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Table 1 Cancer CarePartners Web site components and caregiver skills targeted.

From: Cancer Carepartners: Improving patients' symptom management by engaging informal caregivers

Targeted caregiver skills

 

Web site components

Problem definition & formulation

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Upon logging into the Cancer CarePartners web site, the caregiver sees a depiction of the patient's last symptom scores using horizontal thermometers (Figure 1a). Symptoms are presented in order of severity, with the most severe symptoms displayed at the top of the screen. Caregivers can select a symptom to access additional information about the symptom's cause and management (Figure 1b). Caregivers also can access reports showing trends in each symptom over time.

Generation of alternatives

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The Web site asks caregivers to identify one symptom that they would like to help the patient work on that week. Upon choosing the symptom, the caregiver sees a list of recommendations suited to the patient's last assessment (Figure 1c). Advice is grouped by its targeted domain: namely, activity (i.e. exercise), communication, diet, medication, and mood. For example, if the patient reported dry mouth and the caregiver chooses to address that symptom with additional self-care assistance, they may receive advice such as "make sure the patient has a water bottle at his/her side at all times."

Decision making

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Caregivers are asked to commit to trying three to five tasks for the week from the list of recommendations. To help caregivers make informed decisions about which recommendations to adopt, the Web site describes each task's purpose and what is involved, and provides examples for how to accomplish it.

Solution implementation & verification

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After committing to 3-5 tasks, caregivers can print a list of their choices, or "Task List, " for future reference (Figure 1d). The next time the caregiver logs into the website, she is asked which of the tasks she attempted and whether the recommended action was helpful (Figure 1e). In addition to allowing caregivers to self-monitor the outcomes associated with their assistance, the data allow the investigative team to determine uptake of specific advice offered by Cancer CarePartners and caregivers' perceptions about its benefit.