Can the group effect dominate the influence of the child on the parent's decision to care for type 1 diabetes?

AIM

To understand how the interaction of peer parents in disease-specific social media groups influences their daily treatment decisions.

DESIGN AND METHODS

We examined the content of the largest Hungarian Facebook group for parents of children with type 1 diabetes mellitus, analyzing 28 days of activity using netnography. In addition, we undertook an online quantitative questionnaire to identify group members' (n = 267) attitudes.

RESULTS

In exploring the influence of the community on the decisions of peer-parents, we found that the respondents could be divided into two clusters. The main difference between the clusters was that committed parents sought the online community for advice and asked questions more frequently, and the peer-support community was a more important part of their self-image. Comparing the influence of online communities and children on the parents' decisions, we observed that the community had the most significant impact on attending diabetes-specific events, while children had the greatest influence on meals and leisure time and were often in conflict with parents.

CONCLUSIONS

Social media strongly support the integration of prescribed therapy into daily routine. The influence of the child with diabetes on parental decisions shows that diabetes education needs to become child-centered and that the parent-child relationship should be considered as a crucial element for therapy effectiveness.

PRACTICE IMPLICATIONS

Online parenting groups provide mental support in coping with diabetes and would serve as a primary non-medical information source; the healthcare staff must be supportive or even encouraging when parents join such groups.

From virtual observations to business insights: A bibliometric review of netnography in business research

Netnography is a special kind of qualitative social media research. It applies ethnographic techniques to comprehend social interaction in settings of modern digital communications. This article aims to highlight the key contributors and knowledge structure of this research domain. Utilizing bibliographic data of 722 articles retrieved from the Scopus database, researchers used performance analysis to have insights into the most prolific authors, institutions, countries and journals. Keywords co-occurrence analysis was done to map the knowledge structure. The thematic map tool was used to recognize basic themes, motor themes, niche themes, and emerging themes in order to suggest future research directions. The results indicate that, in terms of research publications, the most productive nation is the United Kingdom. The most lucrative organization has been acknowledged as Griffith University. The most influential author is stated to be Mkono M. The most resourceful source is Journal of Business Research. In addition, three significant knowledge clusters important to study utilizing netnography were identified as a result of co-occurrence of keywords analysis namely, consumer behaviour, co-creation in online brand communities and authenticity. Further, niche and emerging themes include-sustainable tourism, customer engagement and sharing economy. When taken as a whole, this review is a useful tool for quickly understanding the most recent research findings and potential directions for further investigation. An assessment of the state of netnography in business and management research has not been systematically investigated. Hence, the present study aims to thorough a grasp of the state-of-the-art in Netnography research field over the past decades along with the future research directions. Studying the state of the art in the field adds to academic knowledge and provides updated information on the procedure.

Too Lucky to Be a Victim? An Exploratory Study of Online Harassment and Hate Messages Faced by Social Media Influencers

Influencers are persistently exposed through social media. Once almost unapproachable, celebrities are now open to daily interaction with the public. From comments, polls, emails, and even private messages, the public can engage with their celebrities with a mere click. While this engagement provides influencers with advantages, it also renders them particularly susceptible to online harassment and toxic critics. This paper investigates the characteristics, impact, and reactions to cyber victimisation among social media influencers. To accomplish this objective, the paper presents the findings of two studies: a self-reported online victimisation survey conducted among Spanish influencers and an online ethnography. The results indicate that over 70% of influencers have encountered some form of online harassment and toxic critics. Cyber victimisation, its effects, and reactions vary across socio-demographic characteristics and the influencers' profiles. Furthermore, the qualitative analysis of the online ethnography reveals that harassed influencers can be classified as non-ideal victims. The implications of these findings for the literature are discussed.

