Use of an interactive web-based questionnaire to evaluate a breast cancer website

Perspectives of Healthcare Providers and the General Population on a Cancer Awareness Portal: a Qualitative Study

This study was aimed at a qualitative assessment of a cancer informational website, "India Against Cancer," developed by the ICMR-National Institute of Cancer Prevention and Research with the dual purpose of promoting cancer awareness among the general population and providing comprehensive information to healthcare providers. We used the narrative qualitative approach (data collection using in-depth interviews (IDIs) and focused group discussions (FGDs)) and content analysis. Purposive sampling was undertaken for both IDIs and FGDs. Thematic analysis was done on four themes: general cancer awareness, ease of comprehension of the Web portal, the relevance of the website content, and general comments and suggestions. Readability assessment of content of the website was conducted using Flesch-Kincaid Readability methodology. The general cancer awareness was enhanced among the participants after visiting the website. Ease of comprehension of the Web portal content was reported to fare well. The sections on "risk factors," "warning signs," and "diet and cancer" were mentioned as most relevant by the general population, whereas "myths and facts" and "screening guidelines" were most relevant for the healthcare workers. Similarly, references and epidemiology sections were most useful for healthcare researchers/professionals. Readability scores of content in English were appropriate for high school pass audience. The content on "India Against Cancer" website was found to serve its intended purpose of promoting cancer awareness among the general population and providing authentic cancer-related information to the healthcare providers. The suggestions received would enable us to enhance the utility of our website by tailoring it to the needs of the target audience.

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

Background

Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages).

Objective

Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes.

Methods

Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes.

Results

A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features.

Conclusions

The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be applied by designers of health-related websites.

Educating our patients collaboratively: a novel interprofessional approach

Providing cancer patients with more information regarding their treatments allows them to feel more in control, increases self efficacy, and can decrease anxiety. The aims of the present study were to develop an interprofessional group education session and to evaluate the usefulness and acceptability of this session. In addition, informational distress levels pre- and post-education were evaluated. A prostate radiation therapy (RT) education session was developed and facilitated by an interprofessional team. Topics discussed included how RT works, side effects and management, and support services available. Prior to the education session, participants reported their informational RT distress levels using the validated Distress Thermometer (DT). Post-education session, the DT was readministered. In addition, participants completed an acceptability survey to assess format, structure, and usefulness of the education session. Participants agreed that the session contained valuable and useful information helping them understand expectations during treatment, including resource availability, side effects and management, as well as procedural expectation during treatment. All stated they would recommend the session to other patients. The interprofessional nature of the sessions was deemed useful. Suggested areas for improvement included addition of a dietitian, information on long-term side effects, statistics of radiotherapy side effects, impact of radiotherapy on sexual function, and overall quality of life. The group education session significantly improved informational distress levels (p = 0.04). Educating prostate cancer patients utilizing an interprofessional group format can decrease anxiety and stress related to their RT treatment. Future development of group education sessions for other disease site groups may be valuable.

A Pilot Study Evaluating the Usability and Usefulness of a Multi-language Online Patient Education Tool for Patients Undergoing Radiation Treatment: Findings from a Student Project

PURPOSE

Treatment-related information is the most important informational need of cancer patients and online media sources are gaining popularity as a cancer communication method. Our aim was to determine if new multilanguage patient online education modules in radiation therapy are usable and beneficial for the multicultural cancer patient population who may face language barriers.

METHODS

Eight new patients from the radiation oncology clinic at the Odette Cancer Centre (OCC) were recruited to participate in the study over a 3-month period. Testing involved a combination of interviewing, observation, think-aloud methodology, and short survey. Results were analyzed using thematic analysis of responses to the interviews and open-ended survey questions, in addition to Likert scale ratings.

RESULTS

Patients were satisfied with the survey (mean = 96/100) and indicated a high usability score citing the general ease of navigation and clear presentation of information. The usefulness mean score was relatively lower; participants wanted more specific information related to their treatment site and anticipated side effects. There was no consensus on the accessibility of the module. Although all participants appreciated the multilanguage capabilities of the modules, they indicated that the number of languages represented in the modules should be increased.

CONCLUSION

Multilanguage online modules were a good communication tool for patients; however, improvements on the content and language availability were indicated by the study participants.

