Effectiveness of a Health Literacy Promotion Program for Breast Cancer Patients Using Complementary and Alternative Medicine

Abstract

Breast cancer is a major problem for women around the world and a serious public health problem in Thailand. At present, complementary and alternative medicine (CAM) is a preferred alternative for breast cancer patients in Thailand. Therefore, it is imperative to promote health literacy about alternative therapies for patients to use a knowledge base for making smart informed healthcare decisions.

This study was quasi-experimental research, with an experimental group and a comparison group and pretest-posttest measurements. The purpose of this study was to assess the effectiveness of a health literacy promotion program for breast cancer patients using CAM. The subjects were selected by using a purposive sampling method. The participants included 64 patients with breast cancer; they were divided into two groups: 32 patients were in the experimental group and 32 patients were in the comparison group. The experimental group received a health literacy promotion program in using CAM with a duration of 12 weeks. The researcher developed a concept of health literacy from Nutbeam, which consisted of accessing, understanding and analyzing information, and using CAM decisions based on active learning methods, including lectures, discussions, game playing, question and answer sessions and brainstorming. Data were collected regarding the CAM health literacy promotion program and the health literacy test in using CAM. Questionnaire content was validated by three experts for reliability with Cronbach’s alpha coefficient of 0.86. Data were analyzed and presented by descriptive statistics, paired t-test, and the independent 2 sample t-test.

The mean scores of overall health literacy of using alternative and complementary medicine in the experimental group were 7.09 and 9.90 at pretest and posttest, compared with 7.14 and 7.18 in the comparison group, with 95% CI of the difference in health literacy score in using alternative and complementary medicines at posttest compared with pretest. In the experimental group and the comparison group, the values ​​were 2.08 – 3.36 and -0.47 – 0.39 respectively (p < 0.001). Moreover, with regards to access to CAM information, knowledge, and media literacy on using alternative and complementary medicine, the results showed that the experimental group was significantly higher than the comparison group (p < 0.001, p = 0.018 and p = 0.002 respectively).

Therefore, we recommend that health care teams utilize the findings from this research to manipulate and promote health literacy promotion programs among breast cancer patients, in order to enable patients to access information related to CAM. Moreover, communication between nurses and breast cancer patients should be established, to develop expertise for knowledge using CAM as well as to develop effective sources of information related to CAM.