To study the impact of the spontaneous use of Internet on breast cancer patients and on their relationship with health professionals.
A mixed methodology was used. Two questionnaires were designed through three focus groups, and then administered to 186 patients and 59 professionals in order to assess: (1) patients’ use of Internet for health-related information and (2) the impact of this information on patients’ psychological outcomes and on their relationship with professionals.
Patients spent more time looking for illness-related information after diagnosis, using interactive communities more than static information websites. Patients and professionals disagreed about the use of Internet in terms of the knowledge it provides, and its psychological impact. The main barrier reported by patients regarding the sharing of online information with their professionals was the belief that it would damage their relationship.
Both professionals and patients have a protectionist conception of the therapeutic relationship. This attitude tends to dismiss the positive impact that the use of Internet and the new communication tools may have in cancer patients. New resources should provide an “Internet Prescription” and modes of interaction to facilitate a more open digital communication.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
The data of this study are available from the corresponding author upon reasonable request.
Casellas-Grau A, Sumalla EC, Lleras M, Vives J, Sirgo A, León C, Rodríguez A, Campos G, Valverde Y, Borràs JM, Ochoa C (2018) The role of posttraumatic stress and posttraumatic growth on online information use in breast cancer survivors. Psychooncology 27:1971–1978. https://doi.org/10.1002/pon.4753
Holmes MM (2019) Why people living with and beyond cancer use the Internet. Integr Cancer Ther 18:153473541982983. https://doi.org/10.1177/1534735419829830
Soto-Perez-de-Celis E, Perez-Montessoro V, Rojo-Castillo P, Chavarri-Guerra Y (2018) Health-related information-seeking behaviors and preferences among Mexican patients with cancer. J Cancer Educ 33:505–509. https://doi.org/10.1007/s13187-018-1334-8
Bender JL, Wiljer D, Sawka AM, Tsang R, Alkazaz N, Brierley JD (2016) Thyroid cancer survivors’ perceptions of survivorship care follow-up options: a cross-sectional, mixed-methods survey. Support Care Cancer 24:2007–2015. https://doi.org/10.1007/s00520-015-2981-5
Nguyen SKA, Ingledew P-A (2013) Tangled in the breast cancer web: an evaluation of the usage of web-based information resources by breast cancer patients. J Cancer Educ 28:662–668. https://doi.org/10.1007/s13187-013-0509-6
Lleras de Frutos M, Casellas-Grau A, Sumalla EC, Gracia M, Borràs JM, Ochoa Arnedo C (2019) A systematic and comprehensive review of Internet use in cancer patients: psychological factors. Psychooncology 1–10. https://doi.org/10.1002/pon.5194
Lange L, Fink J, Bleich C, Graefen M, Schulz H (2017) Effectiveness, acceptance and satisfaction of guided chat groups in psychosocial aftercare for outpatients with prostate cancer after prostatectomy. Internet Interv 9:57–64. https://doi.org/10.1016/j.invent.2017.06.001
Bouma G, Admiraal JM, de Vries EGE, Schröder CP, Walenkamp AME, Reyners AKL (2015) Internet-based support programs to alleviate psychosocial and physical symptoms in cancer patients: a literature analysis. Crit Rev Oncol Hematol 95:26–37. https://doi.org/10.1016/j.critrevonc.2015.01.011
Kazdin AE (2017) Addressing the treatment gap: a key challenge for extending evidence-based psychosocial interventions. Behav Res Ther 88:7–18. https://doi.org/10.1016/j.brat.2016.06.004
Lleras de Frutos M, Sumalla EC, Casellas-Grau A, Hernández-Ribas R, Ochoa A (2017) El impacto de internet en cáncer: ¿Ha evolucionado el acceso a información sobre salud y la relación con los profesionales sanitarios? [Internet impact in cancer: does health-information access and the relationship with professionals have evolve?]. Cuad Med Psicosomática y Psiquiatr. 1
Algtewi E, Owens J, Baker SR (2017) Online support groups for head and neck cancer and health-related quality of life. Qual Life Res 26:2351–2362. https://doi.org/10.1007/s11136-017-1575-8
D’Silva S, van Kessel K (2014) An evaluation of the quality and content of web sites on cancer related fatigue. J Consum Health Internet 18:313–336. https://doi.org/10.1080/15398285.2014.952997
Abt Sacks A, Pablo Hernando S, Serrano Aguilar P, Fernández Vega E, Martín Fernández R (2013) Necesidades de información y uso de Internet en pacientes con cáncer de mama en España [Information needs and Internet use in breast cancer patients in Spain]. Gac Sanit 27:241–247. https://doi.org/10.1016/j.gaceta.2012.06.014
Rising CJ, Bol N, Burke-Garcia A, Rains S, Wright KB (2017) Perceived stress in online prostate cancer community participants: examining relationships with stigmatization, social support network preference, and social support seeking. J Health Commun 22:469–476. https://doi.org/10.1080/10810730.2017.1304471
Attai DJ, Sedrak MS, Katz MS, Thompson MA, Anderson PF, Kesselheim JC, Fisch MJ, Graham DL, Utengen A, Johnston C, Miller RS, Dizon DS, Collaboration for Outcomes on Social Media in Oncology (COSMO) (2016) Social media in cancer care: highlights, challenges & opportunities. Future Oncol 12:1549–1552. https://doi.org/10.2217/fon-2016-0065