A qualitative framework to assess hospital / medical websites

Nowadays, there are many peoples who access to the internet to search for a proper hospital with their desired medical services. Hence, the website quality of hospitals or medical centers is very important to help patients/users. However, to design high qualitative medical websites, we should first know the medical quality metrics. Then, we should try to find a way to assess different medical websites based on the quality metrics. In fact, medical websites may have a significant role to increase the society's knowledge about people health, provided services for patients etc. Thus, it is necessary to design a framework to evaluate the quality of these websites. Even though there are many medical websites, unfortunately, there are a few studies about quality analysis of medical/hospital websites. In this paper, we propose a qualitative framework to assess different medical websites. The proposed framework consists of 7 main categories, each having different metrics. Finally, to show how these metrics can help designers to assess the websites quality, we have considered 3 different hospitals as case studies. We asked different people including doctors, website designers, and usual peoples to evaluate our defined metrics on each case study. At the end, the results are shown through different charts.

Exploring nurses' attitudes to, and use of, an online palliative care resource

AIM

The internet provides access to information and evidence that can support palliative care practice. This study aims to evaluate the use and utility of a palliative care website with particular regard to its use and issues for nurses. STUDY DETAILS: A survey of online visitors and a postal survey of staff working in palliative care services were conducted; 134 visitors completed the survey and 371 staff in palliative services responded.

FINDINGS

Users of the site found the content credible and over 95% would recommend the site to others. Over 90% of specialist palliative care nurses use online resources and half use the CareSearch website. Awareness of the resource was much lower for registered nurses than specialist nurses working in palliative care.

CONCLUSION

Understanding attitudes to, and use of, online palliative care resources by nurses working in palliative care services could help to develop these resources to more effectively meet their needs and circumstances.

Internet use among adolescent and young adults (AYA) with cancer

BACKGROUND

The Internet serves as an important resource for adult cancer patients, but little is known about Internet use among adolescent and young adults (AYA) with cancer. The aims of this study were to describe (1) cancer-specific websites which AYA with cancer visit and (2) Internet features desired by AYA on cancer-specific websites and how many current AYA cancer websites contain these features.

PROCEDURE

Individual phone interviews were conducted with a convenience sample of 16 AYA with cancer from across North America in June 2005. Content analysis of these interviews were coded and validated for desired website features. Current AYA cancer websites were identified on the Internet and the features on these sites were compared to the features desired by our sample.

RESULTS

Favorite websites visited by AYA with cancer (cancer-related and unrelated) were identified along with current Internet use. Twenty-one distinct cancer website features desired by AYA with cancer were described. Twenty-seven unique AYA cancer websites were found on the Internet during May-June 2006. Each site contained 7.7 (SD = 2.7) of the 21 features identified by participants as desirable, but the highest ranked features did not occur in the majority of these websites.

CONCLUSIONS

AYA with cancer indicate that they prefer to visit cancer websites that contain cancer-related information, provide the ability to chat with AYA with cancer, and offer some type of game. Although many websites exist for AYA with cancer, few individual sites contain the web features identified as most desired by AYA with cancer.

Doctor, what are my chances of having a positive sentinel node? A validated nomogram for risk estimation

PURPOSE

Lymph node metastasis is a multifactorial event. Several variables have been described as predictors of lymph node metastasis in breast cancer. However, it is difficult to apply these data-usually expressed as odds ratios-to calculate the probability of sentinel lymph node (SLN) metastasis for a specific patient. We developed a user-friendly prediction model (nomogram) based on a large data set to assist in predicting the presence of SLN metastasis.

PATIENTS AND METHODS

Clinical and pathologic features of 3,786 sequential SLN biopsy procedures were assessed with multivariable logistic regression to predict the presence of SLN metastasis in breast cancer. The model was subsequently applied to 1,545 sequential SLN biopsies. A nomogram was created from the logistic regression model. A computerized version of the nomogram was developed and is available on the Memorial Sloan-Kettering Cancer Center (New York, NY) Web site.

RESULTS

Age, tumor size, tumor type, lymphovascular invasion, tumor location, multifocality, and estrogen and progesterone receptors were associated with SLN metastasis in multivariate analysis. The nomogram was accurate and discriminating, with an area under the receiver operating characteristic curve of 0.754 when applied to the validation group.

CONCLUSION

Newly diagnosed breast cancer patients are increasingly interested in information about their disease. This nomogram is a useful tool that helps physicians and patients to accurately predict the likelihood of SLN metastasis.