Patients with lower health literacy in radiation oncology: A nursing perspective

Aaron Kok, Sian K Smith, Chris Milross, Georgia Halkett, Haryana M. Dhillon

Research output: Chapter or section in a book/report/conference proceedingChapter in a published conference proceeding


Background: Health literacy is a crucial skill for people affected by cancer and is required to navigate complex health care systems.
Aim: To (1) explore radiation oncology nurses' understanding and awareness of health literacy in radiotherapy patients; (2) examine strategies used to communicate with and support lower health literacy patients.
Method: Semi-structured interviews were conducted with 19 radiation oncology nurses from radiation oncology departments in Sydney, Australia. Framework analysis was used to develop a coding schema of themes identified from interviews. This was used to code, chart and analyse data and compare and contrast how nurse perceptions of health literacy differ.
Results: Five key themes were identified: (1) perceived role of radiation oncology nurses; (2) identifying lower health literacy in patients; (3) consequences of lower health literacy for patients; (4) strategies to improve patient understanding of health information; and (5) suggestions to improve health communication. Nurses made informal judgements about patient’s health literacy skills, relying on intuition and experience. They used verbal and non-verbal cues, and objective outcome measures such as socio-demographic indicators to identify patients with health literacy challenges. Nurses perceived patients with lower health literacy to have difficulty integrating information; increased side-effects potentially alleviated with better self-management, and worse health outcomes including increased hospitalisations and late detection of recurrence resulting from low adherence with follow-up. Strategies used to improve communication among lower health literacy patients included using plain language to deliver information, reiterating and repeating information over the course of treatment, encouraging question asking, and open-ended questions to confirm understanding.
Conclusion: Radiation oncology nurses had low awareness of health literacy, but responded to the needs of low health literacy patients intuitively and appropriately. A more structured approach including plain language prompt sheets to improve delivery and comprehension of information may enhance self-efficacy and result in better health outcomes.
Original languageEnglish
Title of host publicationAsia-Pacific Journal of Clinical Oncology
Publication statusE-pub ahead of print - 19 Nov 2014
EventClinical Oncology Society of Australia -
Duration: 2 Dec 2014 → …


ConferenceClinical Oncology Society of Australia
Period2/12/14 → …


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