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Published in: Supportive Care in Cancer 2/2019

01-02-2019 | Original Article

What do radiation therapists know about health literacy and the strategies to improve it for patients? A qualitative study

Authors: Fiona Quinn, Sian K Smith, Haryana M Dhillon, Charles Gillham, Agnella Craig

Published in: Supportive Care in Cancer | Issue 2/2019

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Abstract

Purpose

Low health literacy leads to poor knowledge and understanding of health information, delayed diagnosis, lower use of preventative medicines/health services, increased likelihood of hospitalisation, and increased patient anxiety. Effective communication facilitates patient understanding and helps patients to manage the adverse side-effects associated with treatment. It is not yet known whether radiation therapists in Ireland tailor their communication to match a patient’s health literacy level. The purpose of this research was to investigate radiation therapists’ knowledge and awareness of health literacy and perceptions of their role in supporting patients with low health literacy.

Methods

Semi-structured interviews were conducted with sixteen radiation therapists working in four radiotherapy departments in Ireland. Data were analysed using the framework approach.

Results

Through discussions with participants, it was apparent that radiation therapists had limited knowledge of the concept of health literacy. Common themes arose from the interviews with four key themes identified:
1.
Strategies used to identify patients’ health literacy
 
2.
Perceived effect of low health literacy
 
3.
Obstacles faced when addressing low health literacy
 
4.
Recommendations to support lower health literacy groups
 

Conclusion

Currently, radiation therapists show some knowledge and awareness of health literacy, but an increased awareness of the prevalence of low health literacy and a structured approach to supporting patients would allow radiation therapists to more effectively communicate with patients, thus improving their treatment experience and reducing the risk of adverse outcomes.
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Literature
1.
go back to reference Pieterse AH, Jager NA, Smets EM, Henselmans I (2013) Lay understanding of common medical terminology in oncology. Psycho-Oncology 22(5):1186–1191 Pieterse AH, Jager NA, Smets EM, Henselmans I (2013) Lay understanding of common medical terminology in oncology. Psycho-Oncology 22(5):1186–1191
2.
go back to reference Wang DS, Jani AB, Tai CG, Sesay M, Lee DK, Goodman M, Echt KV, Kilbridge KE, Master VA (2013) Severe lack of comprehension of common prostate health terms among low-income inner-city men. Cancer 119(17):3204–3211 Wang DS, Jani AB, Tai CG, Sesay M, Lee DK, Goodman M, Echt KV, Kilbridge KE, Master VA (2013) Severe lack of comprehension of common prostate health terms among low-income inner-city men. Cancer 119(17):3204–3211
3.
go back to reference Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 15(3):259–267CrossRef Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 15(3):259–267CrossRef
4.
go back to reference Nutbeam D (2008) The evolving concept of health literacy. Soc Sci Med 67(12):2072–2078CrossRef Nutbeam D (2008) The evolving concept of health literacy. Soc Sci Med 67(12):2072–2078CrossRef
6.
go back to reference Marshall S, Sahm L, McCarthy S (2012) Health literacy in Ireland: reading between the lines. Perspect Public Health 132(1):31–38CrossRef Marshall S, Sahm L, McCarthy S (2012) Health literacy in Ireland: reading between the lines. Perspect Public Health 132(1):31–38CrossRef
7.
go back to reference ABS (2006) Adult literacy and life skills survey, summary results. Australian Bureau of Statistics, Australian Government Publishing Service, Canberra, Cat No 4228.0 ABS (2006) Adult literacy and life skills survey, summary results. Australian Bureau of Statistics, Australian Government Publishing Service, Canberra, Cat No 4228.0
8.
