Informational needs of gastrointestinal oncology patients.

OBJECTIVES: In response to the dearth of consumer health information for patients with gastrointestinal cancers, this study examined the informational needs of these patients to build a plan for future resource development. Although studies have examined informational needs of some such cancers, no published literature has investigated the comprehensive informational needs across all sites of gastrointestinal cancer. METHODS: A cross-sectional needs assessment comprising a self-administered questionnaire was conducted at an ambulatory gastrointestinal oncology clinic in Toronto, Canada. Patient informational needs were measured, including importance of information, amount desired and preferred mode of delivery. Informational needs were grouped into six domains: medical, practical, physical, emotional, social and spiritual. RESULTS: Eighty-two surveys were analysed. The majority of the respondents were male (53.8%), over the age of 50 (77.8%), and born outside of Canada (51.9%). While many did not speak English as a child (46.3%), and do not speak English at home (22.2%), nearly all indicated comfort with receiving health information in English (97.5%). The majority of respondents were college educated (79.3%) and married (73%). Multiple cancer types were reported; the most common being colorectal (39%), followed by pancreatic (12%) and cancers of the gallbladder or bile duct (12%). Overall, respondents placed highest importance on medical information (P < 0.001). Preferred education modalities were pamphlets, websites and one-on-one discussions with health-care professionals. CONCLUSIONS: This study highlights the principal informational needs of patients with gastrointestinal malignancies, along with preferred modality for information delivery. This information will guide the development of educational resources for future patients.

From theory to pamphlet: the 3Ws and an H process for the development of meaningful patient education resources.

There is growing recognition of the importance of patient education given the prevalence and consequences of low health literacy in Canada and the USA. Research has shown that in addition to plain language, the use of theories of learning can contribute to the effectiveness of patient education resources, and as such, various guidelines and toolkits have been put together to help healthcare providers utilize these theories. Despite these efforts, this knowledge is not consistently applied in practice. To address this gap, we describe a new theory-based protocol, the "3Ws and an H," that is designed to guide healthcare providers in the production of effective patient education resources. Adult learning theory underpins each step of the process, and by using the "3Ws and an H," relevant theories are applied as the steps of the protocol are followed. To facilitate the adoption of this process, we describe it using a resource development project for survivors of endometrial cancer as an example.

Creation of a diagnostic wait times measurement framework based on evidence and consensus.

PURPOSE: Public reporting of wait times worldwide has to date focused largely on treatment wait times and is limited in its ability to capture earlier parts of the patient journey. The interval between suspicion and diagnosis or ruling out of cancer is a complex phase of the cancer journey. Diagnostic delays and inefficient use of diagnostic imaging procedures can result in poor patient outcomes, both physical and psychosocial. This study was designed to develop a framework that could be adopted for multiple disease sites across different jurisdictions to enable the measurement of diagnostic wait times and diagnostic delay. METHODS: Diagnostic benchmarks and targets in cancer systems were explored through a targeted literature review and jurisdictional scan. Cancer system leaders and clinicians were interviewed to validate the information found in the jurisdictional scan. An expert panel was assembled to review and, through a modified Delphi consensus process, provide feedback on a diagnostic wait times framework. RESULTS: The consensus process resulted in agreement on a measurement framework that identified suspicion, referral, diagnosis, and treatment as the main time points for measuring this critical phase of the patient journey. CONCLUSIONS: This work will help guide initiatives designed to improve patient access to health services by developing an evidence-based approach to standardization of the various waypoints during the diagnostic pathway. The diagnostic wait times measurement framework provides a yardstick to measure the performance of programs that are designed to manage and expedite care processes between referral and diagnosis or ruling out of cancer.

Maximizing your Patient Education Skills (MPES): a multi-site evaluation of an innovative patient education skills training course for oncology health care professionals.

OBJECTIVE: To evaluate the acceptability and relevance of the Maximizing your Patient Education Skills (MPES) course and to determine whether it significantly improved knowledge regarding patient education (PE) theory, self-assessed PE competencies, and PE skills using case based vignettes. METHODS: 1-Group, multi-site, pre-post-intervention. Participants completed a pre-assessment (T1), participated in the 4-h MPES course, and then a 3-month post-assessment (T2). A focus group was conducted with sub-set of participants. RESULTS: 98 (75%) of participants completed both time points. Participants were highly satisfied with MPES and found it to be relevant. Results showed that MPES had a significant impact on all of our outcome measures. CONCLUSION: Findings from this study show that oncology HCPs knowledge of patient education theory, self-assessed competencies and skills can improve after participating in a brief problem-focused and interactive workshop. PRACTICE IMPLICATIONS: Given the evidence that well-planned education and support can contribute to a number of positive health outcomes and the evidence that HCPs may lack the skills to teach and support patients and their families effectively, these results suggest that MPES course may be of value to oncology professionals. Efforts to further develop this course include exploring alternative funding models and using different learning platforms.