title: Examining the Impact of a Web-Based Intervention to Promote Patient Activation in Chemotherapy-Induced Peripheral Neuropathy Assessment and Management.
abstract: Lack of activation in self-care can compromise a patient's ability to monitor and manage cancer treatment-related side effects, such as chemotherapy-induced peripheral neuropathy (CIPN). The web-based Carevive® Care Planning System (CPS) was developed to promote evidence-based symptom assessment and treatment by enhancing patients' involvement in their own care. The purpose of this single-arm, pre-test/post-test, prospective study was to examine whether the CPS can promote patient activation in CIPN symptom assessment and management. Seventy-five women with breast cancer receiving neurotoxic chemotherapy were recruited from a Comprehensive Cancer Center. Using standardized neuropathy measures embedded within the CPS, patients reported their CIPN symptoms over three consecutive clinical visits and completed the Patient Activation Measure (PAM) at the first and third visits. Mean changes in PAM scores between visits were compared using repeated measure analysis of covariance, adjusting for age. At baseline, patients were diagnosed with cancer within the past year (94.7%), highly activated (85% Level III/IV), and had a mean age of 51.3. PAM scores improved significantly from 67.15 (SD = 13.5; range = 47-100) at visit one to 69.29 (SD = 16.18; range = 47-100) (p = 0.02) (n = 62) at visit three. However, patients perceived the CPS to be of minimal value because it solely focused on CIPN and, for many, CIPN was not severe enough to motivate them to seek out symptom management information. Further research is needed to assess the utility of the CPS in promoting activation in the assessment and management of varying cancer treatment-related symptoms.
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, USA. rjknoerl@umich.edu.
authors.forename: Robert
authors.identifier: 0000-0002-6996-5068
authors.initials: R
authors.lastname: Knoerl
authors.affiliation: Michigan State University College of Nursing, East Lansing, MI, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Lee
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, USA.
authors.forename: James
authors.initials: J
authors.lastname: Yang
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, USA.
authors.forename: Celia
authors.initials: C
authors.lastname: Bridges
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Kanzawa-Lee
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: G
authors.initials: G
authors.lastname: Lita Smith
authors.affiliation: University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Lavoie Smith
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000628:therapy; D010358:Patient Participation; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy*; D011446:Prospective Studies; D012648:Self Care / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer symptom management; Chemotherapy-induced peripheral neuropathy; Patient activation; Peripheral nervous system disease/chemically induced; Technology assessment