Profiling Cancer Patients Based on Their Motives for Seeking Informational and Emotional Support Online

Figures & data

Figure 1. Conceptual model of cancer patients’ motives for using the internet.

Table 1. Motives for seeking informational and emotional support online.

Category	Motives (Would you visit Kanker.nl if you …)
Informational support: Looking for complementary information (KR-20 α = .76)	… want to better understand what the health provider has told you? … received too little information from your health provider? … have any questions after your conversation with your health provider? … want to reduce your uncertainties (e.g., about treatment, the future)? … want to prepare for your conversation with your health provider?
Informational support: Dealing with conflicting information (KR-20 α = .76)	… have received conflicting information from different health providers? … want to put the information that the health provider has told you into perspective? … come across conflicting information on the Internet? … have received conflicting information from your family and/or friends? … want to check the information from the health provider? … have received information that goes against your own opinion? … want information that you did not want to discuss with your health provider during the conversation?
Emotional support: Receiving and/or giving emotional support (KR-20 α = .82)	… want to feel understood by others? … want to have contact with fellow cancer patients? … want information about the possibilities for contact with fellow cancer patients? … want to share your current situation? … want emotional support? … want to share the information you have received from your health provider with others? … want the experiences and advice of other patients? … want to share your experience(s) with others (e.g., about treatment, consequences for your work?) … want to participate in group conversations/group discussions?

Note. Reported Kuder Richardson-20 α concern reliability for each motive category after deleting the item “ … want information about alternative treatments.”

Table 2. Sample characteristics.

Variable	Current patients and cancer survivors N = 181
Age (at time of survey), M (SD), range	60.46 (9.28), 20–88
<50 years, n (%)	25 (13.8)
51–60	60 (33.1)
61–70	75 (41.4)
>71	21 (11.6)
Gender, n (%)
Female	94 (51.9)
Male	87 (48.1)
Education, n (%)
Low education level	23 (12.7)
Middle education level	61 (33.7)
High education level	97 (53.6)
Living situation, n (%)
Alone	40 (22.1)
With Partner	105 (58.0)
With Partner and child(ren)	31(17.1)
With Child(ren)	2 (1.1)
With Other family members (e.g., parent, brother/sister)	1 (0.6)
Other	2 (1.1)
Type of cancer diagnosis^a, n (%)
Breast cancer	41 (22.7)
Stomach, liver or colon cancer, incl. esophageal, rectum, pancreatic, and thyroid cancer	25 (12.8)
Lung cancer	13 (13.8)
Gynecological cancer (e.g., cervical, ovarian, and vulva cancer)	9 (5.0)
Blood or lymph node cancer (e.g., Hodgkin’s disease, non-Hodgkin, leukemia)	15 (8.3)
Urological cancer (e.g., kidney, prostate, bladder, testicular cancer)	41 (22.7)
Head and neck cancer, brain cancer (e.g., mouth or throat, retinal cancer)	11 (6.1)
Skin cancer (e.g., melanoma)	6 (3.3)
Bone cancer, incl. multiple myeloma, Waldenstrom’s disease	7 (3.9)
Other	28 (15.5)
Ongoing treatment, n (%)
Yes	87 (48.1)
Goal of ongoing treatment, n (%)
Curing	35 (40.2)
Sedative and/or palliative	45 (51.7)
I don’t know	7 (8.0)
Time since diagnosis (at time of survey), M (SD), range^b	68.68 (60.93), 2–331
0–12 months, n (%)	17 (11.5)
13–24 months	22 (14.9)
24–36 months	19 (12.8)
37–48 months	12 (8.1)
49–60 months	14 (9.5)
More than 61 months	64 (43.2)

Note. ^aMultiple answers possible. ^b Missing data for 33 participants.

Figure 2. Hierarchical cluster analysis revealed a three-cluster solution.

Table 3. Scoring of the three clusters on the three motive categories.

Motive category	Cluster 1 (n = 83) The overall seekers	Cluster 2 (n = 83) The occasional information seekers	Cluster 3 (n = 15) The contact exchangers	F(2,178)
Informational support: Looking for complementary information, (M, SD), range	High (M = 4.25, SD =1.10), 0-5	Moderate (M = 3.36, SD = 1.43), 0-5	Low (M = 0.47, SD = 0.52), 0-5	61.35***
Informational support: Dealing with conflicting information, (M, SD), range	High (M = 5.57, SD = 1.53), 0-7	Moderate (M = 3.93, SD = 1.60), 0-7	Low (M = 0.33, SD = 0.49), 0-7	83.32***
Emotional support: Giving and/or receiving emotional support, (M, SD), range	High (M = 7.37, SD = 1.50), 0-9	Low (M = 2.57, SD = 1.56), 0-9	Moderate (M = 5.60, SD = 1.76), 0-9	199.91***

Note. Significant difference for the one-way ANOVA was set at 5%.

* p < .05; ** p < .01; *** p < .001.

Table 4. Representation of the three clusters based on the three motive categories.

