“Arab tili globallashuv davrida: innova
tsion yondoshuvlar
va
o‘qitish metodikasi”
mavzusidagi xalqaro ilmiy-amaliy anjuman
433
UNDERSTANDING OF CANCER TERMINOLOGY
AMONG UZBEK PEOPLE
Sharobidinova Shahlo Farxodovna
Uzbekistan State world languages University Assistant teacher
at Translation faculty
shaaxloshka@gmail.com
Annotation.
The objective of this study was to replicate and extend an earlier
studies examining lay people
’
s understanding of cancer-related terms in a Uzbek
sample by examining understanding of general terms relating to diagnosis,
prognosis, treatment and an experimental study of the effects of medical jargon
versus plain language on people
’
s perceptions of the effectiveness of interactions
with oncologists, participation in medical decision making and interpersonal trust.
Key words:
Uzbek people, cancer terminology, medical jargon, common
terms, translation problems.
Аннотация.
Целью данного исследования было повторить и
расширить более ранние исследования, посвященные изучению понимания
неспециалистами терминов, связанных с раком, в узбекской выборке путем
изучения понимания общих терминов, касающихся диагностики, прогноза,
лечения, а также экспериментального исследования влияния медицинского
жаргона по сравнению с простым языком о восприятии людьми
эффективности взаимодействия с онкологами, участия в принятии
медицинских решений и межличностного доверия.
Annotatsiya.
Ushbu tadqiqotning maqsadi tashxislash, bashorat qilish va
davolash bilan bo
g‘
liq umumiy atamalarni tushunish va tibbiy jargon ta
’
sirini
eksperimental
o‘
rganish orqali
o‘
zbek tili lu
g‘
atidagi odamlarning saraton bilan
bo
g‘
liq atamalarni tushunishini
o‘
rganuvchi oldingi tadqiqotlarni takrorlash va
kengaytirish. Odamlarning onkolog shifokorlar bilan
o‘
zaro munosabatlarning
samaradorligi, tibbiy qarorlar qabul qilishda ishtirok etishi va shaxslararo ishonch
haqidagi tasavvurlarini kengaytirishida umumiy til shakllanishidagi rolini
oshirishga qaratiladi.
Cancer patients often misunderstand their diagnosis, prognosis, or
treatment options. This lack of understanding may be due to the complexity of
information and the emotional nature of cancer consultations. However, it can
also be a result of the language doctors use, including euphemisms, vague words,
and medical jargon. Chapman examined lay people
’
s understanding of cancer-
related terms that oncologists use when discussing cancer diagnosis and
prognosis with their patients and found that understanding was suboptimal and
inconsistent.
“Arab tili globallashuv
davrida: innovatsion yondoshuvlar
va
o‘qitish metodikasi”
mavzusidagi xalqaro ilmiy-amaliy anjuman
434
Limited patient understanding can hinder effective physician-patient
communication in a variety of ways. First, the use of jargon, such as technical
terms or ambiguous language, can reduce the effectiveness of patients actively
interacting with their oncologist and participating in decision-making. For
example, patients
’
overall understanding of health information, that is, their
health literacy, has been shown to be positively associated with patient
engagement during consultation. Limited participation in consultation and
decision-making has been reported to be associated with negative consequences,
such as receiving less information and lower quality of life.
Moreover, it was shown that patients with low levels of perceived self-
efficacy were less satisfied with the consultation. Second, the use of unclear and
incomplete information may reduce patients
’
trust in their oncologist. A recent
review found that low levels of trust complicate communication and decision-
making and negatively impact patient outcomes such as psychological well-being.
The present study primarily aims to replicate and extend the descriptive
study of Chapman in a large sample in the UK, examining lay people
’
s
understanding of terms related to diagnosis, treatment and prognosis, and
statistics. Second, we sought to experimentally examine the impact of language
use (jargon versus plain) on laypersons
’
perceptions of the effectiveness of
interactions with an oncologist, participation in medical decision making, and
trust. Third, we sought to examine whether the possible effect of language on
outcomes would be moderated by people
’
s confidence in understanding cancer-
related terms.
