We examined the contents of self-introduction postings from the perspective of discourse analysis.
Discourse is a part of language use which can be either in oral or in written form and its length ranges from a discourse marker, full sentence, to a narrative of personal experience (Sherzer 1987). According to Sherzer (1987), there is a wide variety of sources
of discourse, for example, transcription of interviews, samples of conversations, media and web based materials. The self-introduction postings examined in the present study are a kind of discourse because they are a written form of personal experiences and they are from a bulletin board system, an online medium.
Discourse analysis is to study and analyze language use (Hodges et al. 2008). It starts from the analysis of the text of an interaction. Through analyzing its discourse elements, from word usage and sentence pattern to choice of language and discourse structure, discourse analysis provides an in depth understanding of the pragmatic function of language use (Mishler 1991, Roberts & Sarangi 2005, Hodges et al. 2008). Because discourse generates from actual instances of language use, it should also be interpreted with consideration of its contexts (Sherzer 1987). By understanding the local circumstances and contexts of the discourse under examination, we will be able to discover the ideologies and beliefs participants unconsciously bring to the interaction (Roberts &
Sarangi 2005). Hodges et al. (2008) also mentioned that we should not understand the meaning of a discourse merely at the semantic level but should do it at a higher level.
Therefore, to interpret the collected data, we focus not only on the linguistic features of cancer patients’ accounts but also pay attention to the relevant social or contextual background the discourse is taken from (i.e. KDD cancer board) and also how the linguistic features correlate to such background information and discourse participants.
There are many approaches to discourse analysis and Hodges et al. (2008) simplified them into three types: formal linguistic discourse analysis, empirical discourse analysis and critical discourse analysis. What is employed in the present study is closer to empirical discourse analysis. To seek functions of language use, empirical discourse analysis puts more emphasis on sociological uses of language and its aim is to interpret how the meaning of the language is conveyed by the language users (Hodges et al. 2008). Hodges
et al. (2008) further stated that discourse analysis is an effective method for research related to health care and the health professions. Thus, we employ this approach in order to figure out the psychosocial characteristics of cancer patients that are reflected by the language they use.
To sum up, discourse analysis is conducted to figure out the mode of discourse (how it is said) by analyzing the text of an interaction (what is said) and to further understand the function interaction participants would like to convey or cultural and psychosocial characteristics reflected in the interaction of interaction participants.
We use Examples 3.1 and 3.2 presented below to briefly exemplify how we code the collected data. Sentence segmentation of the postings is based on the patient members’
original segmentation. These two patient members’ disclosed their age-related information through Line 18 in Example 3.1 and Line 2 in Example 3.2, respectively. Thus, these two lines were coded as instances of age-disclosure. The patient member in Example 3.1 mentioned her wonderful life prior to the cancer diagnosis in Lines 2 to 5 and thus these lines were coded as instances of description of the sense of satisfaction with life prior to the cancer diagnosis. Moreover, through Line 1, this patient member indicated that the membership in KDD cancer board was unexpected to her and thus it was coded as an instance of a description of the counter-expectation of getting cancer diagnosis. Besides, this patient member contained the phrase ‘加油/go for it’ in the last line, Line 41, as an encouragement and thus it was coded as an instance of words for encouragement.
Example 3.1
Self-introduction posting by one of the patient members in KDD cancer board.
標題 [自介] 焉知非福?!
Title [self-introduction] A blessing in disguise?!
1 好吧！我得承認，其實自己從來沒想過得要來這個版做自介:(
‘Well! I have to confess that in fact I have never even thought that I would have to come to this board to do self-introduction :(’
2 在一個月前，老娘我還是個天之嬌女。
‘A month ago, I was still in very good condition, just like the dearest daughter of God.’
3 剛在國外念完我的第二個碩士，在倫敦知名的時尚產業找到工
作，
‘Just got my second master’s degree abroad, found a job in famous fashion industry in London.’
4 每天在設計師與精品中打轉，唯一需要想的是下個 party 要穿什
麼，
‘Everyday stayed with designers and fashion goods, the only thing I needed to think was what I should wear to the next party’
5 開開心心地請假回台灣過農曆年...
‘Joyfully asked for a leave for coming back to Taiwan during Chinese New Year …’
6 我想，其實上帝很眷顧我。
‘I think in fact God has mercy on me.’
7 我沒有摸到腫瘤，也沒有任何的不舒服，
‘I did not touch any tumor, neither have any discomfort.’
8 但我做了個夢，夢到自己得了乳癌，夢境實在太真實，醒來我在
和夢裡同個地方，
‘But, I made a dream. I dreamed that I got breast cancer. The dream was too real that after I woke up in the same place as in the dream’
9 我摸到了。
‘I feel it.’
10 一開始去義清觸診，心裡還老大不願意，畢竟網路上都說有 80%
都是良性的，
‘In the first place I went to Yi Qing1 for palpation but I was in fact unwilling to go because on the Internet it is said that 80% is benign.’
