Completing a Life: Comfort Level and Ease of Use of a CD-ROM Among Seriously III Patients

Angela Lambing

Carolyn Anne Markey

Christine M. Neslund-Dudas

Leslie J. Bricker

ONF 2006, 33(5), 999-1006. DOI: 10.1188/06.ONF.999-1006

Purpose/Objectives: To evaluate use of a CD-ROM titled Completing a Life among patients diagnosed with serious illnesses for comfort level with content and ease of computer use.

Design: A prospective pilot study collected a convenience sample of 50 people diagnosed with life-limiting illnesses during a six-month period.

Setting: The hematology/oncology department of a large healthcare system located in a metropolitan area in the midwestern United States.

Sample: Convenience sample of 50 patients diagnosed with life-limiting illnesses. Of the patients enrolled (age range = 38-93 years), 72% were female, 68% were Caucasian, 50% were diagnosed with breast cancer or nonsolid tumors, and 40% were newly diagnosed.

Methods: Subjects viewed the CD-ROM and completed pre- and postintervention surveys.

Main Research Variables: Comfort level with educational media, comfort level of information viewed, and areas of CD-ROM viewed compared to age and stage of illness.

Findings: Ninety percent of patients reported that they were somewhat or very comfortable with the CD-ROM as a learning tool, and ease of use was rated at 98%. Patients' comfort level with the material increased from 76% to 90% after they viewed the CD-ROM.

Conclusions: The pilot study suggests that the Completing a Life CD-ROM can be used with patients facing serious or life-limiting illnesses as an additional resource tool for information.

Implications for Nursing: Nurses typically provide the bulk of educational material for their patients. With limited resources available regarding management of life-limiting illnesses, this resource may provide an excellent addition to resources currently available.

Jump to a section


    A controlled trial to improve care for seriously ill hospitalized patients. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). (1995). JAMA, 274, 1591-1598.

    Bichakjian, C.K., Schwartz, J.L., Wang, T.S., Hall, J.M., Johnson, T.M., & Biermann, J.S. (2002). Melanoma information on the Internet: Often incomplete—A public health opportunity? Journal of Clinical Oncology, 20, 134-141.

    Boyington, A.R., Wildemuth, B.M., Dougherty, M.C., & Hall, E.P. (2004). Development of a computer-based system for continence health promotion. Nursing Outlook, 52, 241-247.

    Bynum, A.B., Cranford, C.D., Irwin, C.A., & Denny, G.S. (2003). Participant satisfaction in an adult telehealth education program using interactive compressed video delivery methods in rural Arkansas. Journal of Rural Health, 19, 218-222.

    Fogel, J., Albert, S.M., Schnabel, F., Ditkoff, B.A., & Neugut, A. (2002). Use of the Internet by women with breast cancer. Journal of Medical Internet Research, 4(2), E9.

    Fogel, J., Albert, S.M., Schnabel, F., Ditkoff, B.A., & Neugut, A. (2003). Racial/ethnic differences and potential psychological benefits in use of the Internet by women with breast cancer. Psycho-Oncology, 12, 107-117.

    Fox, S., & Raine, L. (2000). The online health care revolution: How the Web helps Americans take better care of themselves. In Pew Internet and American Life Project: Online Life Report (p. 23). Retrieved June 1, 2005, from

    Goldschmidt, L., & Goodrich, G. (2000). Multimedia patient education in the office: Going where few patients have gone before. Ophthalmology Clinics of North America, 13, 239-247.

    Greene, D., & Heeter, C. (1998). Breast cancer lighthouse [CD-ROM and Web site]. Retrieved June 1, 2005, from

    Greene, D., Ogle, K., Bricker, L., Lambing, A., Winn, B., & Mishkin, D. (2002). Completing a life [CD-ROM and Web site]. Retrieved June 1, 2005, from

    Greene, D., Ogle, K., & Winn, B. (1998). Easing cancer pain [CD-ROM and Web site]. Retrieved June 1, 2005, from

    Gustafson, D.H., Hawkins, R., Pingree, S., McTavish, F., Arora, N.K., Mendenhall, J., et al. (2001). Effect of computer support on younger women with breast cancer. Journal of General Internal Medicine, 16, 435-445.

    Helwig, A.L., Lovelle, A., Guse, C.E., & Gottlieb, M.S. (1999). An office-based Internet patient education system: A pilot study. Journal of Family Practice, 48, 123-127.

    Hogg, P., Boyle, T., Hennessy, C., Cassidy, S., Dodgeon, J., Hindle, J., et al. (2000). Evaluation of a computer-based information system for patients and members of the public. Radiography, 6(2), 89-100.

