Article

The Influence of Easy-to-Read Pamphlets About Self-Care Management of Radiation Side Effects on Patients' Knowledge

Feleta L. Wilson

Darlene W. Mood

Cheryl K. Nordstrom

Patient education, radiation therapy, radiation oncology
ONF 2010, 37(6), 774-781. DOI: 10.1188/10.ONF.774-781

Purpose/Objectives: To test patients' knowledge of side effects after they review six easy-to-read pamphlets on radiation side effects.

Design: Nonexperimental.

Setting: Urban radiation oncology clinic.

Sample: 47 patients receiving radiation treatment.

Methods: The Knowledge of Radiation Side Effects Test was administered.

Main Research Variables: Patient literacy and knowledge level.

Findings: The self-report of highest grade completed in school was 10th grade; however, the actual reading level was 4th-6th grade. Scores for each knowledge test increased with literacy level, with statistically significant correlations for pamphlets on fatigue, skin problems for women, and skin problems for men. Participants who read at the 4th-6th-grade level scored higher than expected.

Conclusions: Although the pamphlets were deemed easy to read, patients who had the lowest reading levels still had difficulty understanding them.

Implications for Nursing: In addition to written patient information, oncology nurses should use innovative teaching strategies to improve patient understanding and self-care behaviors. A need exists for continued nursing inquiry that will focus on self-care behaviors to manage radiation side effects, particularly for patients with low literacy.

