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Im EO, Chee W, Paul S, Choi MY, Kim SY, Yeo S, Ulrich CM, Schapira MM, Nguyen GT, Meghani S, Mao JJ, Ma G, Inouye J, Deatrick JA, Shin D, Bao T. Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:335-348. [PMID: 38594385 PMCID: PMC11186045 DOI: 10.1007/s13187-024-02415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 04/11/2024]
Abstract
Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1 month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.
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Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA.
| | - Wonshik Chee
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | | | - Mi-Young Choi
- Emory University, Atlanta, USA
- Chungbuk National University, Cheongju, South Korea
| | - Seo Yun Kim
- Emory University, Atlanta, USA
- Department of Nursing, Gangneung-Wonju National University, Gangwon-do, South Korea
| | - SeonAe Yeo
- The University of North Carolina, Chapel Hill, Chapel Hill, USA
| | | | | | | | | | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Grace Ma
- Temple University, Philadelphia, USA
| | | | | | - David Shin
- The University of California, Los Angeles, Los Angeles, USA
| | - Ting Bao
- Integrative Breast Oncology, Dana-Farber Cancer Institute, Boston, USA
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Lepore SJ, Rincon MA, Buzaglo JS, Golant M, Lieberman MA, Bauerle Bass S, Chambers S. Digital literacy linked to engagement and psychological benefits among breast cancer survivors in Internet-based peer support groups. Eur J Cancer Care (Engl) 2020; 28:e13134. [PMID: 31318132 DOI: 10.1111/ecc.13134] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Internet-based peer support groups (ISGs) represent an innovative, scalable approach to addressing information and support needs of cancer survivors. However, this innovation may not benefit survivors equally due to population variance in digital literacy. This study examined how digital literacy influences level of engagement in and psychological benefits from participating in ISGs for breast cancer (N = 183). METHODS Secondary analysis of data from a randomised trial of ISGs that included behavioural measures of engagement, subjective ratings and psychological distress symptoms. RESULTS Digital literacy was positively related to education level (p = .005). Relative to women with high digital literacy, those with lower digital literacy were more likely to report difficulties using the ISG and to value the user's guide and facilitator assistance (all p's < .05). Digital literacy was negatively correlated with computer anxiety pre-intervention, distress before and after online chat during the intervention and post-intervention depressive symptoms (all p's < .05). CONCLUSION Low digital literacy is associated with computer anxiety and barriers to ISG use, as well as distress during and after ISG use. Digital literacy must be taken into account when designing or delivering innovative digital interventions for cancer survivors.
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Affiliation(s)
- Stephen J Lepore
- Department of Social & Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | | | | | - Mitch Golant
- The Cancer Support Community, Philadelphia, PA, USA
| | | | | | - Suzanne Chambers
- University of Technology Sydney, Sydney, New South Wales, Australia
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Gupta T, Schapira L. Online Communities as Sources of Peer Support for People Living With Cancer: A Commentary. J Oncol Pract 2018; 14:JOP1800261. [PMID: 30335558 DOI: 10.1200/jop.18.00261] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Online communities are virtual spaces dedicated to hosting conversations between individuals with a common interest. Information can be shared and obtained incrementally, as users can periodically post both questions and responses to other users' questions. Although online communities have been used frequently by patients for a myriad of health issues, much remains to be learned about these resources. In this commentary, we explore the emerging role of online communities as forums for information exchange and sources of support for patients with cancer and caregivers. We discuss selected examples of online communities launched by research institutions, advocacy groups, philanthropic organizations, start-ups, and novel enterprises featuring collaborations between industry, health care professionals, and advocates. We explore the risks and benefits of online communities as perceived by oncology clinicians and provide practical recommendations for improving communication between clinicians and patients about the use of online resources.
