This chapter investigates whether Taiwanese university students find EL in health information difficult. On average, approximately 90% of them did not have difficulty understanding EL while about 10% of them did. The rates of difficulty appear to increase with the severity of the health condition. Furthermore, the higher the number of different elastic terms intensively used in the excerpt, the more difficulty the participants experience in understanding EL. Based on interviews with approximately 20 participants, we address what may cause the difficulty and identify six reasons (e.g., unfulfilled expectation of specific information, semantic fuzziness combined with insufficient health literacy, unclear instructions that do not match the needs of the patient and family, increased vagueness caused by the intensive use of EL). In order to understand participants’ attitudes towards EL and non-EL, we analysed the participants’ written feedback as to why they preferred EL or non-EL in the health context. Six frames were identified, each with two orientations. Four of the most frequently activated frames are communication, folk–idiosyncratic, trust–scepticism, and voluntary–involuntary action. Two social factors (i.e., gender and age) in relation to Taiwanese participants’ perceptions of and attitudes towards EL are also addressed.

On average only 6.8% of the participants found it difficult to understand the meaning of EL used in the English data. The findings show that participants’ attitudes towards the use of EL in online medical information differ in the six excerpts: while three excerpts with EL were preferred by most, the other three with non-EL were also favoured. On average, a neutral attitude emerged: close to a half of participants preferred EL and the other half non-EL. Twelve frames generated from the data explain why the participants made their choices as regards EL, non-EL, both or neither. The frames are categorised into three groups: language-focused, language-user-focused and diseased-focused. The first grouping consists of six frames: fluidity, informativeness, relevance, accuracy, clarity, and discourse management. They all adhere closely to cooperative principles and relevance theory framework . The second grouping consists of five frames: trustfulness, folk–individual, lay–professional, voluntary–involuntary and indifference. The third grouping is disease focused: choices were made closely linked to the nature of six diseases. This grouping is specific to medical communication.