The Impact of Narratives on Healthcare Decision-Making in Online Discourse

Abstract

This study examines first what type of evidence is most influential in online discussions for patients when making decisions about their health and second how people deploy, interpret, and react to stories in these online discussions to better understand the role and importance of narrative in the medical field. Data was gathered on the platform Reddit using the subreddit r/melanoma for a duration of two weeks. 242 posts were collected and analyzed. Using a combination of grounded theory and coding criteria from sociologist and narrative scholar Francesca Polletta, a code book was developed and applied to all 242 posts to assess narrative impact and engagement. Results demonstrate that evidence based on past experiences and factual information were the most persuasive. Additionally, stories yielded greater discussion, greater empathetic connections, and greater positive responses from online discussants than other forms of evidence. Further, those positive responses indicate that patients seeking medical advice were more likely to express agreement with the advice when it was offered with a story. Given these results, greater attention should be paid to narratives shared in online communities, particularly considering the levels of misinformation and disinformation found online and the evolving relationships between doctors and patients where authority is no longer so easily assumed. KEYWORDS: Narrative; Personal Experience; Fact; Evidence; Persuasion; Medical Decision-Making; Social Media