Patterns in sense making interactions : how people make sense of kidney failure in online renal discussion groups

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Sense making matters because people make sense to understand situations and decide what to do next. Researchers study sense making to understand why space programs fail, why employees resist change, how doctors make diagnoses and how patients cope with experiences and care for themselves. Yet in Library and Information Studies (LIS), sense making research mainly restricts itself to how people interact with information systems. Sense making is rarely defined in any field, but is generally described as a cognitive activity, ignoring potential emotional or experiential aspects of sense making. My aim with this research is to define sense making and extend LIS conceptions of sense making to include whatever might be involved, whether cognitive or not and looking beyond the involvement of information systems. I examined people making sense of kidney failure, a likely situation in which to perceive physicality and emotions in sense making. This thesis has several methodological components including influences by two major sense making theorists, Brenda Dervin and Karl Weick. Based on their insight, I conceive sense making as social, ongoing, enactive processes. Influenced by ethnomethodological descriptions of how meanings emerge in interactions, I participated in online renal support groups, following interactions en vivo. Influenced by practice theory, I view activities as evidence of sense making, and examine discussion posts as written sense making. Therefore I describe external performances of sense making, not internal psychological understandings. The result is a longitudinal, social constructionist investigation of text-based sense making interactions, using content and thematic analyses to attend to collaborative sequences. I found that people collaborated online by developing and breaking patterns of ideas and emotional tones, requiring repetition and time. They connected discussions to their own lives, interrelating feelings, ideas and experiences. Also, they created customized, personalised understandings, improvising shifting connections which allowed them to respond to complexity. These findings confirm conceptions both of sense making as located in time, and as embodied, emotional and lived, not only a mental activity. They also contribute to conceptions of knowing as flexible and transient rather than stable and structured. These are shifts from common LIS conceptions of sense making and knowledge. This thesis describes the important practical implications for clinicians and information professionals that follow from these significant conceptual shifts, demonstrating the practical relevance of having looked beyond information-related data to extend LIS conceptions of sense making.
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