COVID-19 and telemedicine: A netnography approach

The COVID-19 pandemic has consolidated some trends that already existed in our society. Perhaps one of the most visible is the transformation of society towards greater digitisation. Digitalisation has gained weight in all aspects of our lives, and from the point of view of the health system we find an example in the slow historical adoption of telemedicine, which contrasts sharply with the massive conversion to this technology as a tool for social distancing. In this sense, the homebound population is the one most affected by the pandemic and the one that could benefit the most from the use of telemedicine. Using a netnography approach and based on the stimulus-organism-response paradigm, this study proposes to analyse the evolution of perception about telemedicine using the opinions expressed on Twitter. The primary technical tasks of the study incorporate the analysis of topics and the review of emotions and positive image perception using natural language processing. Specifically, tweets about telemedicine generated by the Spanish community are analysed in this work. The findings show that the COVID-19 pandemic has affected emotions and topics of interest related to telemedicine. This has changed the image that it had and the behaviour of the Twitter community in Spain. In conclusion, the study results suggest that changes in health systems affect people's emotions and behaviours.

COVID-19 Vaccine Hesitancy in Denmark and Russia: A qualitative typology at the nexus of agency and health capital

Vaccination of the world population is being embraced by 184 countries as the main strategy to end the COVID-19 pandemic; vaccination rates are stalling even in countries with high vaccine availability, though. This article investigates the phenomenon of vaccine hesitancy in two such countries, the Kingdom of Denmark and the Russian Federation, through a qualitative study of the different types of hesitancy to COVID-19 vaccination programs and their underlying mechanisms. The analysis reveals a typology along the dimensions of agency and health capital: resisting hesitancy based on mistrust of authority, paralyzed hesitancy based on personal fear, informed hesitancy based on informed choice, and empowered hesitancy based on empowered choice. While the mechanisms underlying vaccine hesitancy are to a great extent comparable between the two countries, differences in population size, societal cohesion, and political culture seem to impact the prevalence and severity of types and, thereby, the outcomes of national COVID-19 vaccination programs and national campaigns for mitigating COVID-19 vaccine hesitancy. The implications of these findings extend beyond the particular context of COVID-19 and the countries studied, supporting and nuancing existing models for vaccine hesitancy, as well as providing a starting point for tailored campaigns for mitigating vaccine hesitancy.

Sociocultural factors during COVID-19 pandemic: Information consumption on Twitter

The purpose of the research is to describe the sociocultural factors that emerged during the COVID-19 pandemic. Twitter is used as an instrument for data collection. The study is qualitative and uses the netnographic method. To analyze the flow of messages posted on Twitter, the model proposed by Perez-Cepeda and Arias-Bolzmann (2020), which describes sociocultural factors, is taken as a basis. The semantics that people use are a type of functional knowledge that reveals sociocultural factors. Sentiments were analyzed through lexicon-based methods, which are the most suitable. The categorization and classification of the data are performed based on the information that users post on Twitter. The tweets related to COVID-19 describe the sociocultural issues and the level of sentiment around the pandemic. The discussion centers on the COVID-19 pandemic, information consumption, lexicon, sociocultural factors and sentiment analysis. The study was limited to the social media Twitter; another limitation was not to consider the social group of the users who interact with @pandemic_Covid-19, official account of the World Health Organization (WHO). This research contributes to the social sciences, focusing on sociocultural interaction through the use of the social network Twitter. It describes the link between sociocultural factors and the level of sentiment on issues related to the COVID-19 pandemic.

Getting through COVID-19 together: Understanding local governments' social media communication

This study provides new insights into how local governments (LGs) manage pandemic-related crisis communication with citizens on their social media (SM) profiles. We analyze over 3000 posts published on SM profiles of selected LGs in Poland to get insights on rhetorical communication strategies during the COVID-19 pandemic. We document LGs as they go beyond the simple transmission of information to citizens and use SM in an engaging and educational manner. We found three types of rhetorical strategies and their resonance with the public. Our analysis suggests that LGs are likely to apply the Together communication strategy, which is the most engaging.

A prospective observational study using Netnography

OBJECTIVES

To assess the users' characteristics, discussion contents, and the atmosphere of virtual peer communities.

METHODS

A qualitative, prospective study was conducted using the Netnography method. The most popular, publicly accessible French discussion forums were investigated. The web users' quotes were collected from May to October 2018. Data analysis triangulation was performed by two researchers using the NVivo 12® software.

