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Chen JJ, Brown AM, Garda AE, Kim E, McAvoy SA, Perni S, Rooney MK, Shiue K, Tonning KL, Warren LE, Golden DW, Croke JM. Patient Education Practices and Preferences of Radiation Oncologists and Interprofessional Radiation Therapy Care Teams: A Mixed-Methods Study Exploring Strategies for Effective Patient Education Delivery. Int J Radiat Oncol Biol Phys 2024; 119:1357-1367. [PMID: 38437924 DOI: 10.1016/j.ijrobp.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/02/2024] [Accepted: 02/07/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE Patients' understanding of radiation therapy (RT) and data regarding optimal approaches to patient education (PE) within radiation oncology (RO) are limited. We aimed to evaluate PE practices of radiation oncologists and interprofessional RT care team members to inform recommendations for delivering inclusive and accessible PE. METHODS AND MATERIALS An anonymous survey was administered to all Radiation Oncology Education Collaborative Study Group members (10/5/22-11/23/22). Respondent demographics, individual practices/preferences, and institutional practices were collected. Qualitative items explored strategies, challenges, and desired resources for PE. Descriptive statistics summarized survey responses. The Fisher exact test compared PE practices by respondent role and PE timing. Thematic analysis was used for qualitative responses. RESULTS One hundred thirteen Radiation Oncology Education Collaborative Study Group members completed the survey (28.2% response rate); RO attendings comprised 68.1% of respondents. Most practiced in an academic setting (85.8%) in North America (80.5%). Institution-specific materials were the most common PE resource used by radiation oncologists (67.6%). Almost half (40.2%) reported that their PE practices differed based on clinical encounter type, with paper handouts commonly used for in-person and multimedia for telehealth visits. Only 57.7% reported access to non-English PE materials. PE practices among radiation oncologists differed according to RT clinical workflow timing (consultation versus simulation versus first RT, respectively): one-on-one teaching: 88.5% versus 49.4% versus 56.3%, P < .01, and paper handouts: 69.0% versus 28.7% versus 16.1%, P < .01. Identified challenges for PE delivery included limited time, administrative barriers to the development or implementation of new materials or practices, and a lack of customized resources for tailored PE. Effective strategies for PE included utilization of visual diagrams, multimedia, and innovative education techniques to personalize PE delivery/resources for a diverse patient population, as well as fostering interprofessional collaboration to reinforce educational content. CONCLUSIONS Radiation oncologists and interprofessional RO team members engage in PE, with most using institution-specific materials often available only in English. PE practices differ according to clinical encounter type and RT workflow timing. Increased adoption of multimedia materials and partnerships with patients to tailor PE resources are needed to foster high-quality, patient-centered PE delivery.
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Affiliation(s)
- Jie Jane Chen
- Department of Radiation Oncology, University of California, San Francisco, California
| | - Anna M Brown
- Aspirus Regional Cancer Center, Wausau, Wisconsin
| | - Allison E Garda
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Ellen Kim
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sarah A McAvoy
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Subha Perni
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael K Rooney
- Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kevin Shiue
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kristi L Tonning
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - Laura E Warren
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Daniel W Golden
- Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois
| | - Jennifer M Croke
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
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Avila S, Ruiz MJ, Petereit D, Arya R, Callender B, Hasan Y, Kim J, Lee N, McCall A, Son C, Stack K, Asif S, Besecker T, Juneja A, Li Z, Naik P, Ranka T, Saxena P, Siegfried B, Ichikawa T, Golden DW. Communicating the Gynecologic Brachytherapy Experience (CoGBE): Clinician perceived benefits of a graphic narrative discussion guide. Brachytherapy 2023; 22:352-360. [PMID: 36681540 PMCID: PMC10175118 DOI: 10.1016/j.brachy.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Many current radiotherapy patient education materials are not patient-centered. An interprofessional team developed Communicating the Gynecologic Brachytherapy Experience (CoGBE), a graphic narrative discussion guide for cylinder, intracavitary, and interstitial high-dose-rate (HDR) gynecologic brachytherapy. This study assesses perceived clinical benefits, usability, and anxiety-reduction of CoGBE. METHODS AND MATERIALS An electronic survey was sent to members of the American Brachytherapy Society. Participants were assigned to assess one of the three modality-specific CoGBE versions using a modified Systems Usability Scale (SUS), modified state-trait anxiety index (mSTAI), and Likert-type questions. Free response data was analyzed using modified grounded theory. RESULTS Median modified SUS score was 76.3 (interquartile range [IQR], 71.3-82.5) and there were no significant differences between guide types. Median mSTAI was 40 (IQR, 40-43.3) for all guides collectively. The cylinder guide had a significantly higher median mSTAI than the intracavitary and interstitial guides (41.6 vs. 40.0 and 40.0; p = 0.04) suggesting the cylinder guide may have less impact on reducing anxiety. Most respondents reported that CoGBE was helpful (72%), would improve patient understanding (77%) and consultation memorability (82%), and was at least moderately likely to be incorporated into their practice (80%). Qualitative analysis themes included personalization and relatability (positive); generalizability (negative); illustrations (both). CONCLUSIONS Clinicians rate CoGBE as usable with potential to reduce patient anxiety, especially with more invasive treatment modalities including intracavitary or interstitial high-dose-rate. CoGBE has the potential to improve patient-clinician communication for a wider range of patients due to its accessible, adaptable, and patient-centered design.
