Cancer Nursing
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An International Journal for Cancer Care And the winner is...
Winner of Best Original Research Paper in Cancer Nursing Award 2013
Effects of an Internet Support System to Assist Cancer Patients in Reducing Symptom Distress: A Randomized Controlled Trial Cornelia M. Ruland, PhD 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 and 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.
Special congratulations to
Cornelia M. Ruland, PhD Cornelia M. Ruland received her PhD in nursing from Case Western Reserve University, Cleveland, Ohio, in 1998. She is today the director of the Center for Shared Decision Making and Collaborative Care Research at Oslo University Hospital in Norway. She has led for over a decade an innovative and sustained program of research on developing, testing, and implementing patient-centered health information technologies in clinical practice, primarily in cancer care to improve shared decision making, patient-provider communication, self-management, and collaborative care. Her studies were the first to develop tools to assist clinicians in eliciting and incorporating patients’ illness experiences and preferences into clinical care, to test their applicability in clinical practice, and to demonstrate their effectiveness in improving patient outcomes. Dr Ruland is an elected fellow of the American College of Medical Informatics in recognition of substantial and sustained contributions to the field over many years. A particular emphasis of her work is practice-based clinical trials that combine research on intervention effectiveness with effective ways to adopt and translate interventions into the contexts of everyday practice. Results of interventions from Dr Ruland’s work have been successfully implemented into clinical practice in numerous practices.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
™
An International Journal for Cancer Care And the winner is...
Winner of Best Original Research Paper in Cancer Nursing Award 2013
Effects of an Internet Support System to Assist Cancer Patients in Reducing Symptom Distress: A Randomized Controlled Trial Cornelia M. Ruland, PhD 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 and 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.
Special congratulations to
Cornelia M. Ruland, PhD Cornelia M. Ruland received her PhD in nursing from Case Western Reserve University, Cleveland, Ohio, in 1998. She is today the director of the Center for Shared Decision Making and Collaborative Care Research at Oslo University Hospital in Norway. She has led for over a decade an innovative and sustained program of research on developing, testing, and implementing patient-centered health information technologies in clinical practice, primarily in cancer care to improve shared decision making, patient-provider communication, self-management, and collaborative care. Her studies were the first to develop tools to assist clinicians in eliciting and incorporating patients’ illness experiences and preferences into clinical care, to test their applicability in clinical practice, and to demonstrate their effectiveness in improving patient outcomes. Dr Ruland is an elected fellow of the American College of Medical Informatics in recognition of substantial and sustained contributions to the field over many years. A particular emphasis of her work is practice-based clinical trials that combine research on intervention effectiveness with effective ways to adopt and translate interventions into the contexts of everyday practice. Results of interventions from Dr Ruland’s work have been successfully implemented into clinical practice in numerous practices.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
