The Dialectics of the Production of Printed Educational Material for Cancer Patients: Developing Communication Prostheses

Abstract

There are substantial knowledge and research gaps about the effects of printed educational material on professional practice. In the last decades, the popularization of low-cost leaflets for health education has helped disseminate information more broadly. Nonetheless, several extensive reviews on this matter have led pamphlet producers to inconsistent results and dubious conclusions. In view of the debate on the effectiveness and usefulness of this kind of material, we conducted a review of studies published over the past 54 years (1957–2011), selecting those that brought critical assessments of the role of education through printed materials in health care. Qualitative perspectives were applied to the readings, considering the definition of “efficiency” used by each author. We selected the papers that involved some kind of “value judgment” about this activity, either by quantification of their results or by proposing methods of improving its effectiveness, which illustrated a pattern of rationality behind the production, use, and evaluation of this type of resource. We selected 79 works that were considered a representative sample of the epistemological premises depicted above; from these, 22 were produced by professionals dealing with cancer care. In general, health care leaflets invest in the power of “ideal printed information” as efforts to produce the “perfect information package”—one that efficiently describes its technical content for several purposes. They are used for alleviation of anxiety in imminence of painful procedures as well as for unidirectional persuasion as a kind of “educational strategy” or “health promotion.” Under these perspectives, printed material is frequently used as “communication prostheses”—an artificial support constructed for professionals who lack time, have a great volume of information to transmit, are not able to engage in closer interaction with their patients, or are overconfident in the information resources available on the Internet. These materials are supposed to inform patients by transmitting the adjusted “dose” of information by efficient routes of administration.

In synthesis, information is prepared as an active principle with peculiar assessment methods based on cognitivist premises—which are central in biomedical rationality. With the exception of a few cases, communication prostheses are used without any kind of research on message reception, a specialized tool used by communication experts. These gaps pose the need for a deconstruction of the systems of instrumental thinking, so peculiar to health professionals. The present narrative review addresses the relevance of information through printed material and adds a contribution to the understanding of its use in assisting professionals working with cancer patients.