Internet Use and Advanced Practice Oncology Nursing

Joshua Fogel, PhD


Topics in Advanced Practice Nursing eJournal. 2002;2(4) 

In This Article

Social Support Through the Internet

One area studied quite intensively by nursing researchers is the availability of social support through participating in online self-help groups. A few studies using qualitative approaches were done with cancer patients. One study relied on participant observation and discourse analysis (ie, analysis of selected discussions of posted messages on the listserv to help categorize the qualitative analysis) of a listserv called the Breast Cancer List (, an online discussion group for people concerned about breast cancer. The study concluded that besides exchanging information and personal views, psychological support was a key aspect of the listserv.[13] Another study of cancer patients using the CompuServe Information Service's Cancer Forum in Columbus, Ohio, (currently service does not exist) had a content analysis showing that there were major themes of coping, information, reciprocal support, a sense of community or family, privacy, and availability and hope.[14]

Another study categorized the responses of participants of 3 different Internet cancer support groups comprised of breast cancer patients, prostate cancer patients, and those with mixed cancers. The names of patients and the groups were not listed to protect the confidentiality of those participating. The study indicated that information giving/seeking, encouragement/support, personal opinions, and personal experiences accounted for approximately 85% of the categorized responses.[15]

Other research regarding online self-help groups studied the parents of children with cancer. These researchers studied 3 support groups (N-BLASTOMA, PED-ALL, PED-ONC) from some of the numerous online cancer support groups sponsored by the Association of Cancer On-Line Resources (ACOR). Participants reported benefits of receiving information, sharing experiences, receiving general support, venting feelings, gaining accessibility, and using writing. Their most frequently cited benefit was information giving and receiving.[16]

Recently, researchers have studied the impact of patients accessing medical information from the Internet and the potential benefits of this use. Fogel and colleagues[17] reported that breast cancer patients who use the Internet for breast health information for less than 1 hour weekly are associated with having greater social support and less loneliness than those not using the Internet.

Social support is a psychological category that includes the perceived availability of someone to talk to about one's problems (appraisal support), the perceived availability of people with whom one can do things (belonging support), the perceived availability of a positive comparison when comparing oneself to others (self-esteem support), and the perceived availability of material aid (tangible support).[18] In another study, Fogel and colleagues[19] found that Internet use of medical information among minorities was associated with greater overall social support, appraisal support, and tangible support, but not belonging support and self-esteem support, than among whites. They found that minorities perceived different benefits from this Internet use, especially believing that it offered them tangible support. This has potential clinical significance, as in the case of African Americans, many studies show that African Americans are consistently diagnosed at a later stage of breast cancer, which may affect their survival rates.[20,21,22,23] Perhaps the availability of this Internet-based information may allow these minority groups to be more aware of breast cancer and seek treatment before their cancer reaches an advanced stage.

In summary, Internet technology allows individuals to gain support through participation in many of the forms of Internet use. By participating in an online self-help group, one can obtain this support and other benefits. Likewise, by seeking information on the World Wide Web, one may feel supported as well. Besides the overall psychological sense of well-being and connectedness, Internet support may offer survival benefits. Some research indicates that those who receive social support treatments live longer with their cancer diagnosis than those who have not received these treatments.[24,25] However, this is not conclusive, as a recent study disagreed with these results and found no survival benefits.[26]


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