Ziebland Sue
University of Oxford Department of Primary Health Care, Institute of Health Sciences, Oxford OX3 7LF, UK.
Soc Sci Med. 2004 Nov;59(9):1783-93. doi: 10.1016/j.socscimed.2004.02.019.
To people with the necessary technology the internet can provide vast amounts of health information. However, there are concerns about the quality of the information and how it may affect relationships between patients and doctors. Little empirical research has examined how the internet is used by those diagnosed with a serious illness. This study uses in-depth interviews collected for DIPEx projects with men and women with cancer. The analysis is informed by Radley and Billig's (Sociol. Health Illness 2 (1996) 220) observation that accounts of illness require patients to simultaneously display themselves as 'worthy individuals, as more or less fit participants in the social world' and on Arthur Frank's work on quest narratives. Drawing on in-depth interviews with a woman with inflammatory breast cancer and a man with prostate cancer I will demonstrate how the internet has been used not only to gather information and gain support from others but also to make sense of the experience of cancer. The ability to access health information on the internet may provide patients with an opportunity to display a particularly modern marker of competence and social fitness. However, one of the consequences of easier access to health information may be the emergence of a felt imperative to be (or present oneself as) an expert and critical patient, able to question advice and locate effective treatments for oneself.
对于拥有必要技术的人来说，互联网能提供大量的健康信息。然而，人们担心这些信息的质量以及它可能如何影响医患关系。很少有实证研究考察过身患重病的人是如何使用互联网的。本研究采用了为“疾病经验访谈项目”（DIPEx）收集的对癌症患者的深度访谈。分析借鉴了拉德利和比利格（《社会健康与疾病》2 (1996) 220）的观察结果，即疾病叙述要求患者同时将自己展现为“有价值的个体，或多或少是社会世界中合格的参与者”，还借鉴了亚瑟·弗兰克关于探索叙事的研究。通过对一位炎性乳腺癌女性患者和一位前列腺癌男性患者的深度访谈，我将展示互联网不仅被用于收集信息和从他人那里获得支持，还被用于理解患癌经历。在互联网上获取健康信息的能力可能为患者提供一个展示能力和社会适应性这一特别现代标志的机会。然而，更易获取健康信息的后果之一可能是，患者会产生一种强烈的冲动，要成为（或表现为）专家型和挑剔型患者，能够质疑建议并为自己找到有效的治疗方法。
