Background
Methods
Design
Recruitment
Data collection
Data processing
Data analysis
Results
ID | Sex | Age [years] | Profession | Professional experience in oncology [years] | Type of institution | Discussed PVG | |
---|---|---|---|---|---|---|---|
1 | Female | 71 | Psycho-oncologist | 23 | Medical practice | Breast cancer, metastasized | |
2 | Female | 45 | Physician | 12 | Clinic (certification) | Breast cancer, metastasized | |
3 | Female | 43 | Physiotherapist | 16 | Clinic (certification) | Breast cancer, metastasized | |
4 | Male | 54 | Physician | 26 | Clinic (no certification) | Prostate cancer, metastasized | |
5 | Female | 51 | Psycho-oncologist | 5 | Medical practice | Kidney cancer, metastasized | |
6 | Male | 61 | Psycho-oncologist | 10 | Medical practice | Breast cancer, metastasized | |
7 | Female | 58 | Psycho-oncologist | 5 | Clinic (certification) | Colon cancer, early | |
8 | Female | 62 | Psycho-oncologist | 15 | Medical practice | Breast cancer, metastasized | |
9 | Female | 60 | Psycho-oncologist | 20 | Clinic (no certification) | Supportive therapy | |
10 | Female | 53 | Psycho-oncologist | 2 | Clinic (certification) | Psycho-oncology | |
11 | Female | 60 | Nurse/medical assistant | 31 | Clinic (certification) | Prostate cancer, early | |
12 | Male | 33 | Physician | n.i. | Medical practice | Prostate cancer, early | |
13 | Female | 57 | Nurse/medical assistant | 9 | Clinic (certification) | Breast cancer, metastasized | |
14 | Female | 33 | Nurse/medical assistant | 12 | Clinic (certification) | Breast cancer, metastasized | |
15 | Male | 34 | Psycho-oncologist | 7 | Clinic (certification) | Psycho-oncology | |
16 | Female | 59 | Physician | 22 | Clinic (certification) | Supportive therapy | |
17 | Male | 42 | Psycho-oncologist | 14 | Clinic (certification) | Prostate cancer, metastasized | |
18 | Male | 47 | Physician | 16 | Clinic (no certification) | Supportive therapy | |
19 | Female | 42 | Nurse/medical assistant | 21 | Clinic (certification) | Colon cancer, early | |
20 | Female | 56 | Nurse/medical assistant | 3 | Clinic (certification) | Supportive therapy |
Impact on healthcare
‘So from a psycho-oncological point of view, I would say it can really give security because it gives clarity and information’. (ID05)‘I believe that just as it is now, it is very helpful for […] the patient. […] If the spouse reads it, the girlfriend, whatever. Who then simply has this knowledge, in order to act as a stable person, vicariously convey hope, confidence […]’. (ID06)
‘And I believe that people can’t even formulate what information they need. Because it doesn’t occur to them that they have to lie in bed and vomit, and you’ve forgotten to put a spit bag in front of them. (…) They cannot demand this information. And this information is missing.’ (ID03).
‘And that’s such an overload of information that I think it’s sometimes too much for the condition the patients are in at the time.’ (ID03).
