Background
Online cancer support group discussions enable patients to share their illness experience with others (Seale, Charteris-Black et al. 2010). Technical and emotional support information (Gill & Whisnat, 2012) in addition to asking for advice (Armstrong & Powell, 2009) are some of the matters shared online. The most common way of giving support to others was by sharing information based on personal experiences (Meier, Lyons et al. 2007). This type of support provides newly diagnosed patients with advice about several topics, including exercise (Trevino, Vallejo et al. 2012) from those who ‘have been there’. Information gathered from online discussion boards complements the advice received by health professionals (Armstrong & Powell, 2009). However, the nature of information exchanged online is mostly unknown. The research questions asked:
•What exercise-related information are colorectal cancer patients sharing with each other?
•How do they interact online in relation to these discussions?
The information gathered may aid in patient-clinician discussions involving exercise. A discussion board in the public domain was used in this analysis. Discussion boards in the public domain do not require a username/password to access information posted to the discussion boards. Ethical approval has been granted by the Bond University Human Research Ethics Committee (BUHREC).
Method
A public open access colorectal cancer discussion board was searched for threads containing information related to physical activity or exercise. Keywords such as “exercise”, “physical activity”, “walking”, “resistance”, “training”, and “weights” were used to search for eligible “threads” (online conversations). Only threads initiated by colorectal cancer patients or survivors were included. From >6000 posts the inclusion criteria yielded 75 threads for analysis.
Inductive thematic analysis was conducted (Braun & Clarke 2006) across all threads. This meant taking initial notes of keywords and phrases that highlighted key components of discourse between participants. Initial codes were then made from the initial notes. Provisional themes were then established from similar initial codes. Provisional themes were then discussed and agreed upon by the research team.
Results
Inductive thematic analysis of the threads yielded three main themes.
•Faith in their knowledge demonstrated that forum members were aware of the general benefits of exercise, but felt disappointment that it did not keep the cancer at bay. However members also had faith that exercise would keep them healthy after diagnosis and treatment.
•Cultural value of exercise revealed that forum members shared both the spiritual goodness associated with exercise, as well as the physical benefits or goodness that they feel exercise or physical activity provides them.
•Responsibility to oneself and each other encompassed community and individual feelings of responsibility to become or remain active themselves, and a responsibility to encourage other members of the online community to participate.
Conclusion
In the context of online discussion forums, colorectal cancer survivors share exercise and physical activity information for several different reasons and this seems to influence the relationships they build with each other. This is reflected in their feelings of responsibility towards each other to initiate or maintain a physically active lifestyle.
However, members of the forum also expressed their disappointment in their belief that exercise would have kept them cancer-free, which may influence any advice or encouragement to become physically active from their online peers if they feel it had failed them in the past. Clinicians can use this information in their practice and adjust any exercise discussions they may have with their patients to account for feelings of doubt or fear about exercise their patient may be experiencing.