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Elbashir M, ElHajj MS, Rainkie D, Kheir N, Hamou F, Abdulrhim S, Mahfouz A, Alyafei S, Awaisu A. Evaluation of Health Literacy Levels and Associated Factors Among Patients with Acute Coronary Syndrome and Heart Failure in Qatar. Patient Prefer Adherence 2023; 17:89-105. [PMID: 36642998 PMCID: PMC9835006 DOI: 10.2147/ppa.s385246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/17/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To determine the prevalence of inadequate health literacy and its associated risk factors among patients with acute coronary syndrome (ACS) and/or heart failure (HF) in Qatar. PATIENTS AND METHODS This cross-sectional observational study was conducted among patients with ACS and/or HF attending the national Heart Hospital in Qatar. Health literacy was assessed using the abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Three-item Brief Health Literacy Screen (3-item BHLS). RESULTS Three hundred patients with ACS and/or HF, majority male (88%) and non-Qatari (94%), participated in the study. The median (IQR) age of the participants was 55 (11) years. The prevalence of inadequate to marginal health literacy ranged between 36% and 54%. There were statistically significant differences in health literacy level between patients based on their marital status (p=0.010), education (p≤0.001), ability to speak any of Arabic, English, Hindi, Urdu, Malayalam, or other languages (p-values ≤0.001 to 0.035), country of origin (p≤0.001), occupation (p≤0.001), and receiving information from a pharmacist (p=0.008), a physiotherapist (p≤0.001), or a nurse (p=0.004). CONCLUSION Inadequate health literacy is common among patients with ACS and/or HF. This study suggests a need for developing strategies to assist healthcare professionals in improving health literacy skills among patients with ACS and HF. A combination of interventions may be needed to improve patients' understanding of their disease and medications, and ultimately overall health outcomes.
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Affiliation(s)
- Marwa Elbashir
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Pharmacy Department, Airport Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Maguy Saffouh ElHajj
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniel Rainkie
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Nadir Kheir
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Fatima Hamou
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sara Abdulrhim
- Pharmacy Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Ahmed Mahfouz
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Alyafei
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Correspondence: Ahmed Awaisu, Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar, Tel +974 4403 5596, Fax +974 4403 5551, Email
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Kelly T, Thompson JD, Surjan Y, Rinks M, Warren‐Forward H. Lived experiences of radiation therapists using health literacy strategies with patients-A qualitative review using interpretative phenomenological analysis. J Med Radiat Sci 2022; 69:318-326. [PMID: 35289107 PMCID: PMC9442295 DOI: 10.1002/jmrs.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Adaptive communication is an essential requirement to deliver quality patient-centred care. Determining patients' informational needs and acting on the needs are skills radiation therapists (RTs) employ daily with patients. Learning health literacy (HL) strategies to assist with the informational delivery provides RTs with options to improve patients' understanding of vital radiotherapy treatment information or tasks. This research investigates the lived experiences of RTs from the Illawarra and Shoalhaven Cancer Care Centres in Australia using HL strategies during patient interactions after undertaking HL training workshops. METHODS An interpretative phenomenological analysis (IPA) approach was used. Audio-recorded semi-structured interviews were conducted with six RTs. Two reviewers analysed each interview script separately before discussing and constructing substantive and sub-themes. RESULTS Four substantive themes were constructed: RT personal attitudes and responses to HL, HL strategies used by RTs, patient associated HL needs and barriers when addressing patient HL needs. RTs were either person- or process-focussed during patient interactions. It was identified that information is provided to patients according to how RTs themselves like to learn new information. CONCLUSION This research has allowed an opportunity to inquire into the lived experiences of RTs implementing HL strategies when providing information to patients. While RTs may be person or process-focussed, the patient's needs are always prioritised when providing information, which ultimately results in patient understanding and increased engagement.
