Abstract
Web-based health research is a relatively new phenomenon. Its definition and conceptualization differs markedly as it is deployed within and across a complex array of discourses, with serious implications for nursing research and knowledge development. Web-based health research offers nurse researchers unique and abundant opportunities to provide leadership in the development and conduct of diverse modes of online health research. To appropriately avail themselves of such opportunities, however, nurse researchers must first address the significant ontological, epistemological, methodological, ethical, legal, and professional issues and concerns that nursing research in cyberspace raises.
FOLLOWING the Internet's open accessibility to the public in 1990, its phenomenal growth, speed, dynamism, and seemingly unlimited potential for reaching large and manifold sections of the global population have resulted in the increasing popularity of cyber research in general and cyber health research in particular. Indeed, "knowledge has never been as important-and as accessible-as it is today." 1(p150)
The Internet is the world's largest computer network, linking millions of people and organizations. The World Wide Web (Web), an application of the Internet, allows seemingly endless pieces of information to be densely interlinked and instantly transported across computers and networks across the globe. In 2000 there were more than 100,000 health-related Web sites, with 43% of the estimated 70 million US Internet users utilizing the Internet to access health and medical information. 1 On a daily basis, hundreds of Web sites invite visitors to participate in scientific or pseudoscientific research. Many of these health-related Web sites emanate from commercial sources, which may seriously impact on the constructions of cyber research as well as participant and researcher identities and relationships. Given the proliferation of health-related Web sites, such as consumer health information sites, online health directories, sites targeting specific audiences for specific conditions, and sites dealing with clinical trials and medical research, "patients who surf the Internet are drowning." 2(p69)
To date, research on the Web has been predominately quantitative in nature, but there is increasing interest in the use of the Web for qualitative research, particularly in dealing with sensitive, hidden topics and vulnerable groups.3,4 Despite enthusiastic claims that Web-based research is an "innovative data collection method in nursing research,"5(p68) offering "unparalled opportunities for nurse scientists to harness the power of the Internet to collect data from populations of interest economically and efficiently," 6(p87) very few nurse researchers have undertaken such research. Web-based research, however, is a relatively new phenomenon, with the current literature indicating that there are grave perils as well as abundant opportunities for researchers and participants. 2-6
As cyber research and Web-based health research are written and talked about by various social institutions and groupings in systematically organized ways, they may be viewed to be discourses. According to Foucault, discourses are historically contingent, institutionally supported "practices that systematically form the objects of which they speak," 7(p49) constituting knowledge, forms of subjectivity, and power relations. The discourses of cyber research have constituted knowledge objects such as cyberspace, electronic research, and electronic health, and constructed and positioned subjectivities such as virtual researchers and virtual participants. Discourses are governed by systematic rules, which are subject to contextual influences and social interests. 7 Such rules determine what may be possibly said and thought about Web-based health research, including what types of cyber health research will be sanctioned and which voices will be privileged or subjugated and excluded. Discourses are located in time and space. At this point of time, the hegemonic discourses of cyber health research include those of science and technology. Indeed, Foucault claims, "In societies like ours [horizontal ellipsis] 'Truth' is centred on the form of scientific discourse and the institutions which produce it." 8(p131)
The conceptualization of Web-based health research varies markedly as it is deployed across discourses, with different and competing discourses serving as useful resources for interrogating dominant accounts of cyber health research. The discourse exists within and is informed by a larger discursive field containing a complex array of historically specific complementary and competing discourses that constantly struggle to imperialistically colonize the area of health research on the Web with their own particular institutionally sanctioned constructions of health, research, researcher, participants, and the like, with serious implications for nursing research and knowledge development. A critical examination of such constructions and contestations requires systematizing these different ways of talking and thinking about Web-based heath research. Hence, this article, utilizing a Foucauldian approach to discourse, knowledge, and power, seeks to examine the literature related to Web-based health research, explore its discursive constructions and relationships, and draw out implications for nursing research in cyberspace.