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Affiliation(s)
- Tanya Gupta
- Stanford Cancer Institute; Stanford University, Stanford, CA
| | - Lidia Schapira
- Stanford Cancer Institute; Stanford University, Stanford, CA
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Chee W, Lee Y, Im EO, Chee E, Tsai HM, Nishigaki M, Yeo SA, Schapira M, Mao JJ. A culturally tailored Internet cancer support group for Asian American breast cancer survivors: A randomized controlled pilot intervention study. J Telemed Telecare 2017; 23:618-626. [PMID: 27486198 PMCID: PMC6186171 DOI: 10.1177/1357633x16658369] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The necessity of culturally competent Internet Cancer Support Groups (ICSGs) for ethnic minorities has recently been highlighted in order to increase its attractiveness and usage. The purpose of this study was to determine the preliminary efficacy of a culturally tailored registered-nurse-moderated ICSG for Asian American breast cancer survivors in enhancing the women's breast cancer survivorship experience. Methods The study included two phases: (a) a usability test and an expert review; and (b) a randomized controlled pilot intervention study. The usability test was conducted among five Asian American breast cancer survivors using a one-month online forum, and the expert review was conducted among five experts using the Cognitive Walkthrough method. The randomized controlled pilot intervention study (a pre-test and post-test design) was conducted among 65 Asian American breast cancer survivors. The data were analysed using content analysis and descriptive and inferential statistics including the repeated ANOVA. Results All users and experts positively evaluated the program and provided their suggestions for the display, educational contents, and user-friendly structure. There were significant positive changes in the support care needs and physical and psychological symptoms ( p < 0.05) of the control group. There were significant negative changes in the uncertainty level of the intervention group ( p < 0.10). Controlling for background and disease factors, the intervention group showed significantly greater improvements than the control group in physical and psychological symptoms and quality of life ( p < 0.10). Discussion The findings supported the positive effects of ICSGs on support care needs, psychological and physical symptoms, and quality of life.
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Affiliation(s)
| | - Yaelim Lee
- Yeouido St. Mary’s Hospital, Seoul, Korea,
| | | | | | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, Taipei, Taiwan,
| | | | - Seon Ae Yeo
- University of North Caronia, Chapel Hill, NC,
| | | | - Jun James Mao
- Memorial Sloan-Kettering Cancer Center, New York, NY,
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McCaughan E, Parahoo K, Hueter I, Northouse L, Bradbury I. Online support groups for women with breast cancer. Cochrane Database Syst Rev 2017; 3:CD011652. [PMID: 28278559 PMCID: PMC6464660 DOI: 10.1002/14651858.cd011652.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Survival rates for women with a diagnosis of breast cancer continue to improve. However, some women may experience physical, psychological and emotional effects post diagnosis, throughout treatment and beyond. Support groups can provide opportunities for people to share their experiences and learn from others. As the number of online support groups increases, more and more women with breast cancer will likely access them. OBJECTIVES To assess effects of online support groups on the emotional distress, uncertainty, anxiety, depression and quality of life (QoL) of women with breast cancer. SEARCH METHODS We searched for trials in the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4), MEDLINE, Embase and PsycINFO on 2 May 2016, and we handsearched journals and reference lists. We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) search portal and clinicaltrials.gov on 2 May 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs) assessing effects of online support groups on women with a diagnosis of breast cancer and women who have completed breast cancer treatment. We included studies comparing online support groups with a usual care group, and studies comparing two or more types of online support groups (without a usual care group). DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias. We presented outcome data using mean differences (MDs) and standardised mean differences (SMDs) along with 95% confidence intervals (CIs), and we used the fixed-effect model when appropriate. We assessed the quality of the body of evidence using the GRADE approach. MAIN RESULTS We included six studies (492 women) that assessed online support groups for women with breast cancer. Online support groups in these six trials lasted from six to 30 weeks. Women participated in these groups between 1.5 and 2.5 hours per week, and investigators conducted all studies in the USA. Participants were predominantly white and well educated and were moderate to high earners. Four studies compared an online support group versus a control group, and the other two compared a 'moderated' versus a 'peer-led' online support group, and a 'standard' versus an 'enhanced' online support group, respectively.None of the included studies measured 'emotional distress' or uncertainty. One study (78 women) for which data for analysis were missing reported no positive effects of online support on 'distress' and 'cancer-specific distress' versus support provided by a control group. Two studies measured anxiety: One study (72 women) found no difference in anxiety at the end of the intervention between the online support group and the control group (MD -0.40, 95% CI -6.42 to 5.62; low-quality evidence), and the second study (184 women) reported a reduction in anxiety levels at the end of the intervention when comparing the 'standard' support group (run by participants without prompting from health professionals) versus an 'enhanced' online support group (in which participants were specifically asked by the researcher to respond to one another's need for support).Five studies (414 women) measured depression. Three studies compared depression in the online support group with depression in the control group. Pooled data from two studies (120 women) showed a small to moderate reduction in depression in the online support group compared with control groups at the end of the intervention (SMD -0.37, 95% CI -0.75 to 0.00; very low-quality evidence). The third study, a pilot study (30 women), provided no data for analysis but reported no difference in depression between participants in support and control groups at the end of the intervention. Of the remaining two studies that measured depression, one study (60 women) provided no extractable data for comparison but reported no difference in depressive symptoms between a 'moderated' and a 'peer-led' support group; the other study (184 women) reported greater reduction in depression in the 'standard' support group than in the 'enhanced' online support group.Three studies measured quality of life. One pilot study (30 women) provided limited data for analysis but reported no change in quality of life at the end of the intervention. Only two studies (140 women) provided data for pooling and showed no positive effects on quality of life at four months post intervention compared with controls (SMD -0.11, 95% CI -0.47 to 0.24; very low-quality evidence). At 12 months post intervention, one study (78 women) reported that the intervention group did not attain better quality of life scores than the control group (MD -10.89, 95% CI -20.41 to -1.37; low-quality evidence).We found no data for subgroup analyses on stage of disease, treatment modality and types and doses of interventions. No studies measured adverse effects. AUTHORS' CONCLUSIONS This review did not find the evidence required to show whether participation in online support groups was beneficial for women with breast cancer, because identified trials were small and of low or very low quality. Large, rigorous trials with ethnically and economically diverse participants are needed to provide robust evidence regarding the psychosocial outcomes selected for this review.