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Affiliation(s)
- Toni Kelly
- School of Health SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- Illawarra Shoalhaven Local Health DistrictWollongongNew South WalesAustralia
| | - Jennifer D Thompson
- BreastScreen New South Wales, Hunter New EnglandNewcastleNew South WalesAustralia
| | - Yolanda Surjan
- School of Health SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Marianne Rinks
- Illawarra Shoalhaven Local Health DistrictWollongongNew South WalesAustralia
| | - Helen Warren‐Forward
- School of Health SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
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Gibson C, O'Connor M, White R, Jackson M, Baxi S, Halkett GK. Silenced: Patients' experiences of voicelessness in head and neck cancer. PATIENT EDUCATION AND COUNSELING 2022; 105:2410-2416. [PMID: 35184909 DOI: 10.1016/j.pec.2022.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/21/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The objective of this qualitative study was to explore patients' experiences of communicating with health professionals following a diagnosis of head and neck cancer (HNC). METHODS A qualitative research approach based on social constructionist theory was used. A total of 21 in-depth semi-structured interviews were conducted with people diagnosed with HNC. Thematic analysis was used to identify themes. RESULTS The experience of losing the capacity for speech was experienced by survivors of HNC as distressing and traumatic. Voicelessness was not just a loss of physical speech, but a holistic experience of silencing. A number of tensions emerged including patients' experiences of losing their voice and then finding different ways to verbally express themselves; in interactions with health professionals there was a tension between abrupt, hurried communication and a slower, more mindful communication style. Sub-themes around communication style emerged where disparities between levels of health literacy were unaddressed, and patients' experienced a lack of empathy. Another tension experienced was between an old style medical model and the ideal of person-centred care and the biopsychosocial model of health. CONCLUSION Whether HNC patients lose their voice temporarily, have periods of voicelessness, or are able to speak, but feel unheard, the treatment experience is too often one of disempowerment and silencing of their perspectives. PRACTICE IMPLICATIONS Health professionals are challenged to find creative communication methods, to practice mindful listening, source speech pathology and adaptive technologies, and to facilitate communication that supports patients in expressing their values, preferences and needs.
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Affiliation(s)
- Chandrika Gibson
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Moira O'Connor
- WA Cancer Prevention Research Unit (WACPRU), School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rohen White
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Melanie Jackson
- Radiation Oncology, Genesis Care, Perth, Western Australia, Australia
| | | | - Georgia Kb Halkett
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Li W, Hill C, Cashell A, Hindle D, Feuz C, Rosewall T. Could knowledge of patient demographics facilitate a personalized approach to radiation therapy patient education? J Med Imaging Radiat Sci 2022; 53:41-50. [DOI: 10.1016/j.jmir.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/20/2022]
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Hildenbrand GM. Healthcare Provider Analogies as Memorable Messages. JOURNAL OF HEALTH COMMUNICATION 2021; 26:764-772. [PMID: 34779337 DOI: 10.1080/10810730.2021.2002982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Healthcare providers must explain medical information to patients in a way that patients can understand. Provider use of analogies is one strategy that may help patients better understand medical information. The present study, guided by a memorable message framework, investigated whether participants remembered any analogies used by their healthcare providers, and included a content analysis of the function the analogies served, the types of analogies participants remembered, and the body systems associated with the health issues that were described. Almost one-quarter of participants recalled an analogy used by a provider. The most frequently recalled analogies functioned to describe health conditions or phenomena, followed by elements of the body, and treatments or something external to the body. Analogies were most frequently used to describe health issues associated with the cardiovascular system, musculoskeletal system, digestive system, dental, eye, or skin issues, or the nervous system. The analogies were categorized as mechanical, a feeling or experience, random object, structure, food, nature, war/battle, or medical/body. Provider analogies may be a type of memorable message for some patients. Providers could consider using suitable analogies to explain health issues when communicating with patients, and be trained in effective use of analogies.
