ABSTRACT
OBJECTIVE: This randomized controlled trial aimed to determine whether an interactive CD-ROM improved cancer patients' recall of chemotherapy treatment information over standard written information, and whether demographic, cognitive, and psychological factors better predicted recall than this format of delivery. METHODS: One-hundred-and-one new patients about to commence chemotherapy were randomized to receive written information or a CD-ROM containing treatment information before giving informed consent. Patients' recall, concentration, short-term memory, reading comprehension, anxiety, depression, and coping styles were assessed with standardized measures pre-treatment. Seventy-seven patients completed tests for recall of treatment information before their second chemotherapy session. RESULTS: Intention-to-treat analyses indicated no significant differences between the written information and CD-ROM groups across recall questions about number of drugs received (p=.43), treatment length (p=.23), and treatment goal (p=.69). Binary logistic regressions indicated that for groups combined different variables predicted each of the recall questions. CONCLUSION: An interactive CD-ROM did not improve cancer patients' recall of treatment information enough to warrant changes in consent procedures. PRACTICE IMPLICATIONS: Different variables predicted recall of different treatment aspects highlighting the complex nature of attempting to improve patient recall. Attending to the effect of depression on patient knowledge and understanding appears paramount.
Subject(s)
CD-ROM , Computer-Assisted Instruction/methods , Informed Consent , Multimedia , Neoplasms , Patient Education as Topic/methods , Antineoplastic Agents/therapeutic use , Anxiety/etiology , Audiovisual Aids , CD-ROM/statistics & numerical data , Chi-Square Distribution , Depression/etiology , Educational Measurement , Female , Humans , Informed Consent/psychology , Logistic Models , Male , Mental Recall , Middle Aged , Multimedia/statistics & numerical data , Neoplasms/drug therapy , Neoplasms/psychology , New South Wales , User-Computer InterfaceABSTRACT
OBJECTIVES: This study investigated including spiritual wellbeing as a core domain in the assessment of quality of life (QOL) in an Australian oncology population. METHODS: Four hundred and ninety consecutive cancer patients with mixed diagnoses completed the Functional Assessment of Chronic Illness Therapy--Spiritual Well-Being (FACIT-Sp) and the Mental Adjustment to Cancer (MAC) scale. RESULTS: Overall, 449 patients completed assessments. Spiritual wellbeing demonstrated a significant, positive association with QOL (r=0.59), fighting spirit (r=0.49) and a significant, negative relationship with helplessness/hopelessness (r=-0.47) and anxious preoccupation (r=-0.26). A hierarchical multiple regression showed spiritual wellbeing to be a significant, unique contributor to QOL beyond the core domains of physical, social/family, and emotional wellbeing (R(2) change=0.08, p=0.000). However, high levels of meaning/peace or faith did not appear to significantly impact patients' ability to enjoy life despite chronic symptoms of pain or fatigue, making the current results inconsistent with other findings. CONCLUSION: Results lend further support to the biopsychosocialspiritual model. By failing to assess spiritual wellbeing, the 'true' burden of cancer is likely to be miscalculated. However, at this stage, the exact clinical utility of spirituality assessment is unclear.
