Sheryl Lacoursiere*, University of Massachusetts Boston, Waterbury, CT, United States Track: Research Presentation Topic: Building virtual communities and social networking applications for patients and consumers Presentation Type: Oral presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: A-Pechet Room Date: 2012-09-15 09:00 AM – 09:45 AM Last modified: 2012-09-10

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Background:
The Internet is rapidly evolving. More than 61% of adults will look online the next time they need reliable health or medical information, as opposed to contacting a medical professional. Activities include reading others' commentary and experiences, consulting reviews of providers and facilities, receiving updates, interacting with other patients; and listening to videos or podcasts (The Pew Internet and American Life Project, 2009).

Cardiovascular Disease affects 82.6 million Americans. Annually, there are 5.9 million cardiovascular hospital discharges in the United States. Over 6.8 million cardiovascular surgeries and procedures are performed. Heart disease claims over 1.3 million lives, and represents over 33.6% of all deaths (American Heart Association, 2011)

Little was known about cardiovascular patients who use the Internet. Who are they? What are their diagnoses? How much support have they received? What concerns do they have? How would they respond to online nursing intervention?

Objective
The objective of this study was to determine if the availability of a telehealth Internet-based nurse support intervention had an effect on psychological and physiological outcomes, support, satisfaction, usage and communication in persons with cardiovascular disease who use the Internet.

Methods:
A Pretest-Posttest Comparative Control Group Repeated Measures design was employed using 159 persons with cardiovascular disease who were current Internet users. Participants were recruited via the Internet and randomly assigned to one of two groups for six weeks: (1) The Nurse Support group, which included access to the intervention, Internet-based nurse support delivered at a distance, in a web-based group forum; (2) The Self-Care group, which included access to web links only. Data were collected pre-intervention, and 6- and 12- weeks post-intervention.

Results:
A univariate analysis of variance (ANOVA) for the intervention period revealed a significant increase in site usage (p < .05) by the Nurse Support group compared to the Self-Care group. Multivariate analyses of variance (MANOVAs) were employed to assess differences in psychological, physiological, and support outcomes. There were no overall significant differences between the pretest and the end of 6 weeks, however between 6 weeks and 12 weeks there was a significant main effect for time (p < .05). Univariate ANOVAs indicated a significant increase in psychological outcomes (p < .05) for both time periods, and a significant interaction for physiological outcomes (p < .05) in the second time period, with scores increasing in the Nurse Support group, and decreasing in the Self-Care group. At both time periods, there was significantly more satisfaction (p < .05) in the Nurse Support group. Qualitative analyses of satisfaction at both time periods revealed a combination of eight themes between groups. Analysis of discussion forum communications revealed 98 topics with 685 messages, which were coded and classified by type. A taxonomy of nursing interventions was subsequently developed.

Conclusions:
The results of this study indicate that Internet-based interventions can significantly affect physiological and psychological outcomes, and can help to establish role guidelines for consumer telehealth services. Online support need not be limited to particular diagnoses- the core experience of heart disease engenders commonalities between patients.