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Schneider N, Altmann U, Brandt F, Hübner J, Strauss B, Keinki C. A web-based knowledge database to provide evidence-based information to cancer patients: Utilization within the PIKKO study. Support Care Cancer 2024; 32:521. [PMID: 39017937 PMCID: PMC11254981 DOI: 10.1007/s00520-024-08725-7] [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: 12/22/2023] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Cancer is associated with an urgent need for understandable and reliable information, which is often not satisfied by information available online. Therefore, as part of the PIKKO project, a web-based knowledge database (WDB) was introduced to provide cancer patients with quality-assured, evidence-based information. This paper aims to provide insights into the usage (Who? How? What?) and the effects regarding health literacy of the WDB. METHODS A patient survey and automatically generated logfile data were evaluated. Two user groups, patients and patient navigators (PNs), were compared. RESULTS The 13 PNs were responsible for 1/3 of all accesses over the entire duration of the project. The 413 patients used WDB twice on average and spent an average of 12 min per session online (PNs: 9 min per session, more frequently). The top 3 topics of interest were 'therapy', 'nutrition' and 'carcinogenesis' for the patients, and 'therapy', 'naturopathy' and 'legal regulations/support' for the PNs. Of the patients surveyed, 69% said that WDB was helpful in making informed decisions, 76% found the information they wanted and 90% thought WDB was an appropriate way to provide information. CONCLUSION Our WDB provided important information about cancer and its treatment on a digital way both, to patients and PNs. In routine cancer care, the WDB can improve health literacy and informed decision-making. TRIAL REGISTRATION This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.
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Affiliation(s)
- Nico Schneider
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany.
| | - Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin, Germany
| | - Florian Brandt
- IKK Südwest, Europaallee 3-4, 66113, Saarbrücken, Germany
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology (IPMPP), Jena University Hospital, Stoystrasse 3, 07740, Jena, Germany
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Iyizoba-Ebozue Z, Nicklin E, Price J, Prestwich R, Brown S, Hall E, Lilley J, Lowe M, Thomson DJ, Slevin F, Murray L, Boele F. "Why am I still suffering?": Experience of long-term fatigue and neurocognitive changes in oropharyngeal cancer survivors following (chemo)radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100241. [PMID: 38510557 PMCID: PMC10951087 DOI: 10.1016/j.tipsro.2024.100241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Late effects of cancer treatment, such as neurocognitive deficits and fatigue, can be debilitating. Other than head and neck-specific functional deficits such as impairments in swallowing and speech, little is known about survivorship after oropharyngeal cancer. This study examines the lived experience of fatigue and neurocognitive deficits in survivors of oropharyngeal squamous cell cancer and impact on their daily lives. Methods This work is part of the multicentre mixed method ROC-oN study (Radiotherapy for Oropharyngeal Cancer and impact on Neurocognition), evaluating fatigue and neurocognitive function in patients following radiotherapy +/- chemotherapy for oropharyngeal cancer and impact on quality of life. Semi-structured interviews were conducted in adults treated with radiotherapy (+/-chemotherapy) for oropharyngeal squamous cell carcinoma >/=24 months from completing treatment. Reflexive thematic analysis performed. Results 21 interviews (11 men and 10 women; median age 58 years and median time post-treatment 5 years) were conducted and analysed, yielding six themes: (1) unexpected burden of fatigue, (2) noticing changes in neurocognitive function, (3) the new normal, (4) navigating changes, (5)insufficient awareness and (6)required support. Participants described fatigue that persisted beyond the acute post-treatment period and changes in neurocognitive abilities across several domains. Paid and unpaid work, emotions and mood were impacted. Participants described navigating the new normal by adopting self-management strategies and accepting external support. They reported lack of recognition of these late effects, being poorly informed and being unprepared. Follow-up services were thought to be inadequate. Conclusions Fatigue and neurocognitive impairment were frequently experienced by survivors of oropharyngeal cancer, at least two years after treatment. Patients felt ill-prepared for these late sequelae, highlighting opportunities for improvement of patient information and support services.