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Affiliation(s)
- Grace M Hildenbrand
- Brian Lamb School of Communication, Purdue University, West Lafayette, Indiana, USA
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Sundberg K, Lindström V, Petersson LM, Langius-Eklöf A. Supporting health literacy using an interactive app for symptom management during radiotherapy for prostate cancer. PATIENT EDUCATION AND COUNSELING 2021; 104:381-386. [PMID: 32811748 DOI: 10.1016/j.pec.2020.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 07/10/2020] [Accepted: 08/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Patients' ability to self-monitor symptoms and engage in self-care activities is dependent upon their level of health literacy. Health literacy and self-care ability was compared in men with prostate cancer undergoing radiotherapy that used an app for symptom management with a control group. METHODS Included were an intervention group (n = 66), who used an app for symptom reporting and support for self-care, and a control group (n = 64). Outcomes were Functional Health Literacy, Communicative and Critical Health Literacy and Appraisal of Self-Care Agency (ASA-A). RESULTS The intervention group had improved regarding "ability to select information needed from a variety of information sources" (p = .020), "ability to determine the information credible" (p = .041), and "being able to plan and decide what to do to improve health" (p = .004). No inter-group difference was found for ASA-A. CONCLUSIONS With the support of an app for reporting and managing symptoms, important advanced health literacy skills of selecting, determining, and judging information credible may improve. PRACTICE IMPLICATIONS Patients undergoing treatment for prostate cancer may benefit from an individualized approach, such as an app, for communication with health care providers and as a source of health information to make decisions about their own health.
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Affiliation(s)
- Kay Sundberg
- Department for Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
| | - Veronica Lindström
- Department for Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Lena-Marie Petersson
- Department for Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Ann Langius-Eklöf
- Department for Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
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Radiation therapist health literacy training: Does learning alternate communication methods translate into improved confidence in patient interactions? Radiography (Lond) 2020; 26:220-226. [DOI: 10.1016/j.radi.2019.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/17/2019] [Accepted: 12/02/2019] [Indexed: 11/17/2022]
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Kelly T, Arnold B, Surjan Y, Rinks M, Warren-Forward H. Radiation therapist health literacy training: A qualitative study exploring perceived barriers and attitudes. Radiography (Lond) 2020; 26:294-301. [PMID: 32169311 DOI: 10.1016/j.radi.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/02/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Health literacy (HL) is a universal issue in healthcare. While difficult to assess an individual's HL status, the onus is on the health provider to empower patients to seek understanding of health information provided to them. Universal HL training techniques include implementing plain language and the teach-back method. The research aims to explore the perceptions of Australian radiation therapists (RTTs) learning and implementation of these tools with patients. METHODS RTTs attended two communication and HL workshops one week apart. Participants completed three anonymous surveys (before the first workshop, immediately after the second and three months post workshops) and a workshop evaluation was administered after the second workshop. Participants had the opportunity to provide written comments on all surveys and the evaluation form. A thematic analysis was performed on the written comments by two independent researchers. RESULTS Five themes were revealed after the thematic analysis of the surveys. These themes were: improved patient understanding, impact on professional credibility, practice and timing of using methods, appearing to be condescending to educated patients and increased patient anxiety. The workshop evaluation assessment indicated the success of and improvement for future workshops and revealed seven themes. These were: learning from others, providing a safe environment to share experiences, to be open to learning new methods, more time for learning, role-play aversion, group sizing and thinking beyond the workshops. CONCLUSION While strong evidence of using HL tools for improved patient understanding exists, this qualitative review revealed unexpected barriers with implementing both the plain language and teach-back method. IMPLICATIONS FOR PRACTICE Barriers revealed during HL training could have patient flow on effects when checking for understanding. These challenges need further exploration, to inform all health professionals.
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Affiliation(s)
- T Kelly
- School of Health Sciences, University of Newcastle, Australia; Illawarra Shoalhaven Local Health District, Australia.
| | - B Arnold
- Illawarra Shoalhaven Local Health District, Australia
| | - Y Surjan
- School of Health Sciences, University of Newcastle, Australia
| | - M Rinks
- Illawarra Shoalhaven Local Health District, Australia
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Smith SK, Cabrera-Aguas M, Shaw J, Shepherd H, Naehrig D, Meiser B, Jackson M, Saade G, Bucci J, Halkett GKB, Turner RM, Milross C, Dhillon HM. A low literacy targeted talking book about radiation therapy for cancer: development and acceptability. Support Care Cancer 2018; 27:2057-2067. [PMID: 30225574 DOI: 10.1007/s00520-018-4446-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/26/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To develop a low literacy talking book (written book with accompanying audio-recording) about radiation therapy and explore its acceptability with patients and caregivers. METHOD The talking book was developed iteratively using low literacy design principles and a multidisciplinary committee comprising consumers and experts in radiation oncology, nursing, behavioural sciences, and linguistics. It contained illustrations, photos, and information on: treatment planning, daily treatment, side effects, psychosocial health, and a glossary of medical terms. Semi-structured interviews were conducted with patients who self-reported low functional health literacy and caregivers to explore their views on the resource. Thematic analysis using a framework approach informed the analysis. RESULTS Participants were very satisfied with the content, illustrations, and language in the resource. Most were unfamiliar with the term 'talking book', but liked the option of different media (text and audio). The resource was seen as facilitating communication with the cancer care team by prompting question-asking and equipping patients and their families with knowledge to communicate confidently. CONCLUSIONS The low literacy talking book was well accepted by patients and their caregivers. The next step is to examine the effect of the resource on patients' knowledge, anxiety, concerns, and communication with the cancer care team.
