Sharing and Empathy in Digital Spaces: Qualitative Study of Online Health Forums for Breast Cancer and Motor Neuron Disease (Amyotrophic Lateral Sclerosis)

Enhancing ALS disease management: exploring integrated user value through online communities evidence

Introduction

Assistive technologies (ATs) offer significant potential to improve the quality of life for individuals with Amyotrophic Lateral Sclerosis (ALS). This study explores the concept of integrated user value (IUV), focusing on five key aspects: quality, user experience, cost-effectiveness, safety, and accessibility. Understanding IUV is crucial for enhancing the development and deployment of ATs in ALS disease management.

Methods

A systematic search approach was utilized to collect data from Facebook ALS support groups, comprising posts from individuals with ALS and their caregivers. Using a predefined set of keywords, 416 posts were analyzed. The posts were categorized based on the five aspects of IUV, and an in-depth content analysis was conducted to explore patterns, challenges, and experiences associated with AT usage.

Results

The analysis revealed significant challenges across all aspects of IUV. Quality and user experience were interlinked, with users frequently citing inadequate designs and unmet customization needs. Cost-effectiveness was a key concern, with high costs and limited insurance coverage contributing to financial strain. Accessibility issues, including delays in acquiring devices and insufficient public facilities, further highlighted systemic challenges. Safety concerns emphasized the need for personalized and intuitive AT designs.

Discussion

The findings underscore the importance of a holistic approach to AT development, integrating all five aspects of IUV. Recommendations include enhancing product quality, ensuring affordability, prioritizing user-centered design, and addressing accessibility gaps. Collaboration between AT designers, healthcare providers, and policymakers is essential to optimize AT value and improve the quality of life for individuals with ALS and their caregivers.

The Impact of Linguistic Signals on Cognitive Change in Support Seekers in Online Mental Health Communities: Text Analysis and Empirical Study

BACKGROUND

In online mental health communities, the interactions among members can significantly reduce their psychological distress and enhance their mental well-being. The overall quality of support from others varies due to differences in people's capacities to help others. This results in some support seekers' needs being met, while others remain unresolved.

OBJECTIVE

This study aimed to examine which characteristics of the comments posted to provide support can make support seekers feel better (ie, result in cognitive change).

METHODS

We used signaling theory to model the factors affecting cognitive change and used consulting strategies from the offline, face-to-face psychological counseling process to construct 6 characteristics: intimacy, emotional polarity, the use of first-person words, the use of future-tense words, specificity, and language style. Through text mining and natural language processing (NLP) technology, we identified linguistic features in online text and conducted an empirical analysis using 12,868 online mental health support reply data items from Zhihu to verify the effectiveness of those features.

RESULTS

The findings showed that support comments are more likely to alter support seekers' cognitive processes if those comments have lower intimacy (βintimacy=-1.706, P<.001), higher positive emotional polarity (βemotional_polarity=.890, P<.001), lower specificity (βspecificity=-.018, P<.001), more first-person words (βfirst-person=.120, P<.001), more future- and present-tense words (βfuture-words=.301, P<.001), and fewer function words (βlinguistic_style=-.838, P<.001). The result is consistent with psychotherapists' psychotherapeutic strategy in offline counseling scenarios.

CONCLUSIONS

Our research contributes to both theory and practice by proposing a model to reveal the factors that make support seekers feel better. The findings have significance for support providers. Additionally, our study offers pointers for managing and designing online communities for mental health.

Toxic Relationships Described by People With Breast Cancer on Reddit: Topic Modeling Study

BACKGROUND

Social support is essential to promoting optimal health outcomes for women with breast cancer. However, an estimated 12% of women with breast cancer simultaneously experience intimate partner violence (IPV; physical, psychological, or sexual abuse by an intimate partner). Women who experience IPV during breast cancer may lack traditional social support, and thus seek out alternative sources of support. Online community forums, such as Reddit, can provide accessible social connections within breast cancer-specific communities. However, it is largely unknown how women with breast cancer use Reddit to describe and seek support for experiences of IPV.

OBJECTIVE

This study aims to explore how patients with breast cancer describe toxic relationships with their partners and immediate family members on Reddit.

METHODS

This exploratory, cross-sectional, topic-modeling study analyzed textual data from 96 users in the r/breastcancer subreddit in February 2023. The meaning extraction method, inclusive of principal component analysis, was used to identify underlying components. Components were subjected to sentiment analysis and summative content analysis with emergent categorical development to articulate themes.

