Wednesday 11th December 2013
Mac Voice, the magazine for Macmillan professionals: Winter 2013
In the first of our communication skills series, John Sweeney discusses Information giving in cancer care: a course run by Macmillan Cancer Support and NHS Grampian.
Information prepares people affected by cancer for treatment, helps them cope with their illness and promotes recovery. Most people with cancer want to know more, but many do not receive the right information at the right time or in the right way. There is a need, not only for information provision, but for a supportive and personalised explanation of it.
Health literacy is defined as: ‘The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.’ Research suggests that those with poorer health literacy suffer from higher morbidity.
They are also less likely to seek medical advice with early symptoms, or be prepared with questions for health professionals.
Patients and families often seek information from professionals with whom they’re familiar, perhaps in relation to other health conditions. This indicates a need for nurses from all backgrounds to have the knowledge and skills to offer relevant, specific, accurate and timely information to those they care for, and to be able to interpret this information if needed. Macmillan Support Line staff wanted to help nurses to assess and meet patients’ information needs about cancer, particularly during survivorship. So they designed and delivered a two-day training course to 11 nurses from a range of areas within NHS Grampian.
As well as explaining the importance of health and information literacy, the course taught participants to assess the information needs of someone with cancer and deliver information more effectively.
Some participants visited the Macmillan Support Line in Glasgow to see some of the taught skills in action. All planned to share the information with colleagues and some planned to create an information resource for their own practice area based on some of the principles discussed.
Many considered adopting some of the materials aimed at fostering shared decison making. Others felt the course would help them support the information needs of junior colleagues. Telephone skills was another area of training that was found useful. This is something that is often missing from communication skills courses but is an everyday task for nurses.
‘There was a lot to think about: how and when do I give information? How much is enough? How do I check someone understands? [The course] covered everything from body language to giving information by phone as well as where to find accurate and relevant information.’ - course participant
The handouts and training approach were rated as excellent or good by all participants. All reported an improvement in their information giving skills and said they’d use some of the techniques to check understanding with patients and carers.
Although there are no current plans to deliver the course again, the course material has since been integrated into the training for staff joining Macmillan’s Support Line. Discussion has also taken place with Macmillan’s Professional Engagement team about its possible use with a wider audience, but there are no plans for this at present.
1 van der Meulen N et al. Interventions to improve recall of medical information in cancer patients: a systematic review of the literature. Psychooncology. 2008; 17(9):857-68.
2 CancerBACUP. The cancer information maze: report investigating information access for people with cancer [PDF]. 2005.
3 Institute of Medicine. Health literacy: a prescription to end confusion. Washington DC: National Academies Press. 2004.
4 Edwards M et al. The development of health literacy in patients with a long-term health condition: the health literacy pathway model. BMC Public Health. 2012; 12:130.
5 Manning DL and Dickens C. Health Literacy: more choice, but do cancer patients have the skills to decide? European Journal of Cancer Care. 2006; 15(5):448–452.
6 Stacey et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews. 2011; 10.
Email John Sweeney, Macmillan Information Nurse Specialist, Macmillan Cancer Support.