In the context of the rise of internet, communication through digital media has reconfigured the way of producing, appropriating and disseminating news and information about health. In this sense, blogs have constituted virtual spaces for the sharing of ideas and socialization of knowledge and information that allow the emergence of new problems and objects of research in communication and public health, as well as contributing to the dissemination of information, knowledge and news on health. It was observed that the health market adjusted to the biomedical model focused on technologies and in individual assistance uses this mean to disseminate health narratives. The study has a qualitative, descriptive and documentary approach to verify the applicability of the Analysis Model of Health News Discourse in blogs which released news on technological innovation in health care for Diabetes Mellitus. It is concluded that the analysis model applied to blogs have allowed us to observe that the news shared by the different media, as well as the fear of getting diabetes and the hope for its cure constitute strategies of convincing users of blogs to serve the interests of the market economy in the production of health demands and needs.
Diabetes Mellitus; Internet; Social media; Public health
Digital media in the context of contemporary culture contribute to the reconfiguration of space, time and the communicational process, in which the roles of transmitter and receiver, that is, author and co-author of the shared contents through postings (generically called ‘posts’) of texts and audiovisuals in the form of hypertexts and hyperlinks, take turns in a multivariate movement, reverberating in the form of the discourse on health. This reconfiguration also impacts on the social relationship that is maintained through the interactivity mediated by the communication technology and the information, with the possibility of being resignified by the comments of the users.
For Lemos11 Lemos A. A arte da vida: diários pessoais e webcams na Internet. In: XXV Congresso Brasileiro de Ciências da Comunicação. Salvador: Intercom; 2002 [acesso em 2018 set 15]. Disponível em: http://www.portcom.intercom.org.br/pdfs/37b5da563c6bc5ec6f2697de38bffd84.pdf.
http://www.portcom.intercom.org.br/pdfs/... , the ‘release of the transmitting pole’ allows any internaut to post information on the network, reconfiguring the media scenario. This media scenario presents distinct characteristics regarding the communicational process (transmitter-receiver) and the transmission of information through traditional media.
Blog is a type of website (WordPress, Blogger, TypePad or Moveable) created with the use of an application, which is frequently updated with the addition of new texts, subjects or articles, displayed in reverse chronological order of their publications. According to Gunelius22 Gunelius S. Marketing nas mídias digitais em 30 minutos: manual prático para divulgar seus negócios pela internet de modo rápido e gratuito. São Paulo: Cultrix; 2012., blog visitors can join the conversation by submitting comments on the posts that interest them most. It’s these comments that make blogs social media and make bloggers, people who post on these blogs, build relationships with people around the world.
Blogs are constituted as supports that can meet the communication demands of the individuals who access them, and allow the socialization of knowledge and the dissemination of information. Based on Recuero33 Recuero RC. Weblogs, webrings e comunidades virtuais. Biblioteca online de ciências da comunicação [internet]. 2003 ago [acesso em 2018 set 15]. Disponível em: http://www.bocc.ubi.pt/pag/recuero-raquel-weblogs-webrings-comunidades-virtuais.pdf.
http://www.bocc.ubi.pt/pag/recuero-raque... , it is possible to classify the types of blogs according to the content published in them, which facilitates the perception of how the search for information can be more targeted when carried out only on blogs. Among these types, the ones that are closest to this research are: (a) Daily weblogs - bring posts about the personal lives of the authors, in order to report daily facts; (b) Weblogs publications - bring information in an opinionated way, seeking debate and commentary, being able to approach specific topics or deal with generalities; (c) Mixed weblogs - mix personal and informative posts with news, tips and comments, according to the taste and opinion of the author. It is worth mentioning that a blog is a social network website, which provides different forms of connection, generating different forms of access to differentiated values of social capital44 Ellison NB, Steinfield C, Lampe C. The benefits of Facebook "friends": Social capital and college students' use of online social network sites. J Computer-mediated Comm [internet]. 2007 jul [acesso em 2018 set 15]; 12(esp4):1143-1168. Disponível em: https://academic.oup.com/jcmc/article/12/4/1143/45829615.
