Person-centered education – II: improving knowledge level of colorectal cancer patients through education

Main Article Content

M. Elisa Castro-Peraza
Nieves Lorenzo-Rocha
Angeles Arias-Rodriguez
Kirsi Johansson
Vincente Medina-Arana
Inmaculada Sosa-Alvarez
Encarnacion Garzon-Rodriguez
M. Remedios Afonso-Martin


diagnosis. Written education materials often provide useful support from professionals to patients and family. This study aims to test the assertions that: a) patients are more knowledgeable and certain about care issues related to colorectal cancer using InfoCRCBook (a book with specific information on CRC) and b) knowledge acquisition is related to socio-demographic variables.Methods: Two-groups intervention study. One group received InfoCRCBook and the other non-systematic orally-delivered education. Data were collected using a structured questionnaire guided by an interview. CRC patients on a waiting list for colorectal surgery were eligible for inclusion in the study. The main outcome is knowledge level.Results: The sample consisted of 151 patients. According to socio-demographic variables, gender was not related to knowledge level. Age and schooling were, however, significantly related (p<0.001). The analysis of interactions among variables showed that educational level and the use of the InfoCRCBook explained 72.6% of the knowledge level. Age as a covariate did not affect this relationship.Discussion: The results showed, at all academic levels, that patients increased their knowledge using InfoCRCBook, but mainly at a lower educational level.Conclusion: Pre-operative education using the InfoCRCBook is more effective than standard non-systematic orally-delivered education in all ages, gender and levels of education. The acquired knowledge affects not only the management of the illness, but extends additionally to areas such as living a healthier lifestyle and a greater awareness of the role and concerns of the family. The results of this study are advanced as important in identifying populations at risk and in increasing early diagnosis.

Article Details

Regular Articles


IARC. (2008). World Cancer Report 2008. Retrieved 21st February 2012 from

Viñesa, J.J., Ardanaz, E., Arrazola, A. & Gaminde, I. (2003). Epidemiología clínica del cáncer colorrectal: la detección precoz. Cirugia Española 73 (1) 2-8.

Jefford, M., Gibbs, A. & Reading, D. (2005). Development and evaluation of an information booklet/decision-making guide for patients with colorectal cancer considering therapy in addition to surgery. European Journal of Cancer Care 14 (1) 16-27.

Rozmovits, L., Rose, P. & Ziebland, S. (2004). In the absence of evidence, who chooses?. A qualitative study of patients' needs after treatment for colorectal cancer. Journal of Health Services Research and Policy 9 (3) 159-164.

Baldwin, C.M., Grant, M., Wendel, C., Hornbook, M.C., Herrington, L.J., McMullen, C. & Krouse, R.S. (2009). Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies. Journal of Clinical Sleep Medicine 5 (4) 335-343.

Holmstrom, I. & Roing, M. (2010). The relation between patient-centeredness and patient empowerment: a discussion on concepts. Patient Education and Counseling 79 (2) 167-172.

Balint, E. (1969). The possibilities of patient-centred medicine. Journal of the Royal College of General Practitioners 17, 269-276.

Coulter, A. (1999). Paternalism or partnership? Patients have grown up and there's no going back. British Medical Journal 319 (7212) 719-720.

Johansson, K. (2006). Empowering orthopaedic patients through education. Doctoral Thesis. Turku University.

Johansson, K., Hupli, M. & Salantera, S. (2002). Patients' learning needs after hip arthroplasty. Journal of Clinical Nursing 11, 634-639.

Anderson, R.M. & Funnell, M.M. (2000). Compliance and adherence are dysfunctional concepts in diabetes care. Diabetes Educator 26, 597-604.

Tsay, S.L. & Hung, Lo. (2004). Empowerment of patients with end-stage renal disease -a randomised controlled trial. International Journal of Nursing Studies 41, 59-65.

Johansson, K., Nuutila, L.M., Virtanen, H., Katajisto, J. & Salantera, S. (2005). Preoperative education for orthopedic patients: systematic review. Journal of Advanced Nursing 50, 212-223.

Suhonen, R. & Leino-Kilpi, H. (2006). Adult surgical patients and the information provided to them by nurses: A literature review. Patient Education and Counseling 61, 5-15.

Collingswoth, S., Gould, D. & Wainwright, S.P. (1997). Patient self-administration of medication: a review of the literature. International Journal of Nursing Studies 34, 256-269.

Gibson, P.G., Coughlan, J., Wilson, A.J., Abramson, M., Bauman, A. & Hensley, M.J. (2000). Self-management education and regular practitioner review of adults with asthma (Cochrane Review). In the Cochrane Library, Issue 4: Update Software 2000.

Grimssom, S.P. & Dunagan, L. (2001). Improved Satisfaction during rehabilitation after hip and knee arthroplasty: a retrospective analysis. American Journal of Physical Medicine and Rehabilitation 80, 798-803.

Johansson, K., Salanterä, S., Katajisto, J. & Leino-Kilpi, H. (2004). Written orthopedic patient education materials from the point of view of empowerment by education. Patient Education and Counseling 52 (2) 175-181.

Mumford, M.E. (1997). A descriptive study of the readability of patient information leaflets designed by nurses. Journal of Advanced Nursing 26, 985-991.

Foltz, A. & Sullivan, J. (1998). Get clear: clinical testing of patients' reading abilities. Cancer Nursing 21, 162-166.

Bernier, J.M. (1996). Establishing the psychometric properties of a scale for evaluating quality in printed educational materials. Patient Education and Counseling 29, 283-299.

Teasdale, K. (1998). Empowering patients to self-advocate. Advocacy in Health Care. Bodmin: MPG Books Ltd.

Shuldham, C. (1999). A review of the impact of pre-operative education on recovery from surgery. International Journal of Nursing Studies 36 (2) 171-177.

Martin, C. & Turkelson, S. (2006). Nursing Care of the Patient Undergoing Coronary Artery Bypass Grafting. Journal of Cardiovascular Nursing 21 (2) 109-117.

Díez-Álvarez, E., Arrospide, A., Mar, J., Alvarez, U., Belaustegi, A., Lizaur, B., Larrañaga, A. & Arana, J.M. (2012). Effectiveness of pre-operative education in reducing anxiety in surgical patients. Enfermedades Infecciosas y Microbiologia Clínica 22, 18-26.

Lauerman, C. (2008). Surgical patient education related to smoking. AORN Journal 87 (3) 599-609.

Miles, A. & Mezzich, J.E. (2011). The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice. International Journal of Person Centered Medicine 1 (2) 207-222.

Miles, A. & Mezzich, J.E. (2012). Person-centered medicine: addressing chronic illness and promoting future health. International Journal of Person Centered Medicine 2 (2) 149-152.