title: Empowerment of Cancer Survivors Through Information Technology: An Integrative Review.
abstract: BACKGROUND
  Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute to empowerment of cancer survivors.
  
  
  OBJECTIVE
  We aim to define the conceptual components of patient empowerment of chronic disease patients, especially cancer survivors, and to explore the contribution of existing and new IT services to promote empowerment.
  
  
  METHODS
  Electronic databases were searched to identify theoretical and empirical articles regarding empowerment. We extracted and synthesized conceptual components of patient empowerment (ie, attributes, antecedents, and consequences) according to the integrated review methodology. We identified recent IT services for cancer survivors by examining systematic reviews and a proposed inventory of new services, and we related their features and effects to the identified components of empowerment.
  
  
  RESULTS
  Based on 26 articles, we identified five main attributes of patient empowerment: (1) being autonomous and respected, (2) having knowledge, (3) having psychosocial and behavioral skills, (4) perceiving support from community, family, and friends, and (5) perceiving oneself to be useful. The latter two were specific for the cancer setting. Systematic reviews of IT services and our additional inventory helped us identify five main categories: (1) educational services, including electronic survivorship care plan services, (2) patient-to-patient services, (3) electronic patient-reported outcome (ePRO) services, (4) multicomponent services, and (5) portal services. Potential impact on empowerment included knowledge enhancement and, to a lesser extent, enhancing autonomy and skills. Newly developed services offer promising and exciting opportunities to empower cancer survivors, for instance, by providing tailored advice for supportive or follow-up care based on patients' input.
  
  
  CONCLUSIONS
  We identified five main components of empowerment and showed that IT services may especially contribute to empowerment by providing knowledge. The components of empowerment could be used to develop IT services for cancer survivors. It is important to take into account patients' needs, follow up on these needs, and create a service that is attractive and easy to use.
authors.affiliation: The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Amsterdam, Netherlands.
authors.forename: Wim G
authors.identifier: http://orcid.org/0000-0002-6300-5189
authors.initials: WG
authors.lastname: Groen
authors.forename: Wilma
authors.identifier: http://orcid.org/0000-0002-5258-5923
authors.initials: W
authors.lastname: Kuijpers
authors.forename: Hester Sa
authors.identifier: http://orcid.org/0000-0001-8626-1401
authors.initials: HS
authors.lastname: Oldenburg
authors.forename: Michel Wjm
authors.identifier: http://orcid.org/0000-0001-6173-0662
authors.initials: MW
authors.lastname: Wouters
authors.forename: Neil K
authors.identifier: http://orcid.org/0000-0003-2574-4850
authors.initials: NK
authors.lastname: Aaronson
authors.forename: Wim H
authors.identifier: http://orcid.org/0000-0001-9580-0489
authors.initials: WH
authors.lastname: van Harten
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000523:psychology*; D011209:Power, Psychological; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*
keywords: Internet; chronic disease; health education; neoplasms; power (psychology); review; technology