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Affiliation(s)
- Santiago Avila
- Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | - María J Ruiz
- Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | | | - Ritu Arya
- Texas Oncology Arlington Cancer Center North, Arlington, TX
| | - Brian Callender
- Department of Medicine, The University of Chicago, Chicago, IL
| | - Yasmin Hasan
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Josephine Kim
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Nita Lee
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Anne McCall
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Christina Son
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Kate Stack
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - Sabah Asif
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tyler Besecker
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Arushi Juneja
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Zhongyang Li
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Pinakee Naik
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tanvi Ranka
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Prachi Saxena
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Brian Siegfried
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Tomoko Ichikawa
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - Daniel W Golden
- Pritzker School of Medicine, The University of Chicago, Chicago, IL; Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL.
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Li ZHJ, Kim I, Giuliani M, Ingledew PA. Navigating Radiation Therapy During COVID-19 Using YouTube as a Source of Information. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:412-418. [PMID: 35028927 PMCID: PMC8758466 DOI: 10.1007/s13187-022-02133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/02/2022] [Indexed: 05/20/2023]
Abstract
The COVID-19 pandemic brought considerable change to the practice of radiotherapy. In the meantime, patients are increasingly turning to online resources for health information, with YouTube being one of the biggest platforms. However, little is known about what information is being disseminated to cancer patients about radiotherapy in the context of COVID-19. Therefore, this study aims to characterize and assess YouTube videos on radiotherapy during COVID-19. A YouTube search using the terms "Radiation therapy COVID-19", "Radiation therapy coronavirus", "Radiotherapy COVID-19", and "Radiotherapy coronavirus" was completed using a clear-cache web browser. The top 50 videos were collected from each search. After applying pre-determined exclusion criteria, each video was assessed for general parameters, source, and content. Two raters were used to ensure interrater reliability. One hundred five unique videos resulted from the four searches. Ninety-eight per cent were published in the last year. The median video length was 6 min and 54 s, and the median number of views was 570. Most videos were from the USA (58%). The majority of videos were published by a commercial channel (31%), non-profit organization (28%), or healthcare facility (26%). Forty-two per cent of the videos covered a topic related to radiotherapy during the pandemic. Bias was identified in 6% of videos. YouTube information on radiotherapy during COVID-19 is non-specific and can be misleading. The results of this study highlight the need for healthcare providers to proactively address patient information needs and guide them to appropriate sources of information.
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Affiliation(s)
- Zhang Hao Jim Li
- Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada
| | - Inhwa Kim
- Faculty of Medicine, Dalhousie University, 5849 University Ave, Halifax, B3H 4R2, Canada
| | - Meredith Giuliani
- Department of Radiation Oncology, University of Toronto, 149 College St #504, Toronto, M5T 1P5, Canada
- Princess Margaret Cancer Centre, 610 University Ave, Toronto, M5G 2C1, Canada
| | - Paris-Ann Ingledew
- Division of Radiation Oncology, Department of Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada.
