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Introduction: Online Health Forums (OHFs) allow patient learning and therapeutic patient education (TPE). To reinforce the pedagogical dimension of these tools, it is necessary to understand the learning processes and conditions involved in OHFs. A potential framework for the analysis of this phenomenon is self-directed learning (SDL)., Objective: The objective is to propose a framework for the analysis of learning and TPE in OHFs, based on existing SDL theories. This could allow to identify the learning characteristics of OHFs and to identify potential implications for TPE., Method: A narrative review was conducted on the basis of 40 publications whose analysis through three categories (elements of SDL's definition, learner role and environmental impact) allowed to identify the explanatory theories of SDL., Results: The main result is a proposition for an analytical framework to examine OHFs according to their self-formative characteristics and, then, discuss their links with TPE programs. Indeed, similar principles between SDL and TPE are emerging such as the identification of needs, the autonomy of patients/learners, and the place of Self Efficacy. These similarities highlight the potential complementarity between OHFs and SDL., Conclusion: SDL allows us to understand how Internet users learn on OHFs. Although links between SDL, OHFs and TPE are identified, a better understanding of the learning modes used in OHFs and their functioning according to the user profile could clarify their learning potential and their empowering effect.

Background Patients are using online health forums (OHFs) to exchange about their health, diseases and treatments. Some OHFs are independent, not submitted to health care providers' control nor to social desirability. This must probably influence the very nature of patient's learning. Objectives: This research aims to bring some answers to the following questions: What are the characteristics of independent OHFs? What are OHF internaut patients' profile? How do they use OHFs? Are there any characteristics that might help to understand their use of OHFs? Methods: A literature review has been undertaken querying 10 databases. The review was completed with an analysis of the "grey literature". Eleven keywords were used singly or in combination. The article selection was conducted by two independent researchers. Results: 23 documents were selected and analysed. Five OHF definitions, three user's classifications and four OHF uses were identified and analysed. Discussion: The review allowed us to 1) formulate a definition of a chronic health conditions oriented OHF, 2) describe its characteristics, 3) suggest a users' classification and, 4) describe the four OHF uses. Conclusions: Independent OHF is a virtual and free space beyond institutional control. It may be considered as a learning and educational media, formal and informal, and spontaneous. The understanding of the knowledge acquisition processes and strategies among OHF users is necessary in order to use this web tool as patient education strategy. [ABSTRACT FROM AUTHOR]