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Affiliation(s)
- Eilis McCaughan
- Ulster UniversityInstitute of Nursing and Health ResearchColeraineUKBT52 1SA
| | - Kader Parahoo
- Ulster UniversityInstitute of Nursing and Health ResearchColeraineUKBT52 1SA
| | - Irene Hueter
- Columbia UniversityStatistics Department1255 Amsterdam AvenueNew YorkNYUSA10027
| | - Laurel Northouse
- University of MichiganSchool of Nursing400 N.IngallsAnn ArborMichiganUSA48105
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Chee W, Kim S, Chu TL, Tsai HM, Ji X, Zhang J, Chee E, Im EO. Practical Issues in Developing a Culturally Tailored Physical Activity Promotion Program for Chinese and Korean American Midlife Women: A Pilot Study. J Med Internet Res 2016; 18:e303. [PMID: 27872035 PMCID: PMC5138450 DOI: 10.2196/jmir.6454] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/24/2016] [Accepted: 10/29/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND With advances in computer technologies, Web-based interventions are widely accepted and welcomed by health care providers and researchers. Although the benefits of Web-based interventions on physical activity promotion have been documented, the programs have rarely targeted Asian Americans, including Asian American midlife women. Subsequently, culturally competent Web-based physical activity programs for Asian Americans may be necessary. OBJECTIVE The purpose of our study was to explore practical issues in developing and implementing a culturally competent Web-based physical activity promotion program for 2 groups of Asian American women-Chinese American and Korean American midlife women-and to provide implications for future research. METHODS While conducting the study, the research team members wrote individual memos on issues and their inferences on plausible reasons for the issues. The team had group discussions each week and kept the minutes of the discussions. Then, the memos and minutes were analyzed using a content analysis method. RESULTS We identified practical issues in 4 major idea categories: (1) bilingual translators' language orientations, (2) cultural sensitivity requirement, (3) low response rate, interest, and retention, and (4) issues in implementation logistics. CONCLUSIONS Based on the issues, we make several suggestions for the use of bilingual translators, motivational strategies, and implementation logistics.
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Affiliation(s)
- Wonshik Chee
- School of Nursing, Duke University, Durham, NC, United States
| | - Sangmi Kim
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Tsung-Lan Chu
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Hsiu-Min Tsai
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Xiaopeng Ji
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, United States
| | - Eunice Chee
- School of Nursing, Duke University, Durham, NC, United States
| | - Eun-Ok Im
- School of Nursing, Duke University, Durham, NC, United States
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Im EO, Ji X, Zhang J, Kim S, Lee Y, Chee E, Chee W, Tsai HM, Nishigaki M, Yeo SA, Schapira M, Mao JJ. Issues in Developing and Evaluating a Culturally Tailored Internet Cancer Support Group. Comput Inform Nurs 2016; 34:462-469. [PMID: 27379523 PMCID: PMC5067957 DOI: 10.1097/cin.0000000000000261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this article is to explore practical issues in developing and implementing a culturally tailored Internet Cancer Support Group for a group of ethnic minority patients with cancer-Asian Americans. Throughout the research process of the original study testing the Internet cancer support group, the research team made written records of practical issues and plausible rationales for the issues. Weekly group discussion among research team members was conducted, and the discussion records were evaluated and analyzed using a content analysis (with individual words as the unit of analysis). The codes from the analysis process were categorized into idea themes, through which the issues were extracted. The issues included those in (1) difficulties in using multiple languages, (2) collaboration with the information technology department and technical challenges, (3) difficulties in recruitment, (4) difficulties in retention, (5) optimal timing, and (6) characteristics of the users. Based on the findings, we suggest that researchers plan a workable translation process, check technical needs in advance, use multiple strategies to recruit and retain research participants, plan the right time for data collection, and consider characteristics of the users in the study design.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania
| | - Xiaopeng Ji
- School of Nursing, University of Pennsylvania
| | - Jingwen Zhang
- Annenberg School for Communication, University of Pennsylvania
| | - Sangmi Kim
- School of Nursing, University of Pennsylvania
| | - Yaelim Lee
- School of Nursing, University of Pennsylvania
| | - Eunice Chee
- School of Engineering and Applied Science, University of Pennsylvania
| | | | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, Taiwan