RESULTS

Seven themes emerged related to toxic relationships: (1) contextualizing storytelling with lymph nodes, (2) toxic behavior and venting emotions, (3) abandonment and abuse following diagnosis, (4) toxic relationships and social-related fears, (5) inner strength and navigating breast cancer over time, (6) assessing social relationships and interactions, and (7) community advice and support. Toxic relationships were commonly characterized by isolation, abandonment, and emotional abuse, which had profound emotional consequences for patients. Reddit facilitated anonymous venting about toxic relationships that helped patients cope with intense feelings and stress. Exchanging advice and support about navigating toxic relationships during breast cancer were core functions of the r/breastcancer community.

CONCLUSIONS

Findings emphasized the value of Reddit as a source of social support for patients with breast cancer experiencing toxic relationships. Clinicians who understand that many patients with breast cancer experience toxic relationships and considerable psychological sequelae are better prepared to support their patients' holistic well-being. Further investigation of Reddit as a possible resource for advice, information, and support has the potential to help inform clinical practice and subsequently, patient health outcomes.

Online peer support for people with Amyotrophic Lateral Sclerosis (ALS): a narrative synthesis systematic review

Background

Amyotrophic Lateral Sclerosis (ALS) significantly impacts the lives of people with the diagnosis and their families. A supportive social environment is important for people with ALS to adopt effective coping strategies and health behaviours, and reduce depressive symptoms. Peer support can provide a supportive social environment and can happen in-person and online. Advantages of online peer support are that people can engage from their own home, at their own time and pace, and that it offers a variety of different platforms and modes of communication.

Objectives

To (1) explore the benefits and challenges of online peer support for people with ALS, and (2) identify successful elements of online peer support for people with ALS.

Methods

The method selected for this systematic review was a narrative synthesis. Six databases were systematically searched in April 2020 for articles published between 1989 and 2020. The search was updated in June 2022. The quality of the included studies was assessed with the Critical Appraisal Skills Programme qualitative research checklist.

Results

10,987 unique articles were identified through the systematic database search. Of those, 9 were included in this review. One of the main benefits of online peer support was that people could communicate using text rather than needing verbal communication, which can be challenging for some with ALS. Successful elements included using profile pages and graphics to identify others with similar or relevant experiences. Challenges included ALS symptoms which could make it difficult to use technological devices.

Conclusions

Peer support can provide a non-judgmental and supportive environment for people with ALS, in which they can exchange experiences and emotional support, which can help people in developing adaptive coping strategies. However, ALS symptoms may make it more difficult for people to use technological devices and engage in online peer support. More research is needed to identify what kind of specific barriers people with ALS experience, and how these could be overcome.

Self-help management of patients undergoing chemotherapy: analysis of the online forum of the women's self-help association against cancer

PURPOSE

The aim of this study was to examine threads on chemotherapy in the largest German self-help forum regarding content and emotions.

METHODS

All threads on the subject of chemotherapy that were published by February 6th, 2022 were included in the category "drug therapy". A total of 50 threads were analyzed. A quantitative analysis was carried out with regard to content, emotions, number of replies, number of hits, duration of the conversation, duration of access in days, number density of replies, and hits per day.

RESULTS

16 threads are about side effects and in 18 threads, the emotion is fear. Threads in which the emotion fear was expressed have the highest number of replies at 3367. Shared therapy successes are posted with pleasure and achieved a higher mean value for the duration of conversation with 1374.25 days.

CONCLUSION

An online self-help forum is a very important source of psychosocial support for patients undergoing chemotherapy.

Experiences of Peer Communities in a Cancer Smartphone App Among Adolescents and Young Adults With Cancer

OBJECTIVES

Adolescents and young adults (AYAs) with cancer have identified connection to online communities of same-age peers to be essential for psycho-social support. In this study, the aim was to explore AYAs with cancers' and AYA cancer survivors' use of the Kræftværket cancer app's social forum and experiences of peer communities in the forum. Differences due to gender and treatment status were investigated.

DATA SOURCES

In all, 85 AYAs aged 15-29 were recruited: 46 on and 39 off cancer treatment. The use of the social forum was assessed by a questionnaire, which were analyzed using descriptive statistics, and telephone interviews were analyzed thematically by the Framework Method.

