JMIR Publications

ABSTRACT

Background:

Older migrant cancer patients face many language- and culture-related barriers to patient participation during medical consultations. To bridge these barriers the Health Communicator, an eHealth tool with a multilingual history and video patient education system, was developed which includes specific illness-related modules, such as a Diabetes module. However, it did not include an oncology module yet, despite the fact that the prevalence of Dutch migrant cancer patients will triple in the coming years.

Objective:

The aim of this study was to systematically develop, implement and conduct a pilot-evaluation of an oncological module for the Health Communicator in order to stimulate patient participation among older Turkish-Dutch and Moroccan-Dutch cancer patients.

Methods:

The Spiral Technology Action Research model was used as framework in developing the oncological module, which incorporates five cycles that engage all relevant stakeholders in intervention development. The listen phase consisted of a needs assessment. The plan phase consisted of developing Question Prompt Lists (QPLs) and scripts for patient education videos. Based on pretest results the oncological module was created in the do phase, containing six audiovisual QPLs on patient rights, treatment information, psychosocial support, lifestyle and access to healthcare services, patients’ preferences and clinical trials. Five patient education videos were created about patient rights, psychosocial support, clinical trials and patient-professional communication. In the study phase the oncological module was pilot-evaluated among 27 older Turkish-Dutch and Moroccan-Dutch cancer patients visiting their healthcare professional, who received training prior to the pilot-evaluation. In the act phase, the oncological model was disseminated to practice.

Results:

The patient rights QPL was chosen most often. Patients and healthcare professionals perceived the QPLs as somewhat easy to understand and useful. There was a negative correlation between ease of using the tool and patients’ age. Patients reported that using the module impacted the consultations positively and thought they were more active compared to previous consultations. Professionals also found patients to be more active than usual. Healthcare professionals asked significantly more questions than patients though during consultations. After their consultation, patients requested to see the patients’ rights video most often. Patients rated the videos as easy to understand, useful and informative. The majority of patients reported that they like to use the tool in the future.

Conclusions:

Older migrant cancer patients and survivors and healthcare professionals found the oncological module to be a useful tool and have shown intentions to incorporate this tool into future consultation sessions. Both QPLs and videos were evaluated positively, the latter indicating that the use of narratives to inform older low literate migrant cancer patients about health-related topics in their mother tongue is a viable approach to increase effectiveness of healthcare communication with this target group.