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Pezaro S, Clyne W, Gerada C. Confidentiality, anonymity and amnesty for midwives in distress seeking online support - Ethical? Nurs Ethics 2016; 25:481-504. [PMID: 27377890 DOI: 10.1177/0969733016654315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Midwife health is intrinsically linked to the quality of safe patient care. To ensure safe patient care, there is a need to deliver emotional support to midwives. One option that midwives may turn to may be a confidential online intervention, instead of localised, face-to-face support. RESEARCH DESIGN Following the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards, this realist synthesis approach explores the ethical considerations in permitting confidentiality, anonymity and amnesty in online interventions to support midwives in work-related psychological distress. An iterative search methodology was used to select nine papers for review. To assimilate information, papers were examined for ideas relating to ethical dimensions of online interventions to support midwives in work-related psychological distress. This review takes a narrative approach. FINDINGS Online interventions can support the development of insight, help seeking and open discussion. Additionally, Internet support groups can become morally persuasive in nature. Anonymity and confidentiality are both effective and therapeutic features of online interventions when used in collaboration with effective online moderation. Yet, ethical dilemmas remain where users cannot be identified. DISCUSSION Confidentiality and anonymity remain key components of successful online interventions. However, sanctioning the corollary component of amnesty may provoke moral discomfort for those seeking immediate accountability. For others, amnesty is seen as essential for open disclosure and help seeking. Ultimately, the needs of midwives must be balanced with the requirement to protect the public and the professional reputation of midwifery. CONCLUSION In supporting midwives online, the principles of anonymity, confidentiality and amnesty may evoke some resistance on ethical grounds. However, without offering identity protection, it may not be possible to create effective online support services for midwives. The authors of this article argue that the principles of confidentiality, anonymity and amnesty should be upheld in the pursuit of the greatest benefit for the greatest number of people.
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Im EO, Lee Y, Ji X, Zhang J, Kim S, Chee E, Chee W, Tsai HM, Nishigaki M, Yeo SA, Shapira M, Mao JJ. Internet Recruitment of Asian American Breast Cancer Survivors. ANS Adv Nurs Sci 2016; 39:E17-27. [PMID: 27490884 PMCID: PMC5008853 DOI: 10.1097/ans.0000000000000131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this article is to identify practical issues in Internet recruitment of racial/ethnic minorities by analyzing an Internet intervention study conducted with Asian American breast cancer survivors, and to propose directions for recruitment of racial/ethnic minorities for future Internet research. Six practical issues were identified: (a) a relatively fewer number of Internet communities/groups; (b) hindrances in establishing authenticity;
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania
| | - Yaelim Lee
- School of Nursing, University of Pennsylvania
| | - Xiaopeng Ji
- School of Nursing, University of Pennsylvania
| | - Jingwen Zhang
- Annenberg School for Communication, University of Pennsylvania
| | - Sangmi Kim
- School of Nursing, University of Pennsylvania
| | - Eunice Chee
- School of Engineering and Applied Science, University of Pennsylvania
| | | | - Hsiu-Min Tsai
- Chang Gung University of Science and Technology, Taiwan
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Gonzalez P, Nuñez A, Wang-Letzkus M, Lim JW, Flores K, Nápoles AM. Coping with breast cancer: Reflections from Chinese American, Korean American, and Mexican American women. Health Psychol 2016; 35:19-28. [PMID: 26389720 PMCID: PMC4695243 DOI: 10.1037/hea0000263] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The present study identified and compared the coping strategies of Chinese American, Korean American, and Mexican American breast cancer survivors (BCS). METHODS Six focus groups were conducted with Chinese American (n = 21), Korean American (n = 11), and Mexican American (n = 9) BCS. Interviews were audio-recorded, transcribed, and translated for thematic content analysis of coping experiences and strategies. RESULTS Women reported the use of 8 coping strategies (religious/spiritual, benefit finding, fatalism, optimism, fighting spirit, information seeking, denial, and self-distraction). Among Chinese American BCS, benefit finding was the most referenced coping strategy, whereas religious/spiritual coping was most frequently reported among Korean American and Mexican American BCS. Denial and self-distraction were the least cited strategies. CONCLUSIONS Survivors draw upon new found inner strength to successfully integrate their cancer experience into their lives. Coping models must consider the diversity of cancer survivors and the variability in coping strategies among cultural ethnic minority BCS.