go back to reference Jordan JE, Buchbinder R, Briggs AM, Elsworth GR, Busija L, Batterham R, Osborne RH (2013) The health literacy management scale (HeLMS): a measure of an individual’s capacity to seek, understand and use health information within the healthcare setting. Patient Educ Couns 91(2):228–235 Jordan JE, Buchbinder R, Briggs AM, Elsworth GR, Busija L, Batterham R, Osborne RH (2013) The health literacy management scale (HeLMS): a measure of an individual’s capacity to seek, understand and use health information within the healthcare setting. Patient Educ Couns 91(2):228–235
9.
go back to reference Wolf MS, Feinglass J, Thompson J, Baker DW (2010) In search of ‘low health literacy’: threshold vs. gradient effect of literacy on health status and mortality. Soc Sci Med 70(9):1335–1341 Wolf MS, Feinglass J, Thompson J, Baker DW (2010) In search of ‘low health literacy’: threshold vs. gradient effect of literacy on health status and mortality. Soc Sci Med 70(9):1335–1341
10.
go back to reference Institute of Medicine Committee on Health, L. (2004) In: Nielsen-Bohlman L, Panzer AM, Kindig DA (eds) Health Literacy: A Prescription to End Confusion. National Academies Press (US) Copyright 2004 by the National Academy of Sciences, Washington Institute of Medicine Committee on Health, L. (2004) In: Nielsen-Bohlman L, Panzer AM, Kindig DA (eds) Health Literacy: A Prescription to End Confusion. National Academies Press (US) Copyright 2004 by the National Academy of Sciences, Washington
11.
go back to reference Bostock S, Steptoe A (2012) Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 344:e1602CrossRef Bostock S, Steptoe A (2012) Association between low functional health literacy and mortality in older adults: longitudinal cohort study. BMJ 344:e1602CrossRef
12.
go back to reference Douma KF, Koning CC, Zandbelt LC, de Haes HC, Smets EM (2012) Do patients’ information needs decrease over the course of radiotherapy? Support Care Cancer 20(9):2167–2176 Douma KF, Koning CC, Zandbelt LC, de Haes HC, Smets EM (2012) Do patients’ information needs decrease over the course of radiotherapy? Support Care Cancer 20(9):2167–2176
13.
go back to reference Zeguers M, de Haes HC, Zandbelt LC, ter Hoeven CL, Franssen SJ, Geijsen DD, Koning CC, Smets EM (2012) The information needs of new radiotherapy patients: how to measure? Do they want to know everything? And if not, why? Int J Radiat Oncol Biol Phys 82(1):418–424 Zeguers M, de Haes HC, Zandbelt LC, ter Hoeven CL, Franssen SJ, Geijsen DD, Koning CC, Smets EM (2012) The information needs of new radiotherapy patients: how to measure? Do they want to know everything? And if not, why? Int J Radiat Oncol Biol Phys 82(1):418–424
14.
go back to reference Smith SK, Zhu Y, Dhillon HM, Milross CG, Taylor J, Halkett G, Zilliacus E (2013) Supporting patients with low health literacy: what role do radiation therapists play? Support Care Cancer 21(11):3051–3061 Smith SK, Zhu Y, Dhillon HM, Milross CG, Taylor J, Halkett G, Zilliacus E (2013) Supporting patients with low health literacy: what role do radiation therapists play? Support Care Cancer 21(11):3051–3061
15.
go back to reference Smith SK, Petrak LM, Dhillon HM, Taylor J, Milross CG (2014) Are radiation oncologists aware of health literacy among people with cancer treated with radiotherapy? Eur J Cancer Care (Engl) 23(1):111–120 Smith SK, Petrak LM, Dhillon HM, Taylor J, Milross CG (2014) Are radiation oncologists aware of health literacy among people with cancer treated with radiotherapy? Eur J Cancer Care (Engl) 23(1):111–120
16.
go back to reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 13:117 Gale NK, Heath G, Cameron E, Rashid S, Redwood S (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 13:117
17.
go back to reference Ritchie J, Lewis J (2003) Qualitative research practice: a guide for social science students and researchers. Sage, London Ritchie J, Lewis J (2003) Qualitative research practice: a guide for social science students and researchers. Sage, London
18.
go back to reference Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155(2):97–107 Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K (2011) Low health literacy and health outcomes: an updated systematic review. Ann Intern Med 155(2):97–107
19.