CONCLUSION

Some AYAs assessed the social forum to be more valuable at time of diagnosis, while others experienced meaningful peer-support after cancer. Women were more active and diligent users than men. The following themes were found: 1) Common understanding of each other's challenges; 2) Other AYAs' stories increase the feeling of comfort but can also be difficult to accommodate; 3) A temporary and unwanted community; and 4) The interaction is personal but quickly stalls.

IMPLICATIONS FOR NURSING PRACTICE

The results are relevant to the development of AYA cancer apps, with a view to strengthening peer-to-peer relationships. Although the use of the Kræftværket app was temporary, it presented a meaningful community for AYAs with cancer. The community feeling reduced loneliness and increased the sense of togetherness. The app met AYAs' needs and wishes for peer-to-peer age-appropriate cancer support, which can be implemented and provided by nurses.

Configuration Path Study of Influencing Factors on Health Information-Sharing Behavior among Users of Online Health Communities: Based on SEM and fsQCA Methods

This study examines the determinants that drive the behavior of sharing health information within online health communities. Leveraging the Theory of Planned Behavior, the Technology Acceptance Model, and the "Knowledge-Attitude-Practice" theory, a comprehensive model elucidating the key elements that sway the health information-sharing behavior among users of online health communities is designed. This model is validated through Structural Equation Modeling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA). Findings derived from the SEM suggest that perceived ease of use, perceived usefulness, perceived trust, and perceived behavioral control exert a significant positive impact on attitudes towards health information sharing, the intention to share health information, and the actual health information-sharing behavior. The fsQCA unfolds two unique configuration path models that lead to the emergence of health information-sharing behavior: one predicated on perceived trust and sharing intention, and the other on perceived usefulness, behavioral control, and sharing attitude. This research provides invaluable insights, fostering a deeper comprehension of the dynamics involved in health information sharing within online communities, thereby directing the design of more effective health platforms to augment user engagement and enable informed health decisions.

Use of Online Health Forums by People Living With Breast Cancer During the COVID-19 Pandemic: Thematic Analysis

BACKGROUND

At the time of the UK COVID-19 lockdowns, online health forums (OHFs) were one of the relatively few remaining accessible sources of peer support for people living with breast cancer. Cancer services were heavily affected by the pandemic in many ways, including the closure of many of the customary support services. Previous studies indicate that loneliness, anxiety, distress, and depression caused by COVID-19 were common among people living with breast cancer, and this suggests that the role of OHFs in providing users with support, information, and empathy could have been of increased importance at that time.

OBJECTIVE

This study aimed to examine how people living with breast cancer shared information, experiences, and emotions in an OHF during the COVID-19 pandemic.

METHODS

This qualitative study thematically analyzed posts from the discussion forums of an OHF provided by the UK charity, Breast Cancer Now. We selected 1053 posts from the time of 2 UK lockdowns: March 16, 2020, to June 15, 2020 (lockdown 1), and January 6, 2021, to March 8, 2021 (lockdown 3), for analysis, from 2 of the forum's boards (for recently diagnosed people and for those undergoing chemotherapy). We analyzed the data using the original 6 steps for thematic analysis by Braun and Clarke but by following a codebook approach. Descriptive statistics for posts were also derived.

RESULTS

We found that COVID-19 amplified the forum's value to its users. As patients with cancer, participants were in a situation that was "bad enough already," and the COVID-19 pandemic heightened this difficult situation. The forum's value, which was already high for the information and peer support it provided, increased because COVID-19 caused some special information needs that forum users were uniquely well placed to fulfill as people experiencing the combined effects of having breast cancer during the pandemic. The forum also met the emotional needs generated by the COVID-19 pandemic and was valued as a place where loneliness during the pandemic may be relieved and users' spirits lifted in a variety of ways specific to this period. We found some differences in use between the 2 periods and the 2 boards-most noticeable was the great fear and anxiety expressed at the beginning of lockdown 1. Both the beginning and end of lockdown periods were particularly difficult for participants, with the ends seen as potentially increasing isolation.

CONCLUSIONS

The forums were an important source of support and information to their users, with their value increasing during the lockdowns for a variety of reasons. Our findings will be helpful to organizations offering OHFs and to health care workers advising people living with breast cancer about sources of support.

Positive aspects of caregiving among informal caregivers of persons with dementia in the Asian context: a qualitative study

BACKGROUND

Positive aspects of caregiving are important coping resources for informal caregivers of persons with dementia (PWD). However, existing studies mostly focused on caregivers from western societies and less attention was paid to the potential cultural differences. This study aims to explore positive aspects of caregiving in the Asian context.

