title: Health literacy, communication, and treatment decision-making in older cancer patients.
abstract: Inadequate health literacy and physician-patient communication are associated with poor health outcomes and appear to limit quality of medical decision-making. This review presents and consolidates data concerning health literacy, physician-patient communication, and their impact on medical treatment decisions in elderly cancer patients. This population faces increasingly complex management options, cognitive and sensory deficits, and intergenerational barriers. As a result of these and other factors, older cancer patients have among the lowest health literacy and numeracy rates and often suffer from suboptimal physician-patient communication. These deficiencies impair elderly cancer patients' ability to understand, recall, and act upon information concerning treatment risk and benefit. This situation also makes it difficult for patients to have self-confidence in communicating with their provider and sharing in the decision-making. Moreover, since older cancer patients usually bring a companion to medical appointments, the positive and negative role of a companion in the context of communication and decision-making needs to be considered. Future research should center on developing ways to identify and overcome health communication barriers to improve geriatric cancer care.
authors.affiliation: UCLA Geriatric Oncology Training Program, University of California, Los Angeles David Geffen School of Medicine, Division of Hematology-Oncology, Los Angeles, California 90095, USA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Amalraj
authors.forename: Chelsea
authors.initials: C
authors.lastname: Starkweather
authors.forename: Christopher
authors.initials: C
authors.lastname: Nguyen
authors.forename: Arash
authors.initials: A
authors.lastname: Naeim
mesh_terms: D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D003144:Communication Barriers; D032882:Comprehension; D003657:Decision Making; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006299:Health Services for the Aged; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D010353:Patient Education as Topic; D010358:Patient Participation; D018579:Patient Selection; D010817:Physician-Patient Relations; D011379:Prognosis