https://academic.oup.com/jcmc/article/12... ,55 Recuero R, Araújo R, Zago G. How does Social Capital affect Retweets? In: 5º ICWSM; 2011 jul 17-21. Barcelona. Barcelona: AAAI; 2011 [acesso em 2018 set 15]. Disponível em: file:///D:/Revista/Downloads/2807-14222-1-PB.pdf.. In some cases, blogs have occupied the space of organized media work, since personal reports about an event have gained prominence in the search for information directly from the source, and can become the sources of information themselves.
From this reflection on blogs, digital culture in a market economy, as well as the general computerization of society, mark a historical moment in which the sociability centered on electronically mediated communication serves as a means to strengthen the overwhelming tendency of the dissemination of culture of mass consumption.
In sharp contrast to the traditional mass media (audiovisual and printed), digital media allow ideas and perceptions on health to be shared through hypertexts and hyperlinks, constituting a relationship of interactivity, which occurs between authors and co-authors of informative or news content, thus boosting the digital networks.
However, contents that stimulates consumption are part of the strategies of companies that profit from this same consumption of health services and technologies. The actors promote a network of senses about health from the disease and the risk of being affected by it, reinforcing the interaction in virtual networks between the industries and the health professionals; among patients and health professionals; industries and the mass media; and those with the general public, and, on blogs, those meanings are, partly, reproduced.
Contents posted on blogs - specifically, news - are apparently informative, unpretentious and free, but, in a subliminal way, establish a narrative loaded with senses with the intent of convincing readers both affected or not, for example, by diabetes, to consume services and technologies, strengthening the production of health needs66 Guimarães JMM. Paradigmas e trajetórias tecnológicas em saúde: mídia, acesso e cuidado do diabetes [tese]. Salvador: UFBA/ISC; 2014. 170 p..
Thus, considering that it can contribute to the understanding of the role of digital media in the dissemination of technological innovation in health, this article aims to verify, in blogs of the southern region of Bahia, the applicability of the Analysis Model of the Health News Discourse, used to understand the contribution of the printed media to the production of demand and consumption needs of products and care in diabetes prevention, which has been tested for digital media.
Up to now, similar studies have analyzed news in printed matters on health, from methods of discourse analysis and content suggested by Foucault and Orlandi, among others, however, without necessarily indicating some model of analysis. In this way, the use of the Analysis Model of the Health News Discourse is justified because it is a model used in a study carried out in 2013, in printed magazines of great national circulation - such as ‘Veja’ and ‘IstoÉ’ -, which makes it imperative to test it in other media to verify its limits and possibilities66 Guimarães JMM. Paradigmas e trajetórias tecnológicas em saúde: mídia, acesso e cuidado do diabetes [tese]. Salvador: UFBA/ISC; 2014. 170 p..
The choice for blogs stems from the recognition of the specificity of the use of digital media in health discourse analysis. Digital media, by nature, gain meanings according to their process of reproduction in the network, the possibility of media convergence and the dissemination by different actors, who can be influencers of followers.
Material and methods
This study is qualitative, descriptive and exploratory. Initially, the six cities with the largest number of inhabitants (Eunápolis, Ilhéus, Itabuna, Itamaraju, Porto Seguro and Teixeira de Freitas), in the southern region of Bahia, were selected. Later, through the Google site, the blogs of that region that presented posts with the descriptors diabetes, metformin and insulin in their publications were identified. Subsequently, 10 blogs and 44 posts published in 2015 were identified. The links and names of blogs, the date, title and fragments of the news, information or comments were recorded in the analysis instrument elaborated for the systematization of the data. To remain anonymous, blogs were identified as B1, B2, B3 and so on.