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Affiliation(s)
| | - Alicia Nuñez
- Graduate School of Public Health, San Diego State University
| | | | | | - Katrina Flores
- Eunice Kennedy Shriver National Institute of Child Health & Human Development
| | - Anna María Nápoles
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Peer Support and Mentorship in a US Rare Disease Community: Findings from the Cystinosis in Emerging Adulthood Study. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 8:65-73. [DOI: 10.1007/s40271-014-0085-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Song H, Cramer EM, McRoy S. Information gathering and technology use among low-income minority men at risk for prostate cancer. Am J Mens Health 2014; 9:235-46. [PMID: 24951493 DOI: 10.1177/1557988314539502] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Health communication researchers, public health workers, and health professionals must learn more about the health information-gathering behavior of low-income minority men at risk for prostate cancer in order to share information effectively with the population. In collaboration with the Milwaukee Health Department Men's Health Referral Network, a total of 90 low-income adult men were recruited to complete a survey gauging information sources, seeking behavior, use of technology, as well as prostate cancer awareness and screening behavior. Results indicated participants primarily relied on health professionals, family, and friends for information about general issues of health as well as prostate cancer. The Internet was the least relied on source of information. A hierarchical regression indicated interpersonal information sources such as family or friends to be the only significant predictor enhancing prostate cancer awareness, controlling for other sources of information. Prostate screening behaviors were predicted by reliance on not only medical professionals but also the Internet. Practical implications of the study are discussed.
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Affiliation(s)
- Hayeon Song
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Susan McRoy
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Leng J, Lee T, Li Y, Stern C, Chen MH, Winkel G, Gany F. Support needs of Chinese immigrant cancer patients. Support Care Cancer 2013; 22:33-42. [PMID: 23982771 DOI: 10.1007/s00520-013-1950-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/13/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE To enable better psychosocial, informational, and practical support of Chinese patients with cancer, this study was conducted to identify the specific support needs of Chinese immigrant cancer patients. METHODS The Cancer Portal Project at Memorial Sloan-Kettering Cancer Center's Center for Immigrant Health and Cancer Disparities is a patient navigation program that assists underserved and minority cancer patients in obtaining social and economic assistance at ten New York City cancer clinics. This need assessment was conducted as part of the Portal Project. Sixty-four questions were added to the existing Portal Intake Form about the needs and preferences for Chinese-language support and survivorship services. Descriptive analysis was performed, as well as an exploratory principal component's factor analysis to determine if there were any patterns in the services and programs in which patients were interested. RESULTS Ninety-six patients were approached for participation; 59 agreed to participate. Eighty-eight percent of participants were born in China. Ninety-seven percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. When asked about general interest in support programs, 53 % of the participants were "very interested," 27 % were "maybe interested," and 17 % were "not interested." Programs in which more participants were "very interested" included those that would provide information about obtaining financial assistance (79 %) and social assistance (74 %), information on treatment options (67 %), help in coping with the burden of illness on the family (65 %), and information about general healthcare (63 %). The factor analysis resulted in the identification of five factors: social/financial/treatment and care issues, nutrition and exercise/networking/general health care, coping with fear and stress, herbs and dietary supplements, and acupuncture and acupressure. CONCLUSION In this study, 80 % of the participants expressed interest in programs tailored for Chinese cancer patients. The most frequently preferred topics for potential services were information-based. Findings provide a foundation for future research and the development of culturally and linguistically targeted support programs and interventions for this unique population.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Center for Immigrant Health and Cancer Disparies, Memorial Sloan-Kettering Cancer Center, 300 E. 66th St., 15th Floor, New York, NY, 10065, USA,
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Online communities for breast cancer survivors: a review and analysis of their characteristics and levels of use. Support Care Cancer 2012. [PMID: 23179491 DOI: 10.1007/s00520-012-1655-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Online communities have been heralded as one of the most promising health resources on the Internet. The purpose of this study was to identify the characteristics and levels of use of online communities for breast cancer survivors. METHODS Using Google, we identified websites with a string of computer-mediated communication terms and individual queries of three to five words of online community terms. This was complemented by a review of website resource lists and personal libraries. Two reviewers independently extracted information on their general characteristics and number of members and message board posts. A coding scheme guided content analysis. RESULTS We found 111 websites. Most sites (n = 64, 65.8 %) had a broad focus (e.g., health, cancer, or general). One third (n = 38, 34.2 %) were exclusive to breast cancer and 11 catered to specific disease characteristics. The majority were American (n = 79, 75.2 %), nonprofit (55.0 %), and moderated (69.5 %). Most moderators (85.7 %) were staff or community members; eight sites were moderated by health professionals. Greater than one-third of sites (n = 40, 36 %) were initiated by breast cancer survivors or loved ones. Breast cancer-specific sites contained a total of 4,186,275 posts. One-third (n = 10) contained 93.4 % of posts, displaying over 100,000 posts each. As of April 3, 2012, eight sites were discontinued. CONCLUSIONS There is a wide range of online communities available for breast cancer survivors with extensive archives of personal illness experiences. Future efforts should focus on identifying the factors that determine their success and effectiveness.
