Not finished. I am just proud of the sheer amount of words I wrote today.

Literature Reviews. Everyone doing honours has to do one. So I sat down today at 10am. It is now 3pm. After many bouts of procrastination inducing activities (cleaning my room, facebook, music) I managed to type up 1600 words of my first draft for my lit review.

This is a proud moment for me. Planning to smash the next 1400 or so words tomorrow and then edit as much as I possibly can 🙂

Note* I am not 100% sure how I want to structure this – how it stands at the moment is that the bolded text heading are my categories, bold and italics are my subheadings (not all of them are finished or event started – bearing in mind this is a halfway draft)

Social Media

Social Media and Web 2.0

Social Media most commonly refers to the web-based technologies for communication and sharing over the internet. Although there is no single agreed upon decision, Scott & Jacka (2011, pg. 5) claim that social media “is the set of web-based broadcast technologies that enable the democratisation of content, giving people the ability to emerge from consumers of content to publishers.” Social media needs to be distinguished from other terms that may refer more to the technological or structural aspects of online systems (Hill et. al., 2014).
The differentiation can be made between Web 1.0 systems; typically information resources without a discussion, interactive or sharing component. Web 2.0 systems refer to sites with user generated content such as blog text, music, videos and photos (Anderson, 2007) and has allowed for consumers to become the creators of content (Asberg, 2009). Ravenscroft (2009) has also considered the web 2.0 to be the social and participative web; with emphasis on social networking, media sharing and virtual communities.
The divergence between social media and web 2.0 can be somewhat imprecise, but Figure 1 presents analogue, digital, web 1.0 and web 2.0 media types progressing over time from left to right.

Media types figure

The dotted line in Figure 1 indicates which media we consider to be social media and the shift into web 2.0 (Hill et. al., 2014).


Facebook and the creation of online community

Social media involves the extensive use of electronic media for people in contact through online communities (Toral, 2009), but there is no agreed definition or ideal construct of an online community (De Souza & Preece, 2004).  Virtual communities are a communication platform, usually established through a social networking site through which people that hold the same interests and concerns can interact with one another through cyberspace (Turban, 2006; McKnight et al., 2002).  There are often rules and guidelines used in these closed groups and on Facebook they are monitored by admins, who have the control of the group composition as they accept members to join the group.

Social media as a means for patient support

It is clear that good self-management is necessary for effective medical care for chronic illness (Von Korff et al., 1997) and social media is seen to be an effective mechanism for this; a study conducted by Professor Jenny Strong states that 21% of people used social media to find out about the pain experiences of others so as to compare it to their own conditions (Anonymous, 2012).

Social media, with its ease of access and prominence in web 2.0 culture could help sufferers gain ongoing support for their condition. Social media closed groups on platforms such as Facebook are increasingly popular for people to turn to for support and information. They not limited by geographical or temporal restrictions as might be the case for a face-to-face group (Braithwaite, Waldron, & Finn, 1999) but there may be restrictions for some users if they are physically incapable or do not have adequate internet access. Online support groups based on social media platforms have a great potential for a much larger and diverse group composition (Wright & Bell, 2003), which in turn allows members to potentially access a wider variety of information, advice and support (Coulson & Knibb, 2007). As the nature of Chronic Pain is are very diverse, this is an advantage for members of these groups.

Sociality on Facebook

Sociality can be defined as the extent to a person socialises or interacts with others and their tendency to associate with groups (Hill et. al., 2014). People are fundamentally social; their association with others and the formation of groups is created for the simple goal of forming relationships (Fiske, 1992).
The growth of online channels of communication and the subsequent interaction indicate an expansion or alteration of the social context. Human sociality is seen to be both limited and heightened through online communication platforms such as Facebook. These social media platforms allow for the reduction of geographical and temporal restrictions (Braithwaite, Waldron, & Finn, 1999), manifestation of relationships and creation of online communities through Facebook groups. Alternatively online spaces can present challenges to individual boundaries and privacy. It is well understood that people say and do things in cyberspace that they ordinarily wouldn’t do or say in the face to face world. They loosen up, feel more uninhibited and express themselves more freely, researchers call this the online disinhibition effect (Suler, 2004).