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Affiliation(s)
| | - Emma Nicklin
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - James Price
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Robin Prestwich
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - Sarah Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research
| | - Emma Hall
- The Institute of Cancer Research, London, UK
| | - John Lilley
- Department of Radiotherapy Physics, Leeds Cancer Centre, Leeds, UK
| | - Matthew Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - David J Thomson
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Finbar Slevin
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Louise Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Florien Boele
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Brandt F, Schneider N, Altmann U, Strauß B, Hübner J, Keinki C. [Psychometric Properties of the Qualiskope-A for Measuring Patient Satisfaction with Outpatient Medical Treatment: Use in Oncology and Transferability to Inpatient Care]. DAS GESUNDHEITSWESEN 2023; 85:732-740. [PMID: 37028417 PMCID: PMC11248893 DOI: 10.1055/a-2016-7948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
AIM The Qualiskope-A is a German-language PREM (Patient Reported Experience Measure) which, with the help of 27 items allocated to four scales, enables measurement of patient satisfaction with outpatient medical treatment along four dimensions of patient satisfaction. This study examined whether the questionnaire delivers reliable results in an oncological population and whether its application can be extended to inpatient care. METHOD Required data was collected as part of the PIKKO study. Initially, descriptive statistics and internal consistency (Cronbach's alpha) of the PREM's scales were analyzed. In addition, a sub-sample that assessed the same doctor at two consecutive measurement time points was observed with regard to test-retest reliability (Spearman correlation (rs) between both measurement time points). The measurement model of the Qualiskope-A was then examined using confirmatory factor analysis. To test the transferability to inpatient care, measurement invariance with regard to outpatients and inpatients was computed. RESULTS A total of 476 patients was included in the study. Every score of the Qualiskope-A showed a left-skewed distribution in the sample and revealed pronounced ceiling effects. Cronbach's alpha coefficients were consistently>0,8. Within the test-retest group (n=197), a strong correlation (rs>0,5) was observed between the measurement time points. The fit indices calculated using confirmatory factor analysis showed a good model fit (CFI=0,958; RMSEA=0,026; SRMR=0,040; every factor loadings>0,6). The fit indices, calculated as part of the investigation of measurement invariance, consistently met the defined threshold values. CONCLUSION The Qualiscope-A shows good reliability in the examined oncological sample. It can be used in both outpatient and inpatient settings (no indications of non-invariance were found). Due to pronounced ceiling effects, however, the item scaling should be revised.
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Affiliation(s)
- Florian Brandt
- Versorgungsmanagement/Verträge, IKK Südwest, Saarbrücken, Germany
| | - Nico Schneider
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Uwe Altmann
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Bernhard Strauß
- Institut für Psychosoziale Medizin, Psychotherapie und Psychoonkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Hübner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Keinki
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
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Schneider N, Strauss B, Hübner J, Keinki C, Brandt F, Rubai S, Altmann U. The impact of the COVID-19 pandemic restrictions on the health care utilization of cancer patients. BMC Cancer 2023; 23:439. [PMID: 37189037 DOI: 10.1186/s12885-023-10945-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND COVID-19 has impacted both society and medical care. While Germany entered the first lockdown in spring 2020, the PIKKO study (Patient information, communication and competence empowerment in oncology) was still active. The intervention modules, patient navigator (PN), services of the Saarland Cancer Society (SCS), psycho-social counseling and different courses, and online knowledge database (ODB) continued to be offered, but in an adapted form. It was the aim of this supplementary survey to identify the restrictions and burdens of the pandemic containment strategies on the PIKKO patients and thus on the PIKKO study itself. Furthermore, this work shows how the PIKKO modules were used during the lockdown. METHODS All patients in the PIKKO intervention group (IG) were invited to complete a questionnaire, n = 503. Furthermore, utilization of the SCS and log files of the ODB were analyzed. For socio-demographic data and contacts with the PN, data from the regular PIKKO surveys were used. In addition to descriptive statistics, chi²-tests, F-tests and linear regression analyses were performed. RESULTS 356 patients participated in this supplemental survey. 37.6% reported restrictions. "Restrictions on accompanying persons", "ban on visits to the wards" and "protective mouth-nose-mask" were reported as the greatest burdens. 39.0% expressed fears that the restrictions would have an impact on the course of their disease. Linear regression analyses showed differences in feelings of burden among age groups (more among < 60-year-olds), gender (more among women), children in the household (more with children), and preexisting financial stress (more with financial worries). In April 2020, there was more patient contact with PNs by phone, more SCS psycho-social counseling by phone, adapted SCS course offering, but with significantly fewer participants, and high activity on the ODB. CONCLUSION Cancer patients in the IG reported restrictions from the pandemic containment strategies and feared an impact on their recovery. However, whether a burden is perceived as heavy depends more on gender, age, or pre-existing burdens than on whether the lockdown affects PIKKO or not. The utilization of counseling, courses or the ODB despite lockdown shows the need for such services, especially in times of crisis. TRIAL REGISTRATION This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703 .
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Affiliation(s)
- Nico Schneider
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology, Jena University Hospital, Stoystrasse 3, Jena, D-07740, Germany.
