Introduction
When patients are diagnosed with cancer, they are more often than not put under radiotherapy as one form of treatment. However, this does not mean that all patients with cancer are put under radiotherapy. There are those that are put under other forms of treatment such as chemotherapy. There are also other patients suffering from other forms of ailments that are put under radiotherapy.
Whichever the case, radiotherapy is a source of anxiety, worries and a very stressing experiencing to the patients and their kin. This is why support is a very important component of radiotherapy. Support in radiotherapy can be conceptualized as a form of intervention that helps in easing this anxiety experienced by patients and their family.
The support can be provided by the family members themselves, the nursing fraternity or the care providers, and can also be provided by other members of the society such as the religious organizations (Bolderston 2006).
Support can also be viewed as a form of interpersonal processes riding on social exchanges between the patient, their family, the care providers and other members of the society. These exchanges on the part of the patient are in form of coming into contact with the support, recognizing and experiencing the support (Anonymous 2010).
This preamble points to the fact that there are various forms of support that are there for the radiotherapy patient. This includes social and other forms of support. However, there are concerns to the effect that these services are not accessed by all the deserving patients. This is given the fact that some of the patients are not aware of the existence of these services (Anonymous 2010).
For example, it is noted that thousands of cancer patients are not benefiting from radiotherapy treatment despite the fact that they qualify for the services. This lack of access is attributed to the lack of awareness on the existence of these services on the part of the patients (Anonymous 2010).
It is against this backdrop that efforts have been made by several stakeholders in this field to advertise support services available to the radiotherapy patients. These advertisements are carried out on various platforms. This includes the care providers passing the message to their patients verbally, or advertising on the various magazines and articles aimed at the patients.
This literature review will compare two articles touching on the existence of support services for radiotherapy patients and how the services are advertised. The aim of the researcher will be to engage in a comparative critique of these two articles.
The first article is Information and support: a descriptive study of the needs of patients with cancer before their first experience of radiotherapy. This article is a report on a study carried out by Shanne McNamara. The second article will be What information patients with localized prostate cancer hear and understand, a study by Sandra McGregor.
In this literature review, the researcher will specifically describe the content of the articles, compare and contrast the methodologies used and justifications or lack of thereof for the methodologies used in the articles. The researcher will also look at how the information in the articles informs the researcher’s current area of study and why the articles are important for this study.
Review of Articles
Information and Support: A Descriptive Study of the Needs of Patients with Cancer before Their First Experience of Radiotherapy, McNamara Shanne, 1999
Preamble
This study was carried out in the year 1999 and published in the European Journal of Oncology Nursing. The major aim of this study was to describe the amount of support and information that is made available to radiotherapy patients before they start receiving and attending to this form of treatment.
The study also aimed at highlighting the opinions of the patients regarding the level and type of information and support that, according to them, are required (McNamara 1999).
The study used a self completed questionnaire as the tool for data collection. This questionnaire was mailed to 297 potential respondents. This is before the patients attended their first radiotherapy session. The patients were requested to come back with the completed questionnaire when they came for their first radiotherapy session. 199 patients out of the total 297 returned their completed questionnaires (McNamara 1999).
According to the findings of this study, it appears that patients with different types of cancer receive different levels of information before they attend their first session in radiotherapy. For example, breast cancer patients appear to benefit from more information than patients with other forms of cancer.
Another thing that this study found was that age and gender also influenced the level of information that patients received before they started their radiotherapy sessions.
For example, young females suffering from breast cancer were found to be well informed than other categories of patients. These patients also received better support than other categories of patients before they started their radiotherapy sessions (Nette and Svensson 2004).
This study concluded that patients are in need of more information and support before they start radiotherapy treatments. The study acknowledges the fact that support and information is vital at every stage of radiotherapy treatment. But the scholar notes that the period before the commencement of radiotherapy is especially vital. The information and support is instrumental in reducing the level of anxiety in the patients.
Content of the Study
As already stated, the study looked at the opinion of the patients before they started their radiotherapy sessions. The findings of this study are the main contents of this article.
McNamara (1999) introduces the article by noting that literature in this field points to the fact that cancer patients are more often than not dissatisfied with the amount of information that they are provided with regarding their condition.
This is especially information touching on the diagnosis, treatment and prognosis of their conditions. This is despite the fact that they are the ones who are directly and mostly affected by the handling of their condition (Lyrataopoulos, Barbiere, Greenberg, Wright and Neal 2010).
