Presentation Authors: Alexander E Kiciak*, Andrew Dawson, Thomas Dymond, Michael J Leveridge, D. Robert Siemens, Jason P Izard, Kingston, Canada
Introduction: The Canadian Urological Association (CUA) publishes freely accessible patient information materials (PIM) on a range of urological issues including prostate cancer. Previous work has established that the prostate cancer PIM are written at a grade 11 reading level which may be too complex for low literacy patients. We sought to directly compare the standard CUA PIM to a reconstructed patient-centred PIM.
Methods: PIM covering radical prostatectomy (RP) and radiation therapy (RT) for prostate cancer were rewritten in a simplified format to enhance readability. The final format reflected a 6th grade reading level and was published in a graphical format identical to the original PIM to avoid bias. Patients who had undergone previous treatment for localized prostate cancer or were on active surveillance were recruited from Kingston Health Sciences Centre. Participants evaluated both &[Prime]standard&[Prime] and &[Prime]patient-centred&[Prime] formats of both RP and RT topics. PIM formats and topics were randomized in order of presentation. We collected demographic, educational and disease specific details of our participants. Health literacy was assessed using the REALM-SF. Semi-structured interviews were used to obtain qualitative feedback on all PIM. Participants were asked to score the PIM formats on a Likert scale with respect to usefulness, comprehension and preference of one format over the other.
Results: There were 61 participants with complete information for analysis. The median age of participants was 70 years (50-86) with a median REALM-SF score of 7 (5-7) and 62% (38/61) had at least some college or university education. Patients had been treated with surgery (35/61), radiation (24/61) and active surveillance (18/61). Usefulness ratings were high for all PIM format but did not vary statistically between formats (p = 0.84). Comprehension ratings were significantly higher in the patient-centred PIM (p < 0.01). Preference for PIM format did not reach statistical significance (p=0.32 for RP; p =0.19 for RT). However, within the qualitative feedback 16% of patients commented without prompting that the language within the standard PIM was too complex. Participants also expressed the desire for more information regarding care after treatment.
Conclusions: Within this group of highly educated participants with high health literacy, a simplified written structure improves patient comprehension ratings of informational materials. Future work will focus on revising the informational content of our PIM in an iterative format based on participant feedback.
Source of Funding: This project was sponsored by a research grant from the Canadian Urological Association Scholarship Foundation.