Based on this systematization, it was sought to highlight the meaning of the news published on blogs, based on the Analysis Model of the Health News Discourse, constituted by analytical premises that structure the sentences of the news, being: 1) Subject of the phrase of the news brings proposition as an informative phrase whose content may be true or false. Propositions function as statements that express the meaning of the term or subject; 2) Predicate of the subject of the sentence of the news, composed of arguments understood as a set of statements that relate to each other and validate the premise, fallacious or not; and 3) Implicit premise is the expression of the meaning of the intentionality of the news, which is revealed under a process of deductive and inductive reasoning. Deductive reasoning starts from a general proposition and concludes with a particular proposition, which presents itself as necessary. Inductive reasoning is the one that, after considering a sufficient number of particular cases, concludes a general truth77 Copi IM. Introdução à Lógica. 3. ed. São Paulo: Mestre Jou; 1981.. These premises are structured in the design of news or information, which institute intentionality; that is, the meaning that the author intends to give to the text.
This model of analysis was constituted from readings carried out on the Logic of Irving Copi77 Copi IM. Introdução à Lógica. 3. ed. São Paulo: Mestre Jou; 1981., highlighting the study of methods and principles used to distinguish the correct reasoning from the incorrect reasoning. In addition, Paul Ricoeur88 Ricoeur P. Le conflit des Interprétations: Essais d´Herméneutique. Paris: Du Seuil; 1999. was invoked, in particular, for his work ‘Theory of Interpretation’, in which discourse and excess of meaning make explicit the intention to produce in the reader a relationship of reciprocity, configuring itself as a dialogue.
The news published by blogs follow practically the same pattern of the traditional mass media. The difference is in the format of texts and hypertexts, in the possibility of reproducing and expanding information with complementary sources made available, through the links and hyperlinks that induce access to the opinions of specialists, national and international health institutions, as well as digital influencers of the health market. Therefore, the posts and reactions of the followers of the blog may present themselves as limits regarding the applicability of the analytical premises of the Analysis Model of the Constitutive Elements of the Health News Discourse.
The subject of the sentence of the news expands through the links, but the production of the content of the message uses the same convincing strategies. The intentionality is to reach the connected network of actors in search of news and information about health. In this way, the discursive proposition refers to health, disease and care to reach the potential consumer of health products and services.
The predicate of the subject of the news sentence, which gives meaning to the subject of the news sentence, is also observed on blogs. However, the message is resignified by the network dynamics, observed in reactions of support or in the sharing of new validating arguments, such as information about the region, time (chronological cut of the news), expert opinions. The time category, unlike traditional media, may become current in digital media, even if the information is related to a past event. The technical-scientific validation premise also emerges as an element of strengthening through links and glossaries. The implicit premise reflects the intentionality of the message also in blogs, and aims to convince the reader from affirmative or negative directions of what the author intends to communicate.
The great difference that is established between the mass media and the digital is expressed in the format of its dissemination, production and reception. According to the dynamics of the network, the messages and news that denote the interaction of the actors do not always assume other meanings, either through posts, links or hyperlinks. In the context of health, although in a fragmented way, the author constructs a vision on health, disease and care, from the sharing of discursive contents based on fear and hope.
Results and discussion
The actors of the network reconfigure the communication process when the roles of the transmitter and the receiver take turns in the production of narratives, in the sharing of news and information, in the editing of audiovisual materials, and may or may not modify the meaning and format of the production of news. Therefore, they are distinguished from traditional mass media by the potential of re-signification of the news, from new comments, sharing and re-sharing. The actor is the producer and disseminator of the news or information; and also participant of the network, being able to be not only the blog, but also its followers.