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Affiliation(s)
- Sian K Smith
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia.
| | - Maria Cabrera-Aguas
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Heather Shepherd
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Diana Naehrig
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Chris O'Brien Lifehouse, Integrative Oncology & Supportive Care, Sydney, NSW, Australia
| | - Bettina Meiser
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Lowy Cancer Research Centre C25 Level 4, Cnr High Street and Botany Street, Kensington, NSW, 2033, Australia
| | - Michael Jackson
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - George Saade
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Joseph Bucci
- St George Hospital Cancer Care, Radiation Oncology Unit, Sydney, NSW, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, School of Nursing School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Robin M Turner
- Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher Milross
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Chris O'Brien Lifehouse, Radiation Oncology and Medical Services, Sydney, NSW, Australia
| | - Haryana M Dhillon
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Schnitzler L, Smith SK, Shepherd HL, Shaw JM, Dong S, Turner RM, Sørensen K, Dhillon HM. What information is communicated by radiation therapists to patients during education sessions on the first day of treatment? Eur J Cancer Care (Engl) 2018; 28:e12911. [PMID: 30204270 DOI: 10.1111/ecc.12911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 05/19/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
This study examined the content covered by radiation therapists (RTs) during education sessions; the frequency and types of questions asked by patients; and the relationship between patient characteristics and the number of questions asked. Fifty-eight education sessions were audio-recorded and transcribed verbatim. A coding scheme was developed to examine the frequency of topics covered. It comprised 16 topics under four themes: (a) treatment schedule, (b) procedural information, (c) treatment-related side effects and (d) who will be involved in treatment provision. All education sessions covered information about the treatment plan (n = 58, 100%), and the majority described procedural information about what happens in the treatment room (n = 56, 97%). Least information was given about who will be providing treatment. On average, patients asked a mean of 6 questions (SD = 4.95; range = 0-28). Most frequently asked questions concerned the general treatment (logistics, schedule), accounting for 67% of all questions asked. The least common types of questions were related to the impact of treatment (6%). There were no statistically significant differences in the total number of questions and patient demographics. Patients are provided with most, but not all, of the recommended information. Tailoring of information by RTs was enabled in response to questions asked.
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Affiliation(s)
- Lena Schnitzler
- Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, The Netherlands.,Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sian K Smith
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
| | - Joanne M Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
| | - Skye Dong
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
| | - Robin M Turner
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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Quinn F, Smith SK, Dhillon HM, Gillham C, Craig A. What do radiation therapists know about health literacy and the strategies to improve it for patients? A qualitative study. Support Care Cancer 2018; 27:649-657. [DOI: 10.1007/s00520-018-4353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/11/2018] [Indexed: 01/18/2023]
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Jimenez YA, Cumming S, Wang W, Stuart K, Thwaites DI, Lewis SJ. Patient education using virtual reality increases knowledge and positive experience for breast cancer patients undergoing radiation therapy. Support Care Cancer 2018. [PMID: 29536200 DOI: 10.1007/s00520-018-4114-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Improved access to technology in the radiation therapy (RT) workforce education has resulted in opportunities for innovative patient education methods. This study investigated the impact of a newly developed education tool using the Virtual Environment for Radiotherapy Training (VERT) system on patients' RT knowledge and anxiety. METHOD Breast cancer patients were recruited into a control group (CG) (n = 18) who underwent the standard pre-RT education package at a targeted cancer therapy centre, followed by a VERT group (VG) (n = 19). VG patients attended a VERT-based education session detailing RT immobilisation, planning and treatment. All patients completed questionnaires at four time points throughout their treatment, with survey sub-sections on RT knowledge, experience and anxiety. RESULTS For both groups, anxiety levels were highest at time point 1(T1 after initial radiation oncologist consultation) (CG, 41.2; VG, 43.1), with a gradual decrease observed thereafter at time points before simulation, at the beginning of treatment and at the end of treatment (p > 0.05). The VG's RT knowledge scores were statistically significantly higher than those of the CG scores at all time points following VERT education (p < 0.05). CONCLUSION This study reports the high value of VERT breast cancer-targeted education programs in improving RT knowledge and perhaps decreasing patient anxiety. Continued efforts are required to improve patients' accessibility to VERT in Australia, and to better understand the effect of VERT's unique educational features on patients' emotional and physical needs throughout their RT.
