Khoshnaw Sara, Panzarasa Pietro, De Simoni Anna
Primary Care Unit, University of Cambridge, Cambridge, United Kingdom.
School of Business and Management, Queen Mary University of London, London, United Kingdom.
JMIR Cardio. 2024 Dec 17;8:e53696. doi: 10.2196/53696.
Online health communities (OHCs) enable patients to create social ties with people with similar health conditions outside their existing social networks. Harnessing mechanisms of information diffusion in OHCs has attracted attention for its ability to improve illness self-management without the use of health care resources.
We aimed to analyze the novelty of a metaphor used for the first time in an OHC, assess how it can facilitate self-management of post-stroke symptoms, describe its appearance over time, and classify its diffusion mechanisms.
We conducted a passive analysis of posts written by UK stroke survivors and their family members in an online stroke community between 2004 and 2011. Posts including the term "legacy of stroke" were identified. Information diffusion was classified according to self-promotion or viral spread mechanisms and diffusion depth (the number of users the information spreads out to). Linguistic analysis was performed through the British National Corpus and the Google search engine.
Post-stroke symptoms were referred to as "legacy of stroke." This metaphor was novel and appeared for the first time in the OHC in the second out of a total of 3459 threads. The metaphor was written by user A, who attributed it to a stroke consultant explaining post-stroke fatigue. This user was a "superuser" (ie, a user with high posting activity) and self-promoted the metaphor throughout the years in response to posts written by other users, in 51 separate threads. In total, 7 users subsequently used the metaphor, contributing to its viral diffusion, of which 3 were superusers themselves. Superusers achieved the higher diffusion depths (maximum of 3). Of the 7 users, 3 had been part of threads where user A mentioned the metaphor, while 2 users had been part of discussion threads in unrelated conversations. In total, 2 users had not been part of threads with any of the other users, suggesting that the metaphor was acquired through prior lurking activity.
Metaphors that are considered helpful by patients with stroke to come to terms with their symptoms can diffuse in OHCs through both self-promotion and social (or viral) spreading, with the main driver of diffusion being the superuser trait. Lurking activity (the most common behavior in OHCs) contributed to the diffusion of information. As an increasing number of patients with long-term conditions join OHCs to find others with similar health-related concerns, improving clinicians' and researchers' awareness of the diffusion of metaphors that facilitate self-management in health social media may be beneficial beyond the individual patient.
在线健康社区（OHCs）使患者能够在其现有社交网络之外与患有相似健康状况的人建立社会联系。利用在线健康社区中的信息传播机制，因其能够在不使用医疗资源的情况下改善疾病自我管理的能力而受到关注。
我们旨在分析首次在在线健康社区中使用的一个隐喻的新颖性，评估其如何促进中风后症状的自我管理，描述其随时间的出现情况，并对其传播机制进行分类。
我们对2004年至2011年间英国中风幸存者及其家庭成员在一个在线中风社区中撰写的帖子进行了被动分析。识别出包含“中风遗产”一词的帖子。信息传播根据自我推广或病毒式传播机制以及传播深度（信息传播到的用户数量）进行分类。通过英国国家语料库和谷歌搜索引擎进行语言分析。
中风后症状被称为“中风遗产”。这个隐喻是新颖的，在总共3459个主题帖中的第二个主题帖中首次出现在在线健康社区中。这个隐喻是由用户A撰写的，他将其归因于一位中风顾问对中风后疲劳的解释。该用户是一个“超级用户”（即发帖活跃度高的用户），多年来在回应其他用户撰写的帖子时，在51个不同的主题帖中自我推广了这个隐喻。随后共有7名用户使用了这个隐喻，促成了它的病毒式传播，其中3名用户本身就是超级用户。超级用户实现了更高的传播深度（最高为3）。在这7名用户中，3名用户曾参与用户A提及该隐喻的主题帖，而2名用户曾参与无关对话中的讨论主题帖。总共有2名用户未曾参与与其他任何用户相关的主题帖，这表明该隐喻是通过之前的潜伏活动获得的。
中风患者认为有助于理解其症状的隐喻可以通过自我推广和社交（或病毒式）传播在在线健康社区中传播，传播的主要驱动力是超级用户特质。潜伏活动（在线健康社区中最常见的行为）促成了信息的传播。随着越来越多的慢性病患者加入在线健康社区以寻找有类似健康相关担忧的其他人，提高临床医生和研究人员对有助于健康社交媒体中自我管理的隐喻传播的认识，可能对个体患者之外的人有益。