For Lemos11 Lemos A. A arte da vida: diários pessoais e webcams na Internet. In: XXV Congresso Brasileiro de Ciências da Comunicação. Salvador: Intercom; 2002 [acesso em 2018 set 15]. Disponível em: http://www.portcom.intercom.org.br/pdfs/37b5da563c6bc5ec6f2697de38bffd84.pdf.
http://www.portcom.intercom.org.br/pdfs/... , some principles guide cyberculture: the ‘change of the emission pole in the production of content’; the ‘media reconfiguration’ and the ‘network connection’. The emission pole, the news and information circulating on the network are not necessarily produced in a hegemonic way by the traditional media. The convergence of media (audiovisual and texts) feeds the actions of the actors, according to the intentionality of the news. Networking forms an interactive environment. In this environment, the actors produce narratives about local reality and meanings, from dissonant voices in cyberspace. In this context, the network modifies the process of production, appropriation and dissemination of information and news, which makes it possible to observe the limits and possibilities in the use of the Analysis Model of the Constitutive Elements of the Health News Discourse, which now also advances to understand the information.
It was fundamental to recognize the differences between mass media and digital media. For the analysis of the news published in ‘Veja’ and ‘IstoÉ’, the model was able to understand the meanings created by actors of production, the emission pole, author of narratives on prevention and care of diseases and illnesses. However, the analysis model applied to the context of digital media made it possible to verify that interactivity changes the communicational process and reaffirms the practice in content production. The roles of transmitter and receiver take turns, although this requires a greater care in the explanation of the arguments. Faced with this, the space of blogs and the network of blogs, considered by literature as actors, reproduce news, which are objects of contestation and assimilation by their followers. In this way, the use of the model has brought the challenge of analyzing structured texts with links and hyperlinks that lead to new content and applications.
Health in the blogs of southern Bahia
Blogs, as virtual tools, allow the convergence of media and contribute to the discussion of important topics, especially on health. They can reproduce information and news from the mass media, mainly released by printed news vehicles that, simultaneously, publish content in an online version. According to Martino99 Martino LMS. Teoria das mídias digitais: linguagens, ambientes e redes. 2. ed. Petrópolis:Vozes; 2015., its nature aims to reach a larger audience, distinct from personal blogs, which, in many cases, reproduce news already disseminated in the mass media. It was verified the preponderance of individual and journalistic blogs.
The city of Itabuna (BA) presented the largest number of blogs, with 20 (39.21%); followed by Teixeira de Freitas (BA), with 11 (21.56%); and Ilhéus (BA), with 8 (15.68%). Together, the other cities had 12 (23.52%). From the above, it is observed that blogs appear as a means widely used by the local population to remain informed about the news, in the aforementioned cities in the southern Bahia, in parallel with the mass media (audiovisual and print).
Regarding the identity of the authors, it was observed that in Teixeira de Freitas (BA), in all blogs, the authors were nominated in the pages. In Itabuna (BA), on the other hand, only 12 (60%) had the name of the author; but in Ilhéus (BA), only 4 (50%). However, in relation to the presence of the profile of these authors in the pages of the blogs, in Itabuna (BA), only six (30%) blogs presented the profile of the blogger. In Teixeira de Freitas (BA), two (18.18%), and in Ilhéus (BA), only one (12.5%). From the analysis of the types of posts, it was verified that the text is present in all blogs; the images in 50 (98.02%) blogs; the video in 6 (11.76%) blogs; and audio in only 1 blog. The media convergence becomes significant when, through different media used for the dissemination of content on health and the blog itself, it streamlines the flow of information, which implies the existence of actors that interact forming a network capable of sharing and re-sharing the news.
The posts on health published by different media constitute a process called transmedia, which refers to the use of some media to tell a story or to transmit messages and/or news, forming a network of actors (individual or collective) that boost blogs. In this sense, it was found that the social networking site Facebook was used by 31 (60.77%) blogs, followed by microblogs such as Twitter by 17 (33.33%), Instagram by 9 (17.64%), YouTube by 3 (5.88%) and WhatsApp by 1 (1.96%) blog.
