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Left Hanging in the Air: Experiences of Living With Cancer as Expressed Through E-mail Communications With Oncology Nurses

Grimsbø, Gro Hjelmeland MS, RN; Finset, Arnstein PhD; Ruland, Cornelia M. PhD, RN

doi: 10.1097/NCC.0b013e3181eff008
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Background: Cancer patients experience many physical, psychosocial, and existential problems and worries during their illness. To support patients in managing their illness, we implemented an online patient-nurse communication (OPNC) service, where breast and prostate cancer patients could ask questions and receive advice from oncology nurses.

Objective: The aim of this study was to explore the use and content of patients' e-mail messages sent to oncology nurses and thus gain a "snapshot" of patients' experiences of living with cancer as expressed through these messages.

Methods: Using qualitative content analysis, 276 messages from 60 breast and prostate cancer patients were analyzed. Messages were coded into categories and major themes. Both manifest and latent content was coded.

Results: Four main themes emerged from patients' messages: (1) living with symptoms and side effects, (2) living with a fear of relapse, (3) concerns for everyday life, and (4) unmet information needs from health care providers.

Conclusions: Patients used the OPNC service actively to pose questions and raise concerns related to symptom experiences, fear of relapses, and uncertainty in everyday life. However, patients also expressed experiences of being "left in a void" after being discharged from hospital and living with serious unmet informational needs.

Implications for Practice: The study demonstrated that online communication can provide patients with a space for otherwise unmet questions and worries and that they will seek support from nurses online when given the opportunity. Therefore, OPNC can be an important means and supplement to traditional health care in the effort to support patients to better manage their illness.

Author Affiliations: Centre for Shared Decision Making and Nursing Research, Oslo University Hospital (Ms Grimsbø and Dr Ruland); Faculty of Medicine (Ms Grimsbø and Dr Ruland), Department of Behavioural Science, Institute of Basic Medical Sciences, Faculty of Medicine (Dr Finset), University of Oslo, Norway.

This study was supported by a grant from the Norwegian Cancer Society.

Correspondence: Gro Hjelmeland Grimsbø, MS, RN, Centre for Shared Decision Making and Nursing Research, Oslo University Hospital, Forskningsveien 2B, 0027 Oslo, Norway (gro.hjelmeland.grimsbo@rr-research.no).

Accepted for publication June 29, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.