Prospective Evaluation of Patient Satisfaction Following the Use of Education Materials for Cervical Cancer Brachytherapy

Abstract

There is growing emphasis on incorporating patient education tools in oncology. Preparatory patient education results in greater treatment-related knowledge and less emotional stress at the completion of cancer treatment, possibly as it relates to the development of effective patient coping mechanisms. To improve patient quality of life and promote understanding of intracavitary and interstitial gynecologic brachytherapy, we developed and investigated the role of an illustrated, educational flipbook as a part of the standard consent process. We also assessed the utility of take-home patient education materials on patient satisfaction. Female patients greater than 18 years old, with a diagnosis of cervical cancer undergoing definitive chemoradiation were prospectively randomized to undergo informed consent without (Arm A) or with (Arm B) supplemental education materials. These materials consisted of a descriptive, take-home illustrated flipbook outlining the brachytherapy rationale, workflow process, applicators, and perioperative care. Patients in both arms were given a 12 question, 5-point Likert scale-based survey adapted from a previously validated version to measure patient satisfaction with cancer treatment information. A second survey was given to Arm B patients to assess the educational impact of the take-home materials. The mean score from the patient satisfaction surveys were compared between treatment groups using a two-sample t-test. From October 2012 to January 2013, 14 patients were randomized equally between 2 treatment arms. The mean age was 51 years (range 26-75). Twelve patients completed all 14 patient satisfaction survey questions. Using 5-point Likert items the highest possible total score was 60. The mean total patient satisfaction scores ± standard deviations in Arm A and Arm B were 53.4 ± 6.4 and 58.3 ± 1.6, respectively (P = 0.12). As the study progressed, the mean total scores in Arm A increased. Overall, patients were satisfied with their ability to make informed decisions regarding their cancer treatment. Analysis of satisfaction subscales showed Arm B patients were more satisfied with educational resources, and the opportunity to ask questions about managing side effects. Patients in both groups were least satisfied with information regarding interactions between prescribed cancer treatment and alternative treatments that patients may pursue independently. Arm B patients responded positively to all metrics of adequacy of the take-home educational materials. Brachytherapy educational take-home materials improve patient satisfaction with information regarding gynecologic brachytherapy. The use of the materials also establishes a rubric which facilitates the informed consent process to ensure adequate cancer treatment information is provided.