The thematic content present on blogs was diverse. This diversification stems from the characteristic of digital media itself, which forms networks according to specific interests. In this sense, the news were present in 38 (74.5%) blogs; advertising in 25 (49.01%); denunciations in 23 (45.09%); policy in 22 (43.13%); entertainment in 19 (37.25%); police in 18 (35.29%); sports in 18 (35.29%); interviews in 15 (29.41%); health and culture in 6 (11.33%); economy and article disclosure in 5 (9.8%); education and accidents in 3 (5.88%); disclosure of events in 2 (3.92%); real estate, research, agriculture, service and religion in 1 (1.96%).
One element to be emphasized in these data is the preponderance of news on blogs (75%). This confirms that such a journalistic genre is present in this media, although its majority is of individual character. On the other hand, although it is not the object of this study, the data point to the existence of a receiving public, which is an activity that develops in a network, according to Martino99 Martino LMS. Teoria das mídias digitais: linguagens, ambientes e redes. 2. ed. Petrópolis:Vozes; 2015.(37), with the “[...] content, discussions, exchange of ideas and engagement with practices related to what you like”.
Analysis of the Constitutive Elements of the Health News Discourse
The Analysis Model of the Constitutive Elements of Health News Discourse constitutes analytical premises that contribute to the analysis of the meanings of the news, and the interpretation and appropriation of the discourse, which involves interpreting and being interpreted. The whole process of interpretation occurs in a field of tensions and interests that involve the media as mediator of the news.
The model allows to identify the structures of dissemination of the news, with contents that produce feelings of fear and hope in the health, disease and care process, centered on the biomedical model, focused on the specialization and consumption of goods and services to serve the health market.
Understanding takes place in the dialectical relationship between interpreting and appropriating the intention of the senses to be reported. Thus, one can assume that all interpret the meanings of the news indistinctly. The difference in this process lies in the breadth of interpretation, which depends on the historical, cultural, cognitive and social codes of each reader.
The meaning produced by the news comes loaded with intentionalities, which can start from arguments and reasoning of an inductive and/or deductive character. The reasoning develops from the similarity between particular cases, but one does not arrive at a general conclusion, but only the other particular proposition. In addition, it resembles induction and considers only one particular case as a starting point.
Analysis Model of Constitutive Elements of Health News Discourse
The subject of the sentence of the news brings proposition as an informative phrase, whose content may be true or false. Propositions function as statements that express the meaning of the term/subject.
The predicate of the subject of the sentence of the news is composed of arguments that relate to each other, fallacious or not, and can be expressed through inferences that strengthen the news discourse.
The implicit premise is the intentionality of the news, and it is revealed under a process of inductive and deductive reasoning. Deductive reasoning starts from a general proposition and concludes with a particular proposition, which logically derives from the premises. And inductive reasoning is the one that, after considering a sufficient number of particular cases, concludes a general truth77 Copi IM. Introdução à Lógica. 3. ed. São Paulo: Mestre Jou; 1981.. The premises also make up the news discourse and these elements institute the intentionality, that is, the meaning that the author intends to give to the text of the news.
The first element of the analysis model that constitutes the news discourse in health is the subject of the sentence of the news, composed of three premises: a) Direct totalizing premise, addresses the care and the complications; b) Indirect totalizing premise, addresses topics on prevention, risk factors and diagnosis; c) Particularizing premise, through which the individual is identified in the news.
Regarding the subject of the news sentence, it was verified that 26 (59.09%) posts were classified as an indirect totalizing premise, that is, the news was aimed at the general population and not for people with diabetes, with 16 (36.36%) posts which addressed the theme of disease prevention; 5 (11.36%) addressed risk factors; and 5 (11.36%) talked about diagnoses of the disease. As can be noted on the fragment of news focusing on diabetes prevention, “[...] the joint effort of the D-Day, lectures on diabetes prevention and detection, nutritional and physical guidance will be offered” (B2).
The meaning of this fragment of news reinforces the biomedical model of risk-centered health care, as a way of feeling afraid of acquiring the disease; in the diagnosis associated with the prevention of the disease, without evidencing the social and cultural determinants that produce the incidence of diabetes. It is also observed that the individual is responsible for his/her health and for combating the risk of diabetes.
