Seeking virtual social support through blogging: A content analysis of published blog posts written by people with chronic pain

Navigating who I was and who I am online: How people with dementia use social media platforms to support identity

A diagnosis of dementia can have a powerful impact on identity, and social media platforms offer promising avenues for identity expression and reconciliation. Addressing limited research in this area, we used semi-structured interviews to explore how 10 people with dementia used social media to navigate their identity. Our thematic analysis produced four themes, showing how social media platforms afford unique opportunities for self-expression, visibility, and association, thereby empowering users to maintain their sense of self, challenge stereotypes, and foster community connections. Additionally, social media facilitated a multifaceted and holistic sense of identity beyond the confines of diagnosis. While there were concerns about online self-disclosure, sharing experiences of dementia had therapeutic benefits, aiding in acceptance and adjustment. Participants also leveraged social media to establish continuity between their pre- and post-diagnostic selves, providing a sense of stability amid uncertainty. With the increasing prevalence of social media use among people with dementia, proactive measures by healthcare professionals, policymakers, technology developers, and carers are required to cultivate online experiences that are safe, supportive, and inclusive of people with dementia.

Peer Support for Chronic Pain in Online Health Communities: Quantitative Study on the Dynamics of Social Interactions in a Chronic Pain Forum

BACKGROUND

Peer support for chronic pain is increasingly taking place on social media via social networking communities. Several theories on the development and maintenance of chronic pain highlight how rumination, catastrophizing, and negative social interactions can contribute to poor health outcomes. However, little is known regarding the role web-based health discussions play in the development of negative versus positive health attitudes relevant to chronic pain.

OBJECTIVE

This study aims to investigate how participation in online peer-to-peer support communities influenced pain expressions by examining how the sentiment of user language evolved in response to peer interactions.

METHODS

We collected the comment histories of 199 randomly sampled Reddit (Reddit, Inc) users who were active in a popular peer-to-peer chronic pain support community over 10 years. A total of 2 separate natural language processing methods were compared to calculate the sentiment of user comments on the forum (N=73,876). We then modeled the trajectories of users' language sentiment using mixed-effects growth curve modeling and measured the degree to which users affectively synchronized with their peers using bivariate wavelet analysis.

RESULTS

In comparison to a shuffled baseline, we found evidence that users entrained their language sentiment to match the language of community members they interacted with (t198=4.02; P<.001; Cohen d=0.40). This synchrony was most apparent in low-frequency sentiment changes unfolding over hundreds of interactions as opposed to reactionary changes occurring from comment to comment (F2,198=17.70; P<.001). We also observed a significant trend in sentiment across all users (β=-.02; P=.003), with users increasingly using more negative language as they continued to interact with the community. Notably, there was a significant interaction between affective synchrony and community tenure (β=.02; P=.02), such that greater affective synchrony was associated with negative sentiment trajectories among short-term users and positive sentiment trajectories among long-term users.

CONCLUSIONS

Our results are consistent with the social communication model of pain, which describes how social interactions can influence the expression of pain symptoms. The difference in long-term versus short-term affective synchrony observed between community members suggests a process of emotional coregulation and social learning. Participating in health discussions on Reddit appears to be associated with both negative and positive changes in sentiment depending on how individual users interacted with their peers. Thus, in addition to characterizing the sentiment dynamics existing within online chronic pain communities, our work provides insight into the potential benefits and drawbacks of relying on support communities organized on social media platforms.

Making Sense of the COVID-19 Pandemic: The Use of Blogging by People with Inflammatory Bowel Disease

During the global COVID-19 pandemic one population that faced special challenges was individuals with preexisting chronic health conditions. In this study, we examined how people with inflammatory bowel disease (IBD) managed their autoimmune disease, considering their increased susceptibility to contracting COVID-19. Specifically, we analyzed how people with IBD made sense of their precarious position through the writing of publicly accessible blogs. We found that for IBD patients, navigating healthcare needs in the context of pandemic-related concerns and restrictions meant grappling with several salient, but conflicting tensions: separation vs. connection, safety vs. exposure, uncertainty vs. control, and resilience vs. vulnerability. People with IBD struggled to find a balance between living with IBD while keeping themselves and their loved ones safe from the virus. While the worst of the COVID-19 pandemic may be over, the underlying disease, and the tensions the disease causes, is still present for people with IBD.