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Affiliation(s)
- Yobelli A Jimenez
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia.
| | - Steven Cumming
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Wei Wang
- The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Kirsty Stuart
- The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | - David I Thwaites
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia
| | - Sarah J Lewis
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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Rajah R, Ahmad Hassali MA, Jou LC, Murugiah MK. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies. Perspect Public Health 2017; 138:122-132. [PMID: 28980881 DOI: 10.1177/1757913917733775] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. METHODS CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. RESULTS A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. CONCLUSION Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.
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Affiliation(s)
- Retha Rajah
- Pharmacy Department, Hospital Seberang Jaya, Penang, Malaysia.,Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Mohamed Azmi Ahmad Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Lim Ching Jou
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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14
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Schnitzler L, Smith SK, Shepherd HL, Shaw J, Dong S, Carpenter DM, Nguyen F, Dhillon HM. Communication during radiation therapy education sessions: The role of medical jargon and emotional support in clarifying patient confusion. PATIENT EDUCATION AND COUNSELING 2017; 100:112-120. [PMID: 27542311 DOI: 10.1016/j.pec.2016.08.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 05/22/2023]
Abstract
OBJECTIVE Radiation oncology consultations involve explanation of complex technical concepts using medical jargon. This study aimed to: analyse types and frequency of medical jargon that radiation therapists (RTs) use during education sessions; identify how patients seek clarification from RTs; and, explore RTs communication strategies. METHODS Education sessions were audio-recorded and transcribed. Medical jargon was analysed using MaxDictio (a vocabulary analysis programme). A distinction was made between specialised (specialised terms used in RT or cancer) and contextual jargon (common everyday words with a different meaning in RT). Qualitative data were analysed using Framework analysis. RESULTS Fifty-eight patients and 10 RTs participated. Contextual treatment jargon were the most frequently used jargon (32.2%) along with general medical terms (34.6%). Patients appeared uncertain about the number of treatments, side effects, and the risks of radiation. Patients sought clarification by asking RTs to explain or repeat information. RTs replaced jargon with a simpler word, used everyday analogies, and diagrams. CONCLUSION Use of medical jargon is common in RT education sessions. RTs used different jargon types to varying degrees, but contextual jargon dominated. PRACTICE IMPLICATIONS Training RTs how to tailor information to enhance patients' understanding would be beneficial. Future research exploring medical jargon used in other (non-) oncology settings is required.
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Affiliation(s)
- Lena Schnitzler
- Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, The Netherlands; Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, Level 4, C25 Lowy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Sian K Smith
- Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, Level 4, C25 Lowy Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Heather L Shepherd
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Joanne Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Skye Dong
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
| | - Delesha M Carpenter
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Asheville, USA
| | - Frances Nguyen
- Nutrition and Chronic Disease Prevention, Harris County Public Health & Environmental Services, Houston, USA
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
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15
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Sublette VA, Smith SK, George J, McCaffery K, Douglas MW. Listening to both sides: A qualitative comparison between patients with hepatitis C and their healthcare professionals' perceptions of the facilitators and barriers to hepatitis C treatment adherence and completion. J Health Psychol 2016; 23:1720-1731. [PMID: 27682337 DOI: 10.1177/1359105316669858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This qualitative study compares and contrasts the perspectives of healthcare professionals who treat hepatitis C with those of patients in treatment. Comparative analysis of semi-structured interviews with 20 healthcare professionals and 20 patients undergoing treatment for hepatitis C concluded that patients and healthcare professionals disagreed on the source of communication breakdowns, but both felt that individualised clinical information improved adherence. Stigma was recognised as a barrier to treatment adherence by both patients and healthcare professionals. Limitations of the healthcare system, such as patients receiving inconsistent information and long wait times, negatively impacted both patients and providers.