go back to reference Easton P, Entwistle VA, Williams B (2010) Health in the ‘hidden population’ of people with low literacy. a systematic review of the literature. BMC Public Health 10:459CrossRef Easton P, Entwistle VA, Williams B (2010) Health in the ‘hidden population’ of people with low literacy. a systematic review of the literature. BMC Public Health 10:459CrossRef
20.
go back to reference DfEE (1999) A Fresh Start: improving literacy and numeracy. The report of the working group chaired by sir Claus Moser. Department for Education and Employment, London DfEE (1999) A Fresh Start: improving literacy and numeracy. The report of the working group chaired by sir Claus Moser. Department for Education and Employment, London
21.
go back to reference Levinson W, Kao A, Kuby A, Thisted RA (2005) Not all patients want to participate in decision making. A national study of public preferences. J Gen Intern Med 20(6):531–535 Levinson W, Kao A, Kuby A, Thisted RA (2005) Not all patients want to participate in decision making. A national study of public preferences. J Gen Intern Med 20(6):531–535
22.
go back to reference Kutner M, Greenburg E, Jin Y, Paulsen C (2006) The health literacy of America's adults: results from the 2003 National Assessment of Adult Literacy. National Centre for Education statistics Kutner M, Greenburg E, Jin Y, Paulsen C (2006) The health literacy of America's adults: results from the 2003 National Assessment of Adult Literacy. National Centre for Education statistics
23.
go back to reference Scott TL, Gazmararian JA, Williams MV, Baker DW (2002) Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care 40(5):395–404 Scott TL, Gazmararian JA, Williams MV, Baker DW (2002) Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care 40(5):395–404
24.
go back to reference Agarwal AK, Sethi A, Sareen D, Dhingra S (2011) Treatment delay in oral and oropharyngeal cancer in our population: the role of socio-economic factors and health-seeking behaviour. Indian J Otolaryngol Head Neck Surg 63(2):145–150 Agarwal AK, Sethi A, Sareen D, Dhingra S (2011) Treatment delay in oral and oropharyngeal cancer in our population: the role of socio-economic factors and health-seeking behaviour. Indian J Otolaryngol Head Neck Surg 63(2):145–150
25.
go back to reference Husson O, Mols F, Fransen MP, van de Poll-Franse LV, Ezendam NP (2014) Low subjective health literacy is associated with adverse health behaviors and worse health-related quality of life among colorectal cancer survivors: results from the profiles registry. Psychooncology Husson O, Mols F, Fransen MP, van de Poll-Franse LV, Ezendam NP (2014) Low subjective health literacy is associated with adverse health behaviors and worse health-related quality of life among colorectal cancer survivors: results from the profiles registry. Psychooncology
26.
go back to reference Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J (2005) Socio-economic status of the patient and doctor-patient communication: does it make a difference? Patient Educ Couns 56(2):139–146 Willems S, De Maesschalck S, Deveugele M, Derese A, De Maeseneer J (2005) Socio-economic status of the patient and doctor-patient communication: does it make a difference? Patient Educ Couns 56(2):139–146
27.
go back to reference Manfredi C, Kaiser K, Matthews AK, Johnson TP (2010) Are racial differences in patient-physician cancer communication and information explained by background, predisposing, and enabling factors? J Health Commun 15(3):272–292 Manfredi C, Kaiser K, Matthews AK, Johnson TP (2010) Are racial differences in patient-physician cancer communication and information explained by background, predisposing, and enabling factors? J Health Commun 15(3):272–292
28.
go back to reference Smith SK, Dixon A, Trevena L, Nutbeam D, McCaffery KJ (2009) Exploring patient involvement in healthcare decision making across different education and functional health literacy groups. Soc Sci Med 69(12):1805–1812 Smith SK, Dixon A, Trevena L, Nutbeam D, McCaffery KJ (2009) Exploring patient involvement in healthcare decision making across different education and functional health literacy groups. Soc Sci Med 69(12):1805–1812
29.
