Center for Shared Decision Making and Collaborative Care, Oslo University Hospital, Norway.
Cancer Nurs. 2013 Jan-Feb;36(1):6-17. doi: 10.1097/NCC.0b013e31824d90d4.
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.
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).
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.
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.
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.
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.
癌症患者会经历许多身体和心理社会问题，需要得到支持。WebChoice 是一种基于互联网的交互式健康交流应用程序，允许癌症患者监测他们的症状和问题，提供个性化的信息和自我管理支持，与专家癌症护士进行电子通信，以及为与其他患者进行小组讨论提供电子论坛。
本研究旨在检验 WebChoice 对症状困扰（主要结果）、抑郁、自我效能、健康相关生活质量和社会支持（次要结果）的影响。
在这项为期 1 年的重复测量随机对照试验中，将 325 名乳腺癌和前列腺癌患者随机分为实验组（可访问 WebChoice）和对照组（提供公共癌症网站的 URL）。
在 Memorial Symptom Assessment Scale 的整体症状困扰指数上，组间差异仅具有统计学意义（斜率估计值，-0.052[95%置信区间，-0.101 至-0.004]；t = 4.42；P =.037）。在次要结果上，组间无显著差异。进一步的分析显示，实验组的抑郁症状在组内得到了显著改善。而在对照组中，自我效能和健康相关生活质量随着时间的推移显著恶化。
这是第一项评估交互式健康交流应用程序支持癌症患者进行疾病管理对症状影响的随机对照试验之一。尽管只有一个假设得到了部分支持，但综合结果显示，干预组在大多数结局测量上的得分都有明显的改善趋势。
如果研究结果能够得到进一步研究的支持，WebChoice 可能成为支持护理的重要工具，使癌症患者能够更好地管理自己的疾病。