‘But if the patient who arrives with the guideline and says, “Now you have to do this and this”, it can lead to a problematic relationship’. (ID15)
Dissemination
‘What I think makes it difficult, is that they [PVGs] are little known. At least in my experience few people know about them’. (ID02)
‘When a 60-year-old with a high degree of language barrier comes to me, I don’t hand him a guideline [PVG]. In addition, there are patients who […] don’t have the, let’s say, intelligence […] to be able to deal with such information’. (ID12)
‘When the diagnosis is made […]. Especially in the beginning, they [patients] need a lot of information and sometimes want to know a lot’. (ID14)
Other topics
Code | Sub-code(s) | Aspects Perceived As Positive (\( \uparrow \)) And Negative (\( \downarrow \)) | Quotes | Suggestion for Improvement |
---|---|---|---|---|
Design & Format | Layout, colours, presentation text | \( \uparrow \) Friendly layout and colours | ‘So I think the design is good. I think it’s friendly and clear’. (ID14) | More vivid colours and visuals to enliven the text |
\( \downarrow \) Monotonous (a lot of text, pastel colours) | ‘So the size of the text is not too small, I don’t think so. But it’s a lot of text’. (ID05) ‘[…] I have the impression that it could be depicted a bit more vividly, so that it doesn’t look completely uniform’. (ID09) | |||
Graphics, Structure and Info Boxes | \( \uparrow \) Clear and comprehensible graphics \( \uparrow \) Clear structure of content \( \uparrow \) Info boxes as a preparation for physician–patient-talks | ‘And I believe, […] that if patients have the possibility to read things again or to understand them again on the basis of the graphics, some of which are very successful, or maybe even come to the conclusion, oh, I didn’t even ask that, I would perhaps like to ask that again, then that would probably be a super helpful tool’. (ID02) | No suggestions for improvement based on mainly positive opinions | |
Volume (number of pages) | \( \uparrow \) Volume shows importance | ‘[…] I think it shows patients that they are taken seriously. […] People want patients to know what disease they have, what options they have, who can support them’. (ID05) | Individual formats (e.g. chapters in separate brochures, unlock chapters step-by-step in online formats) | |
\( \downarrow \) Majority: Overwhelming volume | ‘Well, I’m talking about the volume. They [the patients] panic when I show them such bulky brochures’. (ID20) | |||
Format | \( \uparrow \) Participants prefer brochure-format \( \uparrow \) Age might be a factor in preference, as younger patients might prefer PDF and older patients print | ‘We can put something directly in the patient’s hand. This is a slightly more direct way than just giving them the link’. (ID16) | ||
PDF \( \downarrow \) Limited access (problematic for patients without Internet access or those with little experience) \( \downarrow \) Reading on screen may be exhausting because patients experience fatigue during treatment | ‘In rural areas we have the patient groups, let’s say […] 65 years old and upwards […], who are not familiar with social media or Internet […]’. (ID19) | |||
Comprehensibility | Wording | \( \uparrow \) Plain and objective language \( \uparrow \) Restricted use of medical words | ‘In my opinion a lot of effort is being made to use plain language in order to make it understandable for laypeople. That means to use as few foreign medical words as possible […]’. (ID16) | Wording of ‘Patientenleitlinie’ (PVG) Patient information brochure |
\( \downarrow \) Wording ‘Patientenleitlinie’(PVG): does not amplify the original meaning of PVGs | ‘So, I think it’s good because it’s called patient guideline. […] However, a patient information brochure sometimes hits it a little bit better’. (ID04) | |||
Recommendations | \( \uparrow \) Italic font in text | ‘[…] They [recommendations] are written in italics and if I remember correctly, it also says somewhere in the introduction how they are linked to the CPG’. (ID01) | Put recommendations in bold print | |
\( \downarrow \) Difference in grading may be hard for patients to understand \( \downarrow \) Hard to remember the definition of recommendations \( \downarrow \) Italic font | ‘But I think that not all patients on page 40, when it says “should”, still know what that means. I know that because I am used to reading long texts’. (ID03) ‘But in italics, now I see it. It’s down there, yes. Doesn’t stand out so much’. (ID04) | |||
Content | Saturation of information | \( \uparrow \) Most important aspects | ‘So in terms of content, I think it’s very, very good’. (ID04) | Living PVGs to bring information up to date |
\( \downarrow \) Missing content: information about self-care (e.g. breathing exercises), effects of sport exercises, treatment options for nausea, skin care, complementary medicine, information about long-term effects of treatments \( \downarrow \) Not up to date (especially with regard to medications) | ‘What breathing exercises can I do to relax myself when I notice that panic comes up just before the examination. Or when I get the results of the laboratory examination, how can I calm myself down now? These are very simple, concrete techniques that can be experienced’. (ID06) ‘But wait, if they want the latest information, so to speak, then PVGs [are] not the first choice’. (ID15) | |||
Trust | In Content | \( \uparrow \) Overall trust in content \( \uparrow \) Recommend PVGs to patients, family and friends | ‘Since the PVG provides information from the CPG in common language, I find it [PVG] incredibly trustworthy’ (ID15) ‘I could well imagine that I will recommend this [PVG] to patients more often.’ (ID19) | |
\( \downarrow \) Information on certain topics is not up to date (e.g. medications) \( \downarrow \) Knowledge about methodical process in developing PVGs results in perceived inadequate content (e.g. complementary medicine) | ‘So the fact that I know which criteria have to be fulfilled so that they can be evidence-based at all, I am differentiated. Because I think many things do not have the chance to be validated due to such narrow criteria […]’. (ID03) |