The Impact of a Multimedia Informational Intervention on Healthcare Service Use Among Women and Men Newly Diagnosed With Cancer

Carmen G. Loiselle, PhD, RN; Sylvie Dubois, PhD(c), MEd, MBA, RN

Disclosures

Cancer Nurs. 2009;32(1):37-44. 

In This Article

Abstract and Introduction

Abstract

This quasi-experimental longitudinal study documented the impact of a comprehensive cancer informational intervention using information technology on healthcare service use among individuals newly diagnosed with cancer. Women with breast cancer (n = 205) and men with prostate cancer (n = 45) were recruited within 8 weeks of diagnosis at 4 university teaching hospitals in Montreal, Quebec, Canada. The intervention group (n = 148) received a 1-hour training on information technology use, a CD-ROM on cancer, and a list of reputable cancer-related Web sites. The intervention material was available for a period of 8 weeks. The control group (n = 102) received usual care. Self-reported questionnaires were completed at T1 (baseline), T2 (1 week after intervention), and T3 (3 months after intervention). Using multivariate statistics, the experimental group reported significantly more satisfaction with cancer information received compared to the control group. No significant differences were found between experimental and control groups in their reliance on healthcare services. However, women as opposed to men spent more time with nurses, were more satisfied with cancer information received, and relied more heavily on health services. Future research would explore whether the latter observations reflect genuine sex differences or are more contingent on the specific cancer diagnosis.

Introduction

Computer-based interactive educational tools are perceived as engaging and convenient[1,2] and have the potential to enhance psychosocial outcomes in cancer. Informational support, defined as access to or receipt of advice, suggestions, and additional knowledge about a situation, might not only increase knowledge, informed decision making, self-care skills, and adherence to treatment but might also be instrumental in decreasing anxiety, fear, and distress and in increasing hope and empowerment.[3] Informational support has been identified as therapeutic for individuals with cancer particularly when information needs are high.[4] In addition, patients who are better informed tend to report greater satisfaction with their medical care and their interactions with healthcare providers.[4,5]

As the patients' cancer informational needs are predicted to increase in complexity and demand for cancer-related services are predicted to intensify,[6,7] the need for efficient and cost-effective psychosocial and timely informational support is acute. Moreover, when psychosocial care and information needs are unmet, significant psychological distress often follows.[8,9] The consequences of not identifying and effectively managing cancer-related distress include poorer health-related outcomes, decreased quality of life, and increased healthcare costs through higher reliance on services such as emergency department and community health services.[10,11]

Interactive health communication (IHC), defined as the interaction of an individual with or using an electronic device or communication technology to access or transmit health information and support,[12] has been identified as promising for meeting psychosocial needs of individuals diagnosed with cancer.[1] Interactive health communication can guide the individuals' reliance on cancer care services, as it offers readily available, complementary informational support to patients with cancer and their family.[13] However, the contribution of IHC to psychosocial adjustment and healthcare service use remains understudied in cancer supportive care.[13] Healthcare service use refers to the individuals' reliance on health facilities (eg, hospital, clinics, home care) offered by professionals for the treatment and management of illness to meet their healthcare needs.[14]

Purpose of the Study

The larger study examined the impact of multimedia informational support on psychosocial adjustment (C. G. Loiselle et al, unpublished data) with a focus herein on healthcare service use by individuals newly diagnosed with either breast or prostate cancer. These 2 types of cancers were chosen, as they involved different sexes and are the most frequently diagnosed cancers in both Canada and the United States.[7,15]

This article presents findings that were part of a study funded by the Canadian Institutes of Health Research.[16] The analysis focused on 3 research questions:

  1. Does reliance on healthcare services vary between the intervention and control groups, and are there potential sex differences?

  2. Are participants more satisfied with informational support provided by the intervention as opposed to support received in the usual care condition?

  3. Do the aforementioned factors vary across time (eg, between T1 and T3)?

Andersen and Newman's behavioral model of health service use[17] was used as guide to organize and interpret relevant findings. In brief, the model identifies key factors (eg, personal/background and needs, enabling resources, contextual characteristics) that may determine subsequent reliance on healthcare services and health-related outcomes.[18,19] In this study, we assessed how personal characteristics (eg, sex, cancer type) and contextual factors such as cancer informational support may predict reliance on healthcare services.

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