McNamara (1999), in the introduction of this article, notes that this deficit in information is confounding to the scholars and other stakeholders in this sector. This is given the fact that virtually every stakeholder, including the care providers themselves, are aware of the fact that a well informed patient is more likely to be satisfied and more likely to benefit from the services that they receive during the radiotherapy session.
Considering that the care providers are aware of this fact, it is hard to comprehend why they fail to provide their charges with such information well before they start their treatment (Lyrataopoulos et al 2010).
One of the major aims of this study was to find out the amount of information that is given to the patients regarding the form of treatment that they are going to receive. This is especially the information that they were given by the care provider when they were being informed that they needed to undergo radiotherapy.
The researcher also aimed at finding out the amount and type of support that the patients received from the care providers and other professionals in the field before they were enrolled on radiotherapy. This is especially so given that there are several forms of support that can be ideally provided by the health care professionals well before the commencement of the radiotherapy.
This includes psychological support, for example assuring the patients that they are better off receiving radiotherapy than other forms of treatment. The care providers can also provide the patients with information regarding the benefits and risks of this form of treatment. This will reduce the anxiety that comes with uncertainty on the part of the patients (Moss 2006).
This article also contains information touching on the level of information and support that the patients thought they required before they started their radiotherapy sessions.
The article further contains information touching on the kind of participants for the study. The study used several criteria in selecting the respondents to collect information from. The major inclusion criterion that was used was the sampling of any cancer patient that was attending the oncology centre selected with the aim of being enrolled for radiotherapy for the first time.
The researcher ensured that they did not include patients who have received radiotherapy treatment in the past. This is given the fact that such patients would have given responses that were influenced to a larger extent by their experiences in the past, creating bias and reducing the accuracy of the findings of this study (Bottomley and Jones 1997).
In this article, the findings of the study are also contained. The study found that the average number of weeks that have elapsed since the respondents had been informed of their condition to the time of the study was about 27 weeks (McNamara 1999). The period ranged between one month and twelve years. The study found that the duration of time since diagnosis had no impact on the amount and quality of information and support that was made available to the patients.
The study also looked at the effects that previous interventions and treatments such as chemotherapy had on the amount and quality of information that patients were exposed to. It was found that these previous interventions had no significant effect on the quality and quantity of information and support given to these patients before they started their radiotherapy treatment (Fleming 1992: Webb 1994: Wilkinson 1991).
It was found that 86 percent of breast cancer patients had been given information regarding radiotherapy. This is as compared to 72 percent of lung cancer. Also, a significantly higher number of patients with lung cancer felt that they needed more information (51%) as compared to only 39 percent of breast cancer patients (McNamara 1999).
It was also found that breast cancer patients appear to benefit more from support provided by care providers than other category of patients.
This was indicated by the number of patients that reported to have been seen by a care provider such as a nurse before they started on their radiotherapy treatment. 76 percent of breast cancer patients reported to have been seen by a nurse. This is as compared to only 59 percent of lung cancer patients (McNamara 1999).
As far as gender is concerned, this study found that female patients tended to receive more support and information from the health care providers than their male counterparts. 81 percent of the female patients reported that they were seen often by a nurse. This is as compared to 53 percent of the male patients (McNamara 1999).
This gender disparity can be attributed to the fact that majority of the female respondents were suffering from breast cancer (63 percent of the female respondents). This is significant given the fact that the breast cancer patients were more likely to be seen by a nurse before the commencement of their radiotherapy sessions (McNamara 1999).
In summary, more than fifty percent of cancer patients, according to this study, need more information regarding their condition; information touching on their conditions diagnosis, treatment and prognosis. This summation is in line with the findings of similar studies carried out in the field.
For example, Anonymous (2010) found that more than 60 percent of patients with cancer lack information on their condition and the type and benefits of various forms of treatment that they can access.
Methodology of the Study
This study assumed a non-experimental descriptive design. This is given that the researcher needed a design that will enable them to describe the experiences of the patients as far as the amount of information and support they received before they started their radiotherapy treatment was concerned.
Given the aims and objectives of the study and the nature of data that was needed for it to be completed, the researcher used a self completed questionnaire as the tool for data collection. They justified this selection by claiming that the self completed questionnaires would allow for the systematic assessment of the opinions and views of the respondents.
To come up with the contents of the questionnaire, the researcher carried out informal observations and conversations with patients and care providers in the cancer wards of the hospital within which the study was to be conducted. The findings of these informal conversations and observations formed the basis of the questions that were included in the questionnaire.
The researcher had to design their own questionnaire for this study given the fact that they were unable to find a suitable questionnaire design from the literature review that they carried out prior to the designing of the questionnaire.
