Insights Into Dialysis Initiation: A Foucauldian Discourse Analysis of the r/dialysis Reddit Forum.

Résumé

Patients on dialysis develop unique relationships with their providers, fellow patients, and the broader healthcare system. This network of relationships is a well-established key factor influencing both their healthcare experience and mortality rates. Yet, despite ongoing efforts to improve these networks of relationships, health outcomes remain unfavorable for dialysis patients. Investigating the formation of these relationships through a social media platform provides valuable insight into patients lived experiences, shedding light on pervasive power dynamics as seen from the patient perspective while addressing methodological gaps present in the literature. Analyzing social media platforms helps identify critical areas for improvement that may have been overlooked to enhance the experience and outcomes of patients on dialysis. In this paper, we use Foucauldian discourse analysis to examine 41 posts and their associated comments from the r/dialysis forum on Reddit, focusing on the first year of dialysis initiation and exploring how societal discourse shapes and is shaped by peer-to-peer interactions, impressions, communities, and frameworks. In this study, we highlight how power and resistance are reflected in the discursive choices made by patients, as well as its influence on their conceptualizations of the patient-provider relationship as they begin their dialysis journey. These insights add to the dearth of current literature that use social media platforms and discourse analysis in investigating healthcare experiences. They lay the groundwork for better supporting a vulnerable clinical population and provide a foundation for future academic research using this methodology.