It was verified that 17 (38.64%) posts were classified as a direct totalizing premise, when the news is aimed at people with the disease, in this case, diabetes, and 11 (25%) addressed the care/control of the disease and 6 (13.64%) talked about the complications of the disease, as follows:
The training will have a twin-track approach: healthy eating and carbohydrate counting. The event is aimed at diabetics (especially, insulin users), family members, caregivers, health professionals [...]. (B1).
In a market economy, the financing of any event is done by the State, the participants themselves or the private sector. The target audience of the event ‘Diabetics (especially, insulins user), family members, caregivers, health professionals’ suggests the main actors of the narrative of the news: the affected by the disease and his/her caregivers. This reflects an information directed to specific recipients, not just consumers, but indirect diffusers of a particular medicine or technology in health.
With this, another element of the subject of the news phrase appears, which is the particularizing premise when the news addresses a particular case, an individual experience, as an argument that strengthens the news discourse on health correlating with the service offer and technologies for consumption. This was verified in only one (2.27%) post, as can be seen below:
I get up early and apply 18 IU of Lantus daily in the morning; I measure my blood sugar at least six times a day; and I make arrangements to do an hour of exercise, daily. This effort pays off when I compare my strength, my health, with that of many of my friends. Then I realize that I am in great advantage, and I say this without any hypocrisy. (B7).
The news presents the narrative of a person affected by diabetes, emphasizing a daily routine, but it bears the name of the medicine and, at the same time, indicates that the use of this insulin associated with the practice of physical activity results in greater ‘force’ for his health, when compared to the health of his friends, being able to attest all this with a moral discourse that brings enough advantage for himself.
This perspective is based on the second element of the analysis model that constitutes the health news discourse, when referring to the predicate of the subject of the news sentence, that gives meaning to the subject of the news and is subdivided into two categories of analysis, being the first one referring to the premises that validate the news discourse, that is, a validation premise referring to: a) the reference region of the news validation; b) the chronological cut of the news; c) the period in which companies disseminate products and services; d) the technical-scientific opinion; e) the affected as an appealing and emotional element. The second category refers to the conclusive suggestive premise, regarding the communicative process, that culminates in the intentionality of the news, in order to convince the reader from affirmative or negative meanings of what the author intends to communicate66 Guimarães JMM. Paradigmas e trajetórias tecnológicas em saúde: mídia, acesso e cuidado do diabetes [tese]. Salvador: UFBA/ISC; 2014. 170 p..
Regarding the region of reference of the validation of the news, it was present in all posts. The technical-scientific validation premise, which portrays the validity of the discourse of the news, was presented in 40 (91%) posts. These being validated by teachers, researchers and doctors, among others. It is observed, with this, the creation of implicitly disseminated micro-power networks. According to Foucault1010 Foucault M. A microfísica do poder. 26. ed. São Paulo: Graal; 2013.(255),
[...] power has no unique function of reproducing the relations of production. The networks of domination and the circuits of exploitation cover themselves, support themselves, interfere with one another, but do not coincide.
It is concluded that the news legitimates a network of power for the convincing of the reader, and the news is validated by the validating premises (spatial and technical-scientific). One can verify the importance that is given to the validations of these comments by researchers from universities located in the so-called first world countries, which is exemplified in the following fragments:
While Glucagon counteracts the glucose reduction caused by insulin, it is only available in the form of a dry powder that is dissolved in a syringe prior to intramuscular injection. [noted researcher Michael R. Rickels, MD, MS, associate professor of medicine at the University of Pennsylvania, Perelman School of Medicine in Philadelphia]. (B7).
In both analyzed news reports, it was observed that the discourse of those who suffer becomes strategical, and their daily routine, as well as that of doctors and specialists, among others, validating the consumption of products and services for the prevention and care of the patient diabetes, spreading the model of care centered in the biomedical perspective, from the dissemination of technology in health. Since profit is the determining factor to motivate companies in the production of health goods and services, and to obtain the expected return, the guarantee of the market becomes the object of desire of the companies.