Low-dose ketamine infusions for chronic pain management: Does this qualify as evidence-based practice?

Chronic pain is becoming increasingly prevalent and burdensome both worldwide and in the United Kingdom. Due to the complexity of chronic pain and the therapeutic challenge associated, management is often difficult and requires multidisciplinary care encompassing a combination of pharmacological and non-pharmacological strategies. Conventional analgesic treatments, such as opioids and anticonvulsants, are effective in less than half of chronic pain sufferers and are typically limited to short-term use to prevent complications associated with long-term use such as tolerance and dependence. Consequently, research and clinical interest in alternative management options for chronic pain have increased in recent years, with ketamine being one example under investigation. However, since ketamine has been licensed as an anaesthetic for decades, it has bypassed the traditional scrutinous drug development sequence that is typically seen for therapeutics marketed for pain. As such, data supporting the unlicensed administration of ketamine for chronic pain management is lacking and is being outpaced by the rates of off-label use in pain clinics. Recent limited evidence suggests that ketamine, when given as an intravenous infusion in subanaesthetic doses for refractory pain patients, may provide modest analgesic effects in nearly all aetiologies of chronic pain, with side effects common but typically mild. However, there are concerns over the safety of this practice due to the paucity of robust supportive evidence and the accompanying lack of clinical guidelines or standardised protocols. This review shall summarise the literature examining the use of subanaesthetic-dose ketamine infusions for chronic pain to comment on the current level of evidence, with limitations of existing research and future recommendations discussed.

Do Bloggers Have Better Mental Health? The Social, Cognitive, and Psychological Benefits of Blogging in Emerging Adulthood

BACKGROUND

The purpose of this study was to investigate the longitudinal processes by which blogging-related disclosure is linked to mental health. It was hypothesized that blogging had both social and cognitive benefits, including greater perceived social support and fewer memory slips, which were then associated with better mental health.

METHODS

A total of 194 emerging adults were recruited three times at approximately three months apart. Participants filled out a self-report about their blogging activities and perceived benefits, social support, memory, and mental health at each time point.

RESULTS

Path analysis indicated that perceived blogging-related benefits, needs, and traits mediated the relation between frequency of blogging and social support and memory slips, respectively. Moreover, social support marginally predicted greater mental health, whereas memory slips predicted poorer mental health, after controlling for baseline mental health, age, and gender.

CONCLUSIONS

This study established the longitudinal associations between blogging and its benefits that may be vital for emerging adults' mental health.

Striving for a Realistic and Unapologetic View of Huntington's Disease

This article describes how the author, a Huntington's disease (HD) gene expansion carrier and long-time advocate, has helped give voice to the HD community through his blog, At Risk for Huntington's Disease. Since 2005, the 321 articles have helped document the new and harrowing experience of living in the gray zone between a genetic test result and disease onset. At Risk for HD has explored major challenges for the HD community, has become a key reference for HD families, and has chronicled the quest to defeat the disease. This article analyzes the blog's thematic impact.

Experiences of Blogging About Visible and Long-term Skin Conditions: Interpretative Phenomenological Analysis

BACKGROUND

Skin conditions can detract from people's quality of life, much like conditions such as cancer, chronic pain, and depression. Visible skin conditions can lead to risk of stigmatization. It is acknowledged that there is a lack of available psychosocial support for people living with chronic skin conditions. One way in which individuals with long-term conditions are self-managing and providing peer support is through blogging and exchanging information on the web. To date, no research has specifically investigated how individuals with skin conditions experience the use blogging for self-management.

OBJECTIVE

This study sought to investigate the experiences of individuals with visible, long-term skin conditions when blogging about their conditions.

METHODS

A systematic blog search and a short survey were used for recruitment. A total of 4 participants took part in email interviews, which were analyzed using interpretative phenomenological analysis (IPA). Skin conditions included alopecia, psoriasis, and hirsutism. The content of these individuals' blogs was also analyzed using a qualitative template method derived from the IPA analysis.

RESULTS

The interviews and accounts revealed a clear sense of uncertainty about the course of the bloggers' skin conditions. This appeared to be associated with feelings of distress and isolation, searching for treatments, and ultimately a sense of defeat. The data revealed that blogging provided a space where this sense of defeat was managed and challenged. Posting on the web facilitated connection with others and enabled support networks to be established that assisted in challenging the feelings of isolation experienced. The data demonstrate the important role that blogging played for these participants in developing a sense of acceptance of their condition.

