Cancer Stories Online — Discourse Analysis of Self-Introduction Postings by Cancer Patients in a Taiwanese Bulletin Board System

  • 林 怡秀

Student thesis: Master's Thesis


The Internet is an important contemporary channel that allows people to find information and create social networks. With the universality of Internet use, searching for medical information online is a trend (Diaz et al. 2002). Many health-related topics, such as cancer, which are not typically discussed openly in social conversation, are discussed online because of the anonymity granted to participants. In modern society, cancer is perceived as a serious disease and often leads patients to feel helpless. Being diagnosed with cancer and its subsequent treatment are stressful events (Merckaert et al. 2010). While cancer patients need is medical treatment, they also require support from others. However, concern about others’ reactions and the fear of being treated differently or stigmatized (Hilton at al. 2009), may lead cancer patients to feel embarrassed about acknowledging their identity as cancer patients in face-to-face communication. Communicating online is a practical vehicle for patients to express themselves wholly. Understanding a cancer patient’s psychosocial character is important because their psychological state can act as predictors of their quality of life (Parker et al. 2003). Thus, the present study aims to have a better understanding of cancer patients' psychosocial characteristics by examining their accounts of illness experiences posted on Internet forums. The linguistic features were first examined and then the psychosocial characteristics reflected within the linguistic features are further discussed.
The online social medium under investigation in the present study is a Taiwanese Bulletin Board System named KDD (a pseudonym) which is the most famous and widely used one in Taiwan at present. The data examined in the present study, self-introduction posting, is collected from its cancer-related board (‘cancer board’ or ‘KDD cancer board’ hereafter) whose members are mostly cancer patients (‘patient members’ hereafter) and relatives and friends of cancer patients (‘non-patient members’ hereafter). The self-introduction postings which are usually the first posting from members in the cancer board or their first time to introduce themselves officially contain cancer patients’ personal basic information, experiences from the time they received their cancer diagnosis to treatment processes and expression of emotions. In total, 58 self-introduction postings by cancer patients were collected. These were posted between October 29, 2005 and June 29, 2012. Empirical discourse analysis was employed to analyze the self-introduction postings.
After investigation, three linguistic features are found: (1) 84% of patient members spontaneously disclosed their age in the content of their self-introduction postings, either age at the time of posting or age at the time of their cancer diagnosis. The linguistic pattern of age-disclosure can be divided into six types: stative, prospective, retrospective, listing, direct and indirect. Listing and direct formats are termed as ‘neutral pattern for age-disclosure’ in the present study which made up 53% of all types of age-disclosure formats. The other 47% are termed as ‘non-neutral pattern for age-disclosure’ which consisted of stative, prospective, retrospective and indirect format. (2) Patient members tended to provide descriptions of a sense of normalcy and satisfaction with their lives prior to the cancer diagnosis. The satisfaction they mentioned was derived from a number of factors. These included a healthy lifestyle, good physical condition, promising job, good life and educational background. Apart from these, they also provided descriptions about their counter-expectation to the cancer diagnosis which involved two concepts: having no family history of cancer and the unexpected membership in the KDD cancer board. (3) More than half (55%) of the patient members ended their self-introduction postings with words for encouragement which can be classified into three types. The first type contained words with the meaning of praying and blessing, like ‘希望/hope,’ ‘願/wish’ and ‘祝/bless’ and the second type included the phrase ‘加油/go for it’. The third type contained encouraging words.
The feature of age-disclosure showed that being young (in the age group of 20 to 29) is the social characteristic of all members of the cancer board, including patient members and non-patient members. Based on their being young and the above three linguistic features, we forward three arguments with regard to patient members’ psychosocial characteristics: (1) Even though they are not medical professionals they intuitively know the importance of age in medical contexts. (2) They had difficulties in accepting their cancer diagnosis as reflected by their description of a normal and good life prior to the cancer diagnosis. Moreover, they even resist to the cancer diagnosis as supported by the following three viewpoints. First, getting cancer at such a young age runs contrary to the normative expectation of physical health development. Second, presenting their own age when expressing anger about getting cancer strongly suggests that their age is a contributing factor to their anger (e.g. ‘Why me? I am only 27’). Third, the use of evaluative adverb, such as ‘only,’ when disclosing their own age (e.g. ‘I am only 27’) further emphasizes their vehement rejection of their cancer diagnosis. (3) They were in need of mutual support as reflected by their participation in KDD cancer board and their provision of words for encouragement.
Since young cancer patients are the most frequent users of the cancer board, it provides them with an exclusive space to fulfill their psychosocial needs. A dedicated forum also functions as an invaluable corpus of patient voices that can inform health professionals of the needs and concerns of young cancer patients. Moreover, it can equally provide an efficient vehicle for the dissemination of cancer treatment education by health professionals. The present study enhances the understanding of age in medical contexts in the following three directions: Age is (1) a point of reference of a patient’s disease trajectory, (2) a point of reference of a person’s life course, and (3) the reason for denial when a patient is faced with a disease that is foreign to his/her expectation because it violates the assumed normal physical development.
Date of Award2013
Original languageEnglish
SupervisorMei-Hui Tsai (Supervisor)

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