11 人都是這樣，總是會想，我沒那麼倒楣吧？！
‘Human beings is always like this, always think that I am not so unfortunate, right?!’
12 但真的是因為我的夢，我還是硬著頭皮去了...
‘But it was really because of my dream; I still forced myself to go to the hospital.’
13 過程很快，乳房超音波看得很清楚，細針穿刺後也證實是惡性腫
瘤。
‘The process went through quickly, it was very clear through ultrasonic mammography; after fine-needle aspiration it was also verified to be a malignant tumor.’
14 過程可以用幾句話帶過，但心情可不是這樣！
‘The process can be explained in a few sentences but my mood is not!’
15 從小我就愛面子，在醫生面前我沒有哭，很堅強的問了所有我知
道的問題：
‘I am so sensitive about my reputation from my childhood that I did
1 pseudonym for a hospital in northern Taiwan
not cry in front of the doctor but hardily asked every question I know:’
16 手術什麼時候做？腫瘤有多大？以後治療的方式有哪些？
‘When should I undergo operation? What is the size of the tumor?
What are the treatments afterwards?’
17 回家後抱著媽媽，不知道哭了幾天，不斷地問著媽媽...
‘After I returned home, I hugged my mom and did not know for how many days I cried and kept asking my mom…’
18 為甚麼會是我？我才 27 歲！！家裡沒有遺傳，我也不符合高危
險群，為甚麼會是我？！
‘Why me? I am only 27!! It is not hereditary in my family and I am not from high-risk populations. Why me?!’
19 媽媽說，其實你很幸運，如果繼續待在國外，以妳的個性一定懶
得去看醫生，
‘My mom said that in fact you are very lucky, if you kept staying abroad, according to your personality, you must be too lazy to go to see a doctor.’
20 拖到後來都不知道會有多嚴重了，要換個方向想！碰到了就只能
去面對它！
‘You will not know how serious it might be if you kept putting it off.
You have to think it in another way! Once you ran into it, you have to face with it!’
21 爸爸也說，錢不是問題，就算是賣房子，爸爸也一定會給你最
好的！
‘My dad also said that money is not a problem, even if I have to sell
house, daddy will definitely provide you with the best!’
22 有家人的支持，心裡真的會放心很多，謝謝爹地媽咪:)
‘With family’s support, I can really set my mind at ease. Thanks daddy and mommy:)’
23 在義清要切片時，當我躺在手術台上醫生竟然說，腫瘤還很小，
我看乾脆直接拿掉吧！
‘When I was doing biopsy at Yi Qing and lying on the operating table, the doctor, to my surprise, said that the tumor is still very small. Let me just take it away!’
24 結果，造成之後改去漲生做前哨淋巴切除手術時，還被醫生再切
了一次怕之前沒切乾淨
‘As a result, after I transferred to Zhang Sheng2 and underwent sentinel lymph node dissection, the doctor there being afraid that there were still something remained did biopsy again.’
25 昨天手術後複診順便看報告，
‘Yesterday I had a subsequent visit after the operation and also read the report.’
26 期數是 t1c (c 又是代表什麼呢？),前哨淋巴拿了兩顆都沒有感
染:)
‘Stage is t1c (What does c mean?) and the two sentinel lymph node taken out were not infected:)’
27 tumor size 1.6*1.4*1.2cm
‘tumor size 1.6*1.4*1.2cm’
28 tumor grade: score:6 nbr grade: 2 （這個是什麼意思呢）
2 pseudonym for a hospital in northern Taiwan
‘tumor grade: score:6 nbr grade: 2 (What does this means)’
29 ER(3+, 90%), PR(-,<2%), HER-2-NEU(3+)
‘ER(3+, 90%), PR(-,<2%), HER-2-NEU(3+)’
30 但由於腫瘤再義清時已被拿光，漲生的腫瘤醫生又不信任義清的
切片結果，
‘Because the tumor was clearly taken out in Yi Qing and the doctor in Zhang Sheng did not trust the result of biopsy from Yi Qing,’
31 所以還得等到最後 FISH 出來後才能決定最後的治療方法:(
‘I have to wait for the result of FISH in order to decide what eventually will be the treatment:(’
32 但稍微有和醫生討論一下，如果真的是 her2 neu3＋的話，
‘But I have slightly discussed with the doctor, if it is true that it is her2 neu3＋,’
33 就是四次小紅莓+四次紫杉醇+五個禮拜的電療和一年的賀癌平
‘the treatment will be Doxorubicin for four times + Taxol for four times + electrotherapy for five weeks and Herceptin for a year.’
34 這些全部都得自費！
‘I have to pay for all of these at my own expense!’
35 我的疑問是...如果真的只是第一期，有必要做到八次的化療嗎？
‘My question is … if it is really just in stage 1, do I need to undergo chemotherapy for eight times?’
36 這 樣 的 治 療 方 式 那 和 已 經 擴 散 出 去 的 應 該 沒 有 什 麼 差 別 了 吧？！
‘This kind of treatment is nothing different from the treatment for the cases of metastasis, right?!’
