Obadina, E.T., Dubenske, L.L., McDowell, H.E., Atwood, A.K., Mayer, D.K., Woods, R.W., . . . Burnside, E.S. (2014). Online support: Impact on anxiety in women who experience an abnormal screening mammogram. Breast, 23, 743–748. 

DOI Link

Study Purpose

To evaluate the impact of a computer- and web-based tool on the anxiety of women who had an abnormal mammogram.

Intervention Characteristics/Basic Study Process

Patients were randomized in to a study group and comparison group. The study group received an email with instruction for using the Comprehensive Health Enhancement Support System (CHESS). The comparison group received a list of five credible breast imaging websites. Impact of CHESS evaluated anxiety and breast cancer worry and patient satisfaction with their physician interaction at three time points.

Sample Characteristics

  • N = 130  
  • AGE: Older than aged 21 years
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Recalled after a screening mammography
  • OTHER KEY SAMPLE CHARACTERISTICS: English literate; access to Internet

Setting

  • SITE: Single site    
  • SETTING TYPE: Outpatient    
  • LOCATION: University of Wisconsin Breast Center

Phase of Care and Clinical Applications

  • PHASE OF CARE: Diagnostic
  • APPLICATIONS: Elder care

Study Design

Pilot study; randomized intervention and comparison group

Measurement Instruments/Methods

  • State anxiety (SA) subscale of the State-Trait Anxiety Inventory (STAI)
  • The breast cancer worry subscale of the Lerman Breast Cancer Worry Scale (LBCWS)
  • Patient Satisfaction with Doctor Questionnaire (PSQ-MD)

Results

There was a significant difference in the anxiety scores for the intervention group at the biopsy stage (p = 0.02). There was no difference in the two groups at the diagnostic phase. There was no significant difference in the two groups for breast cancer worry.  Satisfaction with the physician was not analyzed because study participants had difficulty identifying who their physician was during the three time points.

Conclusions

Early CHESS may decrease anxiety in woman recalled for abnormal mammograms when combined with an identifiable care team.

Limitations

  • Risk of bias (no blinding)
  • Risk of bias (no appropriate attentional control condition)  
  • Risk of bias (sample characteristics)
  • Measurement/methods not well described

 

Nursing Implications

Providing resources to women with abnormal mammograms is most effective when a healthcare team interaction is provided to reduce anxiety. Online support system may have some benefit but additional research is needed to determine effectiveness for anxiety and other symptoms, and long-term efficacy needs to be examined.