EL DROGUISTA INDEPENDIENTE: SU IMPORTANCIA Y PROBLEMÁTICA

The recent attention directed towards ordinary people in conjunction with the advent of the Internet has led to much research activity in online consumer health information-seeking (Abrahamson, Fisher, Turner, Durrance, & Turner, 2008; Eng, Monkman, Verhoef, Ransum, & Bradbury, 2001). The two main research streams in this area focus on information-seeking using electronic health resources and on issues arising from the use of electronic resources in disseminating health information. Much of this research focuses on the promise and perils of the Internet as a consumer health information source (Calabretta, 2002; Coggan, 2000; Detlefsen, 2004; Huntington, Nicholas, & Gunter, 2004; Klein-Fedyshin, 2002) or the virtues of using the Internet for health promotion and health information delivery (Deering & Harris, 1996; Evers, 2006; Lorence, Park, & Fox, 2006) or using online information for self-care (Nijland, van Gemert-Pijinen, Boer, Steehouder, & Seydel, 2008). Bass, Ruzek, Gordon, Fleisher, McKeon-Conn, and Moore (2006) found that Internet use among newly diagnosed cancer patients led to greater participation in treatment decisions, asking the physician more questions, and greater treatment compliance. These patients viewed the Internet as a powerful tool for both acquiring information and for enhancing confidence. Significantly, Lorence and Heeyoung (2008, 2007, 2006) found that despite policy initiatives intended to erase or bridge the gap

between those with access to digital health information and those without, differences in access persist. The links among Internet use, socioeconomic characteristics, and

demographics have a direct bearing on online health seeking behaviours.

A number of studies have emerged in recent years examining electronic health resources from the information-seeking perspective of certain groups. For example, Flynn, Smith, and Freese (2006), Marschollek, Mix, Wolf, Effertz, Haux, and Steinhagen-

Thiessen (2007), and Silbajoris (2000) studied older adults‘ use of electronic sources for health information. Another area receiving much research attention is how developing technologies support information behaviour, i.e., the information behaviour taking place in virtual communities (Liszka, Steyer, & Hueston, 2006; Tilley, Bruce, Hallam, & Hills, 2006), on portals (Rankow, 2002; Williamson & Manascewiz, 2002), and on mailing lists or e-mail (Goldner, 2006; Meier, Lyons, Rimer, Frydman, & Forlenza, 2007). These studies have shown that participation in virtual communities, portals, and mailing lists are all positively correlated to well-being, a sense of control, and making positive changes. Additionally, these studies show that online fora provide support and are generally viewed as good information sources to the people who use them. However, while there are many benefits to using online technologies, Valimaki, Nenonen, and Koivunen (2007) found that patients still like to receive healthcare information in face-to-face interactions with their healthcare providers in preference over online delivery. Finally, far fewer studies have examined how online health information is used. Only one study by Eastin and Guinsler (2006) studied if, and how, information gathered online was used—the researchers asked if individuals subsequently went to see a doctor or change their behaviour in some way as a result of acquiring information online. They found that for patients who were moderately to highly anxious about their health, seeking online health information resulted in a greater number of medical visits (although this was not a statistically significant relationship). For those patients with low health anxiety, seeking online health information resulted in fewer medical visits. The dearth of research in this area appears to support Savolainen‘s

assertion that information use is a neglected area in LIS.

Previous research has demonstrated that those with illness use a wide range of information behaviour to satisfy information needs (including the use of online information sources and support groups) (Cytryn, 2001; Long, 2003). Eight in ten Internet users have

looked online for health information and 21% of those health information-seekers sought online information about depression, anxiety, stress, or mental health issues (Fox, 2005). It is estimated that one in four health information-seekers joins a support group (Cline & Haynes, 2001) and that many health consumers prefer to obtain their information from online support groups (Wikgren, 2001). Online support groups have been a tremendous boon for those dealing with health concerns and for those caring for someone with a health problem. Research shows that participation in online support groups is significantly correlated to increased coping skills and positive health outcomes (Agnew, 2001; Antle & Collins, 2009; Bacon, Condon, & Fernsler, 2000; Coursaris & Lui, 2009; Fingeld, 2000; Mo & Coulson, 2010; Radin, 2006). A study published by the American Journal of Psychiatry found that 95% of participants in online support groups for depression said communication with other patients alleviated some depression symptoms (Houston, Cooper, & Ford, 2002). Similarly, a recent study by Griffiths, Calear, and Banfield (2009) found that participation in online support groups reduced depressive symptoms. Online support groups provide peer-to-peer support (the preferred means of social support), and online support groups assist in providing empathy, information, advice, a sense of

empowerment and control, humour and inspiration, and they also provide the opportunity to help others (Agnew, 2001; Bacon, Condon, & Fernsler, 2000; Fingeld, 2000; Radin, 2006; Vilhauer, 2009; Wikgren, 2001) .

Wikgren (2001) describes health discussion groups as ―a type of information channel with interesting hybrid properties: they offer access to both formal and informal sources, medical facts, orienting information and emotional support, and advice and information from both known and unknown fellow participants‖ (p. 315). Despite a sinister side to online support groups—flaming, trolls, and malevolent lurkers—the act of sharing one‘s own, and soliciting others‘, advice, stories, opinions and experiences with depression suggests that there is a certain amount of trust among online users. Even while arguing different points of view, users typically have a certain level of implicit trust for others—studies have shown that the vast majority of messages posted on online support groups are positive (Coursaris & Liu, 2009; Storm & Moreggi, 1998). Additionally, other research shows the health benefits of confiding in others. Pennebaker (1990) writes, ―Whereas inhibition is potentially harmful, confronting our deepest thoughts and feelings

have remarkable short- and long-term health benefits […] Not disclosing our thoughts and feelings can be unhealthy. Divulging them can be healthy‖ (p. 14). While Pennebaker‘s research was conducted prior to the popular use of online newsgroups, other research supports the findings that the benefits of disclosure and the act of writing online are transferable from paper to electronic mediums (Agnew, 2001; Ben-Ze‘ev, 2003).