    Hoover, D.R., Crystal, S., Kumar, R., Sambamoorthi, U., & Cantor, J.C. (2002). Medical expenditures during the last year of life: Findings from the 1992-1996 Medicare current beneficiary survey. Health Services Research, 37, 1625-1642.

    Huang, Q.R. (2003). Creating informed consumers and achieving shared decision making. Australian Family Physician, 32, 335-341.

    Jones, J. (2003). Patient education and the use of the World Wide Web. Clinical Nurse Specialist, 17, 281-283.

    King, D.K., Bull, S.S., Christiansen, S., Nelson, C., Strycker, L.A., Toobert, D., et al. (2004). Developing and using interactive health CD-ROMs as a complement to primary care: Lessons from two research studies. Diabetes Spectrum, 17, 234-242.

    Klemm, P., Bunnell, D., Cullen, M., Soneji, R., Gibbons, P., & Holecek, A. (2003). Online cancer support groups: A review of the research literature. Computers, Informatics, Nursing, 21, 136-142.

    Lewis, D. (2003). Computers in patient education. Computers, Informatics, Nursing, 21, 88-96.

    Luker, K.A., & Caress, A.L. (1992). Evaluating computer assisted learning for renal patients. International Journal of Nursing Studies, 29, 237-250.

    Marsch, L.A., & Bickel, W.K. (2004). Efficacy of computer-based HIV/AIDS education for injection drug users. American Journal of Health Behavior, 28, 316-327.

    Maslin, A., Baum, M., Walker, J.S., A'Hern, R., & Prouse, A. (1998). Shared decision-making using an interactive video disk system for women with early breast cancer. Nursing Times Research, 3, 444-455.

    Murray, E., Lo, G., Pollack, L., Donelan, K., Catania, J., White, M., et al. (2003). The impact of health information on the Internet on the physicianpatient relationship. Archives of Internal Medicine, 163, 1727-1734.

    National Telecommunications and Information Administration. (2000). Falling through the net: Defining the digital divide. U.S. Department of Commerce. Retrieved July 10, 2006, from

    Nebel, I.T., Bluher, M., Starcke, U., Muller, U.A., Haak, T., & Pasche, R. (2002). Evaluation of a computer based interactive diabetes education program designed to train the estimation of the energy or carbohydrate contents of foods. Patient Education and Counseling, 46, 55-59.

    Nebel, I.T., Klemm, T., Fasshauer, M., Muller, U., Verlohren, H., Klaiberg, A., et al. (2004). Comparative analysis of conventional and an adaptive computer-based hypoglycaemia education programs. Patient Education and Counseling, 53, 315-318.

    Ogle, K., Greene, D.D., Winn, B., Mishkin, D., Bricker, L.G., & Lambing, A.K. (2003). Completing a life: Development of an interactive multimedia CD-ROM for patient and family education in end-of-life care. Journal of Palliative Medicine, 6, 841-850.

    Ogozalek, V. (1992). The automated pharmacists: Comparing the use of leaflets, text-based computers, and multimedia computers to provide medication information to the elderly. Journal of Medical Education Technology, 4, 6-11.

    Pendergast, T.J. (2001). Advance care planning: Pitfalls, progress, promise. Critical Care Medicine, 29(2, Suppl.), N34-N39.

    Ramirez, T.R., & Mondragon, D. (2002). Computer-based education for patients with cancer at Latino border hospital. Cancer Nursing, 25, 245-250.

    Reis, J., Trockel, M., King, T., & Remmert, D. (2004). Computerized training in breast self-examination: A test in a community health center. Cancer Nursing, 27, 162-168.

    Stern, G. (2002). Using the Internet. Journal of Geriatric Physical Therapy, 25(3), 35-36.

    Treweek, S.P., Glenton, C., Oxman, A.D., & Penrose, A. (2002). Computer-generated patient education materials: Do they affect professional practice? A systematic review. Journal of the American Medical Informatics Association, 9, 346-358.

    VanBiervliet, A., & Edwards-Schafer, P. (2004). Consumer health information on the Web: Trends, issues, and strategies. Dermatology Nursing, 16, 519-523.

    Wilkie, D.J., Huang, H.Y., Berry, D.L., Schwartz, A., Lin, Y.C., Ko, N.Y., et al. (2001). Cancer symptom control: Feasibility of a tailored, interactive computerized program for patients. Family Community Health, 24(3), 48-62.

    Zonfrillo, M.R., Mello, M.J., & Palmisciano, L.M. (2003). Usefulness of computerized pediatric motor vehicle safety discharge instructions. Academic Emergency Medicine, 10, 1131-1133.