Patient conceptualizations of the patient-provider relationship: A discourse analysis of the r/dialysis subreddit
Date
2025
Authors
Ong, Su Han
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Abstract
Patients on dialysis develop unique relationships with their providers, fellow patients, and the broader healthcare system. These connections are well established as key factors influencing both their healthcare experience and mortality rates. Yet, despite ongoing efforts to improve these relationships, health outcomes remain unfavorable for dialysis patients. Exploring these relationships through a social media platform provides valuable insight into patient lived experiences, shedding light on pervasive power dynamics as seen from the patient perspective. This unique approach helps identify critical areas for improvement to enhance the experience and health outcomes of patients on dialysis. In this paper I use Foucauldian discourse analysis to examine posts and comments from the r/dialysis forum on Reddit submitted between 2012 and 2023, focusing specifically on dialysis initiation. It explores how societal discourse shapes patients’ impressions, communities, and frameworks as it both forms and is formed by peer-to-peer interaction. The study highlights how power and resistance are reflected in the linguistic choices made by patients, as well as their evolving 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 the healthcare experience. They lay the groundwork for better supporting a vulnerable clinical population and provide a foundation for future academic research using this methodology.
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Keywords
Dialysis, Patient, Provider, Relationship, Discourse analysis, Foucault