Gustafson David H, Hawkins Robert, McTavish Fiona, Pingree Suzanne, Chen Wei Chih, Volrathongchai Kanittha, Stengle William, Stewart James A, Serlin Ronald C
Department of Industrial Engineering and Preventive Medicine, University of Wisconsin-Madison, WI 53706-1572.
J Commun. 2008 Jun;58(2):238-257. doi: 10.1111/j.1460-2466.2008.00383.x.
To compare the benefits of the Internet generally versus a focused system of services, 257 breast cancer patients were randomly assigned to a control group, access to the Internet with links to high-quality breast cancer sites, or access to an eHealth system (Comprehensive Health Enhancement Support System, CHESS) that integrated information, support, and decision and analysis tools. The intervention lasted 5 months, and self-report data on quality of life, health-care competence, and social support were collected at pretest and at 2-, 4-, and 9-month posttests. CHESS subjects logged on more overall than Internet subjects and accessed more health resources, but the latter used non health-related sites more. Subjects with access to the Internet alone experienced no better outcomes than controls at any of the 3 time points, compared to pretest levels. Subjects with CHESS experienced greater social support during the intervention period and had higher scores on all 3 outcomes at 9 months, 4 months after the intervention ended. CHESS subjects also scored higher than those with Internet access during the intervention period but not significantly after the intervention ended. Thus, CHESS (with one simple interface and integrated information, communication, and skills services) helped newly diagnosed breast cancer patients even after computers were removed. In contrast, patients received little benefit from Internet access, despite having links to a variety of high-quality sites.
为比较互联网总体上与专注的服务系统的益处，257名乳腺癌患者被随机分配到对照组、可访问带有高质量乳腺癌网站链接的互联网组，或可访问整合了信息、支持以及决策与分析工具的电子健康系统（综合健康增强支持系统，CHESS）组。干预持续5个月，在干预前以及干预后2个月、4个月和9个月收集关于生活质量、医疗保健能力和社会支持的自我报告数据。CHESS组的受试者总体登录次数多于互联网组，访问的健康资源也更多，但互联网组的受试者使用非健康相关网站更多。与干预前水平相比，仅可访问互联网的受试者在3个时间点中的任何一个时间点的结果都不比对照组更好。CHESS组的受试者在干预期间获得了更大的社会支持，并且在干预结束4个月后的9个月时，在所有3项结果上得分更高。CHESS组的受试者在干预期间的得分也高于可访问互联网的受试者，但在干预结束后没有显著差异。因此，CHESS（具有一个简单的界面并整合了信息、通信和技能服务）即使在移除电脑后仍对新诊断的乳腺癌患者有帮助。相比之下，尽管可访问各种高质量网站，但患者从互联网访问中获益甚微。