A pilot study was carried out to fine tune the questions and design of the questionnaire. The findings of the pilot study led to minor adjustments to the initial questionnaire.
A number of patients were sampled from the records obtained from the hospital’s oncology department. The researcher selected those patients that had been diagnosed with cancer and they were set to begin their first radiotherapy treatment sessions.
A large number of patients were selected for this study given the fact that the researcher was to rely on the respondents’ self completion of the questionnaire and returning it to the researcher. The researcher was aware that not all the respondents who received the questionnaire will complete it. This is especially so given the fact that they were not been compensated for their troubles in completing the questionnaire.
The data from the completed questionnaires was sorted out using the Microsoft Excel 5 for Windows Analysis Toolpack. This program was important in this study given that it was able to calculate values and create charts from the raw data. As such, the researcher was able to make sense from raw data that meant little in its raw form (McNamara 1999).
The methodology design for this study is justifiable under the circumstances of the study. Given that the investigator was interested in opinions of patients who are yet to experience radiotherapy treatment, it was justifiable to exclude those patients who have undergone radiotherapy in the past.
This is because their responses will be affected by their past experiences. A non-experimental descriptive design is justifiable given that the researcher needed the opinions of the respondents.
Significance of this Article to the Current Study
The major aim of the current study is to explore the existence of support services for radiotherapy patients. This is together to finding out how these services are advertised to the target audience. Given this, the findings of the study reported in this article are significant to the current study.
The reported study highlights the kind of information that cancer patients who are yet to undergo radiotherapy need. This is compared to the actual quantity and quality of information that the patients receive. It is important to note that, as much as information required by the patients and the services that they receive are two different entities, they are also related to some extent.
This is given the fact that the information provided to the patients can be viewed as part of the support services package needed by the patients, at least within the context of the current study.
The findings of the current will, among other things, inform stakeholders in the health care profession when it comes to formulating the contents of advertisements aimed at publicizing the availability of support services for radiotherapy patients.
As such, the findings of McNamara’s study (1999) as reported in this study will go a long way in providing the current investigator with information touching on the informational needs of cancer patients.
However, the significance of McNamara’s study to this current area of research is limited by the limited nature of McNamara’s study. For example, McNamara limits their study to cancer patients who are yet to receive radiotherapy treatment.
As such, the opinions of patients who are already undergoing radiotherapy are left out. This makes hard to gauge the needs of these patients from the findings reported in this article. This is despite the fact that it is equally important to cater for the informational and other forms of needs for patients who are already undergoing radiotherapy treatment.
The McNamara study as reported in this article is also limited to cancer patients alone. This is despite the fact that there are other categories of patients that benefit from radiotherapy. The needs of these patients are not captured in this study. It is important to note that these other categories of patients have needs that should be catered for when it comes to advertising for radiotherapy support services.
What Information Patients with Localised Prostate Cancer Hear and Understand, McGregor Sandra, 2003
Preamble
This study was carried out in the year 2002, but the findings were published in the year 2003. The findings were published in the Patient Education and Counselling journal in the year 2003. The article that is been reviewed in this paper reports the findings of this study.
In the introduction part of the article, McGregor (2003) notes that there are different treatment options that are available to the patients suffering from prostate cancer. This includes radiotherapy, chemotherapy and surgery.
However, McGregor notes that several factors inform the ability of the patient to make decisions regarding these options and to pick and adopt one of them. One of such factor is the provision of information to the patient by the doctor (McGregor 2003).
The information provided by the doctor will help the patient in making the decision regarding their mode of treatment. The patient will be able to make a decision that appropriate to their needs and lifestyle.
However, McGregor (2003) notes that the quality of information that is provided by the doctor is equally significant to the decisions that are made by the patients. The information provided by the doctor, for it to be effective, must be information that the patients can understand and remember.
The study used a sample of patients with localised prostate cancer. This means that those patients suffering from prostate cancer that has spread to other organs and part of their body were not included in the study.
McGregor (2003) used a small sample of respondents (N=10). These were those men that had already been diagnosed with prostate cancer, but had not been treated for early stage disease. This study is even narrower than the McNamara study that was reviewed above.
While McNamara (1999) used a fairly large sample of 199 respondents, McGregor (2003) used ten. Whereas McNamara studied cancer patients at large, including women, McGregor (2003) limits himself to prostate cancer only, and his sample is entirely composed of men.