RESULTS

The users discussed their experience with Parkinson's disease (PD) in a warm atmosphere. 23 discussion threads were analysed: 302 messages posted by 70 users (70% were females; the average illness duration was 6 years); 115 encoded nodes were created. Five user profiles appeared: leader, follower, expert, mixed, and undetermined. Common preoccupations were a lack of time and listening from the physicians' side. Three themes emerged: managing symptoms, living with PD, and sharing illness experiences. Users sought actively for a cure to limit or stop disease evolution, using alternative and complementary therapies to optimize their daily condition.

CONCLUSIONS

Online forums foster person's informal learnings about coping with PD. Healthcare professionals can use these learnings to optimize person-centred support.

PRACTICE IMPLICATIONS

During consultations, healthcare professionals should invite persons to discuss their online activity, informal learnings, beliefs and expectations towards therapeutic strategies.

Insights into the real-life experiences of people living with epilepsy: A qualitative netnographic study

A qualitative netnographic study of epilepsy conversations posted on public social media sites over a 12-month period was conducted in order to identify key themes and issues for people living with epilepsy (PWE). A total of 264,706 conversations posted online between 03 November 2018 and 03 November 2019, which had originated in the UK, Spain, France, Italy, and Germany, were identified using pre-defined and piloted search terms. A random sample of these posts was then analyzed using natural language processing, and qualitative in-depth and contextual analysis. Key themes that emerged related to: disease awareness among the general public; the psychological and physical impact of seizures; the importance of ensuring proper sleep; understanding disease burden through time; finding treatment and managing side effects; and dealing with depression and anxiety. People living with epilepsy highlighted that seizures have a significant impact on mental as well as physical health and can cause limitations to all aspects of life. Fear of having a seizure in public is a major concern for PWE and the anticipation of seizures can worsen anxiety, causing patients to limit social interaction and often leading to social isolation, which may further exacerbate anxiety and depression. People living with epilepsy therefore advocate that greater attention be paid to the mental health impact of epilepsy. Treatment and its side effects were also a major aspect of the online conversation of PWE. Some PWE believe there is a lack of awareness or sensitivity among healthcare professionals, who may underestimate their concerns or not take sufficient time to discuss their needs. These findings therefore help sign-post issues of importance to PWE and areas in which their care may be improved.

"This Isn't Being a Doctor."-Qualitative Inquiry into the Existential Dimensions of Medical Student Burnout

Recent studies report that up to 50% of medical students feel burned out. Medical student burnout has significant public health consequences-as students detach, the quality of patient care is impacted, and students themselves suffer, as evidenced by the increased risk in substance use and suicide. While some theorize that medical student burnout is due to an inability to confront suffering, death, and their own mortality, this hypothesis fails to explain why pre-clinical students also experience burnout despite having minimal clinical exposure. /r/medicalschool, a news-aggregating website for medical students, was queried for posts from the creation of the subreddit, December 11, 2009, to July 1, 2018, for the term "burnout" and its grammatical variations. Three hundred fifty-two posts and their comment threads were analyzed using a grounded theory approach. When the causes of burnout were interpreted using an existential psychodynamic framework, the predominant themes that arose were difficulties dealing with freedom (groundlessness), existential isolation, and meaninglessness, rather than death anxiety stemming from witnessing the suffering of patients. Students feel as if they are not living up to their own values of what a physician should be like and are troubled by the inconsistent values within the hidden, informal, and formal curriculum. Individualized interventions are temporary fixes that allow people to withstand their environment and complete their training; however, the learning environment needs change to better empower students to live a life full of existential meaning.

Investigating the healthcare pathway through patients' experience and profiles: implications for breast cancer healthcare providers

Background

Healthcare systems are facing many changes. Particularly, patients are more engaged in the care process. The medical perspective of the process is insufficient to provide patients with high quality care and service personalisation. This research presents an attempt to complete this medical perspective through an experiential perspective, especially for chronic diseases such as cancer. We investigated patients’ experiences and profiles to reach a deeper understanding of their needs and expectations when they confront the disease.

The objectives of this research were to model the key stages underling the patient pathway and to identify the challenging touch points of the interactions between patients and healthcare providers. Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process.

