Cancer patients’ expectations regarding empowering knowledge and nurse advocacy in Finland and Spain

Abstract

Introduction: Cancer patients are not a homogenous group with the same information needs, but rather a vast range of individuals with different backgrounds, needs, life situations, and stressors. The patients’ knowledge and self-
determination expectations vary during illness trajectory, and they may need counseling by a nurse as patient advocate. Therefore, counseling of cancer patients should be seen as a process aimed at providing the patients with empowering information.

Aim: This study aims to explicate adult cancer patients’ expectations regarding empowering knowledge and counseling nurse advocacy in relation to the significant demographical, situational and clinical factors that affect these expectations during the illness trajectory. Furthermore the aim is to describe the possible differences between two culturally different settings, i.e. northern and southern Europe.

Methods: A survey was conducted using the Expected Knowledge of Hospital Patients® instrument, accompanied by self-determination, advocacy and empowerment related questions, among informants recruited from two university hospitals in Finland (n = 332) and one university hospital in Spain (n = 483).

Results: Several demographical, situational and clinical factors such as age, educational background, actual clinical symptoms and perceived emotional distress of the patient correlated statistically significantly with the knowledge and advocacy expectations. In both datasets, the bio-physiological knowledge represented the most highly expected knowledge domain, and knowledge about social issues or economic matters the least expected domains. Spanish informants had higher knowledge expectations in all sum variables and a higher need for counseling advocacy than Finnish informants. Despite that, the Spanish informants showed slightly higher perceived empowerment in self-determination and advocacy than the Finnish informants.

Conclusions: Patient education in oncologic context should be based on a continuous analysis of patients’ emotional distress and clinical symptoms instead of routine praxis. Therefore, a patient-centered approach to education should be structured and applied to make sure that patients are fully informed about their condition and treatment options and to ensure that patients feel respected in the clinical encounter.