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology, Jena University Hospital, Stoystrasse 3, Jena, D-07740, Germany
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Jena University Hospital, Am Klinikum 1, Jena, D-07747, Germany
| | - Christian Keinki
- The German Cancer Society, Kuno-Fischer-Strasse 8, Berlin, D-14057, Germany
| | - Florian Brandt
- IKK Südwest, Europaallee 3-4, Saarbrücken, D-66113, Germany
| | - Sabine Rubai
- Saarland Cancer Society, Bruchwiesenstrasse 15, Saarbrücken, D-66111, Germany
| | - Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology, Jena University Hospital, Stoystrasse 3, Jena, D-07740, Germany
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin, Germany
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Schneider N, Bäcker A, Strauss B, Hübner J, Rubai S, Wagner S, Schwarz-Fedrow D, Hager L, Brenk-Franz K, Keinki C, Brandt F, Altmann U. Patient information, communication and competence empowerment in oncology: Results and learnings from the PIKKO study. Support Care Cancer 2023; 31:327. [PMID: 37154985 PMCID: PMC10165303 DOI: 10.1007/s00520-023-07781-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE Many concepts for accompanying and supporting cancer patients exist and have been studied over time. One of them was PIKKO (a German acronym for "Patient information, communication and competence empowerment in oncology"), which combined a patient navigator, socio-legal and psychological counseling (with psychooncologists), courses dealing with various supportive aspects, and a knowledge database with validated and easy-to-understand disease-related information. The aim was to increase the patients' health-related quality of life (HRQoL), self-efficacy as well as health literacy and to reduce psychological complaints such as depression and anxiety. METHODS To this purpose, an intervention group was given full access to the modules in addition to treatment as usual, while a control group received only treatment as usual. Over twelve months, each group was surveyed up to five times. Measurements were taken using the SF12, PHQ-9, GAD, GSE, and HLS-EU-Q47. RESULTS No significant differences were found in scores on the mentioned metrics. However, each module was used many times and rated positively by the patients. Further analyses showed a tendency higher score in health literacy with higher intensity of use of the database and higher score in mental HRQoL with higher intensity of use of counseling. CONCLUSION The study was affected by several limitations. A lack of randomization, difficulties in recruiting the control group, a heterogeneous sample, and the COVID-19 lockdown influenced the results. Nevertheless, the results show that the PIKKO support was appreciated by the patients and the lack of measurable effects was rather due to the mentioned limitations than to the PIKKO intervention. TRIAL REGISTRATION This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21.02.2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.
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Affiliation(s)
- Nico Schneider
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany.
| | - Anna Bäcker
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Jena University Hospital, Jena, Germany
| | | | | | | | - Lutz Hager
- SRH Fernhochschule - The Mobile University, Riedlingen, Germany
| | - Katja Brenk-Franz
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
| | | | | | - Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychoonocology (IPMPP), Jena University Hospital, Jena, Germany
- Department of Psychology, MSB Medical School Berlin GmbH, Berlin, Germany
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Erickson N, Sullivan ES, Kalliostra M, Laviano A, Wesseling J. Nutrition care is an integral part of patient-centred medical care: a European consensus. Med Oncol 2023; 40:112. [PMID: 36881207 PMCID: PMC9992033 DOI: 10.1007/s12032-023-01955-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/18/2023] [Indexed: 03/08/2023]
Abstract
While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.
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Affiliation(s)
- Nicole Erickson
- Comprehensive Cancer Center Munich, Ludwig Maximilian University of Munich Hospital, Munich, Germany.
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK.
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands.
| | - Erin Stella Sullivan
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Marianna Kalliostra
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands
- The European Nutrition for Health Alliance, London, UK
| | - Alessandro Laviano
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Joost Wesseling
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
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Isabel Rodrigues Monteiro Grilo A, Catarina Inácio Ferreira A, Sofia Pedro Ramos M, Teresa Mata Almeida Carolino E, Filipa Pires A, da Conceição Capela de Oliveira Vieira L. Effectiveness of educational videos on patient's preparation for diagnostic procedures: Systematic Review and Meta-Analysis. Prev Med Rep 2022; 28:101895. [PMID: 35855928 PMCID: PMC9287602 DOI: 10.1016/j.pmedr.2022.101895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/27/2022] [Accepted: 07/01/2022] [Indexed: 11/06/2022] Open
Abstract
Patients’ anxiety and unfamiliarity are barriers to undergoing diagnostic procedures. Studies found educational videos more effective than other forms of information. Educational videos minimise anxiety and improve patient satisfaction. Educational videos enable medical procedures best practices.
Although diagnostic procedures are crucial for secondary prevention and patient disease control, they often trigger fear and anxiety. These reactions highlight the need to adopt effective interventions to improve patients’ experience and satisfaction. Recently, educational videos have been employed in preparing diagnostic procedures; however, there is no integrated understanding of their effects. This systematic review and meta-analysis aimed to assess the effectiveness of educational videos on patients’ anxiety and satisfaction regarding preparation for diagnostic procedures. Three scientific databases (PubMed; Web of Science, Scopus), were used in this systematic review. Studies about educational videos as a form of preparation for patients undergoing diagnostic procedures published between 2000 and 2021 were included. A meta-analysis was also conducted. Sixteen studies met the inclusion criteria for systematic review, and seven were included in the meta-analysis. Nine studies of the total sample were about vascular procedures and seven studies about other medical image procedures. Of the fourteen studies that evaluated the use of educational videos on patients’ anxiety, nine proved to reduce it significantly. Of the thirteen studies that evaluated satisfaction, seven showed a significant increase in the experimental group. Studies included in the meta-analysis show that educational video patient groups had lower anxiety levels than the control groups after the procedure. Although future studies are required, the results suggest that educational videos effectively prepare patients for diagnostic procedures, improving care quality.
