Dolce Maria C
College of Nursing, New York University, New York, USA.
Oncol Nurs Forum. 2011 May;38(3):353-9. doi: 10.1188/11.ONF.353-359.
PURPOSE/OBJECTIVES: To describe the experiences of cancer survivors and caregivers with healthcare providers in the context of the Internet as a source of health information.
Qualitative description.
Online cancer communities hosted by the Association of Cancer Online Resources.
Purposive sample of 488 cancer survivors, with varying cancer types and survivorship stages, and caregivers.
Secondary data analysis using Krippendorff's thematic clustering technique of qualitative content analysis.
Survivorship, healthcare relationships, and the Internet.
Disenchantment with healthcare relationships was associated with failed expectations related to evidence-based practice, clinical expertise, informational support, and therapeutic interpersonal communication. Survivors and caregivers exercised power in healthcare relationships through collaboration, direct confrontation, becoming expert, and endorsement to influence and control care decisions.
Disenchantment propelled cancer survivors and caregivers to search the Internet for health information and resources. Conversely, Internet information-seeking precipitated the experience of disenchantment. Through online health information and resources, concealed failures in healthcare relationships were revealed and cancer survivors and caregivers were empowered to influence and control care decisions.
The findings highlight failures in cancer survivorship care and underscore the importance of novel interdisciplinary programs and models of care that support evidence-informed decision making, self-management, and improved quality of life. Healthcare professionals need to receive education on survivors' use of the Internet as a source of health information and its impact on healthcare relationships. Future research should include studies examining the relationship between disenchantment and survivorship outcomes.
目的/目标：描述癌症幸存者和护理者在将互联网作为健康信息来源的背景下与医疗服务提供者的经历。
定性描述。
由癌症在线资源协会主办的在线癌症社区。
488名癌症幸存者的目的抽样，这些幸存者具有不同的癌症类型和生存阶段，以及护理者。
使用克里彭多夫定性内容分析主题聚类技术进行二次数据分析。
生存、医疗关系和互联网。
对医疗关系的失望与基于证据的实践、临床专业知识、信息支持和治疗性人际沟通方面的期望未达成有关。幸存者和护理者通过合作、直接对抗、成为专家和认可来在医疗关系中行使权力，以影响和控制护理决策。
失望促使癌症幸存者和护理者在互联网上搜索健康信息和资源。相反，在互联网上寻求信息引发了失望的体验。通过在线健康信息和资源，医疗关系中隐藏的失败被揭示出来，癌症幸存者和护理者有能力影响和控制护理决策。
研究结果凸显了癌症生存护理中的失败，并强调了支持循证决策、自我管理和改善生活质量的新型跨学科项目和护理模式的重要性。医疗专业人员需要接受关于幸存者将互联网作为健康信息来源及其对医疗关系影响的教育。未来的研究应包括考察失望与生存结果之间关系的研究。