- BC Cancer Agency Vancouver Centre, 600 West 10th Avenue, Vancouver, V5Z 4E6, Canada.
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Avila S, Franco I, Bregio C, Haydon A, Macayan JPM, Rooney MK, Ichikawa T, Golden DW, Ortega P. Spanish Adaptation and Evaluation of Clinical Discussion Guides: Communicating the External Beam Radiotherapy Experience (CEBRE) en Español. Int J Radiat Oncol Biol Phys 2023; 116:166-175. [PMID: 36716894 DOI: 10.1016/j.ijrobp.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/09/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Cancer is the leading cause of death for the Hispanic/Latinx United States (US) community, which comprises 64% of the US population with limited English proficiency. Despite the common use of radiation therapy for cancer treatment, there is a dearth of radiation therapy educational materials-at appropriate reading levels-available in Spanish. To address the gap in patient-centered educational resources for communicating with Spanish-speaking patients about radiation therapy, we sought to linguistically and culturally adapt the Communicating the External Beam Radiotherapy Experience (CEBRE) clinical discussion guide series into Spanish. METHODS AND MATERIALS From January to December 2021, we developed and applied a stepwise methodology for Spanish adaptation of the discussion guides involving (1) professional translation; (2) interprofessional review for linguistic and cultural appropriateness and medical accuracy; (3) design review; and (4) evaluation for readability, understandability, and actionability using validated tools. We applied 4 indices for readability evaluation: Gilliam-Peña-Mountain, Läsbarhetsindex, Rate Index, and the Spanish Simple Measure of Gobbledygook. Two trained reviewers assessed understandability and actionability using the Patient Education Materials Assessment Tool. RESULTS After 2 revision rounds, 4 CEBRE en español discussion guides were produced through an interprofessional, iterative translation and linguistic/cultural adaptation process. Readability scores across the 4 guides ranged from 4.3 to 7.3 grade-level equivalents, thereby meeting the American Medical Association's 8th-grade standard. Patient Education Materials Assessment Tool analysis yielded near-perfect scores along understandability and actionability domains. CONCLUSIONS The stepwise linguistic/cultural adaptation process yielded a patient-centered guide that is appropriately readable, understandable, and actionable for Spanish-speaking patients receiving radiation therapy in the US. Future work should include an external evaluation of CEBRE en español by clinicians and patients. The methodology described can be applied to adapting resources for patient-centered communication in other fields of medicine and into other languages as part of an interprofessional approach to delivering equitable health care for all.
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Affiliation(s)
- Santiago Avila
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Idalid Franco
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Celyn Bregio
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Alicia Haydon
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - John Paul M Macayan
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Michael K Rooney
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tomoko Ichikawa
- Institute of Design, Illinois Institute of Technology, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Pilar Ortega
- Departments of Medical Education and Emergency Medicine, University of Illinois College of Medicine, Chicago, Illinois; Department of Diversity, Equity, and Inclusion, Accreditation Council for Graduate Medical Education, Chicago, Illinois.
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Al-Hallaq H, Covington E, Thind K, Movsas B. Can Physics Consults Improve Patient-Centered Care in Radiation Oncology? Int J Radiat Oncol Biol Phys 2023; 115:244-246. [PMID: 36526382 DOI: 10.1016/j.ijrobp.2022.06.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Hania Al-Hallaq
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois.
| | | | - Kundan Thind
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
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Keenan HL, Duke SL, Wharrad HJ, Doody GA, Patel RS. Usability: An introduction to and literature review of usability testing for educational resources in radiation oncology. Tech Innov Patient Support Radiat Oncol 2022; 24:67-72. [PMID: 36262375 PMCID: PMC9574480 DOI: 10.1016/j.tipsro.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/20/2022] Open
Abstract
Usability, or the ease with which something can be used, is a key aspect in ensuring end-users can achieve the best possible outcomes from a given educational resource. Ideally usability testing should take place iteratively throughout the design of the resource, and there are several approaches for undertaking usability testing described in the wider literature. Within radiation oncology education, the extent to which usability testing occurs remains unclear. This literature review aimed to assess current practice and provide a practical introduction to usability testing for educational resource design within radiation oncology. Two web databases were searched for articles describing planned or completed usability testing during the design of a radiation oncology educational resource. Fifteen studies were identified. Data was gathered describing the type of usability testing performed, the number of cycles of testing and the number of test subjects. Articles described design of educational resources for both patients and trainees, with the number of test subjects ranging from 8 to 18. Various testing methods were used, including questionnaires, think aloud studies and heuristic evaluation. Usability testing comprised a range of single cycle through to several rounds of testing. Through illustrative examples identified in the literature review, we demonstrate that usability testing is feasible and beneficial for educational resources varying in size and context. In doing so we hope to encourage radiation oncologists to incorporate usability testing into future educational resource design.