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Tilch MK, Schranz M, Moringlane A, Theobald M, Hess G. Struggling with extensive informed consent procedures for cancer trials-is there even a benefit for the patients? Support Care Cancer 2022; 30:6593-6602. [PMID: 35486229 PMCID: PMC9213264 DOI: 10.1007/s00520-022-07063-w] [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: 11/30/2021] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
Purpose Informed consent procedures in clinical trials often differ in length and complexity to those in clinical routine care. Little is known about the benefit of extensive procedures as intended in clinical trials compared to procedures in routine cancer treatment. Methods In two different clinical studies performed at a comprehensive cancer center, we compared patients’ comprehension and satisfaction of current informed consent procedures in routine clinical care with the level of comprehension and satisfaction of patients treated within clinical trials. Patients with a new cancer diagnosis and recent informed consent received a questionnaire about satisfaction, comprehension, time management, and physician–patient relationship of the informed consent process. Patients in cohort 1 consented to cancer treatment within a clinical trial and were additionally interviewed in a structured way; patients in cohort 2 consented to “standard” chemotherapy and received a follow-up questionnaire after 6 months. Results In cohort 1, 82 patients completed the questionnaire and had an additional structured interview. They were treated in 41 different trials, receiving up to 40 pages of educational material. In cohort 2, 89 patients completed the first and 52 completed the follow-up questionnaire after receiving a standard informed consent form of 6 pages. Subjective understanding and satisfaction with the information provided was equally very high. However, deficits in objective understanding were observed in both cohorts. Conclusion Extensive informed consent procedures for clinical cancer trials have not been associated with a higher level of satisfaction or measurable objective understanding; therefore, the benefit seems to be limited.
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Affiliation(s)
- Marie-Kristin Tilch
- Department of Hematology, Oncology and Pneumology & University Cancer Center, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Melanie Schranz
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | | | - Matthias Theobald
- Department of Hematology, Oncology and Pneumology & University Cancer Center, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Georg Hess
- Department of Hematology, Oncology and Pneumology & University Cancer Center, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
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Schwaegermann MK, Schranz M, Moehler M, Labenz C, Moringlane A, Schmidt M, Theobald M, Hess G. Any progress in informed consenting for cancer treatment? Results from a cross sectional analysis at a comprehensive cancer center. J Cancer Res Clin Oncol 2021; 147:2117-2126. [PMID: 33420813 PMCID: PMC8164598 DOI: 10.1007/s00432-020-03495-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
Purpose Informed consent is required prior to any medical procedure. In the context of cancer treatment, special efforts are needed to inform cancer patients properly about treatment, potential sequelae and alternative therapies. Little is known about the effectiveness of current informed consent strategies and patients’ individual satisfaction. Given the heterogeneity in terms of age, education, sex and other factors, detailed understanding of patients’ comprehension and perception is the basis for further optimization of the informed consent process, which was the aim of the current investigation. Methods Patients with a new cancer diagnosis and recent informed consent were asked to complete a questionnaire about satisfaction, comprehension, time management, physician–patient relationship and other items of the informed consent process. Patients were followed for 6 months and invited to complete a follow-up questionnaire. Results In total, 89 patients completed the first questionnaire and 52 the follow-up questionnaire. Subjective understanding was assumed high, however, this did not correlate with objective understanding. Age and education were identified as influencing factors for comprehension. 85% of the patients were satisfied with the information provided. A major gap was the information on alternative therapies. Moreover, not all patients perceived the consent dialog as such, and particularly the individual treatment intention partially remained unclear for some patients. Conclusions To ensure that informed consent is based on solid understanding, informed consenting must be patient-centered and consider the individual expectations, needs and abilities of cancer patients. Further studies are required to develop tailored informed consent strategies.
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Affiliation(s)
- Marie-Kristin Schwaegermann
- Department of Internal Medicine III, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Melanie Schranz
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Markus Moehler
- Department of Internal Medicine I, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Christian Labenz
- Department of Internal Medicine I, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Alice Moringlane
- Department of Internal Medicine III, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Marcus Schmidt
- Department of Gynecology, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Matthias Theobald
- Department of Internal Medicine III, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Georg Hess
- Department of Internal Medicine III, Comprehensive Cancer Center, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
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