Methods

A qualitative observational nethnography on a French specialized forum for breast cancer patients “les Impatientes” was conducted. A total of 967 reviews were collected over a complete year period from all over France. Thematic and lexicometric content analysis were performed according to the experience dimensions, the pathway stages and touch points, as well as the patients’ profiles.

Results

Data analysis shows that the healthcare pathway experienced by the patients is built around three stages. The discovery stage is closely related to the emotional dimension regarding the patient and physician relationship. The examination stage is characterized by a more technical and informational needs for the types of treatments. The follow-up and survivorship stage illustrates the patients’ need to assess the treatments’ effectiveness and the quality of the follow-up. Moreover, three profiles of patients were identified. The newcomers, the altruists and the autonomous are characterized by different attitudes depending on the stage of the healthcare pathway they were living.

Conclusions

Our research presents an original modelling of the patient pathway and profiles beyond the medical process. It gives practical tracks to improve the healthcare pathway. Patients expect healthcare providers to integrate and strengthen several challenging touch points in order to create satisfactory patient experiences and high quality service.

Birth, attitudes and placentophagy: a thematic discourse analysis of discussions on UK parenting forums

BACKGROUND

The post-partum consumption of the placenta by the mother (placentophagy) has been practiced since the 1970s in the global North and is seemingly increasing in popularity. Maternal placentophagy is not known to have been practiced in any other time period or culture, despite being near-ubiquitous in other placental mammals. An in-depth qualitative exploration as to the reasons for the practice, its increasing popularity and how it is narratively incorporated into discourses surrounding "ideal" natural and medical births are given in this paper.

METHODS

1752 posts from 956 users across 85 threads from the parenting forums Mumsnet and Netmums were identified for inclusion. A thematic discourse analysis was performed using NVivo.

RESULTS

Three main themes were identified: women recounted predominantly positive attitudes towards their own experiences of placentophagy, and they were respectful of others' views and experiences; some had negative views, particularly around the concept of disgust, but again, they were respectful of others' experiences. By far the most common method of consumption of the placenta was encapsulation.

CONCLUSIONS

This paper identifies the motivation for placentophagy to almost universally be for medical benefits, most commonly the prevention or treatment of post-natal depression (PND). Whilst disgust is a common reaction, discussion of risks is rare, and positive experiences outweigh negative ones. The increasing popularity of the practice is ascribed in part to the comparative palatability of encapsulation and the use of the internet to share resources and remove barriers. Parenting forums are important spaces to negotiate normative birth practices, including placentophagy, and act to build communities of women who value personal experience over medical evidence and highly value personal choice and bodily autonomy. Placentophagy is discussed in terms of its relation to natural and medical births with arguments being made using both discourses for and against the practice. This paper argues that placentophagy is practiced as a resistance to medicalisation as an assertion of control by the mother, whilst simultaneously being a medicalised phenomenon itself.

"RIP KFC": Public Perceptions of a Fast-Food Restaurant Closure

This paper used netnography and thematic analysis of the comments made in online news articles to understand better the public response to the closure of the only KFC restaurant in Yellowknife, Northwest Territories, Canada, in 2015. While the popular media often cover fast-food restaurant closures, past academic research has not examined the public response to these closures. To begin to fill this gap, we examined the comments sections of five online news articles from the Canadian news outlet, CBC.ca, and reactions shared on Facebook. 239 commenters made 308 publicly available online comments addressing the closure. Key themes in commenter perceptions included pro-closure reactions, which were based on the perceived public health benefits of reduced fast-food consumption, and anti-closure reactions to such factors as the loss of a local landmark and a source of positive memories. The unfavorable reactions appeared to pose a significant barrier to public acceptance of the KFC closure. This paper argues that it is important to examine public perceptions of fast-food closures to understand better what these restaurants mean to individuals and communities. This information, in turn, can be used to promote healthier restaurant-eating in ways that will complement efforts to encourage healthier food choices.

Online communities as a new source of exploring patient dissatisfaction

PURPOSE

The purpose of this paper is to analyse whether internet forums are an appropriate source for identification of causes of dissatisfaction of patients with non-medical aspects of healthcare services.

