage the challenges of coping. Caregiver anxiety and depression were lower after the intervention.

SIGNIFICANCE OF RESULTS

This pilot study provides insight into the use of a secret Facebook group to facilitate bereavement support to caregivers. Findings highlight the promise of Facebook for hospice bereavement support. Providers and researchers are encouraged to explore the positive outcomes associated with bereavement support.

Cyber support: describing concerns of caregivers of people with pulmonary hypertension

The purpose of this study was to gain an understanding of how caregivers of people with pulmonary hypertension are using an online discussion board. The chronicity and complex medical needs of people with pulmonary hypertension warrant a holistic nursing approach combining the patient and caregiver concerns to adequately address their needs. A qualitative descriptive approach was utilized. A convenience sample over an 18-month period of those caregivers who posted Internet messages to the Pulmonary Hypertension Discussion Board was included. Sociodemographics collected were age and gender of the person with pulmonary hypertension and the relationship of the caregiver to the person with pulmonary hypertension. Clinical variables collected were medications and oxygen use and years since diagnosis. Thematic analysis was used to identify themes. A total of 98 caregivers posted to the discussion board during the 18-month period; 46% of those posting were mothers of children with pulmonary hypertension. Four themes emerged: fear and frustration, questions and concerns, someone to listen to, and moving on with life. These themes characterize how caregivers of people with pulmonary hypertension were using the discussion board. Caregivers of people with pulmonary hypertension may need more information and support from their healthcare providers to adequately care for those with pulmonary hypertension.

Comparison of social support content within online communities for high- and low-survival-rate cancers

People experiencing cancer use the Internet for many reasons, particularly for social support. This study sought to determine how social support content within online support communities for different cancers varied according to cancer survival rate. A quantitative content analysis was conducted on 3717 posts from eight online communities focused on cancers with high and low 5-year relative survival rates. Using Optimal Matching Theory, we predicted that low-survival-rate communities would have more emotional support content than high-survival-rate communities, and high-survival-rate communities would have more informational support content than low-survival-rate communities. Emotional support content was consistently more common than informational support. Overall, high-survival-rate communities had a greater proportion of posts containing emotional support content (75%) than low-survival-rate communities (66%) (χ1 = 20.89 [n = 2235], P < .001). Furthermore, low-survival-rate communities had a greater proportion of posts containing informational support content (46%) than high-survival-rate communities (36%) (χ1 = 21.13 [n = 2235], P< .001). Although the relationships between survival rate and support types were significant, they were not as hypothesized. Deviations from theoretically predicted results suggest that individuals experiencing low-survival-rate cancers may have a greater desire for informational support online than individuals experiencing high-survival-rate cancers.

Social Support Through the Use of ICT for Caregivers of the Chronically Ill: State of the Art

El uso de tecnologías de información y comunicación (TIC) en la nueva era es una necesidad para dar soporte social en salud. Objetivo: caracterizar la producción académica y científica e identificar las estrategias y su evolución acerca del soporte social con el uso de TIC para cuidadores familiares de personas con enfermedad crónica en América en el periodo comprendido entre 1996-2009. Materiales y métodos: revisión documental, descriptiva, con diseño trasversal, desarrollada mediante una búsqueda en bases de datos. Se elaboró una matriz de análisis utilizando la metodología de elaboración de fichas de Hoyos. Resultados: para la elaboración de este estado del arte se seleccionaron 31 artículos publicados entre 1996 y 2009. La totalidad de la literatura existente en soporte social con uso de TIC se ubicó en Norteamérica, con una predominancia del idioma inglés, siendo su mayor producción en el 2004, de los cuales 14 eran cuantitativos y 13 cualitativos que evaluaron la calidad, satisfacción, accesibilidad, información proporcionada y estrategias de seguimiento. Conclusiones: las TIC en cuidadores familiares de personas con enfermedad crónica tienen un efecto protector y generan mejoría en la salud física y mental, y en el vínculo afectivo. Las de mayor uso son la Internet y el teléfono. Se reconoce la importancia de incorporarlas en el contexto colombiano y en la práctica de enfermería a través de proyectos de investigación.