A semi structured interview was used to collect data for the study. This is as opposed to the self completed questionnaire that was used by McNamara (1999). The major aim of the interview was to gauge the knowledge of the respondents regarding their disease and treatment models available. It was found that most of the patients were not informed about the rationale behind the selection of their mode of treatment.
They left the decision to their urologists, and more often than not, went with the decisions made by these urologists. They never asked for clarifications, and their doctors did not find the need to provide them with information (Grahn 1996: Gotay 2005: Agar 2006).
Majority of the patients (80 percent) reported that they did not believe or feel that the mode of treatment selected by their doctor was not the best for them. They cited several factors, such as the incompatibility of the mode of treatment with their lifestyle (McGregor 2003).
Contents of the Article
The major aim of this study is one of the contents reported in this article. The aim of this study, as reported in this article, was to find out what the respondents recalled and comprehended as far as their disease is concerned. These were issues such as the management of their condition and the side effects that this condition had on their lives and their health in general.
McGregor (2003) collected the information from the semi structured interviews in such a way that a video could be developed, a video documenting the various attributes of the disease and the various management and treatment options that are there for the patients (Bell 67).
McGregor (2003) is of the view that the personal and interpersonal characteristics of both the patient and their doctor are instrumental. This is given the fact that this can affect the quality of communication between the two parties (Bell 68). For example, the traits of the patient and the doctor can either improve or inhibit the passage of various messages between the patient and the doctor (Wilkinson 1991: Gotay 2005).
Comprehension of the information exchanged between the patient and the doctor is usually pegged on the way the information is passed across. This means that the perceptions and attitudes that the patients hold regarding the attitude and mannerism of their doctor impacts on their understanding and retention of the information passed across (Greenhalgh 8).
The study found that most of the respondents could not recall major events in their disease’s history. For example, only 2 men out of the total ten could recall the exact date that they were diagnosed with the condition (McGregor 2003).
It was also found that many of the men could not name the procedures that they underwent with their urologist when they went for regular check up to manage their conditions (Greenhalgh 9).
This is an indication of the fact that the doctors did not find it important to inform their patients about the nature of the procedures that they were undergoing. For example, 8 men could describe the procedures that they were been taken through but were not aware of the name of the procedure (McGregor 2003).
All of the respondents could remember undergoing regular blood checks when they visited their urologists. Five of those men could quote their exact PSA levels as they were reported by their doctors. The rest never reported about these readings since their doctors did not give them out. In fact, one of the respondents reported that they were reproached by their doctor for asking about the exact reading of their PSA levels (McGregor 2003).
Methodology of the Study
As earlier indicated in this paper, this study used a sample of ten men who had been diagnosed with localised prostate cancer. Just like in McNamara’s study, the sample was drawn from patients who have not yet started on their treatment (McNamara 1999). The researcher used purposive sampling, where they asked urologists to refer them to their patients who had been diagnosed with the disease within the last three months (Holiday 27).
This methodology was justified given the fact that the researcher was interested in those patients that had not yet started their treatment. The researcher recorded the interviews and transcribed them verbatim. The aim was to capture the exact responses of the subjects.
The researcher complemented this by recording on their notebooks their opinions regarding what they observed, for example the mental state of their respondents during the interview.
The same number of questions was posed to the respondents. The interview duration was however varied, depending on the time that each respondent took to answer the questions that were posed to them. The length of the interviews usually varied from 0.5 hours to 3.5 hours (McGregor 2003).
Significance of the Article to the Current Study
The findings of the study reported in this article are significant to the current study that is being conducted by this researcher. For example, the findings of McGregor study touching on the kind of information that the respondents need from their health care providers will go along way in informing the contents of the advertisements for support services aimed at radiotherapy patients (Holiday 56).
The findings of McGregor’s study will also provide this researcher with information regarding the needs of prostate cancer patients. These findings will also be very instrumental in the researcher’s formulation of the kind of relationship between the doctor and the patient that will be beneficial to the treatment and management of chronic conditions.
However, just like in the case of McNamara study, the significance of this study to the current one is also limited. For example, the study used a small sample size, and as such can not be generalised to the whole community of radiotherapy patients with confidence. The study also limited itself to prostate cancer patients, and as such can not be generalised confidently.
Conclusion
This literature review critically analysed the findings of two studies reported in two different articles. The researcher looked at the contents of these studies and how their findings are related to the current study. It was found that the findings of these two studies were significant to the current study.
However, the significance was limited by the limited nature of the studies. For example, the studies were limited to the case of cancer patients alone. The studies were also limited to the informational and other forms of needs that are experienced by patients that have not yet started their treatment sessions.
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