A Framework of Analysis for the Investigation of Psycholinguistic Constructs in Online Doctor-Patient Interaction

Among the several technological tools available, medical forums are widely used by e-patients. The objective of this study is to investigate some specific sociological constructs and their linguistic realisations in patient posts, and to observe if they may have an impact on adherence to therapies, in line with studies conducted in offline settings. Indeed, the relationship between adherence and the type of adherence message has been lengthily investigated. Some of the psycholinguistic constructs which have been used to understand adherence are control orientation, agency and affect (Bartlett Ellis, Connor & Marshall 2014). A similar model is suggested in this study, including the broader notion of attitude derived from appraisal theory (Martin & White 2005). Thus, patient posts have been coded with the aim of identifying control orientation, agency, and attitude (plus their subsets) and their linguistic realisations in order to understand patient conceptualisation of adherence messages. The data show that these constructs even arise in spontaneous interaction and without the use of specifically designed interviews or questionnaires. Indeed, unprompted posts also display the manifestation of these constructs, with control realisation (CR) emerging particularly frequently. Both internal control realisation (ICR) and external control realisation (ECR) are present. Drawing on studies focusing on offline settings, it is possible to assume that patients displaying ECR are more likely to fail to adhere to a therapy and thus need particular attention and encouragement in managing their disease.