Jump to a section

    References

    Albrecht, T. L., & Goldsmith, D. J. (2003). Social support, social networks, and health. In T. L. Thompson, A. Dorsey, K. Miller, & R. Parrott (Eds.), Handbook of health communication (pp. 263-284). Mahwah, NJ: Lawrence Erlbaum.
    Amalraj, S., Starkweather, C., Nguyen, C., & Naeim, A. (2009). Health literacy communication and treatment decision-making in older cancer patients. Oncology (Williston Park), 23, 369-375.
    Area Health Education Center. (1996). The assessment checklist. Biddeford, ME: University of New England.
    Backscheider, R. (1974). Self-care requirements, self-care capabilities, and nursing systems in the diabetic nurse management clinic. American Journal of Public Health, 12, 1138-1146.
    Baker, L., Wilson, F. L., & Winebarger, A. L. (2004). An exploratory study of the health problems, stigmatization, life satisfaction, and literacy skills of urban, street-level sex workers. Women and Health, 39, 83-96. dx.doi.org/10.1300/J013v39n02_06
    Bevan, J., & Pecchioni, L. (2008). Understanding the impact of family caregiver cancer literacy on patient outcomes. Patient Education and Counseling, 71, 356-364. dx.doi.org/10.1016/j.pec.2008.02.022
    Briss, P., Rimer, B., Reilley, B., Coates, R. C., Lee, N. C., Mullen, P., … Task Force on Community Preventive Services. (2004). Promoting informed decisions about cancer screening in communities and healthcare systems. American Journal of Preventive Medicine, 26, 67-80. dx.doi.org/10.1016/j.amepre.2003.09.012
    DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., & Pignone, M. P. (2004). Literacy outcomes and health outcomes: A systematic review of the literature. Journal of General Internal Medicine, 19, 1228-1239. dx.doi.org/10.1111/j.1525-1497.2004.40153.x
    Doak, C., Doak, L., & Root, J. (1996). Teaching patients with low-literacy skills (2nd ed.). Philadelphia, PA: Lippincott Williams and Wilkins.
    Dodd, M. J. (1982). Assessing patient self-care for side effects of cancer chemotherapy: Part I. Cancer Nursing, 5, 447-451.
    Dunn, J., Steginga, S. K., Rose, P., Scott, J., & Allison, R. (2004). Evaluating patient education materials about radiation therapy. Patient Education and Counseling, 52, 325-332. dx.doi.org/10.1016/S0738-3991(03)00108-3
    Fitch, M. I., Gray, R. E., McGowan, T., Brunskill, I., Steggles, S., Sellick, S., … McLeese, D. (2005). Travelling for radiation cancer treatment: Patient satisfaction. Canadian Oncology Nursing Journal, 15, 107-119.
    Halkett, G., & Kristjanson, L. (2007). Patient's perspective on the role of radiation therapists. Patient Education and Counseling, 69, 76-83. dx.doi.org/10.1016/j.pec.2007.07.004
    Halkett, G. K., Arbon, P., Scutter, S. D., & Borg, M. (2007). The phenomenon of making decisions during the experience of early breast cancer. European Journal of Cancer Care, 16, 322-330. dx.doi.org/10.1111/j.1365-2354.2007.00778.x
    Hasselkus, A., & Moxley, A. (2009). Health literacy at the intersection of cultures. American Speech-Language-Hearing Association Leader, 14(4), 30-31.
    Hogle, W. P. (2007). Radiation therapy in the treatment of breast cancer. Seminars in Oncology Nursing, 23, 20-28. dx.doi.org/10.1016/j.soncn.2006.11.004
    Mast, D. E., & Mood, D. W. (1990). Preparing patients with breast cancer for brachytherapy. Oncology Nursing Forum, 17, 267-270.
    Matthews, A. K., Sellergren, S. A., Manfredi, C., & Williams, M. (2002). Factors influencing medical information seeking among African American patients. Journal of Health Communication, 7, 205-219. dx.doi.org/10.1080/10810730290088094
    Meade, C. D., & Smith, C. F. (1991). Readability formulas: Cautions and criteria. Patient Education and Counseling, 17, 153-158. dx.doi.org/10.1016/0738-3991(91)90017-Y
    Murphy, P. W., Davis, T., Long, S., Jackson, R., & Decker, B. (1993). Rapid estimate of adult literacy in medicine (REALM): A quick reading test for patients. Journal of Reading, 37, 124-130.
    National Work Group on Literacy and Health. (1998). Communicating with patients who have limited literacy skills: Report of the National Work Group on Literacy and Health. Journal of Family Practice, 46, 168-176.
    Neilsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (Eds.). (2004). Health literacy: A prescription to end confusion. Washington, DC: National Academies Press.
    Orem, D. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby.
    Orem, D. (2001). Nursing: Concepts of practice (6th ed.). St. Louis, MO: Mosby.
    Plimpton, S., & Root, J. (1994). Materials and strategies that work in low literacy health communication. Public Health Reports, 109, 86-92.
    Rehwaldt, M., Wickham, R., Purl, S., Tariman, J., Blendowski, C., Shott, S., & Lappe, M. (2009). Self-care strategies to cope with taste changes after chemotherapy [Online exclusive]. Oncology Nursing Forum, 36, E47 E56. dx.doi.org/10.1188/09.ONF.E47-E56
    Roland, K. B., Benard, V. B., Saraiya, M., Hawkins, N. A., Brandt, H., & Friedman, A. L. (2009). Assessing cervical cancer screening guidelines in patient education materials. Journal of Women's Health, 18, 5-12. dx.doi.org/10.1089/jwh.2008.1211
    Rudd, R. (2010). Health literacy studies: Overview. Retrieved from http://www.hsph.harvard.edu/healthliteracy/overview
    Ruthman, J. L., & Ferrans, C. E. (2004). Efficacy of a video for teaching patients about prostate cancer screening and treatment. American Journal of Health Promotion, 18, 292-295.
    Schillinger, D., Piette, J., Grumback, K., Wang, F., Wilson, C., Daher, C., … Blindman, A. B. (2003). Closing the loop: Physician communication with diabetic patients who have low literacy. Archives of Internal Medicine, 163, 83-90. dx.doi.org/10.1001/archinte.163.1.83
    Schim, S. M., Doorenbos, A., Benkert, R., & Miller, J. (2007). Culturally congruent care: Putting the puzzle together. Journal of Transcultural Nursing, 18, 103-110. dx.doi.org/10.1177/1043659606298613
    Smith, S. K., Trevena, L., Nutbeam, D., Barratt, A., & McCaffery, K. J. (2008). Information needs and preferences of low and high literacy consumers for decisions about colorectal cancer screening: Utilizing a linguistic model. Health Expectations, 11, 123-136. dx.doi.org/10.1111/j.1369-7625.2008.00489.x
    Thomas, R., Daly, M., Perryman, B., & Stockton, D. (2000). Forewarned is forearmed Benefits of preparatory information on video cassette for patients receiving chemotherapy or radiotherapy A randomised controlled trial. European Journal of Cancer Care, 36, 1536-1543.
    U. S. Department of Health and Human Services. (2003). Healthy People 2010: Objectives for improving health. Retrieved from http://www.healthypeople.gov/document/pdf/volume1/11healthcom.pdf
    William, S. A., & Schreier, A. M. (2004). The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer [Online exclusive]. Oncology Nursing Forum, 31, E16 E23. dx.doi.org/10.1188/04.ONF.E16-E23
    Wilson, F. L. (2000). Measuring patients' ability to read and comprehend: A first step in patient education. Nursing Connections, 13(3), 19-27.
    Wilson, F. L., Baker, L. M., Nordstrom, C. K., & Legwand, C. (2008). Using the teach-back and Orem's self-care deficit nursing theory to increase childhood immunization communication among low-income mothers. Issues in Comprehensive Pediatric Nursing, 31, 7-22. dx.doi.org/10.1080/01460860701877142
    Wilson, F. L., Brown, D. L., & Stephens-Ferris, M. (2006). Can easy-to-read immunization information increase knowledge in urban low-income mothers? Journal of Pediatric Nursing, 21, 4-12. dx.doi.org/10.1016/j.pedn.2005.06.003
    Wilson, F. L., Mood, D. W., Risk, J., & Kershaw, T. (2003). Evaluation of education materials using Orem's self-care deficit theory. Nursing Science Quarterly, 16, 68-76. dx.doi.org/10.1177/0894318402239069
    Wilson, F. L., & Ntiri, D. (2006, Spring). Meeting the health and information needs of patients with low literacy skills. Journal of Chi Eta Phi Sorority, 10-15.
    Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2003). Elaborating a definition of health literacy: A commentary. Journal of Health Communication, 8(Suppl. 1), 119-120.