RESUMO
OBJECTIVE: Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. DESIGN: Randomized controlled trial conducted between 1995 and 1998. SETTING: Five sites: two teaching hospitals (Madison, Wis, and Chicago, Ill), two nonteaching hospitals (Chicago), and a cancer resource center (Indianapolis, Ill). The latter three sites treat many underserved patients. PARTICIPANTS: Newly diagnosed breast cancer patients (N = 246) under age 60. INTERVENTIONS: Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support. MEASUREMENTS AND MAIN RESULTS: Pretest and two post-test surveys (at two- and five-month follow-up) measured aspects of participation in care, social/information support, and quality of life. At two-month follow-up, the CHESS group was significantly more competent at seeking information, more comfortable participating in care, and had greater confidence in doctor(s). At five-month follow-up, the CHESS group had significantly better social support and also greater information competence. In addition, experimental assignment interacted with several indicators of medical underservice (race, education, and lack of insurance), such that CHESS benefits were greater for the disadvantaged than the advantaged group. CONCLUSIONS: Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.
Assuntos
Neoplasias da Mama/psicologia , Serviços de Informação , Área Carente de Assistência Médica , Educação de Pacientes como Assunto/métodos , Qualidade de Vida , Adulto , Negro ou Afro-Americano , Neoplasias da Mama/etnologia , Feminino , Seguimentos , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Análise Multivariada , Participação do Paciente , Apoio SocialRESUMO
The Comprehensive Health Enhancement Support System (CHESS) is an interactive computer system containing information, social support, and problem-solving tools. It was developed with intensive input from potential users through needs-assessment surveys and field testing. CHESS had previously been used by women in the middle and upper socioeconomic classes with high school and college education. This article reports on the results of a pilot study involving eight African-American women with breast cancer from impoverished neighborhoods in Chicago. CHESS was very well received; was extensively used; and produced feelings of acceptance, motivation, understanding, and relief.
Assuntos
Sistemas de Informação em Atendimento Ambulatorial/tendências , Neoplasias da Mama/psicologia , Área Carente de Assistência Médica , Educação de Pacientes como Assunto/tendências , Apoio Social , Sistemas de Informação em Atendimento Ambulatorial/organização & administração , Sistemas de Informação em Atendimento Ambulatorial/normas , Neoplasias da Mama/epidemiologia , Chicago/epidemiologia , Feminino , Humanos , Educação de Pacientes como Assunto/métodos , Projetos Piloto , Resolução de Problemas , Fatores Socioeconômicos , Estresse PsicológicoRESUMO
The Comprehensive Health Enhancement Support System (CHESS) is an interactive computer system containing information, social support and problem solving tools. It was developed with intensive input from potential users through needs-assessment surveys and field testing. CHESS had previously been used by women in the middle and upper socio-economic classes with high school and college education. This article reports on the results of a pilot study involving eight African-American women with breast cancer from impoverished neighborhoods in the city of Chicago. CHESS was very well received, extensively used and produced feelings of acceptance, motivation, understanding and relief.
