Context Palliation in patient care is under-utilized in part because many patients have insufficient knowledge about this management option. Information technology can improve awareness by providing access to numerous sources of trustworthy information. Evidence Acquisition To estimate what a patient interested in palliation might find online, online resources were searched in July 2010, using terms relevant to palliation. PubMed was searched for publications relevant to discussed topics. Evidence Synthesis Search engines returned vast numbers of hits, and identifying trustworthy sites was difficult. Products judged as trustworthy were classified as information, decision tool, or extended interaction tool. Sites with useful educational material were relatively plentiful; decision guides and interactive tools were much rarer. Available consumer informatics did not address well some terminal illnesses, and some subpopulations such as children, nor was there sufficient attention to literacy levels or principles of instructional design. Online or published information about usage numbers, effectiveness, and cost/benefit considerations was scant. Many sectors, including commercial, government, healthcare, research, and wellness/advocacy groups, have created consumer informatics for palliation. Conclusions Online information about palliation is available, although identifying trustworthy sources can be problematic. General information sites are relatively plentiful, but more tools for decision making, and interaction would increase value of web resources. More attention to literacy levels, instructional principles, and needs of special populations would improve products. Research to measure usage of such tools, ability to influence behavior, and cost/benefit issues is needed.
Nurses and health educators who work with cancer patients are often asked about complementary and alternative medicine (CAM) therapies. "CAM and the Prostate Cancer Patient" is the prototype module for an online continuing education series on CAM. More than 60 nurses and health educators tested the product online. Outcome data indicate that such a program can increase learners' CAM knowledge and perceived self-efficacy in addressing patient questions about CAM. Qualitative responses from testers indicate an appreciation for a balanced approach to the material. Testers found the combination of academic information with professional and patient tips to be useful.Keywords: complementary medicine; cancer; nurse continuing education; CAM Complementary and alternative medicine (CAM) has been variously described, most often defined as those treatments, interventions, and health care practices not taught widely in medical schools, not generally available in hospitals, and often not reimbursed by medical insurance companies (Eisenberg et al., 1998; Office on Alternative Medicine, 1998). Included in this necessarily broad definition are many different practices and therapies, some more widely practiced and/or accepted than others in the United States and other countries with a primarily biomedical health care tradition. Although there is an extensive literature on CAM treatments and cancer, the literature on the efficacy of CAM treatments on cancer survival, side effects, or quality of life is limited with only a few studies that employ the rigor of a randomized clinical trial (Ernst, 2001;Jacobson, Workman, & Kronenberg, 1999, 2000Tagliaferri, Cohen, & Tripathy, 2001). Nurses and other health professionals who work with cancer patients need to be aware of the scientific evidence, when available, and evidence at other levels such as the Best Case Series program (National Cancer Institute, 2001) so they can provide accurate information and guidance to patients. This article describes the formative evaluation of a Web-based continuing education program for nurses and patient health educators on CAM for cancer patients. The outcome data reported here are from the prototype module "CAM and the Prostate Cancer Patient." Development and evaluation of the Cancer CAM ™ continuing education program were based on a two-stage process of formative evaluation. A pilot test assessed the feasibility of the Webbased product to engage nurses and to increase knowledge of CAM, communication skills related to CAM, and self-efficacy related to discussing CAM with patients and colleagues. The results of this pilot test were used to complete the applications for nursing continuing education units (CEUs) and certified health education specialist (CHES) credits and to finetune the prototype module. Based on suggestions from the advisers and nurse pilot testers, health/patient educators were added as a second audience for CAM-related continuing education, and an e-book format was introduced. An evaluation of the prototype addressed the questions o...
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