Effects of an Internet Support System to Assist Cancer Patients in Reducing Symptom Distress A Randomized Controlled Trial

被引:163
作者
Ruland, Cornelia M. [1 ,2 ]
Andersen, Trine [1 ]
Jeneson, Annette [1 ]
Moore, Shirley [3 ]
Grimsbo, Gro H. [1 ]
Borosund, Elin [1 ]
Ellison, Misoo C. [1 ]
机构
[1] Oslo Univ Hosp, Ctr Shared Decis Making & Collaborat Care, N-0424 Oslo, Norway
[2] Univ Oslo, Dept Med, N-0316 Oslo, Norway
[3] Case Western Reserve Univ, FPB Sch Nursing, Cleveland, OH 44106 USA
关键词
Cancer; Internet support; Patient-centered care; Randomized controlled trial; Symptom management; SELF-MANAGEMENT PROGRAM; QUALITY-OF-LIFE; HEALTH COMMUNICATION; ASSESSMENT SCALE; CARE; INFORMATION; INTERVENTIONS; ONCOLOGISTS; PREVALENCE; INSTRUMENT;
D O I
10.1097/NCC.0b013e31824d90d4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Cancer patients experience many physical and psychosocial problems for which they need support. WebChoice is an Internet-based, interactive health communication application that allows cancer patients to monitor their symptoms and problems, provides individually tailored information and self-management support, e-communication with expert cancer nurses, and an e-forum for group discussion with other patients. Objective: The objective of this study was to examine the effects of WebChoice on symptom distress (primary outcome), depression, self-efficacy, health-related quality of life, and social support (secondary outcomes). Methods: In this 1-year repeated-measures randomized controlled trial, 325 breast and prostate cancer patients were randomized into 1 experimental group with access to WebChoice and 1 control group who received URLs of publicly available cancer Web sites. Results: Group differences on symptom distress were significant only for the global symptom distress index on the Memorial Symptom Assessment Scale (slope estimate, -0.052 [95% confidence interval, -0.101 to -0.004]; t = 4.42; P = .037). There were no significant group differences on secondary outcomes. Additional analyses showed significant within-group improvements in depression in the experimental group only. In the control group, self-efficacy and health-related quality of life deteriorated significantly over time. Conclusion: This randomized controlled trial is one of the first to evaluate effects of an interactive health communication application to support cancer patients in illness management on symptoms. Although only 1 hypothesis was partially supported, the combined results show a clear trend toward better scores in the intervention group on most outcome measures. Implications for Practice: If findings can be supported with additional research, WebChoice may become an important tool to support nursing care that can equip cancer patients to better manage their illness.
引用
收藏
页码:6 / 17
页数:12
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