Effect of computer support on younger women with breast cancer

Abstract

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.

Enhancing psychosocial care for people with cancer in rural communities: what can remote counselling offer?

“…[87][88][89] An RCT of newly diagnosed breast cancer patients using the CHESS system showed mixed results, with stronger short-term benefits but limitations for less literate participants. 90 In one study, 72 women were randomly assigned to either a 12-week web-based social support group for women with breast cancer (with a semi-structured, asynchronous newsgroup format moderated by a health care professional) or waitlist control. 91 Effect sizes were moderate and participants perceived a variety of benefits and high satisfaction with the group.…”

Evaluation of an internet support group for women with primary breast cancer

“…27 The few published reports of web-based breast cancer groups have been either in the form of surveys, analysis of participants' communications, 28,29 or uncontrolled studies. 30 Randomized trials are needed to demonstrate the effectiveness of these interventions, particularly regarding their psychologic benefits.…”

“…27,[32][33][34][35] Designed to provide health-related information, emotional support, and decision-making guidance to patients with various illnesses, CHESS support groups are unmoderated and unstructured. Initial findings indicate that women find CHESS beneficial and easy to use.…”

“…Control group participants were given a copy of "Dr. Susan Love's Breast Book." 36 Gustafson et al 37 found that participants assigned to the CHESS condition reported increased social support and competence with seeking on-line information. There were no differences in quality of life (as measured by the Functional Assessment of Cancer Therapy-B [FACT-B]) or well-being.…”

“…Furthermore, the psychologic benefits of participation were greatest for women from underserved populations. 27 The evidence for effective web-based breast cancer support groups is limited. However, on-line interventions have been found to be beneficial to patients seeking treatment/help for substance abuse, 38 sexual abuse, 39 smoking cessation, 40 general medical concerns, 7 parenting concerns, 41,42 eating disorders, [43][44][45] and anxiety.…”