Adilman R, Rajmohan Y, Brooks E, Urgoiti GR, Chung C, Hammad N et al (2016) ReCAP: social media use among physicians and trainees: results of a National Medical Oncology Physician Survey. J Oncol Pract 12:79–80. https://doi.org/10.1200/JOP.2015.006429
Newnham GM, Burns WI, Snyder RD, Dowling AJ, Ranieri NF, Gray EL, McLachlan S (2005) Attitudes of oncology health professionals to information from the Internet and other media. Med J Aust 183:197–200. https://doi.org/10.5694/j.1326-5377.2005.tb06996.x
Bylund CL, Sperka M, D’Agostino TA (2015) Formative assessment of oncology trainees’ communication with cancer patients about Internet information. Palliat Support Care 13:197–200. https://doi.org/10.1017/S1478951513000928
Suñer R, Santiñà M (2014) Alfabetització per a la salut: definicions, conceptes i la seva relació amb la salut [Literacy for health: definitions, concepts, and relationship with health]. In: Suñer R, Santiñà M (eds) Alf. per a la Salut estàndards i recomanacions per als Prof. la Salut, Girona, Spain: Documenta Universitaria, p 13–26
Bylund CL, Gueguen JA, D’Agostino TA, Imes RS, Sonet E (2009) Cancer patients’ decisions about discussing Internet information with their doctors. Psychooncology 18:1139–1146. https://doi.org/10.1002/pon.1511
Creswell JW, Plano Clark VL, Gutmann ML, Hanson WE (2003) Advanced mixed methods research designs. In: Tashakkori A, Teddlie C (eds) Handb. Mix. methods Soc. Behav. Res. Sage, Thousand Oaks, pp 209–240
Morse JM (1991) Approaches to qualitative-quantitative methodological triangulation. Nurs Res 40:120–123
Denzin N, Lincoln YS (2000) Handbook of qualitative research, 2nd edn. Sage, Thousand Oaks
Botella L, Herrero O (2000) A relational constructivist approach to narrative therapy. Eur J Psychother Couns 3:407–418. https://doi.org/10.1080/13642530010012048
Denzin NK, Lincoln Y (2015) Manual de investigación cualitativa: Paradigmas y perspectivas en disputa. Volumen II. Barcelona, Gedisa
Fogel J, Albert SM, Schnabel F, Ditkoff BA, Neugut AI (2002) Use of the Internet by women with breast cancer. J Med Internet Res 4:e9. https://doi.org/10.2196/jmir.4.2.e9
European Commission (2014) Flash Eurobarometer 404 (European citizens’ digital health literacy). Cologne, Germany
Helft PR, Hlubocky F, Daugherty CK (2003) American oncologists’ views of Internet use by cancer patients: a mail survey of American Society of Clinical Oncology members. J Clin Oncol 21:942–947. https://doi.org/10.1200/JCO.2003.08.007
Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101. https://doi.org/10.1191/1478088706qp063oa
IBM Corporation. IBM SPSS statistics for windows 2012
Lee C, Ramírez AS, Lewis N, Gray SW, Hornik RC (2012) Looking beyond the Internet: examining socioeconomic inequalities in cancer information seeking among cancer patients. Health Commun 27:806–817. https://doi.org/10.1080/10410236.2011.647621
Valero-Aguilera B, Bermúdez-Tamayo C, García-Gutiérrez JF, Jiménez-Pernett J, Cózar-Olmo JM, Guerrero-Tejada R, Alba-Ruiz R (2014) Information needs and Internet use in urological and breast cancer patients. Support Care Cancer 22:545–552. https://doi.org/10.1007/s00520-013-2009-y
Kowalski C, Kahana E, Kuhr K, Ansmann L, Pfaff H (2014) Changes over time in the utilization of disease-related Internet information in newly diagnosed breast cancer patients 2007 to 2013. J Med Internet Res 16:e195. https://doi.org/10.2196/jmir.3289
D’Agostino TA, Ostroff JS, Heerdt A, Dickler M, Li Y, Bylund CL (2012) Toward a greater understanding of breast cancer patients’ decisions to discuss cancer-related internet information with their doctors: an exploratory study. Patient Educ Couns 89:109–115. https://doi.org/10.1016/j.pec.2012.05.008
Finck C, Barradas S, Zenger M, Hinz A (2018) Calidad de Vida en pacientes con cáncer de mama: asociación con optimismo y apoyo social [Quality of life in patients with breast cancer: association with optimism and social support]. Int J Clin Health Psychol 18:27–34. https://doi.org/10.1016/j.ijchp.2017.11.002
The authors thank the CERCA Programme Generalitat de Catalunya for the institutional support.
This study has been funded by the Instituto de Salud Carlos III through the project (FIS PI15/01278) co-funded by the European Regional Development Fund, ERDF, “a way to build Europe” //FONDOS FEDER “una manera de hacer Europa.” Grup de recerca consolidat: Recerca en serveis sanitaris en càncer, 2017SGR00735. It was also partially supported by grants from Asociación Española Contra el Cáncer and the Generalitat de Catalunya (grant number 2014SGR0635). None of the sponsors was involved in the implementation of the study.
Conflict of interest
The authors declare that they have no conflict of interest.
The authors assert that all participants gave their informed consent prior to their inclusion in the study. All procedures conducted complied with the ethical standards of the relevant institutional committees on human experimentation, and with the Helsinki Declaration as revised in 2008.
Informed consent was obtained from all individual participants included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Ochoa-Arnedo, C., Flix-Valle, A., Casellas-Grau, A. et al. An exploratory study in breast cancer of factors involved in the use and communication with health professionals of Internet information. Support Care Cancer (2020). https://doi.org/10.1007/s00520-020-05335-x
- Breast cancer
- Internet prescription
- Therapeutic relationship