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Affiliation(s)
- Heather L. Keenan
- School of Clinical Medicine, University of Cambridge, United Kingdom
| | - Simon L. Duke
- School of Clinical Medicine, University of Cambridge, United Kingdom
- Education Centre, University of Nottingham, United Kingdom
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7
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Alkureishi MA, Johnson T, Nichols J, Dhodapkar M, Czerwiec MK, Wroblewski K, Arora VM, Lee WW. Impact of an Educational Comic to Enhance Patient-Physician-Electronic Health Record Engagement: Prospective Observational Study. JMIR Hum Factors 2021; 8:e25054. [PMID: 33908891 PMCID: PMC8116991 DOI: 10.2196/25054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/06/2021] [Accepted: 03/18/2021] [Indexed: 01/16/2023] Open
Abstract
Background Electronic health record (EHR) use can impede or augment patient-physician communication. However, little research explores the use of an educational comic to improve patient-physician-EHR interactions. Objective To evaluate the impact of an educational comic on patient EHR self-advocacy behaviors to promote patient engagement with the EHR during clinic visits. Methods We conducted a prospective observational study with adult patients and parents of pediatric patients at the University of Chicago General Internal Medicine (GIM) and Pediatric Primary Care (PPC) clinics. We developed an educational comic highlighting EHR self-advocacy behaviors and distributed it to study participants during check-in for their primary care visits between May 2017 and May 2018. Participants completed a survey immediately after their visit, which included a question on whether they would be interested in a follow-up telephone interview. Of those who expressed interest, 50 participants each from the adult and pediatric parent cohorts were selected at random for follow-up telephone interviews 8 months (range 3-12 months) post visit. Results Overall, 71.0% (115/162) of adult patients and 71.6% (224/313) of pediatric parents agreed the comic encouraged EHR involvement. African American and Hispanic participants were more likely to ask to see the screen and become involved in EHR use due to the comic (adult P=.01, P=.01; parent P=.02, P=.006, respectively). Lower educational attainment was associated with an increase in parents asking to see the screen and to be involved (ρ=−0.18, P=.003; ρ=−0.19, P<.001, respectively) and in adults calling for physician attention (ρ=−0.17, P=.04), which was confirmed in multivariate analyses. Female GIM patients were more likely than males to ask to be involved (median 4 vs 3, P=.003). During follow-up phone interviews, 90% (45/50) of adult patients and all pediatric parents (50/50) remembered the comic. Almost half of all participants (GIM 23/50, 46%; PPC 21/50, 42%) recalled at least one best-practice behavior. At subsequent visits, adult patients reported increases in asking to see the screen (median 3 vs 4, P=.006), and pediatric parents reported increases in asking to see the screen and calling for physician attention (median 3 vs 4, Ps<.001 for both). Pediatric parents also felt that the comic had encouraged them to speak up and get more involved with physician computer use since the index visit (median 4 vs 4, P=.02) and that it made them feel more empowered to get involved with computer use at future visits (median 3 vs 4, P<.001). Conclusions Our study found that an educational comic may improve patient advocacy for enhanced patient-physician-EHR engagement, with higher impacts on African American and Hispanic patients and patients with low educational attainment.
