Supportive Care in Cancer

, Volume 18, Issue 5, pp 553–560 | Cite as

Social and psychological determinants of participation in internet-based cancer support groups

  • Mette Terp Høybye
  • Susanne Oksbjerg Dalton
  • Jane Christensen
  • Lone Ross
  • Katrin Gaardbo Kuhn
  • Christoffer Johansen
Original Article



In this study, we identified the social and psychological characteristics of Danish cancer patients that determine use of the internet for support.

Materials and methods

We invited 230 cancer patients taking part in a public rehabilitation program to participate in an internet module comprising training in the retrieval of cancer-related information from the internet and self-support groups. Persons who were motivated to join the internet groups (N = 100; 47%) were compared with persons who chose not to participate (N = 111) on the basis of self-reported baseline questionnaire data. Nineteen persons either did not return the questionnaire or had missing values in confounding variables.


Cancer patients who were motivated to participate in internet support groups belong to higher socioeconomic groups (based on household income and employment) compared to non-participants. We observed no difference between the two groups in quality of life or psychological well-being, while coping to some extent seemed related to participation in internet support groups.


This study adds to the discussion on social inequality in internet use by cancer patients, showing that patients who are not inclined to use internet-based interventions are characterized by social position and employ more passive coping strategies.


Cancer Internet Support groups Rehabilitation Socioeconomic position Psychological measures 



The study was funded by the IMK Foundation, the Tryg Foundation, and the Danish Cancer Society. The authors wish to acknowledge the important collaboration of the staff at Rehabilitation Center Dallund, Denmark, in providing time in the rehabilitation schedule at the center for the internet teaching lectures.




