Information on the risks and benefits of cancer-related screening tests, treatments, and preventive measures may leave a person feeling more confused than clear-headed. A team led by Angela Fagerlin, PhD, of the Center for Bioethics and Social Sciences in Medicine at University of Michigan Health System in Ann Arbor, has outlined 10 steps that have been empirically shown to improve patient comprehension regarding such matters. The list was presented in the Journal of the National Cancer Institute.
Use plain, simple language. Patients do not always understand medical terms or expressions. Explain the disease process and treatment slowly and pause to give the patient a chance to ask questions.
Statements about relative risk do not always illustrate how likely a person is to experience a benefit or consequence, so clearly communicate absolute risk and be sure patients understand what that statistic means in terms of the chance that something will happen to them.
Help patients visualize their risk. Have the patient draw 100 boxes and color in one box for each percentage point of risk to give a visual representation (pictograph) of the meaning behind the numbers.
Relate risk as a frequency rather than as percentages. For example, instead of telling the patient that 60% of people experience a particular side effect, tell them that in a room of 100 people, 60 will experience the side effect and 40 will not.
Be sure to clarify when the risk of an adverse effect exists regardless of whether the patient chooses to undergo a particular treatment.
State the most important points last. Studies have shown that people remember the last thing they heard best.
Provide a written summary of the discussion points or encourage the patient to take notes. Information for treatment decisions may be a lot of information.
Caution patients against relying too heavily on averages, and advise them instead to focus on the information that applies specifically to their case.
Devote most of your discussion to the treatment options and facts most relevant to a given patient.
Be sure to put a particular risk in a long-term perspective as well as a short-term perspective, such as the risk of recurrence in 10 or 20 years as well as in 1 or 5 years. ONA