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Literacy levels in Prostate Cancer Patients:
the Relationship between Health Literacy Level,
Understanding of Cancer Information and
Decision-Making -Results from Phase 1
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Agnella Craig 1, 2, Aidan Seery 2.
1 Applied Radiation Therapy Trinity Research Group, Discipline of Radiation Therapy, TCD
2 School of Education, TCD.
• Study outline
• Phase 1
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– Health Literacy
– Prostate Cancer
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– Methods and Results
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• Background
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Overview
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focus on one’s ability to
obtain, process and understand
health information and services
necessary to make appropriate health
decisions
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Considered as a
quality of
the individual
but also the interaction of the individual
with the society in which they live.
Sørensen et al., 2012
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Personal Factors
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Factors that Influence HL level
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General literacy levels
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Cognitive skills
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Motivation
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Physical and emotional health
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Experience with health care
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Specific health condition
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Beliefs about health
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Socioeconomic status
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Social Supports
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System Factors
HCP 's communication skills
Complexity of health
information
Characteristics of healthcare
setting
System demands and
expectations upon patients
Time pressures upon health
care professionals
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Health Literacy and Cancer
• Research in HL
– Has focused on general population and other areas
within medicine rather than oncology.
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– Prevention: Attendance for screening programmes
– Research on HL in the cancer population is
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Koay et al . 2012
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“suboptimal, using less robust measurement tools”
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1 in 8 men in Ireland
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Age profile at Diagnosis
http://www.ncri.ie/sites/ncri/files/factsheets/FACTSHEET_prostate_1.pdf
Last updated 20th March 2015
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– Overall Survival
– Side effects
– Possible Side Effects
– Surgery
– Radiotherapy
• External Beam
• Brachytherapy
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– Hormone Therapy
– Active surveillance
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• Treatment Outcome
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• Treatment options
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Treatment
• Urinary Dysfunction
• Sexual Dysfunction
• Bowel Dysfunction
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Prostate Cancer
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Study Aims
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1. Evaluate the impact health literacy level
has on cancer knowledge
2. Ascertain if patients involved in decisionmaking are knowledgeable about their
options
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Methodology
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*Delbecq, A. L., Van de Ven, A. H., & Gustafson, D. H. (1975)
To ascertain the information
required to make a decision
about treatment
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Phase 1-Nominal Group Technique (NGT)
Structure of Nominal Group Technique
Welcome, purpose and procedure.
Consent and Demographics
Step 2:
Generating Ideas
Question given to participants.
Participants -silently write down any ideas that come to mind.
Step 3:
Sharing Ideas
Share the ideas
Round robin style feedback session
No debate
A written record is made of all the ideas generated
Step 4:
Group Discussion
Participants can ask for clarity on any of the ideas generated.
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Step 1:
Introduction
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Prioritising of ideas generated from the original question.
Step 5:
Voting and Ranking The meeting concludes after reaching a specific outcome
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e.g. The top ten ideas from the discussion.
Delbecq, A. L., Van de Ven, A. H., & Gustafson, D. H. (1975)
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Phase 1- NGT
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“Based on your experience,
what do you think men diagnosed with prostate cancer
should know before deciding on their treatment?”
N=7
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Age range: 60-75 yrs
Recruitment: Previous Prostate Cancer Pts, Irish Cancer Society
Treatment included: (alone or combination)
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Surgery, Hormone Therapy,
Radiotherapy: photons, brachytherapy, protons.
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“pull down
the shutters”
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Words like “active
surveillance and
watchful
wait”???
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“How to weed out
the information”
“health warning”
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“everyone's
cancer and
circumstances
are different”
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Cancer is slow
growing…?
“weeks/months”
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Next Step
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Cancer Knowledge Test
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*Delbecq, A. L., Van de Ven, A. H., & Gustafson, D. H. (1975)
^http://www.healthliteracy.ie/academics/eu-health-literacy-survey
Ascertain the information
required to make a decision
about treatment
Measure:
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Health Literacy (HLS-EU questionnaire^)
Cancer knowledge
Social support, Decision making
Explore HL issues identified in
phase 2 and further examine the
decision making process
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agnella.craig@tcd.ie
01 896 3926
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Agnella Craig