CONCLUSIONS

Blogging may provide a way for individuals to self-manage distress associated with visible skin conditions. It may provide similar benefits to those known to be derived from emotional disclosure that occurs during writing, with an added peer support dimension. Blogging has occurred naturalistically on web-based forums, and this study demonstrates how this form of interaction may warrant adaptation for use with web-based psychosocial interventions for people living with skin conditions. This study had a limited sample of 4 bloggers; therefore, further exploration would be needed to consider the utility of this approach.

What makes an online help-seeking message go far during the COVID-19 crisis in mainland China? A multilevel regression analysis

Various studies have explored the underlying mechanisms that enhance the overall reach of a support-seeking message on social media networks. However, little attention has been paid to an under-examined structural feature of help-seeking message diffusion, information diffusion depth, and how support-seeking messages can traverse vertically into social media networks to reach other users who are not directly connected to the help-seeker. Using the multilevel regression to analyze 705 help-seeking posts regarding COVID-19 on Sina Weibo, we examined sender, content, and environmental factors to investigate what makes help-seeking messages traverse deeply into social media networks. Results suggested that bandwagon cues, anger, instrumental appeal, and intermediate self-disclosure facilitate the diffusion depth of help-seeking messages. However, the effects of these factors were moderated by the epidemic severity. Implications of the findings on support-seeking behavior and narrative strategies on social media were also discussed.

"You have people here to help you, people like me." A Qualitative Analysis of a Blogging Intervention for Adolescents and Young Adults with Depression or Anxiety

Blogging in the lay community has been shown to be a popular means of expression for all ages exhibiting mental illness symptoms. With the recent rise of mental illness rates among adolescents, blogging in a space specifically designated to discuss mental health topics for adolescents could potentially be beneficial for this demographic. In order to reveal whether or not blogging has positive effects on adolescents and young adults, we created a moderated, anonymous eHealth intervention for those in this demographic experiencing depression and/or anxiety symptoms. This intervention, called Supporting Our Valued Adolescents (SOVA), allows a safe place for participants ages 14-26 (inclusive) to read, write, and comment on blog posts regarding various mental health topics. In this paper, we analyze 40 SOVA blog posts and their corresponding comments written by 18 participants over a six-month period to see if actively engaging on the website was beneficial for their mental health. These posts and comments were analyzed on their degree of self-disclosure, regulatory and interpersonal support, acknowledgement of others, and reader feedback. We found that the content analyzed implied that blogging had a positive effect on participants using this online intervention.

Self-disclosure in public and private groups of people with mental illnesses in Facebook

Purpose

The Internet enables various voices and opinions that previously did not participate in the community discourse to express themselves. People with mental illnesses make use of social networks to advance their special needs in varied ways. The study aims to examine the nature of the discourse that takes place in public and private groups of people with mental illnesses.

Design/methodology/approach

The research corpus consisted of the content of 615 messages taken from public and private groups of people with mental illnesses in Facebook. Linguistic parameters (the total number of words, the number of words in the first person) were examined for each message. Two skilled judges classified the messages on a self-disclosure scale to determine the degree of disclosure of personal information, thoughts and emotions.

Findings

The results of the study indicate that the messages published in public groups are longer than the messages in private groups; however, the level of personal disclosure in messages written in private groups is deeper than in messages written in public groups. In addition, the level of self-disclosure in opening posts was found to be greater than the level of self-disclosure in comments.

Practical implications

In the study, the authors focus on the ways people in excluded populations make use of virtual tools to advance both their personal and social needs.

Originality/value

The study is innovative, as it explores the discourse of people with mental illnesses in public and private groups on Facebook.

Strengthening positive social pathways via digital social applications in individuals with social skills deficits: A scoping review

BACKGROUND

Effective digital social capital interventions have great potential to establish trusted social pathways to access supportive services and to enable talking about issues contributing to distress.

AIM

This review explores the digital social capital interventions used in individuals with social skills deficits, and the best social health outcomes achieved.

METHOD

Four databases (PubMed, CINAHL, PsychINFO, and Web of Science) were used with no time limitation, and 33 papers were included.

