Purpose ? The purpose of this paper is to explore whether online communities meet their potential of providing environments in which social relationships can be readily established to help patients cope with their disease through social support. The paper aims to develop and test a model to examine antecedents of the formation of virtual relationships of cancer patients within virtual communities (VCs) as well as their effects in the form of social assistance. Design/methodology/research ? Data were collected from members of virtual patient communities in the German-speaking internet through an online survey to which 301 cancer patients responded. The data were analyzed with partial least square (PLS) structural equation modeling. Findings ? Virtual relationships for patients are established in VCs and play an important role in meeting patients? social needs. Important determinants for the formation of virtual relationships within virtual communities for patients are general internet usage intensity (active posting vs lurking) and the perceived disadvantages of CMC. The paper also found that virtual relationships have a strong effect on virtual support of patients; more than 61 per cent of the variance of perceived social assistance of cancer patients was explained by cancer-related VCs. Emotional support and information exchange delivered through these virtual relationships may help patients to better cope with their illness. Research limitations/implications ? In contrast to prior research, known determinants for the formation of virtual relationships (i.e. marital status, educational status, gender, and disease-related factors such as the type of cancer as control variables, as well as general internet usage motives, and perceived advantages of CMC as direct determinants) played a weak role in this study of German cancer patients. Studies on other patient populations (i.e. patients with other acute illnesses in other cultures) are needed to see if results remain consistent. Practical implications ? Participants and administrators of patient VCs have different design criteria for the improvement of VCs for patients (e.g. concerning community management, personal behaviour and the usage of information in online communities). Once the social mechanisms taking place in online communities are better understood, the systematic redesign of online communities according to the needs of their users should be given priority. Originality/value ? Little research has been conducted examining the role of VCs for social relationships and social networks in general and for patients in particular. Antecedents and effects of virtual social relationships of patients have not been suf?ciently theoretically or empirically researched to be better understood. This research combines various determinants and effects of virtual relationships from prior related research. These are integrated into a conceptual model and applied empirically to a new target group, i.e. VCs for patients.
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