  1. 1.
    Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB (2003) Evaluation of an internet support group for women with primary breast cancer. Cancer 97:1164–1173CrossRefPubMedGoogle Scholar
  2. 2.
    Gustafson DH, Hawkins R, Pingree S, McTavish F, Arora NK, Mendenhall J, Cella DF, Serlin RC, Apantaku FM, Stewart J, Salner A (2001) Effect of computer support on younger women with breast cancer. J Gen Intern Med 16:435–445CrossRefPubMedGoogle Scholar
  3. 3.
    Owen JE, Klapow JC, Roth DL, Shuster JL Jr, Bellis J, Meredith R, Tucker DC (2005) Randomized pilot of a self-guided internet coping group for women with early-stage breast cancer. Ann Behav Med 30:54–64CrossRefPubMedGoogle Scholar
  4. 4.
    Wangberg SC, Andreassen HK, Prokosch HU, Santana SM, Sorensen T, Chronaki CE (2008) Relations between internet use, socio-economic status (SES), social support and subjective health. Health Promot Int 23:70–77CrossRefPubMedGoogle Scholar
  5. 5.
    Andreassen HK, Bujnowska-Fedak MM, Chronaki CE, Dumitru RC, Pudule I, Santana S, Voss H, Wynn R (2007) European citizens’ use of E-health services: a study of seven countries. BMC Public Health 7:53CrossRefPubMedGoogle Scholar
  6. 6.
    Helft PR, Eckles RE, Johnson-Calley CS, Daugherty CK (2005) Use of the internet to obtain cancer information among cancer patients at an urban county hospital. J Clin Oncol 23:4954–4962CrossRefPubMedGoogle Scholar
  7. 7.
    Buntrock S, Hopfgarten T, Adolfsson J, Onelov E, Steineck G (2007) The internet and prostate cancer patients: searching for and finding information. Scand J Urol Nephrol 41:367–374CrossRefPubMedGoogle Scholar
  8. 8.
    Dalton SO, During M, Ross L, Carlsen K, Mortensen PB, Lynch J, Johansen C (2006) The relation between socioeconomic and demographic factors and tumour stage in women diagnosed with breast cancer in Denmark, 1983–1999. Br J Cancer 95:653–659CrossRefPubMedGoogle Scholar
  9. 9.
    Dalton SO, Ross L, During M, Carlsen K, Mortensen PB, Lynch J, Johansen C (2007) Influence of socioeconomic factors on survival after breast cancer—a nationwide cohort study of women diagnosed with breast cancer in Denmark 1983–1999. Int J Cancer 121:2524–2531CrossRefPubMedGoogle Scholar
  10. 10.
    Dalton SO, Schuz J, Engholm G, Johansen C, Kjaer SK, Steding-Jessen M, Storm HH, Olsen JH (2008) Social inequality in incidence of and survival from cancer in a population-based study in Denmark, 1994–2003: summary of findings. Eur J Cancer 44:2074–2085CrossRefPubMedGoogle Scholar
  11. 11.
    Høybye MT, Dalton SO, Christensen J, Larsen LR, Kuhn KG, Jensen JN, Carlsen K, Johansen C (2007) Research in Danish cancer rehabilitation: social characteristics and late effects of cancer among participants in the FOCARE research project. Acta Oncol 10:1–9Google Scholar
  12. 12.
    UNESCO (1997) International Standard Classification of Education (ISCED) 1997.Available from: Accessed 25 November 2005
  13. 13.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376CrossRefPubMedGoogle Scholar
  14. 14.
    McNair DM, Lorr M, Droppleman LF (1971) Profile of mood states. Educational and Industrial Testing Service, San Diego, CAGoogle Scholar
  15. 15.
    McNair DM, Lorr M, Droppleman LF (1992) EdiTS manual for the profile of mood states. Manual for the profile of mood states. Educational and Industrial Testing Service, San Diego, CAGoogle Scholar
  16. 16.
    Watson M, Law M, dos Santos M, Greer S, Baruch J, Bliss J (1994) The Mini-MAC: further development of the mental adjustment to cancer scale. J Psychosoc Oncol 12:33–46CrossRefGoogle Scholar
  17. 17.
    Watson M, Haviland JS, Greer S, Davidson J, Bliss JM (1999) Influence of psychological response on survival in breast cancer: a population-based cohort study. Lancet 354:1331–1336CrossRefPubMedGoogle Scholar
  18. 18.
    SAS Institute Inc. (2005) SAS OnlineDoc® 9.1. SAS Institute Inc., Cary, NCGoogle Scholar
  19. 19.
    Cameron LD, Booth RJ, Schlatter M, Ziginskas D, Harman JE, Benson SR (2005) Cognitive and affective determinants of decisions to attend a group psychosocial support program for women with breast cancer. Psychosom Med 67:584–589CrossRefPubMedGoogle Scholar
  20. 20.
    Boesen E, Boesen S, Christensen S, Johansen C (2007) Comparison of participants and non-participants in a randomized psychosocial intervention study among patients with malignant melanoma. Psychosomatics 48:510–516CrossRefPubMedGoogle Scholar
  21. 21.
    Høybye MT, Johansen C, Tjørnhøj-Thomsen T (2005) Online interaction. Effects of storytelling in an internet breast cancer support group. Psychooncology 14:211–220CrossRefPubMedGoogle Scholar
  22. 22.
    Shaw BR, Hawkins R, Arora N, McTavish F, Pingree S, Gustafson DH (2006) An exploratory study of predictors of participation in a computer support group for women with breast cancer. Comput Inform Nurs 24:18–27CrossRefPubMedGoogle Scholar
  23. 23.
    Klemm P, Hurst M, Dearholt SL, Trone SR (1999) Gender differences on internet cancer support groups. Comput Nurs 17:65–72PubMedGoogle Scholar
  24. 24.
    Owen JE, Klapow JC, Roth DL, Tucker DC (2004) Use of the internet for information and support: disclosure among persons with breast and prostate cancer. J Behav Med 27:491–505CrossRefPubMedGoogle Scholar
  25. 25.
    Statistics Denmark (2003) Available from: Accessed 1 April 2008
  26. 26.
    Ottens M, European Commission, Eurostat (2006) Use of the internet among individuals and enterprises. Statistics in focus 12. Available from: Accessed 15 April 2008
  27. 27.
    European Opinion Research Group (EORG), Spadaro R (2003) Eurobarometer 58.0: European Union citizens and sources of information about healthGoogle Scholar
  28. 28.
    Talosig-Garcia M, Davis SW (2005) Information-seeking behavior of minority breast cancer patients: an exploratory study. J Health Commun 10(Suppl 1):53–64CrossRefPubMedGoogle Scholar
  29. 29.
    Demunter C, European Commission, Eurostat (2006) How skilled are Europeans in using computers and the internet? Statistics in focus 17. Available from: Accessed 15 April 2008
  30. 30.
    Helgeson VS, Cohen S, Schulz R, Yasko J (2000) Group support interventions for women with breast cancer: who benefits from what? Health Psychol 19:107–114CrossRefPubMedGoogle Scholar
  31. 31.
    Friedman DB, Hoffman-Goetz L, Arocha JF (2006) Health literacy and the World Wide Web: comparing the readability of leading incident cancers on the internet. Med Inform Internet Med 31:67–87CrossRefPubMedGoogle Scholar
  32. 32.
    Lieberman MA, Golant M, Giese-Davis J, Winzlenberg A, Benjamin H, Humphreys K, Kronenwetter C, Russo S, Spiegel D (2003) Electronic support groups for breast carcinoma: a clinical trial of effectiveness. Cancer 97:920–925CrossRefPubMedGoogle Scholar
  33. 33.
    Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT (2007) Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat 105(2):209–219CrossRefPubMedGoogle Scholar
  34. 34.
    Klee M, Groenvold M, Machin D (1997) Quality of life of Danish women: population-based norms of the EORTC QLQ-C30. Qual Life Res 6(1):27–34CrossRefPubMedGoogle Scholar
  35. 35.
    Debess J, Riis JO, Pedersen L, Ewertz M (2009) Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark. Acta Oncol 4:532–540CrossRefGoogle Scholar
  36. 36.
    Boesen EH, Ross L, Frederiksen K, Thomsen BL, Dahlstrom K, Schmidt G, Naested J, Krag C, Johansen C (2005) Psychoeducational intervention for patients with cutaneous malignant melanoma: a replication study. J Clin Oncol 23(6):1270–1277CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Mette Terp Høybye
    • 1
  • Susanne Oksbjerg Dalton
    • 1
  • Jane Christensen
    • 2
  • Lone Ross
    • 3
  • Katrin Gaardbo Kuhn
    • 1
  • Christoffer Johansen
    • 1
  1. 1.Department of Psychosocial Cancer Research, Institute of Cancer EpidemiologyDanish Cancer SocietyCopenhagenDenmark
  2. 2.Department of Statistics and Epidemiology, Institute of Cancer EpidemiologyDanish Cancer SocietyCopenhagenDenmark
  3. 3.Research Unit, Department of Palliative MedicineBispebjerg HospitalCopenhagenDenmark

Personalised recommendations