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Im EO, Lee B, Chee W. The Use of Internet Cancer Support Groups by Asian Americans and White Americans Living With Cancer. J Transcult Nurs 2011; 22:386-96. [DOI: 10.1177/1043659611414142] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To explore the use of Internet cancer support groups (UICSG) by Asians and Whites living with cancer and determine the factors influencing their UICSG. Design and Method: A cross-sectional Internet study among 30 Asians and 30 Whites. The instruments included (a) questions on sociodemographic and cultural factors, and disease status, (b) the Support Care Needs Survey-34 Short Form, (c) the 2003 Health Information National Trends Survey subscale on Internet usage, and (d) the UICSG Questionnaire. The data were analyzed using the Wilcoxon rank-sum test and nonparametric multiple regression analyses. Results: There was a significant ethnic difference in the UICSG, but there were no ethnic differences in general Internet use or needs for help. Across the ethnic groups, the significant factors influencing the UICSG included “self-reported ethnic identity,” “born in the United States,” and “general Internet use.” Conclusion: Nurses should consider the cultural factors that influence the UICSG.
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Zordan RD, Juraskova I, Butow PN, Jolan A, Kirsten L, Chapman J, Sedgwick C, Charles M, Sundquist K. Exploring the impact of training on the experience of Australian support group leaders: current practices and implications for research. Health Expect 2011; 13:427-40. [PMID: 20550596 DOI: 10.1111/j.1369-7625.2010.00592.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Existing literature suggests that the effectiveness of a support group is linked to the qualifications, skills and experience of the group leader. Yet, little research has been conducted into the experiences of trained vs. untrained support group leaders of chronic-illness support groups. The current study aimed to compare the experience of leaders, trained vs. untrained in group facilitation, in terms of challenges, rewards and psychological wellbeing. METHODS A total of 358 Australian leaders of cancer and multiple sclerosis (MS) support groups, recruited through State Cancer Councils and the MS society (response rate of 66%), completed a mailed survey. RESULTS Compared with untrained leaders, those with training were significantly younger, leading smaller groups and facilitating more groups, more frequently (all P < 0.05). Trained leaders were more likely to be female, educated beyond high school, paid to facilitate, a recipient of formal supervision and more experienced (in years) (all P < 0.01). Untrained leaders reported more challenges than trained leaders (P < 0.03), particularly struggling with being contacted outside of group meetings (52%) and a lack of leadership training (47%). Regardless of level of training, leaders identified a number of unmet support and training needs. Overwhelmingly, leaders found their facilitation role rewarding and the majority reported a high level of psychological wellbeing. CONCLUSIONS Group facilitator training has the potential to reduce the burden of support group leadership. Developing interventions to assist support group leaders will be particularly beneficial for leaders with minimal or no training group facilitation training.
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Affiliation(s)
- Rachel D Zordan
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW, Australia
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Wen KY, McTavish F, Kreps G, Wise M, Gustafson D. From Diagnosis to Death: A Case Study of Coping With Breast Cancer as Seen Through Online Discussion Group Messages. JOURNAL OF COMPUTER-MEDIATED COMMUNICATION : JCMC 2011; 16:331-361. [PMID: 23055657 PMCID: PMC3466054 DOI: 10.1111/j.1083-6101.2011.01542.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
To understand the underlying psychosocial reactions against the unfolding of medical events that announce the disease progression, the objective of this analysis was to identify the patterns of online discussion group message themes in relation to the medical timeline of one woman's breast cancer trajectory. 202 messages posted by Darlene (our studied case) were analyzed by 2 independent coders using a grounded theory approach. The findings suggest that the pattern of messages was clearly correlated with distress-inducing events. The most frequent interaction theme was about building friendship with peers through communication of encouragement, validation, appreciation, and life sharing. Narratives of medical progression were constantly updated to identify similarities with peers. Family issues were increasingly raised at the end of life.
