Tang Yao, Jiayi Liu, Yuhang Zhang, Jingyi Cao, Huarui Cao
Background/Objectives: Digital healthcare communities enable patients to exchange emotional support, experiential knowledge, and social companionship but may also expose patients to distress, misinformation, conflict, and relational harm. This study identified beneficial and harmful patient-to-patient interaction practices and explored how patients interpreted these experiences in relation to future self-continuity and perceived quality of life. Methods: A two-phase sequential qualitative design was used. Phase 1 analyzed 871 valid discussion topics from a Chinese digital diabetes community. Phase 2 involved two rounds of semi-structured interviews, conducted approximately two months apart, with 12 adults with type 2 diabetes purposively sampled across six interaction categories identified in Phase 1. Interview data were analyzed using a hybrid deductive-inductive thematic approach with longitudinal within-case and cross-case comparison. Results: Phase 1 identified 25 patient-to-patient interaction practices encompassing both beneficial and harmful practices across emotional, informational, and social domains. In Phase 2, participants described supportive interactions in terms of greater hope, perceived control, and social belonging, whereas harmful interactions were described in terms of fear, uncertainty, self-doubt, and mistrust. Participants further described how these experiences related to their future selves. Participants who experienced their future selves as more attainable, recognizable, and personally meaningful also described greater hope, emotional stability, meaning, and engagement in self-management. Participants also perceived connections between these future-oriented interpretations and psychological, existential, and physical aspects of their quality of life. However, these findings should not be interpreted as evidence of a causal relationship between future self-continuity and quality of life. Conclusions: Patient-to-patient interactions in digital healthcare communities may be experienced as both supportive and harmful and may be related to how patients interpret the relationship between their present and future selves. Future self-continuity provides an interpretive perspective for understanding how online peer experiences may be associated with patients' perceptions of well-being within the observed time frame. These findings should be interpreted within the specific sociocultural and healthcare context of a Chinese digital diabetes community and warrant further investigation across different populations and digital healthcare settings.