title: Web-based symptom management for women with recurrent ovarian cancer: a pilot randomized controlled trial of the WRITE Symptoms intervention.
abstract: BACKGROUND
  Little research has focused on symptom management among women with ovarian cancer. Written Representational Intervention To Ease Symptoms (WRITE Symptoms) is an educational intervention delivered through asynchronous web-based message boards between a study participant and a nurse.
  
  
  OBJECTIVE
  We evaluated WRITE Symptoms for 1) feasibility of conducting the study via message boards, 2) system usability, 3) participant satisfaction, and 4) initial efficacy.
  
  
  METHODS
  Participants were 65 women (mean age, 56.5; SD = 9.23) with recurrent ovarian cancer randomized using minimization with race/ethnicity (non-Hispanic white vs. minority) as the stratification factor. Measures were obtained at baseline and two and six weeks after intervention. Outcomes were feasibility of conducting the study, system usability, participant satisfaction, and efficacy (symptom severity, distress, consequences, and controllability).
  
  
  RESULTS
  Fifty-six (87.5%) participants were retained, and the mean usability score (range 1-7) was 6.18 (SD = 1.29). All satisfaction items were scored at 5 (of 7) or higher. There were significant between-group effects at T2 for symptom distress, with those in the WRITE Symptoms group reporting lower distress than those in the control group [t(88.4) = -2.57; P = 0.012], with a similar trend for symptom severity [t(40.4) = -1.95; P = 0.058]. Repeated measures analysis also supported a group effect, with those in the WRITE Symptoms group reporting lower symptom distress than those in the control condition [F(1, 56.7) = 4.59; P = 0.037].
  
  
  CONCLUSIONS
  Participants found the intervention and assessment system easy to use and had high levels of satisfaction. Initial efficacy was supported by decreases in symptom severity and distress.
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA. Electronic address: donovanh@pitt.edu.
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Donovan
authors.affiliation: University of Wisconsin-Madison School of Nursing, Madison, Wisconsin, USA.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Ward
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Knapp
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bender
authors.affiliation: School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.affiliation: University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fields
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA; Carlow University, Pittsburgh, Pennsylvania, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Ingel
mesh_terms: D005240:Feasibility Studies; D005260:Female; D058015:Health Communication / Q000379:methods; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000503:physiopathology* / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000503:physiopathology* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010352:Patient Dropouts; D017060:Patient Satisfaction; D010865:Pilot Projects; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: Ovarian neoplasm; health communication; palliative care; patient education; randomized trial; symptom management; telenursing
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