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McDowell H, Kim E, Shaw BR, Han JY, Gumieny L. Predictors and Effects of Training on an Online Health Education and Support System for Women with Breast Cancer. JOURNAL OF COMPUTER-MEDIATED COMMUNICATION : JCMC 2010; 15:412-426. [PMID: 21949474 PMCID: PMC3179372 DOI: 10.1111/j.1083-6101.2010.01516.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many breast cancer patients currently turn to Internet-based education and support to help them cope with their illness. This study explores the role of training in influencing how patients use a particular Interactive Cancer Communication System (ICCS) over time and also examines what pre-test characteristics predict which people are most likely to opt in or out of training in the first place. With use of pre-test survey and unobtrusive individual records of ICCS system use data (N = 216), nonparametric tests revealed that only having a later stage of cancer predicted whether or not patients participated in training. Results indicated that participating in training was a significant predictor of higher levels of using the CHESS system. In particular, the repeated measures analysis of covariance found the significant interaction as well as main effect of group (i.e., training vs. no training) and time (i.e., individual's CHESS usages at different times) in interactive and information CHESS services, suggesting that 1) the training group has a higher level of usage than the no training group, 2) both of the groups' usage decreased over time, and 3) these joint patterns hold over time. Practical guidelines for future ICCS campaign implementation are discussed.
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Moloney MF, Aycock DM, Cotsonis GA, Myerburg S, Farino C, Lentz M. An Internet-Based Migraine Headache Diary: Issues in Internet-Based Research. Headache 2009; 49:673-86. [DOI: 10.1111/j.1526-4610.2009.01399.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Im EO, Chee W, Lim HJ, Liu WM. An online forum exploring needs for help of patients with cancer: gender and ethnic differences. Oncol Nurs Forum 2008; 35:653-60. [PMID: 18591169 DOI: 10.1188/08.onf.653-660] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore gender and ethnic differences in needs for help among patients with cancer. RESEARCH APPROACH Qualitative. SETTING Internet and community settings. PARTICIPANTS 16 self-identified patients with cancer aged at least 18 years who could read and write English. METHODOLOGIC APPROACH Using six discussion topics on needs for help, an online forum was administered for one month. Data were analyzed with thematic analysis. MAIN RESEARCH VARIABLES Need for help. FINDINGS Four major themes emerged: (a) from side effects to racism, (b) same or double stress, (c) cultural hesitance and God, and (d) a family disease with mistrust. Depending on gender and ethnicity, the participants' concerns were various and ranged from a simple physical need to a social need for elimination of racism in United States society. Women tended to report double burden and stress as patients with cancer resulting from their gender. Ethnic minorities tended to be hesitant to talk about cancer or seek help because of the stigmatized nature of cancer. Ethnic minority patients perceived cancer as a family disease that they needed to go through as a family, and they tended to mistrust healthcare providers. CONCLUSIONS The overriding theme was a marginalized experience for ethnic minority patients with cancer. INTERPRETATION Researchers should include cultural needs as a separate category of needs and consider contextual factors influencing the needs of patients with cancer in their daily lives.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Texas, Austin, TX, USA.
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22
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Fogel J, Ribisl KM, Morgan PD, Humphreys K, Lyons EJ. Underrepresentation of African Americans in online cancer support groups. J Natl Med Assoc 2008; 100:705-12. [PMID: 18595573 DOI: 10.1016/s0027-9684(15)31346-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Internet is increasingly important for many cancer survivors because it provides access to the latest information on cancer treatments and also allows them to receive support by participating in online cancer support groups. Unfortunately, little is known about why African-American cancer survivors are underrepresented in online cancer support groups. This article reviews the relevant literature and discusses three possible explanations for why African Americans are underrepresented in online cancer support groups: the digital divide/digital inequality, preferences for face-to-face support or culture-specific online support, and trust concerns. We conclude that a health inequity exists with regard to the utilization of information that can be obtained from online cancer support groups. However, with regard to the potential benefits of the psychosocial and emotional support aspect of online cancer support groups, a health inequity may not exist, as African Americans have other preferred avenues for obtaining needed support, and there is no evidence that this is detrimental to their health.
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Affiliation(s)
- Joshua Fogel
- Department of Economics, Brooklyn College, City University of New York, Brooklyn, NY, USA.
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Abstract
The purpose of this study was to explore demographic characteristics of a specific online population, midlife women recruited through Internet communities or groups, and to provide future direction for Internet research among midlife women. Using a feminist perspective, the study focused on ethnic variations in the characteristics of the midlife women. A total of 192 midlife women were recruited through Internet communities. The Internet survey included questions on sociodemographic characteristics and health/illness status. The data were analyzed using descriptive and inferential statistics. The findings indicated that midlife women recruited through Internet communities tended to be white, young, married, and affluent. The findings also indicated significant ethnic differences in sociodemographic characteristics. The findings suggest that researchers need to consider that midlife women recruited from Internet communities tend to be a specific group of midlife women.
