Table 3: Qualitative analysis of focus group transcripts: topics, themes, and concepts.

TopicThemeConcepts

Internet useUse of the Internet for cancer informationSurvivorship
Disease information
Clinical trials
Medication
Nutrition
Use of specific websites including Medline, WebMD, Facebook, and local patient portal
For medical informationTest results
Choosing a doctor
Internet for social and practical purposesSocial networking and support
News
Manage finances
Mode of Internet useDo not rely solely on Internet for medical information
Limited use of smartphones
Primarily use computers at home, work, and at the clinic
Need assistance from friends/family to use Internet

Communication with healthcare providersPatient related barriersLanguage barriers
Difficulty discussing sensitive topics
Nervousness hinders communication
Prefer to use Spanish websites
Provider related barriersProviders unavailable for communication by phone/email

Appraisal of symptom and quality of life issuesAdd/revise skin-related symptomsDiscoloration, skin irritation, dryness, and burns
Add/revise emotional symptomsInclude bad mood, anxiety, motivation, peace, and tranquility
Add additional symptomsRunny nose, fever, problems with urination, weight gain, and headaches
Symptoms for possible revisionPrefer “tiredness,” “weariness,” or “exhaustion” over fatigue
Revise “poor emotional state” for clarity
Specify type of “pain”









Feedback regarding Spanish ESRA-C
Perceived benefitsImproved communication with providers
Can report symptoms and get information in private
Helps to know what to expect
“Real time” symptom appraisal
Asks about suicidal thoughts and depression
Perceived barriers to useMedical terminology difficult to understand
Wants to be sure healthcare team will get the information
Suggestions for changes to assessments/responsesPrefer faces scale for pain assessment
Question “never” as an appropriate response to SQOL
Discussion of pain levels not clear (0–10 scale)
Response of “more than half the days” difficult to understand
Suggestions for additional features and messagingMore personal experiences from a patient perspective
More familiar and identifiable icons
Message that “cancer” does not necessarily mean death
Search function
Newsletter
Dictionary of terms
Email
Moderated chat with other patients
Caregiver assessments and resources
Message that spirituality and faith are useful for coping with cancer
Nutritional information
Prevalence of symptoms
Prevalence of different types of cancer
What to expect from chemotherapy and radiation therapy