Among its amazing transformations of daily life, the Internet is responsible for a monumental transfer of power from the hands of physicians to the hands of patients. Medical information is one of the most commonly sought commodities by internet users. A growing number of websites are emerging in answer to the needs of cancer patients. This study examines CHESS (Comprehensive Health Enhancement Support System), an eHealth information and support system, in the context of women with breast cancer. User data documents strong usage patterns that may, however, lead to premature behavioral explanations. Individual differences literature suggests that such documented usage patterns may provide a selective view of the full user experience. To do justice to eHealth's goal of improving patient quality of life, researchers must better understand how cancer patients are using eHealth services, why they are using them, and patient impressions of the experience. The qualitative perspective respectfully demands that that the researcher crawl into the individual patient's experience in search of eHealth's potential as well as serve the critically ill in more powerful and meaningful ways.

This qualitative study looks at the individual experiences of 18 breast cancer patients in the context of CHESS. Participants were interviewed for rich descriptions of their CHESS experiences, including what they found most valuable, when they used the site, and how their situations changed over six months. They responded to survey questions related to individual differences in cognitive preferences and completed the Herrmann Brain Dominance Instrument. Grounded theory and narrative analyses of the data reveals the following themes: a time-ordered pattern of usage; typology of seeking motivations; complex usage relationships between women and online discussion; and the influence of women's learning characteristics as reflected by the narrative, choice of services, gaps in service, and reasons for usage. Analysis also suggests the presence of a "survivor-based thinking" style that transforms natural thinking patterns in unusual ways. Finally, study conclusions are discussed along with their implications for application and further research.