Regarding diabetes, it is assumed the existence of an identity of the receiving/reproducing public of the news, since they referred to prevention, risk factors (overweight, sedentarism, smoking, inadequate diet) and diagnosis of the disease. This news have been directed to the public who lives in a context of risk in relation to their age and the lifestyle they lead. When the news addresses issues of care that impact morbidity and mortality (cardiac complications, cerebrovascular, peripheral vascular, ocular, renal, neuropathic; acceleration of death and disability), it is understood that the reading public is the carrier of diabetes66 Guimarães JMM. Paradigmas e trajetórias tecnológicas em saúde: mídia, acesso e cuidado do diabetes [tese]. Salvador: UFBA/ISC; 2014. 170 p..
Finally, it was verified the validating premise affected, which addresses the appealing and emotional element of the patient affected by the disease in only two (4.55%) posts. In the fragment below can be observed the emotional appeal for the validation of the speech.
It is observed, as well, that the persuasion strategy is configured by the hope of healing through the use of insulin, evidencing the incentive to use medications and the hope of reducing discomfort. For Marcondes Filho1111 Marcondes CF. O capital da notícia: jornalismo como produção social da segunda natureza. São Paulo: Ática; 1989., it is configured as a strategy of emptying the real, the contradictory, the controversial, exonerating the market system itself, so that the culture of consumption is instituted as something naturalized.
The predicate of the subject of the news reveals the communicative process that culminates in the intentionality of the news, aiming to convince the reader from affirmative or negative meanings of what the author intends to communicate. Therefore, it is divided into two categories of analysis: a) Suggestive affirmative premise; and b) Suggestive negative premise.
The suggestive affirmative premise was present in 27 (61%) analyzed news, while the suggestive negative premise in 17 (39%). The suggestive conclusive affirmative premise gives relevance to the positive ideological qualities of the discourse that is intended to affirm about the disease: hope, regarding prevention, diagnosis, control, living without pain and cure. The following post fragment exemplifies convincing strategies in producing hope in relation to cure, control, and prevention of disease:
The Encounter will have conferences, lectures, symposia, a round table discussion and right to questions and answers. Its main focus is the updating of health professionals in relation to the treatment of Diabetes Mellitus, emphasizing the new drugs, technologies and aiming at the optimal control of the disease, as well as the prevention of complications from the primary care, at the outpatient level. (B4).
The post presents affirmative discursive propositions to give relevance to the positive ideological qualities of the discourse that one intends to affirm on the disease: the hope regarding the control of this. That is, the hope of overcoming the possible limitations arising from the complications of diabetes, with the progress of science.
The negative suggestive premise gives relevance to the negative ideological qualities in the discourse that is intended to affirm negatively about the disease, in the face of uncertainties: fear of disease, risks, complications and death, as follows:
[...] In addition, the disease can still cause heart attack, kidney problems and blindness - most of these complications could be prevented with early diagnosis and healthier habits. (B4).
Another post also reflects fear:
Nutritionist Patrícia Ruffo, a master of Science from the University of São Paulo, states that only 26% of diabetics manage to control diabetes, which is a chronic disease. (B3).
It is observed that the discourse disseminated on blogs legitimizes and reproduces the culture of medicalization. It uses the same strategies of fear and hope as a phenomenon of convincing the participants of the blog, just as traditional media do. Thus, in the context of virtual relations, it is verified that the narrative meanings of the news attribute to the health-disease process a biased sense for the pathological manifestation in the individual, the strengthening of the consumption of goods and services for the prevention of diabetes without considering the social determinants which produce the disease.