go back to reference D’ haese S, Vinh-Hung V, Bijdekerke P, Spinnoy M, de Beukeleer M, Lochie N, de Roover P, Storme G (2000) The effect of timing of the provision of information on anxiety and satisfaction of cancer patients receiving radiotherapy. J Cancer Educ 15(4):223–227 D’ haese S, Vinh-Hung V, Bijdekerke P, Spinnoy M, de Beukeleer M, Lochie N, de Roover P, Storme G (2000) The effect of timing of the provision of information on anxiety and satisfaction of cancer patients receiving radiotherapy. J Cancer Educ 15(4):223–227
30.
go back to reference DeWalt DA, Broucksou KA, Hawk V, Brach C, Hink A, Rudd R, Callahan L (2011) Developing and testing the health literacy universal precautions toolkit. Nurs Outlook 59(2):85–94 DeWalt DA, Broucksou KA, Hawk V, Brach C, Hink A, Rudd R, Callahan L (2011) Developing and testing the health literacy universal precautions toolkit. Nurs Outlook 59(2):85–94
31.
go back to reference Garcia SF, Hahn EA, Jacobs EA (2010) Addressing low literacy and health literacy in clinical oncology practice. J Support Oncol 8(2):64–69PubMedPubMedCentral Garcia SF, Hahn EA, Jacobs EA (2010) Addressing low literacy and health literacy in clinical oncology practice. J Support Oncol 8(2):64–69PubMedPubMedCentral
32.
go back to reference Osborne H (2013) Health literacy from A-Z: practical ways to communicate your health message, 2nd ed. David C.Cella Osborne H (2013) Health literacy from A-Z: practical ways to communicate your health message, 2nd ed. David C.Cella
33.
go back to reference Wolf MS, Williams MV, Parker RM, Parikh NS, Nowlan AW, Baker DW (2007) Patients’ shame and attitudes toward discussing the results of literacy screening. J Health Commun 12(8):721–732 Wolf MS, Williams MV, Parker RM, Parikh NS, Nowlan AW, Baker DW (2007) Patients’ shame and attitudes toward discussing the results of literacy screening. J Health Commun 12(8):721–732
34.
go back to reference Parikh NS, Parker RM, Nurss JR, Baker DW, Williams MV (1996) Shame and health literacy: the unspoken connection. Patient Educ Couns 27(1):33–39 Parikh NS, Parker RM, Nurss JR, Baker DW, Williams MV (1996) Shame and health literacy: the unspoken connection. Patient Educ Couns 27(1):33–39
35.
go back to reference Macabasco-O’Connell A, Fry-Bowers EK (2011) Knowledge and perceptions of health literacy among nursing professionals. J Health Commun 16(Suppl 3):295–307CrossRef Macabasco-O’Connell A, Fry-Bowers EK (2011) Knowledge and perceptions of health literacy among nursing professionals. J Health Commun 16(Suppl 3):295–307CrossRef
36.
go back to reference Coleman C (2011) Teaching health care professionals about health literacy: a review of the literature. Nurs Outlook 59(2):70–78CrossRef Coleman C (2011) Teaching health care professionals about health literacy: a review of the literature. Nurs Outlook 59(2):70–78CrossRef
37.
go back to reference Halkett G, O’Connor M, Aranda S, Jefford M, Merchant S, York D, Miller L, Schofield P (2016) Communication skills training for radiation therapists: preparing patients for radiation therapy. J Med Radiat Sci 63(4):232–241. https://doi.org/10.1002/jmrs.171 Halkett G, O’Connor M, Aranda S, Jefford M, Merchant S, York D, Miller L, Schofield P (2016) Communication skills training for radiation therapists: preparing patients for radiation therapy. J Med Radiat Sci 63(4):232–241. https://​doi.​org/​10.​1002/​jmrs.​171
38.
go back to reference Dhillon HM, Smith SK, Stefanic N, Turner R, Naehrig D, Shepherd HL, Halkett GK, Shaw J (2016) Pilot-testing the feasibility and acceptability of a radiation therapy talking book. Asia Pac J Clin Oncol 12:107–107 Dhillon HM, Smith SK, Stefanic N, Turner R, Naehrig D, Shepherd HL, Halkett GK, Shaw J (2016) Pilot-testing the feasibility and acceptability of a radiation therapy talking book. Asia Pac J Clin Oncol 12:107–107
Metadata
Title
What do radiation therapists know about health literacy and the strategies to improve it for patients? A qualitative study
Authors
Fiona Quinn
Sian K Smith
Haryana M Dhillon
Charles Gillham
Agnella Craig
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4353-4

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