title: An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction.
abstract: OBJECTIVE
  The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction.
  
  
  METHODS
  Health care professionals (HCPs) were invited to participate and to recruit TLPs. TLPs were informed on the self-care education program "In Tune without Cords" (ITwC) after which they gained access. A study specific survey was used (at baseline T0 and postintervention T1) on TLPs' uptake. Usage, satisfaction (general impression, willingness to use, user-friendliness, satisfaction with self-care advice and strategies, Net Promoter Score (NPS)), sociodemographic, and clinical factors were analyzed.
  
  
  RESULTS
  HCPs of 6 out of 9 centers (67% uptake rate) agreed to participate and recruited TLPs. In total, 55 of 75 TLPs returned informed consent and the baseline T0 survey and were provided access to ITwC (73% uptake rate). Thirty-eight of these 55 TLPs used ITwC and completed the T1 survey (69% usage rate). Most (66%) TLPs were satisfied (i.e., score ≥7 (scale 1-10) on 4 survey items) with the self-care education program (mean score 7.2, SD 1.1). NPS was positive (+5). Satisfaction with the self-care education program was significantly associated with (higher) educational level and health literacy skills (P = .004, P = .038, respectively). No significant association was found with gender, age, marital status, employment status, Internet use, Internet literacy, treatment modality, time since total laryngectomy, and quality of life.
  
  
  CONCLUSIONS
  The online self-care education program ITwC supporting early rehabilitation was feasible in clinical practice. In general, TLPs were satisfied with the program.
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors: Ingrid C
authors: IC
authors: Cnossen
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.|Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands.
authors: Cornelia F
authors: CF
authors: van Uden-Kraan
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors: Simone E J
authors: SE
authors: Eerenstein
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors: Femke
authors: F
authors: Jansen
authors: Department of Epidemiology and Biostatistics, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors: Birgit I
authors: BI
authors: Witte
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center (MUMC), PO Box 5800, 6202, AZ, Maastricht, The Netherlands.
authors: Martin
authors: M
authors: Lacko
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center (Erasmus MC), PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
authors: José A
authors: JA
authors: Hardillo
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center (Radboud UMC), PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
authors: Jimmie
authors: J
authors: Honings
authors: Department of Otolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center Groningen (UMCG), PO Box 30001, 9700, RD, Groningen, The Netherlands.
authors: Gyorgy B
authors: GB
authors: Halmos
authors: Department of Otolaryngology-Head and Neck Surgery, Medical Center Leeuwarden (MCL), PO Box 888, 8901, BR, Leeuwarden, The Netherlands.
authors: Noortje L Q
authors: NL
authors: Goedhart-Schwandt
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.|Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center (UMCU), PO Box 85500, 3508, GA, Utrecht, The Netherlands.
authors: Remco
authors: R
authors: de Bree
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors: C René
authors: CR
authors: Leemans
authors: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center (VUmc), PO Box 7057, 1007, MB, Amsterdam, The Netherlands. im.verdonck@vumc.nl.|Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands. im.verdonck@vumc.nl.
authors: Irma M
authors: IM
authors: Verdonck-de Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D020407:Internet; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Laryngeal cancer; Self-care; Total laryngectomy; eHealth