Munchausen By Internet: A Netnographical Case Study

Friday, 25 July 2014: 1:50 PM

Cynthia A. Witney, RN, MHA, DipTch (Nsg) GradDipAdmin (Hlth)
Joyce Hendricks, PhD, RN, RM
Vicki Cope, PhD, RN, RM, MHS
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia


Title        Munchausen by Internet: A netnographical case study

The Internet is a global phenomenon that provides a conduit for people to meet and collaborate without ever meeting face to face. As such, issues of truthfulness and trust are ongoing for all those who choose to click the mouse and enter cyberspace. This paper presents a case study drawn from a wider research project using netnography (Kozinets, 2010) where a purpose built www site called ‘the Click’ was developed and managed.  

Netnography has been used for more than a decade by researchers in the consumer and marketing field, thus is not now a new term and is widely accepted by these researchers as the preferred term to describe ethnographic research applied to the study of online communities and cultures  (Kozinets, 2010).    When Crotty’s scaffolding for research is applied to netnography, a relatively new research methodology, it appears that it can be positioned in one of two ways, either under the category of ethnography as a variation of ethnography (Crotty, 1998, p. 5), or because of the way the study is pursued per online observation and interaction between researcher and research participants, as a new type of methodology.

'the Click' is a member only online therapeutic community set up to support people with breast cancer and their family and friends.  This case study reveals that a member of this online community was identified with behaviors consistent with a factitious disorder the more extreme type of which is referred to as Munchausen Syndrome. When Munchausen Syndrome occurs online it is referred to as Munchausen by Internet. If the person also fabricates illnesses for immediate family members online it is known as Munchausen by proxy by Internet (Cunningham & Feldman, 2011, p. 185).  The aim of this case study is to highlight how nurses and others can identify members of health related online support communities who are untruthful, using some of the aids to diagnosis of a factitious disorder and management strategies developed by Feldman (2000).