METHODS

A qualitative methodology with semi-structured interviews was adopted. A total of 29 informal caregivers of PWD in Singapore were interviewed from Apr 2019 to Dec 2020. All the interviews were audio-recorded and transcribed verbatim for the analysis. Inductive thematic analysis was conducted.

RESULTS

The results revealed a total of three major themes with 11 sub-themes including: 1) positive aspects within self (i.e., better understanding of dementia and caregiving, personal growth, role satisfaction, and improved awareness of self-care); 2) positive aspects between caregiver and PWD (i.e., chance to demonstrate filial piety towards PWD, happiness and positive attitudes of PWD, positive interactions with PWD, and closer relationships with PWD); and 3) positive aspects between caregiver and others (i.e., empathy towards other caregivers, befriending peers, and sharing dementia and caregiving knowledge with others).

DISCUSSION

Findings from this study improved our understanding on positive aspects of caregiving among informal caregivers of PWD in the Asian context. In addition to similar themes across cultures such as personal growth, our study identified a few unique themes like improved awareness of self-care and chances to demonstrate filial piety. For future studies targeting Asian caregivers, it is necessary to include these cultural-specific positive aspects of caregiving.

Midwife empathy and its association with the childbirth experience: a cross-sectional study

BACKGROUND

Although pregnancy and childbirth comprise a life-course that most midwives experience, whether their own experiences of childbirth resonate with other women during childbirth remains to be determined. In this study, we therefore characterized midwives' empathic capabilities and defined their underlying factors.

METHOD

We conducted a cross-sectional study with data from 464 midwives in Guangdong, China, that were collected through the "Chinese version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP)." This questionnaire contains sections related to midwife demographics and delivery characteristics. We then implemented multivariate logistic regression analysis to identify empathy-related factors.

RESULTS

Our analysis revealed 303 (65.3%) participants in the high-empathy group while 161 (34.7%) were in the middle-empathy group. Compared with the reference groups, these results indicated that higher empathy was associated with an elevated educational level (OR, 1.83; 95% CI, 1.04-3.25), high monthly salary (OR, 2.30; 95% CI, 1.11-4.80), and no shift work (OR, 2.89; 95% CI, 1.09-7.63). The odds of a high empathy score were higher for midwives who experienced two childbirths (2.27, 1.11-4.66) and for those who had children under the age of 3 years (2.81, 1.34-5.92).

CONCLUSION

Midwives possess a moderate-to-high level of empathy, and the greater the number of childbirths they experienced and the younger their children, the higher their reported empathy score. This study contributes novel information regarding the empathic behavior of midwives toward women who give birth in China.

Use of the Internet for Health Purposes-A National Web-Based Cross-Sectional Survey among Adults in Poland

The Internet is one of the most popular information sources. This study aimed to assess the public attitudes towards the use of the Internet for health purposes as well as to identify factors associated with the use of the Internet for health purposes among adults in Poland. A web-based cross-sectional survey was carried out between 9 and 12 September 2022 on a nationwide random-quota sample of 1092 adults in Poland. The study questionnaire included 10 questions on Internet use for health purposes. The most common reason for the use of the Internet for health purposes was searching for information on drugs and their effects (69.9%). Almost two-thirds of participants used the Internet for searching for health information (64.9%), for doctors/medical services (63.4%), or for medical facilities (65.3%). Over half of the participants used the Internet for checking online reviews of doctors (55.2%) and 43.5% of the participants ordered drugs or dietary supplements online. Out of 9 different socioeconomic factors analyzed in this study, having higher education, being female, as well as living in cities from 100,000 to 499,999 residents were the most important factors (p < 0.05) associated with the use of the Internet for health purposes. This study confirmed a high level of adoption of medical Internet in Poland.

Weaving a new blanket together: lessons on compassionate leadership and engagement from a virtual regional summit on early childhood wellness in northern communities of British Columbia, Canada

BACKGROUND

Early childhood is a critical period of development for infants, young children, and their families. An array of services, programs, and interventions exist to support families during this life stage, often delivered by a diverse range of professionals. Overlap in early years services exists between healthcare, social care, childcare, education, and not-for-profit organizations. Such diversity in services has the potential to add a rich experience to early childhood development, or without collaboration, widen service gaps, risking providers' ability to meet the needs of families.