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Affiliation(s)
- Maria A Alkureishi
- Department of Academic Pediatrics, University of Chicago, Chicago, IL, United States
| | - Tyrone Johnson
- Department of Internal Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jacqueline Nichols
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
| | - Meera Dhodapkar
- Yale University School of Medicine, New Haven, CT, United States
| | - M K Czerwiec
- Center for Medical Humanities & Bioethics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, IL, United States
| | - Vineet M Arora
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Wei Wei Lee
- Department of Medicine, University of Chicago, Chicago, IL, United States
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Association Between Patient Education Videos and Knowledge of Radiation Treatment. Int J Radiat Oncol Biol Phys 2021; 109:1165-1175. [PMID: 33301819 DOI: 10.1016/j.ijrobp.2020.11.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Patient knowledge of radiation therapy (RT) before consult is typically limited, with many having misconceptions or fears. There exists a need to improve patient education in RT. Our purpose was to study the impact of patient education videos on patient-reported knowledge of RT, anxiety/fear, and satisfaction. METHODS AND MATERIALS At our institution, we created 2 RT educational videos: a general RT video and a breast cancer-specific video. Patients presenting for breast RT who agreed to participate (n = 107) were randomly assigned to receive a link to the videos (video group; n = 58) or not (no-video group; n = 49) before consultation. Pre- and postconsult surveys were administered assessing patient-reported measures on a 5-point Likert-type scale. RESULTS Patients in the video group reported significantly higher levels of confidence in their knowledge of radiation side effects, with 45.6.% at least somewhat confident versus 21.3% in the no-video group (P = .009; median on a 5-point Likert-type scale, 2 [interquartile range {IQR}, 2-3] versus 2 [IQR, 1-2], respectively [P = .012]). There was a trend toward higher knowledge of the radiation treatment process in the video group (median, 3 [IQR, 2-3] versus 2 [IQR, 2-3] for no-video group; P = .064). There were no significant differences in preconsult anxiety or fear between the groups, but of those who were assigned videos, 46.8% reported decreased anxiety afterward, and 66.0% felt more comfortable coming to a consult. While those in the no-video group hypothesized that a video would be helpful (median, 3; IQR, 3-4), those in the video group found them to be very helpful in real life (median, 4; IQR, 45; P = .0009). After the consult, all patients in both groups were satisfied. CONCLUSIONS Patient education videos increase patient-reported knowledge of RT and are found to be very helpful.
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Rooney MK, Santiago G, Perni S, Horowitz DP, McCall AR, Einstein AJ, Jagsi R, Golden DW. Readability of Patient Education Materials From High-Impact Medical Journals: A 20-Year Analysis. J Patient Exp 2021; 8:2374373521998847. [PMID: 34179407 PMCID: PMC8205335 DOI: 10.1177/2374373521998847] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Comprehensive patient education is necessary for shared decision-making. While patient–provider conversations primarily drive patient education, patients also use published materials to enhance their understanding. In this investigation, we evaluated the readability of 2585 patient education materials published in high-impact medical journals from 1998 to 2018 and compared our findings to readability recommendations from national groups. For all materials, mean readability grade levels ranged from 11.2 to 13.8 by various metrics. Fifty-four (2.1%) materials met the American Medical Association recommendation of sixth grade reading level, and 215 (8.2%) met the National Institutes of Health recommendation of eighth grade level. When stratified by journal and material type, general medical education materials from Annals of Internal Medicine were the most readable (P < .001), with 79.8% meeting the eighth grade level. Readability did not differ significantly over time. Efforts to standardize publication practice with the incorporation of readability evaluation during the review process may improve patients’ understanding of their disease processes and treatment options.
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Affiliation(s)
- Michael K Rooney
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gaia Santiago
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Subha Perni
- Harvard Radiation Oncology Program, Boston, MA, USA
| | - David P Horowitz
- Department of Radiation Oncology and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - Anne R McCall
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
| | - Andrew J Einstein
- Division of Cardiology, Department of Medicine and Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - Reshma Jagsi
- Department of Radiation Oncology and Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
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Gutiontov SI, Golden DW, McCloskey S, Shumway D, Sullivan DR, Wall TJ, Gunderson LL, Jagsi R. Informed Consent in Radiation Oncology. Int J Radiat Oncol Biol Phys 2021; 109:29-35. [PMID: 32911020 DOI: 10.1016/j.ijrobp.2020.08.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/10/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Stanley I Gutiontov
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Susan McCloskey
- Ronald Reagan UCLA Medical Center Department of Radiation Oncology, Los Angeles, California
| | - Dean Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Donald R Sullivan
- Department of Pulmonary and Critical Medicine, Oregon Health & Science University, Portland, Oregon
| | | | | | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
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