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      Characteristics and perception of social support by patients with fibromyalgia in Facebook Translated title: Características e percepção de apoio social por pacientes com fibromialgia no Facebook

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          Abstract

          ABSTRACT BACKGROUND AND OBJECTIVES: Analyze the interactive behavior, characteristics, perception of social support, and interests of patients with fibromyalgia on online discussion groups. METHODS: A participatory netnography has been conducted for 6 months on Facebook in order to keep track of a fibromyalgia community with more than 8,000 members. An electronic survey composed by a validated social support scale was sent to the members of the group. Another online survey was applied by the group coordinator in order to build the users' profile. RESULTS: The online environment has often been indicated as the only place to get something off one's chest. Regular testimonials on social discrimination due to Fibromyalgia were recorded, coming from the family itself, from friends and even from health professionals. Patients' rights and new treatments are among the topics of greatest interest. The target group seemed to have a social echo, but it has difficulties to generate engagement among its members. Low social support was reported by most of the 444 respondents. However, many also criticized the group positively. There were 3,217 people who responded the survey applied by the coordinator: 97.5% female respondents, 86.2% were between 31 and 60 years old, 60.1% were diagnosed by a rheumatologist, 16.5% by an orthopedist, and 6.8% by a general practitioner. The five most unpleasant symptoms informed were: pain, anxiety, memory problem, irritability, and tingling. CONCLUSION: New forms of online education and social support for fibromyalgia on online groups are relevant resources to be considered in patient care programs.

          Translated abstract

          RESUMO JUSTIFICATIVA E OBJETIVOS: Analisar o comportamento interativo, as características, a percepção de apoio social e os interesses de pacientes com fibromialgia em grupos de discussão online. MÉTODOS: Foi feita uma netnografia participativa que acompanhou por 6 meses uma comunidade de Fibromialgia com mais de 8.000 membros no Facebook. Um inquérito eletrônico sobre suporte social com escala validada foi enviado aos membros do grupo. Outro questionário online para traçar o perfil dos usuários foi aplicado pela coordenadora do grupo. RESULTADOS: O ambiente online foi apontado frequentemente como único local de desabafo. Registraram-se depoimentos regulares sobre discriminação social decorrentes da Fibromialgia - advindos da própria família, de amigos e, até mesmo, de profissionais de saúde. Direitos dos pacientes e novos tratamentos aparecem dentre os temas de maior interesse. O grupo acompanhado mostrou ter repercussão social, mas apresenta dificuldades para gerar envolvimento entre os membros. Baixo apoio social foi alegado pela maioria dos 444 respondentes. No entanto, muitos também criticaram positivamente o grupo. O questionário aplicado pela coordenadora teve 3.217 respondentes, a saber: 97,5% do sexo feminino; 86,2% com idade entre 31 e 60 anos; 60,1% cujo diagnóstico foi dado por um reumatologista, 16,5% por ortopedista e 6,8% por clínico geral. Os cinco principais sintomas mais desagradáveis citados pelos pacientes foram: dor, ansiedade, problema de memória, irritabilidade e formigamento. CONCLUSÃO: Novas formas de educação online e de apoio social em grupos virtuais para fibromialgia são recursos relevantes a serem considerados em programas de atenção a pacientes.

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          Interactive Health Communication Applications for people with chronic disease.

          Interactive Health Communication Applications (IHCAs) are computer-based, usually web-based, information packages for patients that combine health information with at least one of social support, decision support, or behaviour change support. These are innovations in health care and their effects on health are uncertain. To assess the effects of IHCAs for people with chronic disease. We designed a four-part search strategy. First, we searched electronic bibliographic databases for published work; second, we searched the grey literature; and third, we searched for ongoing and recently completed clinical trials in the appropriate databases. Finally, researchers of included studies were contacted, and reference lists from relevant primary and review articles were followed up. As IHCAs require relatively new technology, the search time period commenced at 1990, where possible, and ran until 31 December 2003. Randomised controlled trials (RCTs) of IHCAs for adults and children with chronic disease. One reviewer screened abstracts for relevance. Two reviewers screened all candidate studies to determine eligibility, apply quality criteria, and extract data from included studies. Authors of included RCTs were contacted for missing data. Results of RCTs were pooled using random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios for binary outcomes; heterogeneity was assessed using the I(2 )statistic. We identified 24 RCTs involving 3739 participants which were included in the review.IHCAs had a significant positive effect on knowledge (SMD 0.46; 95% confidence interval (CI) 0.22 to 0.69), social support (SMD 0.35; 95% CI 0.18 to 0.52) and clinical outcomes (SMD 0.18; 95% CI 0.01 to 0.35). Results suggest it is more likely than not that IHCAs have a positive effect on self-efficacy (a person's belief in their capacity to carry out a specific action) (SMD 0.24; 95% CI 0.00 to 0.48). IHCAs had a significant positive effect on continuous behavioural outcomes (SMD 0.20; 95% CI 0.01 to 0.40). Binary behavioural outcomes also showed a positive effect for IHCAs, although this result was not statistically significant (OR 1.66; 95% CI 0.71 to 3.87). It was not possible to determine the effects of IHCAs on emotional or economic outcomes. IHCAs appear to have largely positive effects on users, in that users tend to become more knowledgeable, feel better socially supported, and may have improved behavioural and clinical outcomes compared to non-users. There is a need for more high quality studies with large sample sizes to confirm these preliminary findings, to determine the best type and best way to deliver IHCAs, and to establish how IHCAs have their effects for different groups of people with chronic illness.
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            The internet-based arthritis self-management program: a one-year randomized trial for patients with arthritis or fibromyalgia.

