The effects of Internet or interactive computer-based patient education in the field of breast cancer: A systematic literature review

Department of Nursing Science, University of Turku and Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland.
Patient Education and Counseling (Impact Factor: 2.6). 10/2009; 79(1):5-13. DOI: 10.1016/j.pec.2009.08.005
Source: PubMed

ABSTRACT The aim of this systematic review was to analyze what kind of Internet or interactive computer-based patient education programs have been developed and to analyze the effectiveness of these programs in the field of breast cancer patient education. Patient education for breast cancer patients is an important intervention to empower the patient. However, we know very little about the effects and potential of Internet-based patient education in the empowerment of breast cancer patients.
Complete databases were searched covering the period from the beginning of each database to November 2008. Studies were included if they concerned patient education for breast cancer patients with Internet or interactive computer programs and were based on randomized controlled, on clinical trials or quasi-experimental studies.
We identified 14 articles involving 2374 participants. The design was randomized controlled trial in nine papers, in two papers clinical trial and in three quasi-experimental. Seven of the studies were randomized to experimental and control groups, in two papers participants were grouped by ethnic and racial differences and by mode of Internet use and three studies measured the same group pre- and post-tests after using a computer program. The interventions used were described as interactive computer or multimedia programs and use of the Internet. The methodological solutions of the studies varied. The effects of the studies were diverse except for knowledge-related issues. Internet or interactive computer-based patient education programs in the care of breast cancer patients may have positive effect increasing breast cancer knowledge.
The results suggest a positive relationship between the Internet or computer-based patient education program use and the knowledge level of patients with breast cancer but a diverse relationship between patient's participation and other outcome measures.
There is need to develop and research more Internet-based patient education.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background There is growing recognition of the importance of the active involvement of consumers and community members in health care. Despite the long history of consumer and community engagement (CCE) research and practice, there is no consensus on the best strategies for CCE. In this paper, we identify various dimensions of CCE-related strategies and offer a practical model to assist policy-makers, practitioners and researchers. Methods We undertook a large-scale, scoping meta-review and searched six databases using a list of nine medical subject headings (MeSH) and a comprehensive list of 47 phrases. We identified and examined a total of 90 relevant systematic reviews. Results Identified reviews show that although there is a significant body of research on CCE, the development of the field is hindered by a lack of evidence relating to specific elements of CCE. They also indicate a diverse and growing enterprise, drawing on a wide range of disciplinary, political and philosophical perspectives and a mix of definitions, targets, approaches, strategies and mechanisms. CCE interventions and strategies aim to involve consumers, community members and the public in general, as well as specific sub-groups, including children and people from culturally and linguistically diverse backgrounds. Strategies for CCE vary in terms of their aim and type of proposed activity, as do the methods and tools which have been developed to support them. Methods and tools include shared decision making, use of decision aids, consumer representation, application of electronic and internet-based facilities, and peer support. The success of CCE is dependent on both the approach taken and contextual factors, including structural facilitators such as governmental support, as well as barriers such as costs, organisational culture and population-specific limitations. Conclusions The diversity of the field indicates the need to measure each component of CCE. This meta-review provides the basis for development of a new eight stage model of consumer and community engagement. This model emphasises the importance of clarity and focus, as well as an extensive evaluation of contextual factors within specific settings, before the implementation of CCE strategies, enabling those involved in CCE to determine potential facilitators and barriers to the process.
    BMC Health Services Research 09/2014; 14:402. DOI:10.1186/1472-6963-14-402 · 1.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: information are expected to adhere to the terms and constraints invoked by each author's copyright. In most cases, these works may not be reposted without the explicit permission of the copyright holder. This version of the referenced work is the post-print version of the article—it is NOT the final published version nor the corrected proofs. If you would like to receive the final published version please send a request to Paul at, and I will be happy to send you the latest version. Moreover, you can contact the publisher's website and order the final version there, as well. The current reference for this work is as follows: (2015). "Patient compliance behavior in a mobile healthcare system: An integration of theories of rational choice and planned behavior, If you have any questions and/or would like copies of other articles we've published, please email Paul at (or any of the other authors) and we'd be happy to help. Paul's vita can be found at Paul also has an online system that you can use to request any of his published or forthcoming articles. To go to this system, click on the following link: Abstract The lack of patient compliance to medical recommendations and treatments suggested by doctors has long been a significant problem. In practice, patient education is considered an important intervention to empower patients and increase their compliance. It has been advocated as a means of improving patient medical knowledge and compliance. However, evidence of the efficacy of computer-aided patient education is still relatively limited; little is known on how the latest mobile technologies affect patients' compliance behavior. Based on Rational Choice Theory (RCT) and Theory of Planned Behavior (TPB), we propose and test a research model to investigate the compliance behavior of patients supported by a mobile healthcare system. We conducted a field survey with actual patients in the U.S. who used the system, and employed SEM techniques for data analysis. Overall, we found strong support for using RCT and TPB as a key theoretical foundation to assess patients' compliance behavior.
    Hawaii International Conference on Systems Sciences (HICSS 2015), Kauai, HI, January 5–8 (accepted 17-Aug-2014), Kauai, HI; 01/2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Increasingly, Information and Communication Technology (ICT) applications enter the daily lives of consumers. Availability of various multimedia interfaces offers the opportunity to develop and adjust ICT solutions to all aspects of society including health care. To address the challenges of the ongoing adaptive progress of ICT, decision makers profit from estimates of expectable merits and risks of future technological developments. The aim of the present study was to assess the prevailing opinions and expectations among Austrian stakeholders regarding ICT-assisted health promotion. Methods In total, 73 experts (74% males) engaged in the Austrian health care sector participated in a biphasic online Delphi survey. Panellists were assigned to three groups representing medical professionals, patient advocates, and administrative personnel. In a scenario-based questionnaire, experts evaluated potential advantages and barriers as well as degree of innovation, desirability, and estimated date of implementation of six future ICT scenarios. Scenario-specific and consolidated overall opinions were ranked. Inter-group differences were assessed using ANOVA. Results Panellists expected the future ICT-supported health promotion strategies to especially improve the factors living standard (56%), quality of health care (53%), and patient's knowledge (44%). Nevertheless, monetary aspects (57%), acceptance by patient advocates (45%), and data security and privacy (27%) were considered as the three most substantial hampering factors for ICT applications. Although overall mean desirability of the scenarios was quite high (80%) amongst panellists, it was considerably lower in medical professionals compared to patient advocates and administrative personnel (p = 0.006). This observation suggests a more precautious attitude of this specific interest group regarding technological innovations. Conclusions The present Delphi survey identified issues relevant for successful implementation of ICT-based health care solutions, providing a compilation of several areas that might require further research. In the light of ageing societies facing the perceived threat of permanent online surveillance, different requirements and expectations of end users should be accounted for by various stakeholders. Thus, close collaboration could facilitate the harmonization process on hot health topics among interest groups.
    International Journal of Medical Informatics 09/2014; DOI:10.1016/j.ijmedinf.2014.09.005 · 2.72 Impact Factor