Patient-Held Logbooks for Cancer Care Treatment at a Rural Hospital: A Contribution to Patient-Centred Social Practice

Background/Purpose: Clinical management is one of the most important factors in health care. Traditionally, it is under strict supervision of health professionals and the patient’s role is marginalised. Research in Critical Discourse Analysis has shown that effective management needs to address the issue of patient empowerment. Patient-held records, when developed and designed effectively have the propensity to improve engagement, cooperation and communication between health care providers and patients. They aid clinical governance and have been shown to improve patient confidence and satisfaction as they seek and receive care. Our research on patient-held logbooks aims to provide evidence in support of the patient-centred approach to healthcare management and better communication between health professionals in cancer treatment.

Methods: A mixed-method exploratory study conducted 12-week post distribution of logbooks to patients undertaking cancer care. Data was gathered through questionnaires returned by 66 participants (response rate of 57.4%) and interviews with five clinical oncology nurses at a rural hospital. Frequencies and proportions were used to describe collected data from the questionnaires. Critical Discourse Analysis in combination of thematic analysis was used as a qualitative research approach to analyse texts in the interviews and open question of the questionnaires. Different themes in terms of discourses or phenomenology were identified from data analysis.

Results: The general effectiveness of the patient logbook was assessed based on its usefulness, usability, efficiency and satisfaction. The logbook was considered useful among 63 (95.1%) participants. They acknowledged the logbook enabled them to be better informed, created a feeling of empowerment and greater control over their medical condition. From the Critical Discourse Analysis perspective, the feedback to the logbook can be interpreted in terms of social practice with four emerging discourses: social control, privacy, trust and collaborative communication.

Conclusion: The evaluation generated rich, in-depth information and provided useful insights into the general quality and usefulness of the logbook for cancer care. As a whole, the findings signalled a welcome reaction toward the introduction of the logbook and this general positive attitude is expected to translate itself into a more active and dedicated commitment towards its adoption in the future.