            To determine the efficacy of an Internet-based Arthritis Self-Management Program (ASMP) as a resource for arthritis patients unable or unwilling to attend small-group ASMPs, which have proven effective in changing health-related behaviors and improving health status measures. Randomized intervention participants were compared with usual care controls at 6 months and 1 year using repeated-measures analyses of variance. Patients with rheumatoid arthritis, osteoarthritis, or fibromyalgia and Internet and e-mail access (n = 855) were randomized to an intervention (n = 433) or usual care control (n = 422) group. Measures included 6 health status variables (pain, fatigue, activity limitation, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 5 utilization variables (physician visits, emergency room visits, chiropractic visits, physical therapist visits, and nights in hospital), and self-efficacy. At 1 year, the intervention group significantly improved in 4 of 6 health status measures and self-efficacy. No significant differences in health behaviors or health care utilization were found. The Internet-based ASMP proved effective in improving health status measures at 1 year and is a viable alternative to the small-group ASMP.
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              Social Uses of Personal Health Information Within PatientsLikeMe, an Online Patient Community: What Can Happen When Patients Have Access to One Another’s Data

              Background This project investigates the ways in which patients respond to the shared use of what is often considered private information: personal health data. There is a growing demand for patient access to personal health records. The predominant model for this record is a repository of all clinically relevant health information kept securely and viewed privately by patients and their health care providers. While this type of record does seem to have beneficial effects for the patient–physician relationship, the complexity and novelty of these data coupled with the lack of research in this area means the utility of personal health information for the primary stakeholders—the patients—is not well documented or understood. Objective PatientsLikeMe is an online community built to support information exchange between patients. The site provides customized disease-specific outcome and visualization tools to help patients understand and share information about their condition. We begin this paper by describing the components and design of the online community. We then identify and analyze how users of this platform reference personal health information within patient-to-patient dialogues. Methods Patients diagnosed with amyotrophic lateral sclerosis (ALS) post data on their current treatments, symptoms, and outcomes. These data are displayed graphically within personal health profiles and are reflected in composite community-level symptom and treatment reports. Users review and discuss these data within the Forum, private messaging, and comments posted on each other’s profiles. We analyzed member communications that referenced individual-level personal health data to determine how patient peers use personal health information within patient-to-patient exchanges. Results Qualitative analysis of a sample of 123 comments (about 2% of the total) posted within the community revealed a variety of commenting and questioning behaviors by patient members. Members referenced data to locate others with particular experiences to answer specific health-related questions, to proffer personally acquired disease-management knowledge to those most likely to benefit from it, and to foster and solidify relationships based on shared concerns. Conclusions Few studies examine the use of personal health information by patients themselves. This project suggests how patients who choose to explicitly share health data within a community may benefit from the process, helping them engage in dialogues that may inform disease self-management. We recommend that future designs make each patient’s health information as clear as possible, automate matching of people with similar conditions and using similar treatments, and integrate data into online platforms for health conversations.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                brjp
                BrJP.
                BrJP
                Sociedade Brasileira para o Estudo da Dor (São Paulo, SP, Brazil )
                2595-0118
                2595-3192
                March 2018
                : 1
                : 1
                : 4-8
                Affiliations
                [2] Itanhaém SP orgnameAssociação Brasileira dos Fibromiálgicos Brazil
                [1] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Programa de Pós-Graduação em Gestão e Informática em Saúde Brazil
                Article
                S2595-31922018000100004
                10.5935/2595-0118.20180003
                b3100d73-9ece-46db-acf2-46dfa3a6b32c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 03 October 2017
                : 04 January 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 5
                Product

                SciELO Brazil


                Redes sociais,Apoio social,Fibromialgia,Fibromyalgia,Social networks,Social support

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