METHODS

In northern British Columbia (BC), Canada, a group of individuals came together to approach building relationships and engagement across sectors in early years services using compassionate systems leadership (CSL). A virtual summit was hosted with early childhood service providers including peer support workers and parents/caregivers using a hybrid model of pre-recorded asynchronous sessions combined with a live workshop. The purpose of the event was to find common ground, celebrate local success, and build understanding of how to work collaboratively across the region to identify and address early years priorities.

RESULTS

The event was successful in engaging 121 providers across early years services from a broad geographic region. Applying CSL principles for engagement allowed the team to examine how all partners could address silos in early years services across northern BC. Using a reflexive thematic approach, four key themes were identified at the Summit: (1) early years services are a patchwork but there are dreams of weaving a new blanket together, (2) an ideal model of service is family-centred and inclusive, (3) all sectors are needed at the table, and (4) compassion is the thread that weaves this work together.

CONCLUSIONS

The application of CSL principles can be used to guide engagement and develop supportive spaces for open conversation about creating systems change. In facilitating a space that allowed for vulnerability and relational ways of engaging across sectors we discovered commitment and a willingness for those present to consider new ideas and partnerships that would allow for greater integration of early years services in northern BC.

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review

BACKGROUND

The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions.

OBJECTIVE

To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions.

METHODS

We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care.

RESULTS

Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence.

CONCLUSIONS

Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.

Amyotrophic lateral sclerosis in social media: Content analysis of YouTube videos

The purpose of this study is to analyze the characteristics, content, and quality of information available on YouTube regarding amyotrophic lateral sclerosis (ALS), and explore the search results and number of views and quality of the videos. A search was performed on YouTube on 10 June 2020, using the search term ''Lou Gehrig's disease" in the Korean language, and the first 100 videos were targeted for analysis. General characteristics (e.g., number of views, video length, etc.) were collected, and upload source, target audience, subject of the video, and quality of the videos using a global quality score (GQS) were assessed. About two-thirds of the videos were for the general public (62.0%), while the other third were made for patients and their families with ALS (38.0%). The mean GQS was 3.70 ± 1.42, and 60 videos were classified as high-quality videos. ALS-related videos on YouTube play a role in raising awareness among the general public of this devastating disease, however, practical information regarding disease management for patients and family is relatively insufficient. The quality and characteristics of the videos varied greatly and sometimes the lowest quality videos were shown in the top pages of search results.

Mirroring, monitoring, modelling, belonging, and distancing: Psychosocial processes in an online support group of breast cancer patients

Breast cancer patients are primary users of Internet Health Forums, virtual self-help communities where they find and share information, preoccupations, and support. Previous literature has mainly focused on analysing the contents and the outcomes of breast cancer forums' participation. In light of the Community of Practice theoretical model, our research investigated the psychosocial processes that build and shape patients' experience and participation in the forum. We conducted 16 semi-structured email interviews with breast cancer patients recruited within a well-established online community. Thematic analysis identified five processes-mirroring, monitoring, modelling, belonging, and distancing-that marked three phases of users' experience: initiation, participation, detachment. An interactive dynamic characterised the identified processes: the disease's experience was shaped by and, in turn, it crafted this virtual community. These community processes contributed to participants' empowerment at practical, informative, and emotional levels through the development of a shared repertoire of resources, stories, and ways of dealing with patients' recurring problems.

Long Covid - The illness narratives

Callard and Perego depict long Covid as the first illness to be defined by patients who came together on social media. Responding to their call to address why patients were so effective in making long Covid visible and igniting action to improve its care, we use narrative inquiry - a field of research that investigates the place and power of stories and storytelling. We analyse a large dataset of narrative interviews and focus groups with 114 people with long Covid (45 of whom were healthcare professionals) from the United Kingdom, drawing on socio-narratology (Frank), therapeutic emplotment (Mattingly) and polyphonia (Bakhtin). We describe how storytelling devices including chronology, metaphor, characterisation, suspense and imagination were used to create persuasive accounts of a strange and frightening new condition that was beset with setbacks and overlooked or dismissed by health professionals. The most unique feature of long Covid narratives (in most but not all cases) was the absence, for various pandemic-related reasons, of a professional witness to them. Instead of sharing their narratives in therapeutic dialogue with their own clinician, people struggled with a fragmented inner monologue before finding an empathetic audience and other resonant narratives in the online community. Individually, the stories seemed to make little sense. Collectively, they provided a rich description of the diverse manifestations of a grave new illness, a shared account of rejection by the healthcare system, and a powerful call for action to fix the broken story. Evolving from individual narrative postings to collective narrative drama, long Covid communities challenged the prevailing model of Covid-19 as a short-lived respiratory illness which invariably delivers a classic triad of symptoms; undertook and published peer-reviewed research to substantiate its diverse and protracted manifestations; and gained positions as experts by experience on guideline development groups and policy taskforces.

