Perspectives on Education From Gastrointestinal (GI) Cancer Patients in the Deep South: Qualitative Analysis

High-quality perioperative education for cancer patients undergoing surgery is associated with positive patient experiences and postoperative outcomes. Significant variations in the receipt and quality of education exist, and these gaps need to be better understood. We aimed to explore facilitators and barriers to high-quality education from a cohort of gastrointestinal (GI) cancer patients.

This qualitative study is part of the Advancing Surgical Cancer Care and Equity in the Deep South (ASCENDS) study. Participants were English-speaking adults (> 18-years old) from Alabama and Mississippi diagnosed with stage I-III colorectal, pancreatic, or esophageal cancer from 2018 to 2021. Individual semi-structured interviews focused on identifying facilitators and barriers to cancer surgical care including those related to patients' education across the surgery process. Data were analyzed using inductive thematic and content analysis with NVivo 12.6 Plus.

Of 36 GI cancer patients (19 colorectal, 10 esophageal, and 7 pancreatic) interviewed, most underwent surgery (n = 31, 86.1%); ages ranged from 44 to 87 years, 42% were female, and 30% identified as Black. Patients emphasized clear delivery of instructions as a major facilitator across the three surgical phases. A facilitating role of the key providers, mainly nurses, in the delivery of education and education materials was important during perioperative and postoperative phases. Reported barriers were related to receiving incomplete instructions and a rushed way instructions were communicated during the preoperative and perioperative phases.

GI cancer patients valued clear delivery of instructions supplemented with explanations provided in lay terms to better understand relevant care processes. Addressing barriers such as incomplete instructions and lack of thorough education, within specific surgical phases, may improve education delivery. Future research should explore more effective ways to deliver education in lay terms across the surgical process.