Category	Motives (Would you visit Kanker.nl if you …)	The overall seekers (n = 83), n (%)	The occasional information seekers (n = 83), n (%)	The contact exchangers (n = 15), n (%)
Informational support: Looking for complementary information	… want to better understand what the health provider has told you?	77 (92.8) ^a	68 (81.9) ^a***	2 (13.3) ^b***
	… received too little information from your health provider?	78 (94.0) ^a	71 (85.5) ^a***	3 (20.0) ^b***
	… have any questions after your conversation with your health provider?	67 (80.7) ^a**	47 (56.6) ^c***	0 (0.0) ^b***
	… want to reduce your uncertainties (e.g., about treatment, the future)?	71 (85.5) ^a***	49 (59.0) ^c***	1 (6.7) ^b***
	… want to prepare for you conversation with your health provider?	60 (72.3) ^a*	44 (53.0) ^c**	1 (6.7) ^b**
Informational support: Dealing with conflicting information	… have received conflicting information from different health providers?	81 (97.6) ^a	77 (92.8) ^a***	3 (20.0) ^b***
	… want to put the information that the health provider has told you into perspective?	63 (75.9) ^a***	40 (48.19) ^c**	0 (0.0) ^b***
	… came across conflicting information on the Internet?	71 (85.5) ^a	60 (72.3) ^a***	1 (6.7) ^b***
	… have received conflicting information from your family and/or friends?	52 (62.7) ^a***	23 (27.7) ^b	0 (0.0) ^b***
	… want to check the information from the health provider?	65 (78.3) ^a***	39 (47.0) ^c**	0 (0.0) ^b***
	… have received information that goes against your own opinion?	72 (86.7) ^a**	52 (62.7) ^c***	1 (6.7) ^b***
	… want information that you did not want to discuss with your health provider during the conversation?	58 (69.9) ^a***	35 (42.2) ^c*	0 (0.0) ^b***
Emotional support: Giving and/or receiving emotional support	… want to feel understood by others?	58 (69.9) ^a***	17 (20.5) ^ab	6 (40.0) ^a
	… want to have contact with fellow cancer patients?	38 (45.8) ^a***	80 (96.4) ^a	15 (100.0) ^b***
	… want information about the possibilities for contact with fellow cancer patients?	77 (92.8) ^a***	32 (38.6) ^b***	13 (86.7) ^a
	… want to share your current situation?	72 (86.7) ^a***	11 (13.3) ^c***	9 (60.0) ^b*
	… want emotional support?	45 (54.2) ^a***	6 (7.2) ^b	3 (20.0) ^ab
	… want to share the information you have received from your health provider with others?	61 (73.5) ^a***	12 (14.5) ^b	4 (26.7) ^b***
	… want the experiences and advice of other patients?	81 (97.6) ^a***	55 (66.3) ^b	12 (80.0)^ab
	… want to share your experience(s) with others (e.g., about treatment, consequences for your work?)	74 (89.2) ^a***	20 (24.1) ^c*	8 (53.3) ^b*
	… want to participate in group conversations/group discussions?	64 (77.1) ^a***	22 (26.5) ^b***	14 (93.3) ^a

Note. Differing superscripts (a, b, c) indicate significantly different mean scores within a row; comparisons were made between clusters in order of 1 to 2, 3 to 1, and 2 to 3 and provided with level of significance in the same order * p < .05; ** p < .01; *** p < .001.

Table 5. Comparison of the three clusters based on psychological and background characteristics, and perception of health care services.

Variable	The overall seekers (n = 83; 45.9%)		The occasional information seekers (n = 83; 45.9%)		The contact exchangers (n = 15; 8.3%)		F-test (2, 178), p-value	Welch and Games-Howell post hoc pattern
	M	SD	M	SD	M	SD
Cancer-related psychological distress
Intrusive thinking	2.82	0.73	2.72	0.65	2.63	0.77	0.75, p = .475	ns
Cancer Worry	2.04	0.71	1.91	0.65	2.10	0.78	0.97, p = .381
Intolerance for uncertainty	2.42	0.71	2.20	0.64	2.39	0.77	2.27, p = .107
Coping style	4.05	1.01	4.01	1.02	3.60	1.02	1.37, p = .256	ns
Trust in doctors	3.85	0.83	4.13	0.70	4.00	0.92	2.67, p = .072	ns
Age	60.66	7.63	60.93	10.77	56.80	8.43	1.30, p = .276	ns
Gender, n (%)							1.61, p = .203	ns
Male	40 (48.2)		43 (51.8)		4 (26.7)
Female	43 (51.8)		40 (48.2)		11 (73.3)
Educational level, n (%)							1.19, p = .307	ns
Low education level	10 (12.0)		10 (12.0)		3 (20.0)
Middle education level	36 (43.4)		22 (26.5)		3 (20.0)
High education level	37 (44.6)		51 (61.4)		9 (60.0)
eHealth literacy^a	1.98	0.35	1.91	0.38	2.47	0.75	11.77, p < .001	1 < 3 ***; 2 < 3 ***

Note. One-way ANOVAs with Welch and Games-Howell post hoc tests for violation of the assumption of homogeneity variance. ^a = significant difference among all profiles (global level), for the one-way ANOVA, significant difference among all profiles was set at 5%.

* p < .05; ** p < .01; *** p < .001; ns = non-significant.

Data availability statement

The data underlying this article will be shared upon reasonable request to the corresponding author.