Effect of Computer Support on Younger Women with Breast Cancer

National Black Leadership Initiative on Cancer, University of Illinois at Chicago, Chicago, Ill (FMA)
Journal of General Internal Medicine (Impact Factor: 3.42). 12/2001; 16(7):435 - 445. DOI: 10.1046/j.1525-1497.2001.016007435.x
Source: PubMed


OBJECTIVE: Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved.DESIGN: Randomized controlled trial conducted between 1995 and 1998.SETTING: Five sites: two teaching hospitals (Madison, Wis, and Chicago, Ill), two nonteaching hospitals (Chicago), and a cancer resource center (Indianapolis, Ill). The latter three sites treat many underserved patients.PARTICIPANTS: Newly diagnosed breast cancer patients (N = 246) under age 60.INTERVENTIONS: Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support.MEASUREMENTS AND MAIN RESULTS: Pretest and two post-test surveys (at two- and five-month follow-up) measured aspects of participation in care, social/information support, and quality of life. At two-month follow-up, the CHESS group was significantly more competent at seeking information, more comfortable participating in care, and had greater confidence in doctor(s). At five-month follow-up, the CHESS group had significantly better social support and also greater information competence. In addition, experimental assignment interacted with several indicators of medical underservice (race, education, and lack of insurance), such that CHESS benefits were greater for the disadvantaged than the advantaged group.CONCLUSIONS: Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.

Download full-text


Available from: Andrew Salner,
  • Source
    • "There have been several studies linking participation in online cancer social support intervention with behavioral and or health status outcomes including participation in health care, depression, and stress (Gustafson et al., 2001; Winzelberg et al., 2003; Wise, Han, Shaw, McTavish, & Gustafson, 2008). Some of these authors and others have examined the links between what is being said during these interactions and outcomes. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Internet has been used extensively to offer health education content and also for social support. More recently, we have seen the advent of Internet-based health education interventions that combine content with structured social networking. In many ways this is the Internet equivalent to small group interventions. While we have some knowledge about the efficacy of these interventions, few studies have examined how participants engage with programs and how that might affect outcomes. This study seeks to explore (a) the content of posts and (b) the nature of participant engagement with an online, 6-week workshop for cancer survivors and how such engagement may affect health outcomes. Using methodologies related to computational linguistics (latent Dirichlet allocation) and more standard statistical approaches, we identified (a) discussion board themes; (b) the relationship between reading and posting messages and outcomes; (c) how making, completing, or not completing action plans is related to outcome; and (d) how self-tailoring relates to outcomes. When considering all posts, emotional support is a key theme. However, different sets of themes are expressed in the first workshop post where participants are asked to express their primary concern. Writing posts was related to improved outcomes, but reading posts was less important. Completing, but not merely making, action plans and self-tailoring are statistically associated with future positive health outcomes. The findings from these exploratory studies can be considered when shaping future electronically mediated social networking interventions. In addition, the methods used here can be used in analyzing other large electronically mediated social-networking interventions.
    Health Education & Behavior 10/2014; 42(1). DOI:10.1177/1090198114550822 · 2.23 Impact Factor
    • "The results of the present study showed that multimedia method increased the level of pregnant women's awareness about prenatal care up to 6 weeks after intervention. Gustafson et al. (2001) showed there was a significant difference in two groups of computer education and brochure education, concerning awareness of breast cancer in the US.[15] Murray et al. (2001) showed that although use of computer and multimedia increased patients’ awareness of primary care in hypertrophied prostate patients, the difference between these two groups (multimedia and conventional) was not significant.[16] Meanwhile, our results showed the efficacy of both methods of multimedia and illustrated booklet. "
    [Show abstract] [Hide abstract]
    ABSTRACT: E-learning can increase knowledge in patients and provide an efficient way to enhance the personnel-patient interaction as well as patient-specific education materials. So, the aim of this study was to compare the effects of two methods, multimedia and illustrated booklet educational method, on primigravida women's knowledge of prenatal care. This was a quasi-experimental study based on pre- and post-tests carried out on 100 primigravida women (50 in electronic and 50 in illustrated booklet groups) referring to Navabsafavi Health Center of Isfahan University of Medical Sciences in 2012. Subjects were randomly divided into two groups of learning interventions, including multimedia and illustrated booklet. Subjects' knowledge scores were collected using a researcher-made questionnaire with 50 questions. Before training, the mean scores (out of 50) of knowledge in e-learning and illustrated booklet education groups were 29.21 ± 7.4 and 30.01 ± 6.4, respectively. The difference between the mean scores was not significant 4-6 weeks after education. The score was 44.74 ± 3.4 in the e-learning group and 40.74 ± 6.4 in the illustrated booklet group, which showed a statistically significant difference (P < 0.01). Also, the level of knowledge increased in e-learning and illustrated booklet groups as 61% and 37%, respectively. This study showed that the courses of e-learning training improved the knowledge of pregnant women to a higher extent compared to illustrated booklet education. Therefore, different aspects of e-learning, including computer literacy and infrastructure of telecommunications, should be revised.
    Iranian journal of nursing and midwifery research 03/2014; 19(2):127-31.
  • Source
    • "A trained facilitator moderates discussions to ensure that discussions are supportive and do not contain inaccurate or harmful information. The data used in this study were collected as part of a larger randomized clinical trial to examine different component parts of the CHESS ''Living with Breast Cancer'' intervention (Gustafson et al., 2001). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.
    Computers in Human Behavior 01/2014; 30:13-22. DOI:10.1016/j.chb.2013.07.024 · 2.69 Impact Factor
Show more