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16
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Prabhu AV, Hansberry DR, Agarwal N, Clump DA, Heron DE. Radiation Oncology and Online Patient Education Materials: Deviating From NIH and AMA Recommendations. Int J Radiat Oncol Biol Phys 2016; 96:521-8. [PMID: 27681748 DOI: 10.1016/j.ijrobp.2016.06.2449] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE Physicians encourage patients to be informed about their health care options, but much of the online health care-related resources can be beneficial only if patients are capable of comprehending it. This study's aim was to assess the readability level of online patient education resources for radiation oncology to conclude whether they meet the general public's health literacy needs as determined by the guidelines of the United States National Institutes of Health (NIH) and the American Medical Association (AMA). METHODS Radiation oncology-related internet-based patient education materials were downloaded from 5 major professional websites (American Society for Radiation Oncology, American Association of Physicists in Medicine, American Brachytherapy Society, RadiologyInfo.org, and Radiation Therapy Oncology Group). Additional patient education documents were downloaded by searching for key radiation oncology phrases using Google. A total of 135 articles were downloaded and assessed for their readability level using 10 quantitative readability scales that are widely accepted in the medical literature. RESULTS When all 10 assessment tools for readability were taken into account, the 135 online patient education articles were written at an average grade level of 13.7 ± 2.0. One hundred nine of the 135 articles (80.7%) required a high school graduate's comprehension level (12th-grade level or higher). Only 1 of the 135 articles (0.74%) met the AMA and NIH recommendations for patient education resources to be written between the third-grade and seventh-grade levels. CONCLUSION Radiation oncology websites have patient education material written at an educational level above the NIH and AMA recommendations; as a result, average American patients may not be able to fully understand them. Rewriting radiation oncology patient education resources would likely contribute to the patients' understanding of their health and treatment options, making each physician-patient interaction more productive and efficient.
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Affiliation(s)
- Arpan V Prabhu
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - David R Hansberry
- Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David A Clump
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Dwight E Heron
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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17
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Sublette VA, Smith SK, George J, McCaffery K, Douglas MW. Listening to both sides: A qualitative comparison between patients with hepatitis C and their healthcare professionals' perceptions of the facilitators and barriers to hepatitis C treatment adherence and completion. J Health Psychol 2016; 22:1300-1311. [PMID: 26857543 DOI: 10.1177/1359105315626786] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This qualitative study compares and contrasts the perspectives of healthcare professionals who treat hepatitis C with those of patients in treatment. Comparative analysis of semi-structured interviews with 20 healthcare professionals and 20 patients undergoing treatment for hepatitis C concluded that patients and healthcare professionals disagreed on the source of communication breakdowns, but both felt that individualised clinical information improved adherence. Stigma was recognised as a barrier to treatment adherence by both patients and healthcare professionals. Limitations of the healthcare system, such as patients receiving inconsistent information and long wait times, negatively impacted both patients and providers.
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Affiliation(s)
- Victoria A Sublette
- 1 The University of Sydney, Australia.,2 The Westmead Institute for Medical Research, Australia.,3 Westmead Hospital, Australia
| | | | - Jacob George
- 1 The University of Sydney, Australia.,2 The Westmead Institute for Medical Research, Australia.,3 Westmead Hospital, Australia
| | | | - Mark W Douglas
- 1 The University of Sydney, Australia.,2 The Westmead Institute for Medical Research, Australia.,3 Westmead Hospital, Australia
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18
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In Regard to Byun et al. Int J Radiat Oncol Biol Phys 2015; 93:728. [DOI: 10.1016/j.ijrobp.2015.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/19/2015] [Indexed: 11/18/2022]
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19
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Lettre à la Rédactrice en chef. J Med Imaging Radiat Sci 2015; 46:10-11. [DOI: 10.1016/j.jmir.2015.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Goguen J. Letter to the Editor. J Med Imaging Radiat Sci 2015; 46:9-10. [DOI: 10.1016/j.jmir.2015.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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