The Impact of Patient Education in Oncology/Hematology Care: Empowering Patients in Their Battle Against Cancer

By: Yvette C. Terrie, BS Pharm, RPh, Consultant Pharmacist

As health care providers, we all strive to deliver the best quality of care to our patients and the heroic efforts of health care providers has definitely been validated during the COVID-19 pandemic and their commitments to patient care are deeply appreciated. Cancer continues to be one of the leading causes of death both in the United States and worldwide. The importance of the dedicated care given by those health care providers in the oncology/hematology field cannot be overstated. According to the National Cancer Institute’s Surveillance, Epidemiology and End Results Program (SEER), in 2020, an estimated 1.8 million individuals will be diagnosed with cancer with an estimated 606,520 deaths in the United States.¹ A diagnosis of cancer is overwhelming and often patients feel as if their world has been turned upside down. After a patient receives a cancer diagnosis, health care providers have many opportunities to educate patients and their families regarding prognosis, treatments, chemotherapy safety, management of adverse effects as well as day to day life issues such as work, disability and insurance. Daily, the dedicated health care providers working in the oncology/hematology field help patients face the devastating effects and challenges of cancer and end of life issues. Advances in medicine enable them to also see patients improve overall survival rates and some patients even beat cancer. These committed health care providers treat the entire patient especially since the diagnosis of cancer impacts the patient both physically and psychologically.

Various publications have confirmed that patient education is a critical component of patient care especially in the care of patients with cancer because patient education empowers patients. Patient education also provides them with pertinent information that enables them to make informed decisions about their health. There is also evidence indicating that the more informed a patient is about the disease and treatment, the more comfortable that patient will be with care and these patients are also more likely to adhere to selected treatment regimens. In a recent publication, Wood et al emphasized the significance of empowering patients and caregivers by providing them with concise, consistent, and relevant education. They cited survey results that revealed five key areas for health care providers to expand consistency in educational delivery:²

• Individual learning needs assessment
• Educational delivery approach
• Resource standardization and availability
• Handoff between departments and disciplines
• Documentation of educational progress

Wood et al also noted that education resources should provide timely, consistent, and personalized information, using an array of teaching strategies tailored to individual patient needs.²

In an effort to gain a clearer understanding of the role of patient education in cancer care, several health care providers practicing in an oncology infusion center were asked about their views on the impact and need for patient education in cancer care.

• A chemotherapy/infusion RN stated, “Patient education is very important in patient care especially with regard to oncology patients because after all a diagnosis of cancer can be scary. Educating patients on their cancer diagnosis and care helps to calm patient’s fears of the unknown and increases their understanding. Educating patients allows for patients to make informed decisions and helps with compliance. Educating patients and their families helps the patients feel they are actively involved in their care and increases autonomy. Patient outcomes are more positive when patients and family members are informed about their chemotherapy regimens, side effects and restrictions if any.”
• A RN and cancer care navigator stated, “Education is very important in-patient care, especially in the area of oncology. As a cancer care nurse navigator, it is of utmost importance that the patient is educated about their disease, treatments, procedures, and follow-up in order to receive the best outcomes. Education fosters compliance, decreases anxiety and stress, builds trust as observed by working over thirty years as a registered nurse. The patient is not only educated about the physical expectations, but the emotional, psychosocial, financial, and spiritual elements are addressed. Education empowers the patient as well as the caregiver in knowing what to expect, what lies ahead in their treatment plans. For example, patients who acquire neutropenia, a decrease in the number of white blood cells should be educated about why this happens and what precautions should be taken. Patients who may encounter hair loss should be educated before this happens, to why this happens and how to address the issue if it is perceived as a barrier to positive patient outcomes. Education is ongoing in caring for the patient with cancer and it is one of the key factors in sustaining positive outcomes. The nurse is not only a nurturer in the health care arena he/she is an educator extraordinaire.”
• A hematology/oncology RN stated, “Patient care is very important for patient outcomes in a clinical field. Education helps patients make informed decisions about their care. When patients are more knowledgeable about their care and treatment options, they are better able to identify how the treatment will affect them and if it is the best option for them at that given time. In doing that, the providers and nursing staff need to issue informative material to help keep patients active in the education about their treatment. Making sure that this material is easy to read and understandable. When the patient is included in their care, it can give them a sense of autonomy and independence. Letting them know that they are still in charge of their care, this gives them a sense of self-worth.”
• An oncology LPN stated, “Patient education for oncology patients/caregivers is a very important component to health care treatment/plans. Educating patients/caregivers will aid in their ability to comply with treatment and help ease their anxiety while being treated. Patient education will also ensure quality of care with positive outcomes. Lastly education can prevent hospital readmission rates by not returning to the hospital for same health care issues.”

An oncology physician’s assistant stated, “Patient education is one of the clinician's most underutilized and underrated tools especially in cancer care. A cancer diagnosis yields a sense of uncertainty and helplessness in many patients. We as oncology PAs and NPs and other health care personnel have the ability to use patient education to empower patients to take some control of their cancer journey. We can help ease anxieties. It helps them better understand the plan and gives them focus. I believe it is of the utmost importance for providers to give patients as much education as possible about their condition, their symptoms and their treatment plan. I believe it improves patient outcomes when that stress of uncertainty of a cancer diagnosis is minimized via patient education.”

Conclusion

During my years of pharmacy practice, I had the opportunity to work at an oncology/hematology infusion center and quickly realized that the health care providers working in this field are truly special health care providers who are sometimes referred to as “Angels of Mercy” because of their awe-inspiring dedication to the care of patients as they face the difficult physical and emotional battle with cancer. I also had the privilege of seeing my sister dedicate her life to caring for her patients as a registered nurse and then as an oncology nurse practitioner for over 30 years and her commitment to providing quality care and patient education inspired other health care providers to do the same. Every day as patients bravely face their cancer battles, it is encouraging to know that there are oncology/hematology health care providers who are empowering their patients with knowledge about their cancer treatments and providing these patients with quality health care. The power and impact of patient education should never be underestimated. It is one of the best tools health care providers can use to improve patient care and offers hope to patients.

This article is dedicated in memory of my sister, Nicole who committed her life to the care of oncology patients and touched the lives of many individuals.  Her caring spirit and memory live on forever in the hearts of those who knew and love her.  THANK YOU also to her fellow co-workers at the Southeast Louisiana Veterans Healthcare System Hematology/Oncology Department for their daily commitments to providing quality care to their patients. Your professionalism, dedication, compassion, knowledge and care are greatly appreciated.

Yvette C. Terrie, Consultant Pharmacist, Medical Writer and creator of A Pharmacist’s Perspective (https://apharmacistsperspective.blogspot.com/ ).

References

1. Common Cancer Sites - Cancer Stat Facts. SEER website. https://seer.cancer.gov/statfacts/html/common.html. Accessed June 11, 2020.
2. Wood LS, Moldawer NP, Lewis C. Immune Checkpoint Inhibitor Therapy: Key Principles When Educating Patients. Clinical Journal of Oncology Nursing. https://cjon.ons.org/cjon/23/3/immune-checkpoint-inhibitor-therapy-key-principles-when-educating-patients. Published June 1, 2019. Accessed June 11, 2020.