Insaka: mobile phone support groups for adolescent pregnant women living with HIV

BACKGROUND

Mobile phone-based interventions have been demonstrated in different settings to overcome barriers to accessing critical psychosocial support. In this study, we aimed to assess the acceptability and feasibility of a phone-based, peer-to-peer support group intervention for adolescent pregnant women aged 15-24 years living with HIV in Zambia.

METHODS

Sixty-one consenting participants were recruited from Antenatal Clinics of two large urban communities in Lusaka. They were invited to participate in the mobile phone-based intervention that allowed them to anonymously communicate in a small group led by a facilitator for 4 months. A mixed methods approach was used to assess acceptability and feasibility, including a focus group discussion, pre- and post-intervention interview and analysis of the content of the text message data generated.

RESULTS

Participants reported finding the platform "not hard to use" and enjoyed the anonymity of the groups. Seventy-one percent of participants (n = 43) participated in the groups, meaning they sent text messages to their groups. Approximately 12,000 text messages were sent by participants (an average of 169 messages/user and 6 mentors in 6 groups. Topics discussed were related to social support and relationships, stigma, HIV knowledge and medication adherence.

CONCLUSION

The study showed that the intervention was acceptable and feasible, and highlighted the potential of the model for overcoming existing barriers to provision of psychosocial support to this population.

A qualitative study of online support communities for lung cancer survivors on targeted therapies

BACKGROUND

Due to recent treatment advances, people who have non-small cell lung cancer with oncogenic alterations are an important new group of cancer survivors. Little is known about lung cancer online support communities. This research was guided by two primary questions: (1) How do these lung cancer survivors engage in online support communities? and (2) What are the psychological, social, and physical impacts of such engagement?

METHODS

Qualitative in-depth interviews were conducted with patients with advanced lung cancer (N = 40) to learn about their experiences with the illness. We used qualitative thematic analysis, inductive and deductive, as outlined by Carspecken. We adapted the framework for studying online communities developed by Zhang and colleagues to examine engagement with and impacts of involvement in online lung cancer support communities.

RESULTS

Participants described engaging in the online community through (1) initializing communication through asking questions or sharing resources, (2) responding to others comments or inquiries, or (3) simply observing/reading others posts. Participation had physical, psychological, or social impacts, with benefits (e.g., empowerment) and risks (e.g., feelings of jealousy or misinformation) in each domain. Participants used various strategies to mitigate negative impacts, such as distancing oneself as needed.

CONCLUSIONS

Online lung cancer support communities provide support, camaraderie, and specialized health information. However, there are also risks of online engagement, such as social comparison or accessing misinformation. Understanding the utility of online support communities for lung cancer survivors on targeted therapies and further addressing their risks are urgent tasks, especially in the post-COVID era.

The Exchange of Informational Support in Online Health Communities at the Onset of the COVID-19 Pandemic: Content Analysis

Background

Online health communities (OHCs) provide social support for ongoing health-related problems. COVID-19, the disease caused by SARS-CoV-2, has been an acute and substantial stressor worldwide. The disease and its impact, especially in the beginning phases, left many people with questions about the nature, treatment, and prevention of COVID-19. Unlike typical chronic ailments discussed on OHCs, which are more established, COVID-19, at least at the onset of the pandemic, is distinct in that it lacks a consensus of clinical diagnosis and an existing community foundation.

Objective

The study aims to investigate a newly formed OHC for COVID-19 to determine the topics and types of information exchange as well as the sources of information this community referenced during the early phases of the COVID-19 pandemic in the United States.

Methods

A total of 357 posts from a COVID-19 OHC on the MedHelp platform were annotated according to an open-coding process. Participants’ engagement patterns, topics of posts, and sources of information were quantified.

Results

Participants who offered informational support had a significantly higher percentage of responding more than once than those seeking information (P<.001). Among the information-seeking topics, symptoms and public health practice and psychological impacts were the most frequently discussed, with 26% (17/65) and 15% (10/65) of posts, respectively. Most informational support was expressed through feedback/opinion (181/220, 82.3%). Additionally, the most frequently referenced source of information was news outlets/websites, at 55% (11/20). Governmental websites were referenced less frequently.