37 另外，我知道標把健保沒有給付，但連小紅莓和紫杉醇也沒有 嗎？
‘Besides, I know that NHI does not pay for targeted drug but is it true that they also do not pay for Doxorubicin and Taxol?’
38 我不是個很樂觀的孩子，但總希望可以和媽咪說得一樣，塞翁
失馬焉知非福，
‘I am not an optimistic child but I hope it will be just like what mommy said a setback may turn out to be a blessing in disguise.’
39 希望這次生病，能夠改變我的生活作息和飲食習慣，也是一件好
事:)
‘I hope the experience of falling ill can change my lifestyle and dietary habit and that will be a good thing:)’
40 現在每天都乖乖地三餐正常和運動！希望接下來面對化療可以
也一切順利！
‘Now I obediently have normal meals and exercise everyday! Hope the following chemotherapy will go smoothly as well!’
41 大家一起加油吧！！！
‘We can do this!!!’
Example 3.2
Self-introduction posting by the patient member who took the lead in writing in listing format.
標題 [自介] 病友一號小金剛報到
Title [self-introduction] fellow patient no. 1 Little King Kong check in 1 ID︰C (女)
‘ID: C (female)’
2 年齡︰22
‘Age: 22’
3 所在地︰新竹
‘Location: Hsinchu’
4 病名︰鼻咽癌併發骨轉移(第 IV-c 期)
‘Name of disease: Nasopharyngeal carcinoma with bone metastasis (in the stage of IV-c)’
5 治療方式︰四年前放療 41 次+化療 3 次、一年前轉移至大腿骨化
療半年無效，
‘Way of treatment: four years ago, I underwent radiation therapy for 41 times + chemotherapy for 3 times and a year ago, it had metastasized to thighbone and so I underwent chemotherapy for half a year but in vain.’
6 局部放射 1X 次、然後在今年五月發現再度轉移至脊椎附近，
‘Partial radiation therapy for 1X times and then this May it was found to metastasize again to nearby spine.’
7 三個化療療程無效，改用局部放射 11 次，現在休息等待下次化 療。
‘Three courses of chemotherapy were in vain so it is changed to partial radiation therapy for 11 times, now I am taking a rest to wait for next chemotherapy.’
8 就醫所在地︰漲生腫瘤科 放射腫瘤科
‘Place for taking medical treatment: Division of Oncology and Division of Radiation Oncology in Zhang Sheng’
9 目前狀態︰閒閒沒事在家發發燒修養中。
‘Present condition: fooling around and staying at home, having fever and taking a rest’
10 目標︰再活個幾十年，環遊世界當浪人。
‘Goal: to be alive for ten more years and traveling around the world to be a vagrant’
11 註備︰目前我只想得到這些，大致上這樣應該就好了吧？有想到
再補上來，
‘Remarks: at present I can only think of these, it is enough in substance, right? I will add more information if I think of any other’
12 還有人有什麼建議的話，盡量表示喔！
‘If anyone has any suggestion, please bring it up as much as possible!’
13 家屬的話，請不只介紹你的家人，也多介紹自己本人喔。
‘If you are family members of cancer patients, please not only introduce your family members but also introduce more about yourselves.’
14 還有我也是第一次當版主，很多不懂，也請多多指教。
‘And, it is also my first time to be the host of a board, there are many things I do not understand and please kindly give me your advice.’
15 小的心路歷程請洽︰(the link to C’s personal weblog is taken off here)
My experiences please refer to: (the link to C’s personal weblog is taken off here)
In order to strengthen our arguments and make them more valid, we make some comparison and provide some other related information. They will be mentioned later in the sections they correlate to. Besides, we have to declare that because interaction on the Internet is not face-to-face and identities of Internet users do not necessarily reflect those in real life, we can never be sure regarding the real social characteristics of the members in BBS (Riva 2002), such as, gender, age, level of education and so on. Therefore, our analysis of social characteristics of members in KDD cancer board is simply based on the information presented or constructed in the members’ self-introduction postings.
CHAPTER FOUR
FINDINGS
In this chapter, we present our three major findings: (1) age-disclosure (2) normal and wonderful life prior to cancer diagnosis (3) words for encouragement.
4.1 Age-Disclosure
After reading through the self-introduction postings from patient members, we found that 49 out of the 58 patient members (84%) spontaneously mentioned their own age or the year they were born. The age they mentioned was either age at the time of posting (‘age at posting’ hereafter) or age at the time of their cancer diagnosis (‘age at cancer diagnosis’
hereafter). There were also cases where both of them were mentioned.
We found that the linguistic pattern for age-disclosure can be divided into six types.
Table 4.1 shows the number of times, percentage and examples of each type from our collected data. Most of these 49 patient members mentioned their age-related information only once within their posting content. However, three of them mentioned twice and thus
Table 4.1 shows the number of times, percentage and examples of each type from our collected data. Most of these 49 patient members mentioned their age-related information only once within their posting content. However, three of them mentioned twice and thus