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Abstract
The purpose of this study was to describe characteristics of cancer patients who were attending Internet cancer support groups and to provide direction for future research. A total of 204 cancer patients were recruited through Internet cancer support groups by posting the study announcement on the Web sites of such groups. The participants were asked to fill out Internet survey questionnaires on sociodemographic characteristics and health/disease status. The data were analyzed using descriptive and inferential statistics, including t tests, analysis of variance, and Chi-square tests. Findings indicate that cancer patients recruited through Internet cancer support groups tended to be middle-aged, well-educated, female, and middle class. The findings also indicate that there were significant differences in some characteristics according to gender and ethnicity. Based on the findings, some implications are suggested for future research using and developing Internet cancer support groups.
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Im EO, Chee W. The Use of Internet Cancer Support Groups by Ethnic Minorities. J Transcult Nurs 2008; 19:74-82. [DOI: 10.1177/1043659607309140] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recent studies have indicated that Internet Cancer Support Groups (ICSGs) tend to serve highly educated, high-income Whites at an early stage of cancer. Why do very few ethnic minority cancer patients, especially ethnic minority women, participate in ICSGs? In this article, the possible answers to this question are explored through a literature review from a feminist perspective. The potential reasons identified through the review include (a) gender and ethnic differences in attitudes toward ICSGs, (b) gender and ethnic differences in need for help, and (c) gender- and ethnic-specific contexts. Based on the discussion, implications for future research are proposed.
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Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, School of Nursing,
| | - Wonshik Chee
- The University of Texas at Austin, College of Engineering
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Reb AM. Transforming the Death Sentence: Elements of Hope in Women With Advanced Ovarian Cancer. Oncol Nurs Forum 2007; 34:E70-81. [DOI: 10.1188/07.onf.e70-e81] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Im EO, Chee W, Tsai HM, Bender M, Lim HJ. Internet communities for recruitment of cancer patients into an Internet survey: a discussion paper. Int J Nurs Stud 2006; 44:1261-9. [PMID: 16962122 PMCID: PMC2235818 DOI: 10.1016/j.ijnurstu.2006.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Revised: 06/16/2006] [Accepted: 07/13/2006] [Indexed: 11/22/2022]
Abstract
The purpose of this paper is to provide future directions for the usage of Internet communities (ICs) for recruitment of research participants based on issues raised in an Internet survey among 132 cancer patients. About 317 general and 233 ethnic-specific Internet Cancer Support Groups and 1588 ethnic-specific ICs were contacted to recruit cancer patients. Research staff recorded issues and wrote memos during the recruitment process. The written memos and records were later analyzed using content analysis. The issues included: (a) difficulty in identifying appropriate ICs and potential participants, (b) meta-tags, (c) dominant white and women groups, (d) dynamics inside ICs, (e) difficulty in trust building, and (f) potential selection bias. The findings suggest that researchers thoroughly review the ICs' information, be recognizant of potential gender and ethnic issues and current trends in Internet interaction, and consider potential selection bias.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Texas at Austin, 1700 Red River, Austin, TX 78701, USA.
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Im EO, Chee W. Nurses' acceptance of the decision support computer program for cancer pain management. Comput Inform Nurs 2006; 24:95-104. [PMID: 16554693 DOI: 10.1097/00024665-200603000-00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes nurses' acceptance of a decision support computer program for cancer pain management and explores the relationships between the nurses' acceptance and their sociodemographic characteristics. A feminist perspective was used as a theoretical guide for the research process. This was an Internet intervention study among 122 nurses working with cancer patients. Nurses' acceptance of the decision support computer program was measured using the Questionnaire for User Interaction Satisfaction. The data were analyzed using descriptive and inferential statistics, including analysis of variance and correlation analyses. There were significant differences in the total scores of user satisfaction by sex, religion, ethnicity, job title, and specialty. The results suggest that nurses do welcome decision support systems and that nurses' sociodemographic and professional characteristics should be considered in the development of decision support systems.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Texas at Austin, Austin, TX 78701, USA.
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29
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Evans W. Bibliography. HEALTH COMMUNICATION 2005; 18:195-9. [PMID: 16083411 DOI: 10.1207/s15327027hc1802_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- William Evans
- Institute for Communication and Information Research, University of Alabama, Tuscaloosa, AL 35487-0172, USA.
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