Narratives of empowerment and compliance: Studies of communication in online patient support groups

Purpose: New technologies enable new forms of patient participation in health care. Thearticle discusses whether communication in online patient support groups is a source ofindividual as well as collective empowerment or to be understood within the tradition ofcompliance. The discussion is based on a qualitative analysis of patient communicationin two online groups on the Danish portal sundhed.dk, one for lung patients and one forwomen with fertility problems.Methods: The object of study is the total sum of postings during a specific period of time –a total of 4301 posts are included. The textmaterial was analyzed according to the textualparadigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysismoves from describing communicative characteristics of the site to a thorough semanticanalysis of its narrative structure of construing meaning, interaction and collective identity,and finally as a source of collective action.Results: The meta-narratives of the two groups confirm online patient support groups forindividual empowerment, for collective group identity, but not for collective empowerment.The collective identities of patienthood on the two sites are created by the users (patients)through specific styles of communication and interaction, referred to as ‘multi-logical nar-ratives’.Conclusion: In spite of the potential of online communities of opening up health care tothe critical voice of the public, the analysis points to a synthesis of the otherwise oppositepositions of empowerment and compliance in patient care. On a collective level, the site isempowering the individual users to comply with ‘doctor’s recommendations’ as a group.