Health Literacy andQuality Of Life in women with Breast cancera Focus on basic essentials Assoc Prof DrLohSiewYim BSc. Applied Rehabilitation(UK), MSc Medical Education (UK), M Counselling (M), PhD (Aust) Dept of Rehabilitation/ Faculty Of Medicine /University Malaya /50630, Kuala Lumpur Email: firstname.lastname@example.org; email@example.com
background Poor access to complete and accurate information continues to pose a challenge for women in developing countries to make decision about treatment. Low health literacy has been associated with poor health status in many diverse populations, (even when education and other well-established predictors of health status are controlled) (Sentell et al., 2011). Aim: Examine the differences in knowledge (in a control versus experimental group), and examine if I) knowledge ii)QOL improves (after a 4week self-mx program. (US Department of Health and Human Services, 2000) Hawai'i.Sentell T, Baker KK, Onaka A, Braun K 2011 Low health literacy and poor health status in Asian Americans and Pacific Islanders J Health Commun. 16 Suppl 3():279-94
Methods • Examination of secondary data collected (from a clinical controlled trial) on women newly diagnosed with breast cancer (n=147) who were allocated to a 4 weeks Self mx intervention • Between group, we compared between the exp (n=69) vs control group (n=78) • Within experimental group, we compared the baseline (T0) versus post intervention (T1) • - for changes in the level of basic essential knowledge over time
Intervention (n= 68) Control group = usual care (n=78)
RESULT: At baseline……. • At baseline, the percentages of women who were unaware of their cancer profiles were quite similar. • There were no statistical sig differences between the experimental and control groups • HER_2 status : 84% (exp) versus 82 % (control).. unaware • Grade : 62 % (exp) versus 65 % (control).. • Type : 67 versus 69 % (control).. • Hormonal Receptor Status: 57 versus 54 % (control). • Stage • Size Less than 20 %%
RESULT: at post intervention Sig differences at baseline and post ix for experiment group BUT not for control N=68 exp Table 2 Control group BC profile(n=78) Knowledge of 6 basic info. of cancer = zero) 83 % -- unaware of HER2 status. 68 % ---unaware of BC TYPE 64 % __unaware of GRADE of cancer cell 55 %__ unaware of HORMONAL receptor status 18 % __unaware of SIZE of breast cancer 13% __unaware of STAGE of breast cancer For control: At baseline, BC literacy were very poor . At post-intervention, no significant improvement Most women do not know their 1. type, 2. Herceptin status, 3. grade
RESULT: QOL of women with BC on a 4-week SM Quality of Life in Breast Cancer Survivors: 2 Years Post Self-management Intervention. Article in Asian Pacific journal of cancer prevention: APJCP · January 2011
RESULT: BSE practice and etc Experiment (n=68) 80% of the breast cancer survivors self-detected the breast lumps, despite a high 85% of these women reporting they were never taught about BSE. 70% of the women maintained that lack of knowledge on how to do a BSE was the key barrier to a more regular BSE practice. After the educational intervention, an increase from 17% (at baseline) to 67% (at post-test) of self reported monthly BSE practices.
This is a simple secondary analyses from data gathered from a CCT It is critical that the cognitive and social skills that determine a person’s motivation and ability to gain access, to understand, and to use information in ways that promote and maintain good health [Nutbeam, 2011] needs to be consciously addressed. Basic fundamental information should not be taken for granted • DISCUSSION Nielsen-Bohlman L, Panzer AM, Kindig DA. Institute of Medicine Committee on Health Literacy. In: Health Literacy: A Prescription to End Confusion. Washington, DC: National Academies Press; 2004.Google Scholar U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. In: National Action Plan to Improve Health Literacy. Washington, DC: National Institutes of Health; 2010.Google Scholar U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. In: Healthy People 2020. Washington, DC: National Institutes of Health; 2011.Google Scholar . D. Nutbeam, “Health promotion glossary,” Health Promotion, vol. 1, no. 1, pp. 113–127, 1986
conclusion Majority Women had very low Breast cancer literacy at baseline. Knowledge improves after 4 weeks for experimental group but remain the same for women in the control group, who also had lower QOL. Multi-modal efforts including patient self management to improve health literacy of women with breast cancer can narrow the gap of health disparity, and improves their QOL.
Recommendation Future study examining health literacy of cancer survivors with validated measures of health literacy tools to examine its direct relationship to several health-promoting behaviors and QOL is warranted
Thank You • References • SY loh & SY Chew . Awareness and practice of bSE in malaysian women with breast cancer . Asia Pacific Journal of cancer prevention 2, 199-202 • SY Loh et al . Effect of patients self managemnt for breast cancer as a chronic illness- journal of caancer survivorship 2013 sept 7(3) 331-42 • SY Loh et al Quality of life in breast cancer survivors – two years post self management . Asia pacific journal of cancer prvention 2011 12(6) 1497-501 • SY Loh & H jonsson Cancer survivorship Care –a perspective from an occupational partipation. Journal of cancer science & thrapy 2016 • Assoc Prof DrLohSiewYim/ University Malaya/ Email: firstname.lastname@example.org;/ email@example.com
Title: Breast cancer literacy and quality of life in Cancer Survivors - a focus on basic essentials Author: Siew Yim, Loh (PhD), Faculty of Medicine/ 2. Cancer survivorship division, CEPH Intro: Poor access to complete and accurate information continues to pose a challenge for women in developing countries to make decision about treatment. Objectives: Examine the disparity in cancer knowledge in a control versus experimental group, and examine if I) knowledge ii)QOL improves (after a 4week self-mx program. Method: Examination of secondary data collected (from a clinical controlled trial) on women newly diagnosed with breast cancer (n=147) was performed, on the baseline versus post intervention knowledge of basic breast cancer profile. Knowledge levels of women in both arms [experimental (n=69) attending a self-management program; control group (n=78)] were compared for change in the level of knowledge over time Results: In the experiemental group, breast cancer literacy were very poor at baseline. Not a single woman had knowledge of all six basic characteristics of cancer profile. A high percentage (83%) were totally unaware of HER2 status. Majority had low literacy on types of breast cancer (68%), grade of cancer cell (64%), status of hormonal receptor (55%), size of breast cancer (18%) stage of breast cancer (13%). At post-intervention, there were significantly improves literacy in the experimental group, and experimental group had better QOL. Conclusion: Overall, women in this study had very low cancer literacy. Intervention group with higher quality of life were also having better QOL and lower distress, compared to the control group.. Multi-modal efforts including patient self management to improve health literacy of women with breast cancer can narrow the gap of health disparity, and improves their QOL. Keyword: Knowledge disparity, cancer literacy, patient self-management, intervention, QOL, distress,