Online Support Tool Reduces Depression, Ups QOL in Cancer Patients

Results of a large 1-year randomized controlled trial have shown that a web-based interactive support system tailored for cancer patients reduced patients’ feelings of depression and improved their sense of well being, compared with being given access to resources that are publically available on the internet. The study was reported online first April 9 in the journal Cancer Nursing.

A web-based interactive support system tailored for cancer patients reduced patients’ feelings of depression and improved their sense of well being

The lead author is Cornelia M. Ruland, RN, PhD, director of the Center for Shared Decision Making and Nursing Research, Rikshospitalet University Hospital, Oslo, Norway, and an adjunct assistant professor of medical informatics at Columbia University, New York. Her coauthors are other researchers from Oslo University and one investigator from Case Western Reserve University, Cleveland, Ohio: Shirley M. Moore, PhD, RN, FAAN, the Edward J. and Louise Mellen Professor of Nursing and Associate Dean for Research.

The investigators assessed WebChoice, which they described as an “interactive health communication application that allows cancer patients to monitor their symptoms and problems, [and which] provides individually tailored information and self-management support, e-communication with expert cancer nurses, and an e-forum for group discussion with other patients.”

For the study, 325 patients with breast or prostate cancer were randomized into either an experimental group that had access to WebChoice or a control group who were given URLs of publicly available websites for patients with cancer. The primary objective was to assess the impact of WebChoice on symptom distress. Secondary objectives included changes in levels of depression, self-efficacy, health-related quality of life, and social support.

The researchers found that patients randomized to WebChoice had lower symptom distress based on the global symptom distress index of the Memorial Symptom Assessment Scale (P = .037), a validated patient-rated instrument that provides information about a variety of common symptoms. While no significant group differences were seen in terms of secondary outcomes, additional analyses showed significant improvements in depression for some patients in the WebChoice group only. Regarding the control group given the cancer website URLs, the investigators reported that “self-efficacy and health-related quality of life deteriorated significantly over time.”

In discussing the results, Dr. Ruland and colleagues wrote that their study “is one of the first to evaluate effects of an interactive health communication application to support cancer patients in [symptom] management,” noting that “the combined results show a clear trend toward better scores in the intervention group on most outcome measures,” and adding that if additional research supports these initial findings, “WebChoice may become an important tool to support nursing care that can equip cancer patients to better manage their illness.”