Objectives: The main purpose of this Internet-based study was to evaluate coping with illness in an online sample of cancer patients and to compare the findings with data of an offline study conducted by Zaun (2002). Additionally, the patients were asked to point out their attitudes towards online health care.

Methods and data: The online survey included the Freiburger Questionnaire on Coping with Illness (FKV-LIS) measuring different coping strategies (depressive coping, active, problem-oriented coping, distraction and self-encouragement, religiousness and searching for meaning, trivializing and wishful thinking), and the questionnaire Attitudes towards online Health Care (ATOHC) for the evaluation of attitudes towards healthrelated Internet use (community and news, outcomes, trusted information and advice, self-efficacy in evaluating information and intention, disclosure). The sample was recruited in German-speaking cancer bulletin boards. The online questionnaire was also promoted through links on medical and health information sites. In this online study the data of 293 patients with various types of cancer (e.g., breast cancer, Hodgkin's disease, prostate cancer) was analysed. The participants mainly were female (67%) and had a higher education (43%).

Results: Compared with patients of the offline study conducted by Zaun (2002), the online sample particularly showed less depressive coping as well as trivializing and wishful thinking. Furthermore, they used significantly more active, problem-oriented coping, distraction and self-encouragement. The sample's attitudes towards the online community and web-based news and their self-efficacy in evaluating information on the Internet were moderate. However, trust in web-based information and advice as well as disclosure were relatively low. The patients perceived their psychological and physical health as being moderately influenced by their health-related Internet use.

Conclusions: In comparison to an offline sample, the online recruited cancer patients' less depressive and more active coping, their higher distraction and self-encouragement indicate a more positive illness processing and a stronger self-efficacy of Internet users participating in cancer bulletin boards or searching for online health information. Thus, the web-based activities as well as a kind of healthy distrust of online information and advice might be an additional expression of active, problem-oriented and reflective coping with illness.