title: Effects of an internet support system to assist cancer patients in reducing symptom distress: a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Shared Decision Making and Collaborative Care, Oslo University Hospital, Norway. cornelia.ruland@rr-research.no
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ruland
authors.forename: Trine
authors.initials: T
authors.lastname: Andersen
authors.forename: Annette
authors.initials: A
authors.lastname: Jeneson
authors.forename: Shirley
authors.initials: S
authors.lastname: Moore
authors.forename: Gro H
authors.initials: GH
authors.lastname: Grimsbø
authors.forename: Elin
authors.initials: E
authors.lastname: Børøsund
authors.forename: Misoo C
authors.initials: MC
authors.lastname: Ellison
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D011471:Prostatic Neoplasms / Q000523:psychology*; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D020377:Self Efficacy; D012944:Social Support; D063189:Symptom Assessment / Q000379:methods