There can be different way to conceptualise individuals in their social contexts to help understand the impact of online sociality on communication. The sociality hierarchy model has three depicted levels of online communication (Figure 2. Hill et. al., 2014), broadcast, conversational and community based conversation.

sociality hierarchy model

Broadcast social media occurs at the individual level, with users speaking to the crowd or from a virtual soap box, sharing information about themselves for anyone to consume; one person communicating with many others. Conversational social media happens at an interpersonal level, between two people and is similar to analogue or face to face communication. Community based conversation via social media happens when groups communicate with one another within their membership ranks. The key concept at this communication level is sharing information; conversations are many to many – an individual may start the conversation but there is the potential for many to join in and see the conversation, even if they are not a contributing part of it.

Chronic Pain

Chronic Pain and the Pain Scale
Chronic Pain persists for an extended period of time and is usually defined as pain lasting for longer than six months, or pain that persists beyond the expected healing time (Field & Swarm, 2008). Clinically, pain is defined by ‘what the patient states it is’ and then it is up to the physician to determine precisely what the patient means (Jay, 2007). It is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage (APS, 1992; Mersky & Bogduk, 1994).  Pain is not determined by tissue damage alone; there is no predictable relationship between identifiable tissue injury and the sensation of pain (McCaffery & Pasero, 1999).

There are a range of different diagnoses a patient could potentially receive when investigating the cause of their chronic pain, including Fibromyalgia, pain in the muscles and ligaments, Chronic Fatigue Syndrome, patient always being tired and Non-specific Neuropathic Pain, pain caused by faulty nerves (Butler & Moseley, 2003); the reasons for the chronic pain are sometimes unable to be defined, and diagnoses are very extensive. People who have Chronic non-malignant pain may describe pain for which little or no tissue damage is found, but the inability to identify tissue damage sufficient enough to explain pain is not proof that the pain is of psychological origin (Portenoy & Kanner, 1996).


Chronic cancer pain and chronic non-malignant pain may reflect both nociceptive and neuropathic pain. Figure 3 highlights the difference between nociceptive and neuropathic pain and gives an example of the type of pain experienced in each case. Nociceptive is the term used to describe how pain becomes conscious through four basic processes: transduction, transmission, perception and modulation. Neuropathic pain is distinctly different from nociceptive pain as it is pain that is sustained by an abnormal processing of sensory input by the peripheral or central nervous system (McCaffery & Pasero, 1999).

The reality of Chronic Pain for many patients and their families is quite difficult to accept as there may be no cure. It is often possible to improve quality of life, increase function and reduce sense of suffering but often people can feel isolated as Chronic Pain can be a very difficult illness to understand (Cowan, 2011).


Social and Physiological implications of Chronic Pain



Effective self-management is an established therapeutic goal for people living with and treating Chronic Pain (Borkan & Cherkin, 1996) therefore the understanding the extent and nature of daily self-management of chronic pain symptoms is important. Numerous of studies in clinical populations of chronic pain sufferers have consistently shown that self-management of symptoms and the support provided by chronic pain community groups produce better outcomes (Cohen et al., 2000; Von Korff et al., 1994).

The increasing pressures that are facing our health care system can place burdens on patients, some who are have been waiting more than two years to see pain management specialists (Anonymous 2012); there is mounting pressure regarding the importance of effective self-management of Chronic Pain, so that people have access to information and assistance without having to wait until it is too late (Blyth, et al. 2005).

Online Support – A part of managing Chronic Pain

The social media phenomenon is an integral part of Internet culture and thus published literature describing social media interventions and support for chronic disease management need to become more prevalent. It has also been suggested that social media may allow for communication processes that differ from those offered by other information technologies, such as the traditional online support group (Fox, 2011). This shift is important to note as it cements the significance of the idea of Web 2.0 (Hesse, et. al., 2011).

Support Groups

The evolution of the support group

Support groups can be a helpful tool as they allow members to share comparable experiences and similar challenges they may be facing, which can lead to the exchange of social support (Gottlieb, Maitland et al., 2013) and provide the opportunity for social comparison with peers (Campbell, Phaneuf, & Deane, 2004).

Development of online support groups


Models and Tools

Content and discourse analysis

Technology Acceptance Model (TAM) and use of Facebook

Netnography as a tool

Computer mediated communication

[U1]Do I need to add more to this section?


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