title: Web based survivorship interventions for women with breast cancer: An integrative review.
abstract: OBJECTIVE
  Breast cancer survivors' experience a range of negative sequelae post-treatment including depression, anxiety, physical side effects from treatment, sexuality concerns and decreased quality of life. Survivorship care is recommended by the IOM to meet the post treatment needs of survivors but implementation is variable and barriers to delivery such as time and resource restraints have been identified. Web-based interventions may be a way to overcome some barriers to providing quality survivorship care that is efficacious, cost efficient and convenient. The purpose of this integrative review is to summarize and synthesize the current research on web-based interventions for breast cancer survivorship care and evaluate the data to determine potential implications for practice.
  
  
  METHODS
  The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this integrative review. Key search terms included breast cancer, survivor, intervention, web, internet and technology. Articles evaluating web-based survivorship interventions (n = 405) for early stage breast cancer patients who completed active therapy were included.
  
  
  RESULTS
  Fifteen studies met inclusion criteria: six randomized controlled trials, six survey based studies, one qualitative study, one retrospective chart review and one mixed methods study. Studies evaluating cognitive behavioral therapy provided the strongest data. Other studies evaluated exercise and lifestyle interventions, symptom management programs and pilot/exploratory work. Findings suggest that web-based survivorship interventions are feasible and acceptable to breast cancer survivors.
  
  
  CONCLUSIONS
  Web-based survivorship interventions have the potential to meet the needs of breast cancer survivors while possibly overcoming some of the documented barriers to survivorship care implementation.
authors.affiliation: Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA. Electronic address: postk@bc.edu.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Post
authors.affiliation: Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; Massachusetts General Hospital, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA. Electronic address: jane.flanagan@bc.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Flanagan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012944:Social Support; D013315:Stress, Psychological / Q000628:therapy*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Intervention; Survivorship; Web-based