The effect of health literacy on patient’s perceived shared decision making among Chinese cancer patients

In this chapter the author describes the challenges of engaging and communicating with patients and how technology can improve communication, elicit honest patient disclosure, and create more productive conversation and help patients engage and partner in their care. The author will also discuss how research with multimedia programs reveals it can help reduce anxiety, improve knowledge, help low health literacy audiences, and contribute to improved outcomes. This chapter will also examine how multimedia decision aid programs can help patients understand their options and complex risk information, while helping them consider their values and preferences so they can truly engage in shared decision making.

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Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results

Journal of the American Medical Informatics Association ◽

10.1197/jamia.m1365 ◽

2003 ◽

Vol 10 (6) ◽

pp. 573-579 ◽

Cited By ~ 57

Author(s):

Cornelia M. Ruland ◽

Thomas White ◽

Marguerite Stevens ◽

Gilbert Fanciullo ◽

Samir M. Khilani

Keyword(s):

Decision Making ◽

Cancer Patients ◽

Shared Decision Making ◽

Symptom Management ◽

Shared Decision ◽

Preliminary Results ◽

Computerized System

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Abstract P4-11-07: Shared decision making (SDM) in routine care treatment of breast cancer patients – a survey of patients following surgery

10.1158/1538-7445.sabcs17-p4-11-07 ◽

2018 ◽

Author(s):

S Feiten ◽

I Scholl ◽

M Schmidt ◽

J Dünnebacke ◽

A Franzen ◽

...

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Cancer Patients ◽

Shared Decision Making ◽

Routine Care ◽

Shared Decision ◽

Breast Cancer Patients ◽

Care Treatment

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Health literacy is a barrier to shared decision making in early prostate cancer (PCA) among African American (AA) men.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.84 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 84-84 ◽

Cited By ~ 1

Author(s):

William Martin-Doyle ◽

Christopher Paul Filson ◽

Susan Regan ◽

Quoc-Dien Trinh ◽

Sierra Williams ◽

...

Keyword(s):

Decision Making ◽

African American ◽

Health Literacy ◽

Cancer Treatment ◽

Shared Decision Making ◽

Treatment Options ◽

Univariate Analysis ◽

Shared Decision ◽

Newly Diagnosed ◽

Treatment Choices

84 Background: ASCO, AUA, ASTRO and SUO endorse shared decision making for men with localized PCa. We explored treatment decisions among providers and their AA patients (pts) in a prospective cohort study at Grady Memorial Hospital and the Atlanta Veterans Administration Hospital. Methods: Following their visit, 18 providers documented the PCa treatment options they had discussed with 124 newly diagnosed, early-stage, African American PCa pts. At a subsequent visit, prior to choosing their cancer treatment, pts were asked to name the options they had discussed with their provider. Demographics were collected. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Numeracy, comprehension of common PCa terms, and anatomic knowledge were assessed using published methods (Kilbridge K, et al. J Clin Oncol 27:2015-2021, 2009). Chi-square, t-tests and multivariate logistic regression were used to identify variables associated with correct understanding of treatment choices. Results: Just 23.4% of pts correctly understood their treatment options. In univariate analysis, only health literacy was statistically significantly associated with comprehension of PCa treatment options (p < 0.05). In a multivariate logistic model adjusting for age, education, income, numeracy, comprehension of common PCa terms, and anatomic knowledge; health literacy remained the only significant predictor of pts’ comprehension of their treatment choices (OR 3.8, 95% CI 1.2-11.9, p = 0.021). Even among the 49 pts with the highest level of health literacy, only 34.7% correctly understood their cancer treatment options (compared to 16.0% among low literacy patients). Conclusions: Successful shared decision making requires pts to understand their treatment choices. Information presented by healthcare providers may be overwhelming for newly diagnosed pts, particularly those with lower health literacy. Our study suggests that even pts with the highest level of health literacy may need additional support to understand their PCa treatment options.

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Health Literacy and Health-Care Engagement as Predictors of Shared Decision-Making Among Adult Information Seekers in the USA: a Secondary Data Analysis of the Health Information National Trends Survey

Journal of Cancer Education ◽

10.1007/s13187-016-1052-z ◽

2016 ◽

Vol 33 (1) ◽

pp. 67-73 ◽

Cited By ~ 8

Author(s):

Lisa T. Wigfall ◽

Andrea H. Tanner

Keyword(s):

Health Care ◽

Decision Making ◽

Data Analysis ◽

Health Literacy ◽

Health Information ◽

Shared Decision Making ◽

Secondary Data ◽

Shared Decision ◽

The Usa ◽

National Trends

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English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.131350 ◽

2014 ◽

Vol 41 (7) ◽

pp. 1290-1297 ◽

Cited By ~ 49

Author(s):

Jennifer L. Barton ◽

Laura Trupin ◽

Chris Tonner ◽

John Imboden ◽

Patricia Katz ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Decision Making ◽

Health Literacy ◽

Shared Decision Making ◽

Language Proficiency ◽

English Language ◽

English Language Proficiency ◽

Shared Decision ◽

Limited Health Literacy ◽

Limited Health

Objective.Treat-to-target guidelines promote shared decision making (SDM) in rheumatoid arthritis (RA). Also, because of high cost and potential toxicity of therapies, SDM is central to patient safety. Our objective was to examine patterns of perceived communication around decision making in 2 cohorts of adults with RA.Methods.Data were derived from patients enrolled in 1 of 2 longitudinal, observational cohorts [University of California, San Francisco (UCSF) RA Cohort and RA Panel Cohort]. Subjects completed a telephone interview in their preferred language that included a measure of patient-provider communication, including items about decision making. Measures of trust in physician, education, and language proficiency were also asked. Logistic regression was performed to identify correlates of suboptimal SDM communication. Analyses were performed on each sample separately.Results.Of 509 patients across 2 cohorts, 30% and 32% reported suboptimal SDM communication. Low trust in physician was independently associated with suboptimal SDM communication in both cohorts. Older age and limited English proficiency were independently associated with suboptimal SDM in the UCSF RA Cohort, as was limited health literacy in the RA Panel Cohort.Conclusion.This study of over 500 adults with RA from 2 demographically distinct cohorts found that nearly one-third of subjects report suboptimal SDM communication with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts, as was limited English language proficiency and older age in the UCSF RA Cohort and limited health literacy in the RA Panel Cohort. These findings underscore the need to examine the influence of SDM on health outcomes in RA.

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