Introduction: Internet support groups occupy a substantial body of research in terms of their perceived benefits. This especially applies to online cancer discussion forums across several specialties, including breast cancer. There is little doubt that such forums offer information, and emotional support (Gooden & Winefield, 2007), empowerment (Drossaert et al. 2008) and facilitation of hope, catharsis and altruism (Vilhauer, 2009). However little is documented about how such forums facilitate the shared decision making (SDM) process relating to breast cancer treatment.
Methods
As part of a larger study, an extensive online search was conducted on breast cancer forum websites. Keywords combination such as treatment/surgery decision; conversation; and advice were used alongside sample defining terms such as “discussion forum” and “breast cancer”. Extracts were selected based on their alignment with decision making rhetoric and analysed using positioning theory (Harré & van Langenhove, 1999).
Results
The dissonance between being given a choice of whether or not to have certain treatments, while simultaneously being strongly advised to do so by clinicians was clearly documented. Online forum contributors voiced this and positioned themselves as independent advisors whilst adopting other perspectives namely the experienced and older survivor, the researcher; and validation seeker.
Conclusion
While SDM is often attributed to the interactions between patient and clinician, these results suggest that there its definitive scope be broadened to include online peers. This is especially relevant to breast cancer patients given the specific issues of body changes and varied choices they face.