RESULTS

A diverse range of digital social programs was used for social capital improvement based on individuals' characteristics (e.g. age range and illnesses). Programs ranged from digitally-enhanced self-help or self-guided treatment (to enhance the self-efficacy of individuals), to group treatments and/or web-based caregiver support services. They comprised mobile social apps, video blogging, video-communication system/video-conferencing, and online social communication, to more advanced techniques such as virtual reality. All of these modalities were shown to be beneficial for improving the social health of individuals. Interventions targeted two aspects of social capital: (1) cognitive social capital, focusing on enhancing trust and control, self-efficacy on life. Some examples were cognitive behavioural therapy, and increasing the received and more importantly perceived social support. (2) structural social capital, focusing on individuals' relationships with family/carers, friends, peers to other connections at the macro level, such as health care providers and their community as a whole. The two interconnected aspects of social capital play a role in decreasing fears of being judged by others, general fears in social interactions and interpersonal problems.

CONCLUSION

Guided digital social support interventions result in open and flexible access to various resources through supportive social networks, for patients and their family members/carers.

Exploring peoples' lived experience of complex regional pain syndrome in Australia: a qualitative study

OBJECTIVES

Complex regional pain syndrome (CRPS) is a persistent pain condition which is often misunderstood and poorly managed. Qualitative studies are needed to explore the lived experience of the condition and to better understand patient perspectives on their management experiences and needs. The aim of this study was to explore the lived experience of CRPS in Australia, including exploration of their perceptions of care and advice received from healthcare professionals.

METHODS

A qualitative study with individual in-depth semi-structured, face-to-face interviews was performed (n=15, 80% female, average time elapsed since diagnosis 3.8 years). Qualitative data were analysed using an inductive thematic analysis approach.

RESULTS

Four main themes with associated subthemes were identified, representing the participants' journey: (1) Life Changing Impact of CRPS (Subthemes: Impact on self, Impact on others); (2) Variable Experiences of Care (Subthemes: Helpful experiences of care, Unhelpful experiences of care); (3) Making Sense of CRPS (Subthemes: Knowledge and understanding, Dealing with unpredictability); and (4) Perceptions on Lessons Learned from Living with CRPS (Subthemes: Acceptance was an important part of the journey, Trial and error was necessary to find an individual way forward, Coping strategies).

CONCLUSIONS

The themes identified align to and expand on prior qualitative research findings in people with CRPS. It highlights the challenges people face related to their personal self, their close relationships and their social and work roles. It highlights the difficulties these people have in finding reliable, trust-worthy information. These findings suggest that healthcare professionals may benefit from education about how to better support people with CRPS, including helping people to navigate to the right care. Engaging people with CRPS in the development of educational resources should be a future research goal. It is recommended that patient perspectives are incorporated into the development of care pathways for CRPS.

"It's like she's talking about me" - Exploring the value and potential impact of a YouTube film presenting a qualitative evidence synthesis about chronic pain: An analysis of online comments

Background

There is very limited research exploring the value and impact of qualitative research in chronic pain despite the large volume of research.

Aims

The aim of this study was to find out whether viewers’ comments in response to a YouTube film, portraying findings from a qualitative evidence synthesis about living with pain, revealed any potential value or impact to viewers.

Methods

We collected online data posted in response to the film Struggling to Be Me. We used themes from a large review of qualitative research as an a priori analytic framework. We used inductive thematic analysis to distil the essence of data that did not fit this framework. A thematic analysis of online comments to evaluate the impact of an arts-based health research film on people living with chronic pain is presented.

Results

We developed two inductive themes that explored the value and potential impact of watching the film online: (1) It has given voice to our suffering and (2) it makes me feel that I am not alone. Two subthemes added insight to the a priori framework: First, I have had enough of me added insight to the theme my life is impoverished and confined; second, I am treated like a criminal because I take opioids added insight to the theme lost personal credibility.

Conclusions

Our findings indicate that watching the YouTube film has potential value and impact, giving voice to suffering and making people feel that they are not alone. There are specific ethical challenges relating to internet-mediated research.

