Department of Medicine (Hematology & Oncology), UCLA School of Medicine, Los Angeles, CA, USA.
200 UCLA Medical Plaza, Suite 120, Los Angeles, CA, 90095, USA.
J Cancer Educ. 2022 Oct;37(5):1479-1485. doi: 10.1007/s13187-021-01987-3. Epub 2021 Mar 24.
Physicians are encouraged to communicate with their patients about financial concerns, but are infrequently taught skills necessary to do so. This study describes a curriculum for oncology fellows aimed to improve skills of cost-health literacy, and provides assessment of the curriculum impact on self-perceived cost communication practices. Oncology fellows at a large academic program in 2019 participated in a cost-health literacy curriculum over 3 months. The curriculum consisted of a didactic on financial toxicity (45 min), a problem-based learning case highlighting financial toxicity risk factors and areas for intervention (30 min), and a group discussion (30 min) to review and consolidate strategies to navigate financial toxicity in direct patient care. A cost-health literacy survey was administered at baseline and at the conclusion of the curriculum to evaluate the impact of the program. Of 19 participants, 16 completed both the pre-survey and post-survey and were included in the analysis. After the intervention, participants were more likely to report comfort discussing out-of-pocket costs (50% vs. 19%, p = 0.002) and to feel they could help a patient experiencing financial toxicity (62% vs. 6%, p = 0.005). There was no improvement in the subjective assessment of patient financial distress (57% v 50%, p = 0.759). Oncology fellows can improve self-reported cost-health literacy skills through participation in a targeted, brief curriculum. Further studies are warranted to determine how this approach can be applied in other settings and if it objectively impacts cost communication practices.
鼓励医生与患者就财务问题进行沟通，但很少教授他们进行此类沟通所需的技能。本研究描述了一项针对肿瘤学研究员的课程，旨在提高成本健康素养技能，并评估该课程对自我感知成本沟通实践的影响。2019 年，在一个大型学术项目中，肿瘤学研究员参加了为期 3 个月的成本健康素养课程。该课程包括一个关于财务毒性的讲座（45 分钟）、一个强调财务毒性危险因素和干预领域的基于问题的学习案例（30 分钟），以及一个小组讨论（30 分钟），以审查和巩固在直接患者护理中应对财务毒性的策略。在课程开始前和结束时，我们使用成本健康素养调查来评估该计划的影响。在 19 名参与者中，有 16 名完成了前测和后测，并纳入了分析。干预后，参与者更有可能报告在讨论自付费用时感到舒适（50%对 19%，p = 0.002），并认为他们可以帮助正在经历财务毒性的患者（62%对 6%，p = 0.005）。然而，患者经济困境的主观评估并没有改善（57%对 50%，p = 0.759）。肿瘤学研究员可以通过参与有针对性的简短课程来提高自我报告的成本健康素养技能。需要进一步的研究来确定如何将这种方法应用于其他环境，以及它是否会客观地影响成本沟通实践。
