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Purpose/Objectives: To describe the experiences of patients with cancer using the Internet for information and support to manage the self-care aspects of illness and treatment, including symptom management.Research Approach: Heideggerian hermeneutics branch of phenomenology.Setting: The interviews took place in outpatient settings in the northeastern United States, including clinics, patients' homes, and the researchers' office.Participants: 20 patients self-identified as users of the Internet for cancer care.Methodologic Approach: Data were collected by informal interviews that provided the narrative stories for hermeneutic analysis.Main Research Variables: Internet use for cancer care and patient-provider relationship.Findings: Five related themes and one constitutive pattern described patients' experiences. The themes were retrieving and filtering Internet information according to personal situation by Internet-savvy people in patients' support networks, seeking hope from the newest treatment options while coping with fear in manageable 'bytes,' self-care for personal illness situations with meaningful information regarding symptom management, empowering patients as partners when Internet information served as a second opinion in decision making and validating treatment decisions, and Internet as providing peer support. The constitutive pattern was Internet use as assisting patients in discovering ways to live with cancer as a chronic illness instead of a death sentence.Conclusions: Patients with cancer are incorporating Internet use into their cancer care. They perceive changing provider-patient relationships when they participate in treatment decisions.Interpretation: Computer-savvy patients and their personal support networks will avail themselves of Internet information, creating the need for new interaction patterns and relationships with providers. [Abstract for this article also available on page 38 of printed version. Full article available at www.ons.org/xp6/ONS/Library.xml/ONS_Publications.xml/ONF [ABSTRACT FROM AUTHOR]

Background: In Western culture, evidence has shown that in women with breast cancer exercise decreases fatigue and improves quality of life. However, only 1 pilot study about the effect of exercise has been examined in the Asian breast cancer population that indicated feasibility. Therefore, it is important to further study the effect of an exercise program for Taiwanese women with breast cancer., Objective: The purpose of this study was to test the effects of a walking program on Taiwanese women newly diagnosed with early-stage breast cancer., Methods: This was an experimental, longitudinal study with 4-time repeated measures based on Bandura's Self-efficacy Theory, with the aim of implementing interventions to boost exercise self-efficacy and to evaluate research outcomes. SPSS 17.0 with descriptive statistics using frequency, percentage, mean, and SD as well as inferential statistics such as t test, χ test, hierarchical linear model, repeated-measures analysis of variance, and analysis of covariance was used for data analysis., Results: Results of this study indicated that subjects in the exercise group had significantly better quality of life, less fatigue, less sleep disturbances, higher exercise self-efficacy, more exercise behavior, and better exercise capacity compared with those in the usual-care group after the intervention., Conclusions: This program was effective and feasible, but more research studies with experimental, longitudinal design to verify the effects of this exercise program on Taiwanese women with breast cancer will be needed., Implications for Practice: Nurses, depending on skill and knowledge, can encourage physical activity, refer patients to rehabilitation programs, and prescribe and monitor exercise in breast cancer population.

Introduction: Five to 10% of breast cancers are caused by inherited mutations of the BRCA1/2 genes. Knowledge of inherited risk for cancer has potential for psychosocial consequences. The purpose of this review is to determine the survivorship concerns of women with mutations of BRCA1/2; with and without a diagnosis of cancer., Methods: The search strategy included a search of CINAHL, PsycINFO, Medline, Pubmed, and Cochrane databases to identify research reports with specific aims of determining physical, psychosocial or spiritual outcomes of genetic testing for breast and ovarian cancer syndrome in adults at high risk for BRCA1/2 mutations. The identified studies were analyzed by design, sampling, and outcome measures. They were categorized by domain and main findings by domain are summarized., Results: One systematic review, ten qualitative and 27 quantitative studies met the inclusion criteria. Four theoretical frameworks were identified., Discussion/conclusions: Survivorship concerns were multidimensional and included issues related to risk reduction procedures, psychological and emotional impacts, and impact on family and social relationships. Many adults experience temporary distress after receipt of positive BRCA1/2 testing. Usually the distress is not clinically significant, however support is desired from health professionals, others who have a BRCA1/2 mutation, and family as decisions are made regarding screening and risk-reducing options. Social relationships are impacted as information is communicated to family members. Limitations of the current state of the science, opportunities to build evidence for the future and implications for nursing practice and education are identified.

Purpose/objectives: To understand the experiences of oncology nurses who use the Internet in their practice when their patients use the Internet for cancer care., Research Approach: Heideggerian hermeneutics branch of phenomenology., Setting: Oncology nurses were interviewed at their practice settings (n = 13), the researcher's office (n = 5), or their homes (n = 2)., Participants: 20 nurses recruited from local and national Oncology Nursing Society meetings. Their practice sites were cancer centers, hospitals, clinics, veterans centers, communities, and Internet companies., Methodologic Approach: Data were collected by informal interviews that provided the narrative stories for hermeneutic analysis., Main Research Variables: Internet use for cancer care, nurse-patient relationships, and Internet use for nursing practice., Findings: Five related themes emerged: (a) varying degrees of Internet integration in the practice environment, (b) changing schools of thought, (c) developing Internet use for professional practice, (d) redefining relationships, and (e) new nursing skills. The two constitutive patterns are (a) integrating Internet into practice out of necessity and (b) reflecting historical changes in practice patterns influenced by technology., Conclusions: Nurses who use the Internet are developing new practice patterns that incorporate technology and foster nurse-patient partnerships. Practice environments either foster or hinder technology use. Nurse computer competency is essential., Interpretation: Findings reflect the influence of adapting technology on practice. Internet use is a catalyst for redefining nurse-patient relationships into partnerships. The movement suggests a need for nurse Internet competencies, environmental support, and consideration for patient access (digital divide). Evaluation of content in nursing curricula and of patient competencies is advised. Further research on patient experiences is recommended.