Sense making in complex health situations. Virtual health communities as sources of information and emotional support
| Date | 18 November 2019 |
| Published date | 18 November 2019 |
| DOI | https://doi.org/10.1108/AJIM-02-2019-0049 |
| Pages | 789-805 |
| Author | Sharon Naveh,Jenny Bronstein |
| Subject Matter | Library & information science |
Sense making in complex
health situations
Virtual health communities as sources of
information and emotional support
Sharon Naveh and Jenny Bronstein
Department of Information Science, Faculty of Humanities,
Bar Ilan University, Ramat-Gan, Israel
Abstract
Purpose –Using a sense making approach, the purpose of this paper is to examine the role that virtual
health communities play as a source of informational and social support for pregnant diabetic women.
The paper helps to understand how women suffering from a critical medical condition (i.e. diabetes during
pregnancy and birth) manage a complex health situation.
Design/methodology/approach –The data sample consisted of 507 posts collected from a virtual health
community for diabetic pregnant women. Data were analysed deductively looking for different expressions of
normality and different types of health information about diabetes.
Findings –Content analysis revealed four themes that reflect the process that diabetic women go through
from their attempts to conceive through pregnancy and birth. The findings show that for women dealing with
a chronic illness such as diabetes, the breakdown of normal was the beginning of the pregnancy that
prompted a new range of informational and emotional needs. The members of the community negotiated a
socially constructed sense of normality and tried to empower other members with a new sense of normal by
sharing information about their births. The findings also showed that members of the community disclosed
personal health information to elicit medical information, advice and social support from other members.
Originality/value –The study highlighted the significance of sense-making processes in managing
complex health situations and the value of virtual communities as sources of information and social support
as to resolve discontinuities in the management of their illnesses.
Keywords Social media, Information seeking, Sense making, Diabetes, Illness management,
Virtual health communities
Paper type Research paper
Introduction
The sense-making framework is a meta-theoretical set of assumptions that describes an
iterative process by which people construct meaning from experience (Dervin, 1999); it has
been described as a “behaviour, both internal (i.e. cognitive) and external (i.e. procedural),
which allows the individual to construct and design his/her movement through time–space”
(Dervin, 1983, p. 3). Sense making rests on the discontinuity premise (Dervin, 2003) as a
fundamental aspect of reality (Savolainen, 1993) that mandates humans to “take steps to
construct sense in constantly changing life situations”. Humans face discontinuities or gaps
in all aspects of their lives, and these gaps can be cognitive or physical such as illnesses.
This concept of a “gappy”reality (Dervin, 1999, p. 370) has been applied in past studies
dealing with health information (Genuis and Bronstein, 2017; Pakenham, 2008) to reach an
understanding of the ways by which people facing health disruptions try to reconstruct a
sense of identity and purpose within their lives (Ruthven, 2019).
Sense makingis both a personal and a social process.On a personal level, sense makingis a
process of identity construction undertaken by an individual who is “viewed as a theorist,
constructing theories about discontinuous reality and able to describe that make sense”
(Godbold, 2010, pp. 2-3). As Weick (1995) asserted, “depending on who I am, my definition of
what is ‘out there’will also change”(p. 20). Sense making is also a social process, a shared
co-construction of meaning between people and within communities (Weick, 1995). Th is social
Aslib Journal of Information
Management
Vol. 71 No. 6, 2019
pp. 789-805
© Emerald PublishingLimited
2050-3806
DOI 10.1108/AJIM-02-2019-0049
Received 28 February 2019
Revised 28 April 2019
7 June 2019
1 July 2019
7 July 2019
13 July 2019
22 July 2019
Accepted 24 July 2019
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/2050-3806.htm
789
Sense making
in complex
health
situations
construction of meaning has been studied in the past to understand how members of virtual
health communities seek, use and share information and social support to socially construct
meaning (Andsager and Powers, 2001; Bronstein, 2014; Schaefer and Dervin, 2011).
Virtual communities have become a “modern-day village square”(Walther and Boyd,
2002a, b) in which users can express their opinions, share experiences, ask for advice and
react to other people’s posts, co-constructing a common reality that helps them make sense
of the common challenges they face (Bronstein, 2017; Chen, 2014; Kim et al., 2012; Yoo et al.,
2014). The common reality constructed by the members of these virtual communities with
their unique forms of information exchange has become an important source for providing
personal assistance for a variety of issues, especially health-related matters (Bers et al., 2003;
Bronstein, 2014; Brady et al., 2017; Chorbev et al., 2011; Schaefer and Dervin, 2011; Vayreda
and Antaki, 2009; Wang et al., 2017; Wright, 2016; Zhang et al., 2017). Fox (2014) asserted
that members of online social platforms have “critical health information –about
themselves, about each other, about treatments –and they want to share what they know to
help other people. Technology helps to surface and organize that knowledge to make it
useful for as many people as possible”. Hence, interactions between members of a virtual
health community represent “reality-constructing, meaning making occasions”(Holstein
and Gubrium, 1995, p. 4).The need to make sense arises when the continuity of life is
disrupted by the appearance of a problem and this discontinuity or gap “does not permit the
individual to move forward without constructing a new changed sense”(Dervin, 1989).Thus,
by seeking information, people facing health challenges or disruptions strive to achieve a
sense of normality that enables them to bridge the gaps in their newly formed reality and to
make decisions for themselves (Godbold, 2010).
Following Genuis and Bronstein’s (2017) line of thought, this study “operationalizes
normality as an element of sense-making that can move individuals forward in the iterative
process of gap-bridging and sense making”(p. 8). That is, people suffering from chronic
illnesses will seek information to better understand what “normal”is within the reality of
their disease, validating their own unique health experience with the experience of others
facing the same health challenge. As described by Penrod et al. (2012, p. 181), “‘Seeking
normal’refers to processing of available information that aims to recreate a sense of pattern
in the midst of chaos”. We would argue that sense making is particularly suited for
understanding complex health situations since sense making is “an ongoing process of
improvisation, of making do to make what sense one can, a constantly changing sense in a
reality which is also constantly changing and only partially understood”(Godbold, 2010,
p. 3). As is the case for diabetic pregnant women who, all throughout their pregnancies, have
to confront and manage serious and often life-threatening maternal health issues such as
preeclampsia, Caesarean section, cardiovascular complications and foetal outcomes,
including congenital anomalies, stillbirth, macrosomia, birth trauma, hypoglycaemia and
long-term effects on the unborn child (Berger et al., 2016).
Prior research has shown that women facing a problematic pregnancy rely on personal
stories of pregnancy and birth that “provided ‘real’experienceand were particularlyvalued for
their emotional understanding”(Lowe et al., 2009, p. 1483). The community of diabetic
pregnant women was chosen for the study because it allowed the examination of the
sense-makingprocess of a group of individuals: having to managea complex health situation
such as pregnancyin conjunction with a chronic and life-threateningdisease such as diabetes,
a complicatedhealth reality in which thetwo medical conditions areinterconnected; having to
manage both theirhealth and well-being and thatof their unborn babies. Hence, byobtaining
this information from other women and by interacting with them, members of the virtual
health community strive to bridge the gaps they encounter during their pregnancy and
construct a new and shared sense of normality in their situation, within the context of the
process they are experiencing. Past studies that have examined different health information
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