Finally, the third and final element that constitutes the health news discourse is the implicit premise, which presents the intentionality of the news in its text and statements1212 Fiorin JL. Elementos da análise de discurso. São Paulo: Contexto; 2013.. Of the 44 analyzed articles, 21 (32%) suggest that the intentionality was to disseminate information about diagnostic exams; 19 (29%) were referring to health services available in the market, or to be made available; data regarding medicines available or to be launched on the market were 15 (23%); 5 (8%) referred to the food and beverage market; applications and others presented 2 news each one (3%); and, finally, the book market, presented 1 (2%) news. Some implicit elements of the news discourse may be observed in the following fragments:
Study proves: drinking beer daily brings health benefits. And the list is large: according to a survey done in Spain, it has proven that drinking a pint of the drink a day fights diabetes, avoids weight gain and prevents against hypertension. (B1).
[...] the Diet and Health application, a healthy weight loss program; in addition to other products such as Tecnonutri, Consulte.me and DS Kids, an application aimed at the healthy eating of children. (B4).
The fragments evidence the disclosure of beverages, in which beer would be the preventive food for diabetes, and applications for healthy eating. In this sense, the information conveyed on blogs evidences the disclosure of goods. Therefore, the network connections of economic, political and cultural processes create new asymmetries, sources of inclusion and exclusion, redefine productive processes, labor relations and cultural relations.
It was verified that the use of premises and implicit arguments to sell news, to disseminate health technologies, at the service of companies that, strategically, seek to form or foment market of consumers of products and services, from the prevention to the care of diabetes.
In the communication field, it is noticed that the news tends to reach a certain specific consumer, although the intention of the blogs that divulge news is to attend to private interests, mainly in what refers to the health market. However, the sense of news commonly found on blogs influences the creation of health needs to generate demands; therefore, companies use this communication feature to intensify the consumption of products or services. And the State, in spite of directing the news to the same target public of the private companies, aims at the other goals potentially focused on themes of collective interest, also envisioning to build its political hegemony.
The need is a category that dialogues with the stony principles of the Unified Health System (SUS) and the public policies that guide its guidelines and priorities. The concept of false needs arises from the desire that is configured in the competitive dynamics and marketing of the industry1313 Aragão E, Loureiro S, Temporão JG. Trajetórias tecnológicas na indústria farmacêutica: desafios para a equidade no Brasil. In: Paim JS, Almeida Filho N, organizadores. Saúde Coletiva: Teoria e Prática. Rio de Janeiro: Medbook; 2014.. Therefore, it can be observed that, in spite of all the benefits that social networks provide, there is still the private means using it for the sake of its profit, for example, through the news and the premises imposed through them.
It was verified that the Analysis Model of the Health News Discourse, used in the analysis in printed media (magazines), can be used in the analysis of blogs on the health theme. On the one hand, it is recognized that the news has the capacity to inform when it is exercising the educational function, regarding the disease, its health risk factors, preventive guidelines, protection against the risks and damages of diabetes. On the other hand, it acts as an instrument to legitimize a market strategy, generating health needs that strengthen the hegemony of this market, since it demarcates an argumentative logic, which intends to convince the reader (affected by the disease or not) of the need to consume news, products and services.
Therefore, it can be said that the use of the Analysis Model of the Constitutive Elements of the Health News Discourse made it possible to understand how blogs disseminate apparently informative and gratuitous news, with a load of meanings that tries to convince readers affected and not affected by diabetes, strengthening the production of health needs.
It is worth mentioning, also, that testing the Analysis Model of Health News Discourse on blogs made it possible to verify that in the digital media, whose dynamics and characteristics differ from those related to mass media, the model presents limits that arise from the difference in production, dissemination and reception of communicational content. The limit focuses on the difficulty of finding a structure of the constitution of the news meanings, when the links can also function as inducers of meanings or re-signified.
Finally, to advance the model for analysis in digital media, it is suggested to include the interactive premise as an integral element of the predicate of the subject of the news, which consists of understanding the process of interaction between transmitter and receiver, with the possibility of re-signification or not of the message. That is, the receiver becomes the producer when confirming, deconstructing or re-signifying the message.
- Financial support: non-existent
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- Publication in this collection
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22 Oct 2018