Treatment Information and Navigation Program for New Patients With Breast Cancer in Malaysia

Abstract

Purpose Advancements in medical treatment with wider treatment options have made breast cancer (BC) care more complex. Short consultation time with physicians, patient fears, and poor coping skills at the time of diagnosis may affect a patient’s decision, causing treatment delays and nonadherence. The main reasons for advanced BC presentation in Malaysia are a delay in making a treatment decision and poor breast health literacy on the disease and its treatment outcomes. To address this gap, we developed an audio-visual tool on multimodal treatments; adverse effects; navigating admission, discharge, and follow-up; and advice on diet and exercise to maintain a healthy lifestyle during the survivorship period in layperson language in Malay, Mandarin, and English. This study aims to assess its effectiveness in improving patient knowledge and satisfaction. Methods A pilot study of 50 patients found that patients needed face-to-face interaction to watch the video. Hence, a breast care nurse–led orientation was developed. A self-administered pre- and postsurvey in 246 patients with newly diagnosed breast cancer in University Malaya Medical Centre was performed to evaluate expectations, satisfactions, and knowledge. We scored the results with the following Likert scale terms: 0 means no knowledge and 4 means a great degree of knowledge. Scoring was done pre- and postintervention. A Wilcoxon matched paired signed rank test was used in the analysis. Results Among 246 patients who received the intervention, 79.3% (n = 197) found that the video met or exceeded their expectations, and 80.2% found the video effective in broadening their perspective on BC treatments. One hundred seventy-one patients (69.2%) rated the video as highly meeting their expectations. There were significant improvements in knowledge of treatment options for BC (mean scores 0.93 v 2.97 for pre- and postintervention; P < .001). Similar findings were found in different types of operations for BC; admission procedures; and information on chemotherapy, radiotherapy, hormone therapy, and alternative medicine. Knowledge scores for healthy diet, physical activity after treatment, and care of the arm were observed ( P < .001). Conclusion Video-based information on treatments and navigating care through a breast care nurse–led service effectively improved patients’ knowledge and satisfaction. This approach can be used to educate patients with cancer in a middle-resource setting. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.