Visual aids for communicating cancer treatment paths: A questionnaire study

Abstract

AbstractObjectivesTo evaluate legibility, comprehension, and clinical usability of visual aids to communicate cancer treatment paths.DesignQuestionnaire study. Two open-label, cross-sectional questionnaires, a single-centered, patient questionnaire.SettingTwo online questionnaires, one in-person questionnaire (patients with haematological neoplasms at the University Hospital Dresden, Germany).ParticipantsOnline questionnaires included 306 and 160 participants respectively (18 to >60 yrs). Clinical evaluation included 30 patients (44 to 72 yrs), 11 were re-surveyed, 24 responses from attending physicians.Main Outcome MeasuresParticipants ability to understand cancer treatment paths with audio information, or supplemented with two formats of visual aids; to comprehend visual representations for key treatment terms; patients ability to understand and recall their cancer treatment path.ResultsVisual aids, pictogram- or text-based, significantly improved participants response quality (mean response quality 0.81 pictogram/0.84 text, audio: 0.68, p< 0.001), increased response confidence (mean confidence 0.84 pictogram/0.86 text, audio: 0.66, p< 0.001), and information was rated higher (mean information quality rating 0.85 pictogram/0.82 text, audio: 0.71, p< 0.001). In the visual aids, key terms were encoded with visual representations. 7/8 terms were comprehensible as pictograms (>85% transparency), fewer when encoded as comics or photos (5/8 and 4/8 >85% transparency). Comprehensibility is term-specific, i.e., no pictogram tested significantly more understandable than comic, 3 were more comprehensible than photos (p < 0.001). In clinical questionnaires, patients were able to comprehend information about treatment paths (mean response quality 0.82) and recall this (mean response quality 0.71 after several weeks). Patients (n=30) and physicians (n=24) rated the visual aids as very or partially helpful.ConclusionsVisual aids to communicate cancer treatment path information are legible and increase short- and long-term comprehension. Patients and physicians welcome integration of visual aids to supplement communication about cancer treatments.Ethics reviewPatient interviews were reviewed by TU Dresden ethics board (BO-EK-338072022).