Conclusions

The trends of this community could be useful in prioritizing public health responses to address the most common questions asked by the public during crisis communication and in identifying which venue of communication is most effective in reaching a public audience during such times.

Towards a Model of Leader Character Development: Insights From Anatomy and Music Therapy

Leader character has emerged as a critical foundation for leadership. In spite of the view that leader character can be developed, there has been limited holistic attention to what it takes to develop character. Character requires conscious development, and that conscious development not only requires an understanding of what character is, but how the anatomy of character enables and inhibits character development and expression. By anatomy, we refer to the four underlying anatomical systems—physiology, affect, behavior, and cognition (PABC)—that function independently, and in an interrelated manner, to support the development of character. For illustration, we offer the practice of listening to music as a means to develop character, highlighting the links between the PABC systems and character development.

Scalable Implementation of Hippocampal Network on Digital Neuromorphic System towards Brain-Inspired Intelligence

In this paper, an expanded digital hippocampal spurt neural network (HSNN) is innovatively proposed to simulate the mammalian cognitive system and to perform the neuroregulatory dynamics that play a critical role in the cognitive processes of the brain, such as memory and learning. The real-time computation of a large-scale peak neural network can be realized by the scalable on-chip network and parallel topology. By exploring the latest research in the field of neurons and comparing with the results of this paper, it can be found that the implementation of the hippocampal neuron model using the coordinate rotation numerical calculation algorithm can significantly reduce the cost of hardware resources. In addition, the rational use of on-chip network technology can further improve the performance of the system, and even significantly improve the network scalability on a single field programmable gate array chip. The neuromodulation dynamics are considered in the proposed system, which can replicate more relevant biological dynamics. Based on the analysis of biological theory and the theory of hardware integration, it is shown that the innovative system proposed in this paper can reproduce the biological characteristics of the hippocampal network and may be applied to brain-inspired intelligent subjects. The study in this paper will have an unexpected effect on the future research of digital neuromorphic design of spike neural network and the dynamics of the hippocampal network.

Patients' Willingness to Share Information in Online Patient Communities: Questionnaire Study

Background

Online patient communities provide new channels for users to access and share medical information. In-depth study of users’ willingness to share information in online patient communities is of great significance for improving the level of information sharing among the patient community and the long-term development of communities.

Objective

The aim of this study was to build a model of factors affecting patients’ willingness to share medical information from the perspective of both positive and negative utilities. Specifically, we aimed to determine the influence of online information support and privacy concerns, as well as the moderating effect of disease severity and information sensitivity of different patients on their willingness to share.

Methods

Data from 490 users with experience in online patient communities were collected through a questionnaire survey, and structural equations were applied to empirically verify the model hypotheses.

Results

Privacy concerns negatively affected the patients’ willingness to share information (P<.001), whereas online information support positively affected patients’ willingness to share information (P<.001), and information sensitivity negatively moderated the impact of online information support on sharing willingness (P=.01). Disease severity positively moderated the impact of privacy concerns on sharing willingness (P=.05). However, the hypotheses that information sensitivity is a negative moderator and disease severity is a positive moderator of the impact of privacy concerns on sharing willingness could not be supported.

Conclusions

To improve the level of user information sharing, the online patient community should design a safe user registration process, ensure the confidentiality of information, reduce the privacy concerns of users, and accurately identify the information needs of patients to provide personalized support services.

Exploring the use and quality of Internet discussion forums in pregnancy: A qualitative analysis

BACKGROUND

The Internet is widely used as a source of health information to assist decision making in pregnancy. Concerningly, the quality of information shared on online pregnancy forums is unclear. Our objectives were to explore online pregnancy forum health-related use and evaluate quality of information shared.

METHODS

This retrospective qualitative study had two phases of data collection and analysis. First, thematic analysis of a representative sample (n = 480) of posts explored motivators for forum use. Second, a subgroup (n = 153) of threads with clinical content was assessed for congruence with reputable sources.

RESULTS

Common motivators for forum engagement were a desire for lived experience, unlimited access, and the opportunity to express emotions. Of 1098 responses sharing advice, information, or experience, 601 (54.7%) were accurate; 230 (20.9%) were erroneous, incomplete, or misleading; and 267 (24.3%) lacked credible evidence. Of these, 60 (5.5%) were potentially harmful. Responses often directed women to a health care practitioner, but concerningly, failed to refer ten women in need of urgent medical assessment. Few discussions were self-regulating, with only 12 of 230 (5.2%) poor-quality messages subsequently rectified.

