Degree Name

Doctor of Philosophy


University of Wollongong. Faculty of Commerce


This thesis reports the findings of a study concerning the complex dynamic phenomenon of online health. Online health has the potential to greatly improve health outcomes, because the Internet develops an increasing capability to support richer interactions between health professionals and the public. However, this potential has yet to be fully realised. Therefore, the aim of this study is to provide a greater understanding of this phenomenon.

The research adopts an interpretivist perspective, which brings together a suitable mix of methodologies and theoretical concepts. This study applies an innovative, mixed methods approach, namely usability testing, Q Methodology, content analysis, and, Activity Theory. The main focus of this study is on the perceptions of diverse users of online health websites, as well as the interactive features of the medium that could meet the needs of these diverse users. As a result, the research has significant contributions to theory and also lessons for practice.

The research was conducted in four phases of data collections, as follows: Phase 1 consisted of usability testing of a respected palliative care website to assess the needs of various users and to suggest areas for improvement; Phase 2 was the first stage of a Q study with thirty seven (37) participants which revealed public users’ varying attitudes toward online palliative care in the context of the Australian healthcare environment; Phase 3 was a content analysis of health and palliative care websites to explore their interactive features and various designs of online health systems worldwide, with a particular focus on online palliative care websites; Phase 4 the second stage of the Q study with seventy (70) participants which revealed a greater diversity of users’ perceptions toward online health websites, including palliative care clinicians.

The results of the research are significant for both academics and practitioners. Froma scholarly perspective, this study is important theoretically and methodologically. It demonstrates how the application of dimensions of the interactivity concept can underpin the content and design aspects of online health. Activity theory was found to be useful as a powerful, descriptive tool that provides a holistic explanation of people’s views and motives when engaged in different activities in relation to accessing online health websites. By applying a mixed methods approach of data analysis involving usability testing, content analysis and the techniques of Q Methodology, this research covered both objective and subjective aspects of the online health context. Although Q Methodology is a relatively new method appliedin the online health literature, Q Methodology was found to be a valuable method for categorizing people’ differing perceptions of online health websites. The combination of Activity Theory and Q Methodology provided appropriate techniques for conducting the research and then interpreting its results in an integrated holistic manner. The research findings contribution to an overall understanding of users’ perceived needs from online health websites, the importance of designing websites to meet varying needs and the need to anticipate how these needs may change in the future as technologies evolve.



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.