DESIGN/METHODOLOGY/APPROACH

Based on the guidelines of netnography qualitative research the authors identify relevant posts or comments on selected online forums in which web users show their dissatisfaction with healthcare services. Five popular Slovenian forums representing different interest communities have been chosen and 42 forums' topics have been reviewed.

FINDINGS

Online communities have an important role in exploring patient dissatisfaction. Through content analysis comments were coded into meaningful categories and subcategories.

RESEARCH LIMITATIONS/IMPLICATIONS

Some comments were more explicit, while others have provided general and looser reasons for dissatisfaction, and in such cases coding and content analysis of comments was more difficult.

PRACTICAL IMPLICATIONS

Contents expressed within online communities are helpful in designing improvement activities since they enable determination of concrete relevant measures aiming at eliminating and preventing the established causes of discontent, such as instituting new policies, introducing training programs, determining desired changes in culture.

ORIGINALITY/VALUE

Usefulness of the netnography as a qualitative method of research is confirmed through confirmation that causes of dissatisfaction of Slovenian patients, which have been identified in the authors research are similar to those identified in previous research in the field of patient satisfaction conducted in Slovenia. Results constitute a new form of researching patient dissatisfaction and expose the specific causes of patient dissatisfaction with healthcare services in Slovenia.

#Deathbedlive: the end-of-life trajectory, reflected in a cancer patient's tweets

Background

Understanding physical and psycho-social illness trajectories towards the end of life can help in the planning of palliative and supportive care. With terminal patients increasingly seeking and sharing health information and support via social media, it is timely to examine whether these trajectories are reflected in their digital narratives. In this exploratory study, we analysed the Twitter feed of prominent cancer sufferer and physician, Kate Granger, over the final 6 months of her life.

Methods

With the consent of Kate’s widower, Chris Pointon, 1628 Twitter posts from @GrangerKate were manually screened. The 550 tweets judged relevant to her disease were qualitatively content analysed with reference to the six modifiable dimensions of the patient experience in Emanuel and Emanuel’s ‘framework for a good death’. The frequency of each tweet category was charted over time and textual content was examined and cross-referenced with key events, to obtain a deeper understanding of its nature and significance.

Results

Tweets were associated with physical symptoms (N = 270), psychological and cognitive symptoms (N = 213), social relationships and support (N = 85), economic demands and care giving needs (N = 85), hopes and expectations (N = 51) and spiritual beliefs (N = 7). While medical treatments and procedures were discussed in detail, medical information-seeking was largely absent, likely reflecting Kate clinical expertise. Spirituality was expressed more as hope in treatments or “someone out there listening”, than in religious terms. The high value of Kate’s palliative care team was a dominant theme in the support category, alongside the support she received from her online community of fellow sufferers, friends, family and colleagues. Significant events, such as medical procedures and hospital stays generated the densest Twitter engagement. Transitions between trajectory phases were marked by changes in the relative frequency of tweet-types.

Conclusions

In Kate’s words, “the power of patient narrative cannot be underestimated”. While this analysis spanned only 6 months, it yielded rich insights. The results reflect theorised end-of-life dimensions and reveal the potential of social media data and digital bio-ethnography to shine a light on terminal patients’ lived experiences, coping strategies and support needs, suggesting new opportunities for enhancing personalised palliative care and avenues for further research.

Brand communities embedded in social networks

Brand communities represent highly valuable marketing, innovation management, and customer relationship management tools. However, applying successful marketing strategies today, and in the future, also means exploring and seizing the unprecedented opportunities of social network environments. This study combines these two social phenomena which have largely been researched separately, and aims to investigate the existence, functionality and different types of brand communities within social networks. The netnographic approach yields strong evidence of this existence; leading to a better understanding of such embedded brand communities, their peculiarities, and motivational drivers for participation; therefore the findings contribute to theory by combining two separate research streams. Due to the advantages of social networks, brand management is now able to implement brand communities with less time and financial effort; however, choosing the appropriate brand community type, cultivating consumers' interaction, and staying tuned to this social engagement are critical factors to gain anticipated brand outcomes.