CONCLUSIONS

Exchange of information and emotional support among peers are key functions of online pregnancy forums. There is a modest prevalence of poor-quality or potentially harmful information but more concerningly a lack of peer moderation. We suggest health care practitioners ensure pregnant women have a clear understanding of when clinical consultation is required. Clinicians may wish to discuss the supportive community aspects of online forums in cases where offline support is lacking.

Secret groups and open forums: Defining online support communities from the perspective of people affected by cancer

Objective

A quarter of people diagnosed with cancer lack social support. Online cancer communities could allow people to connect and support one another. However, the current proliferation of online support communities constitutes a range of online environments with differing communication capacities and limitations. It is unclear what is perceived as online cancer community support and how different features can help or hinder supportive group processes. This study aimed to explore how perceived support is influenced by the different features and formats of online support environments.

Methods

In-depth qualitative interviews were conducted with 23 individuals affected by a range of cancer diagnoses, including both cancer survivors and family members. Data were analysed using deductive thematic analysis guided by a constructivist epistemological perspective.

Findings

Online supportive communities were defined and differentiated by two themes. Firstly, ‘Open forums’ were identified with thematic properties which facilitated a uniquely informative environment including ‘Safety in anonymity’, ‘Perceived reliability’ and ‘Exposure and detachment’. Secondly, ‘Secret groups’ were identified with thematic properties which enhanced an emotionally supportive environment including ‘Personalised interactions’, an overt ‘Peer hierarchy’, and ‘Crossing the virtual divide’.

Conclusions

Properties of groups can engender different degrees of interpersonal relations and different supportive interactions. In particular, support community designers may want to adapt key features such as anonymity, trustworthiness of websites, and the personalised nature of conversations to influence the development of supportive environments. In personalised peer-led groups, it may be prudent to provide guidance on how to reassert a positive environment if arguments break out online.

Codifying Online Social Support for Breast Cancer Patients: Retrospective Qualitative Assessment

BACKGROUND

Social media has emerged as the epicenter for exchanging health-related information, resources, and emotional support. However, despite recognized benefits of social media for advancing health-promoting support exchange, researchers have struggled to differentiate between the different ways social support occurs and is expressed through social media.

OBJECTIVE

The objective of this study was to develop a fuller understanding of social support exchange by examining the ways in which breast cancer patients discuss their health needs and reach out for support on Facebook and to develop a coding schema that can be useful to other social media researchers.

METHODS

We conducted a retrospective qualitative assessment of text-based social support exchanges through Facebook among 30 breast cancer survivors. Facebook wall data were systematically scraped, organized, coded, and characterized by whether and which types of support were exchanged. Research questions focused on how often participants posted related to cancer, how often cancer patients reached out for support, and the relative frequency of informational, instrumental, or socioemotional support requests broadcast by patients on the site.

RESULTS

A novel ground-up coding schema applied to unwieldy Facebook data successfully identified social support exchange in two critical transitions in cancer treatment: diagnosis and transition off cancer therapy. Explanatory coding, design, and analysis processes led to a novel coding schema informed by 100,000 lines of data, an a priori literature review, and observed online social support exchanges. A final coding schema permits a compelling analysis of support exchange as a type of peer community, where members act proactively to buffer stress effects associated with negative health experiences. The coding schema framed operational definitions of what support meant and the forms each type of support could take in social media spaces.

CONCLUSIONS

Given the importance of social media in social interaction, support exchange, and health promotion, our findings provide insight and clarity for researchers into the different forms informational, resource, and emotional support may take in Web-based social environments. Findings support broader continuity for evaluating computer-mediated support exchange.

Making expertise fit: On the use of certified versus experiential knowledge in becoming an informed patient

This article reports a discursive psychological study of online conversations among patients with ADHD, diabetes, or ALS on what constitutes an “informed patient.” Being informed means different things for different patient groups. Whether patients prioritize experiential or certified expert knowledge is not indicative of patients’ preferences per se but depends on how they give meaning to the responsibilities particular to their disease. ADHD patients hold each other accountable for demonstrating the seriousness of their disease. ALS patients use expert information to orient to a norm of thinking positive. Diabetes patients challenge experts to carve out independence from the diabetes regimen.