Sharing the pain: an observational analysis of Twitter and pain in Ireland

INTRODUCTION

Studies involving Twitter and chronic pain can provide highly valuable patient-generated information. The aim of this paper was to examine pain-related tweets in Ireland over a 2-week period from 22 June 2017 to 5 July 2017 using pain-related keywords. We wished to identify Twitter user gender profile; most common discussion topics; sentiment analysis; and dissemination of tweets.

METHODS

A third-party data analytics company conducted a Twitter social media analysis over a randomly chosen 14-day period between the dates 22 June and 5 July 2017. All relevant keywords were included in the search. Author group consensus yielded 24 terms. Geographical location was restricted to Ireland. A computational sentiment dictionary was used to provide a rating of the emotional properties of the text on a 9-point scale from -5 to +4 of negative to positive sentiment. Dissemination was calculated by the number of times the tweet was displayed ('impressions').

RESULTS

There were 941 tweets identified during the study from 715 contributors. These generated 2.88 million impressions. The most frequently occurring keywords were headache (n=321); migraine (n=147); back pain (n=123); cannabis (n=114); and chronic pain (n=85). There were 1.94 times as many tweets from females as males. The highest proportion of tweets from female users was in the fibromyalgia (83%) and migraine (60%) categories; and from males in the sciatica (35%), chronic pain (34%) and back pain (32%) categories. Cannabis-related tweets reflected mostly non-personal content (90%), with a highly positive sentiment, and the highest number of impressions per tweet. The largest amount of advice was offered in the back pain category. Reposting of other users' content ('retweets') was more likely to contain a positive sentiment.

CONCLUSION

A substantial discussion of pain-related topics took place on Twitter during our study period. This provided real-time, dynamic information from individuals on discussion topics in pain medicine. This can be used to gain a greater understanding of the pain experience. As patients are increasingly acquiring healthcare information through online sources, high-quality information from approved sources should be promoted on such platforms.

What Women With Disabilities Write in Personal Blogs About Pregnancy and Early Motherhood: Qualitative Analysis of Blogs

BACKGROUND

More than 1 in 10 women of reproductive age identify as having some type of disability. Most of these women are able to become pregnant and have similar desires for motherhood as women without disability. Women with disability, however, face greater stigma and stereotyping, additional risk factors, and may be less likely to receive adequate reproductive health care compared with their peers without disability. More and more individuals, including those with disability, are utilizing the internet to seek information and peer support. Blogs are one source of peer-to-peer social media engagement that may provide a forum for women with disability to both share and obtain peer-to-peer information and support. Nevertheless, it is not clear what content about reproductive health and pregnancy and/or motherhood is featured in personal blogs authored by women with spinal cord injury (SCI), traumatic brain injury (TBI), spina bifida, and autism.

OBJECTIVE

The objective of this study was twofold: (1) to examine the information being shared in blogs by women with 4 types of disabilities, namely, SCI, TBI, spina bifida, and autism, about reproductive health, disability, health care, pregnancy, and motherhood; and (2) to classify the content of reproductive health experiences addressed by bloggers to better understand what they viewed as important.

METHODS

Personal blogs were identified by searching Google with keywords related to disabilities, SCI, TBI, spina bifida, and autism, and a variety of keywords related to reproductive health. The first 10 pages of each database search in Google, based on the relevance of the search terms, were reviewed and all blogs in these pages were included. Blog inclusion criteria were as follows: (1) written by a woman or care partner (ie, parent or spouse) of a woman with a self-identified diagnosis of SCI, TBI, spina bifida, or autism; (2) focused on the personal experience of health and health care during the prepregnancy, prenatal, antepartum, intrapartum, and/or postpartum periods; (3) written in English; and (4) published between 2013 and 2017. A descriptive and thematic qualitative analysis of blogs and corresponding comments was facilitated with NVivo software and matrix analysis.

RESULTS

Our search strategy identified 125 blogs that met all the inclusion criteria; no blogs written by women with spina bifida were identified. We identified 4 reproductive health themes featured in the blog of women with disabilities: (1) (in)accessible motherhood, (2) (un)supportive others, (3) different, but not different, and (4) society questioning motherhood.

CONCLUSIONS

This analysis of personal blogs about pregnancy and health care written by women with SCI, TBI, and autism provides a glimpse into their experiences. The challenges faced by these women and the adaptations they made to successfully navigate pregnancy and early motherhood provide insights that can be used to shape future research.