One hundred and eighty lay participants completed a questionnaire
assessing comprehension, confidence in understanding, and anxiety after reading
20 scenarios representing cancer-related terms and perceived communication
effectiveness, decision-making effectiveness, and trust in a brief case study
depicting an oncologist. using jargon or simple language.
Individuals meeting the criteria were invited to participate and were
informed of the purpose and procedure of the study. After verbal consent was
obtained, participants were seated and asked to complete the questionnaire. The
researcher alternated slang and simple versions of the questionnaire. Care was
taken to ensure that participants did not search for information when completing
the questionnaire. The institutional ethics board approved the study.
Participants were asked to indicate whether they believed that their
knowledge about cancer was above average due to having experience with cancer
in their personal life (yes/no) or through education or work (yes/no)). In
addition, participants reported their age, gender and level of education.
Educational level was classified as low (primary/low vocational; <9 years of
schooling education), secondary (average level of professional education; 10
–
14
years), high (highest level of professional/academic level; >15 years).
The questionnaire asked participants to imagine that they were a cancer
patient. To assess comprehension, 20 short scenarios were presented in which
“Arab tili globallashuv davrida: innova
tsion yondoshuvlar
va
o‘qitish metodikasi”
mavzusidagi xalqaro ilmiy-amaliy anjuman
435
the oncologist used technical or potentially ambiguous language, that is,
euphemisms, modifiers, or prognostic, diagnostic, or probabilistic terms related
to diagnosis, prognosis, or treatment. Five scenarios were obtained from
Chapman, two from Sutherland, and three were based on a purposive sampling of
videos of Dutch radiation oncologists
’
first consultations with patients with
different types and stages of cancer. These consultations were recorded as part of
an unrelated observational study and served as inspiration for the development
of three additional scenarios corresponding to Uzbek practice. The resulting
scenarios were checked for veracity by two surgeons and one radiation
oncologist. Participants were asked to indicate what they thought the oncologist
was saying using an open-ended response format (three scenarios) or a multiple-
choice response format (seven scenarios). To replicate Chapman
’
s study as
closely as possible, we adopted the response formats they used for the questions
generated from their study. Closed scenarios other than Sutherland et al. "Don
’
t
know" response option included. Participants were also asked to indicate for each
scenario how confident they were in their understanding (1 = not at all confident,
2 = not confident, 3 = somewhat confident; 4 = confident and 5 = very confident)
and how worried they were. They viewed the scenario (1 = not at all annoying, 2
= not at all annoying, 3 = slightly annoying, 4 = annoying, and 5 = very annoying)
as additional indicators of understanding.
Experimental manipulations
To experimentally examine the effects of language, participants were
presented with one of two vignettes. Again, these were developed using content
and terminology taken from the example videos first consultations with radiation
oncologists. In the episodes, the oncologist provided information about treatment
options in jargon or plain language. As a manipulation check, participants were
asked to indicate whether they found the wording used difficult (1 = strongly
disagree, 2 = disagree; 3 = neither disagree nor agree; 4 = agree; 5 = strongly
agree).
Criteria for evaluation
Participants
’
perceived effectiveness of interactions with their oncologist
was measured using the five-item Perceived Effectiveness of Patient-Provider
Interaction Scale. Participants were asked to indicate how confident they were
that, for example, they would be able to get their questions answered by the
physician presented or that they would be able to get the most out of their visit.
Internal consistency was high. Higher total scores (range 5
–
25) indicate higher
perceived effectiveness. Participants
’
perceived decision-making participation
self-efficacy was assessed using the five-item Decision-Making Participation Self-
Efficacy Scale. The DEPS assesses patients
’
confidence in participating in decision
making, such as confidence that they can tell their doctor which treatment option
they prefer. Internal consistency was high. Higher total scores (range 5
–
25)
indicate higher perceived self-efficacy. Participants
’
trust in their oncologist was
assessed using two items from the Wake Fo
rest Physician Trust Scale: “You are
“Arab tili globallashuv
davrida: innovatsion yondoshuvlar
va
o‘qitish metodikasi”
mavzusidagi xalqaro ilmiy-amaliy anjuman
436
not worried about putting your life in the hands of this doctor” and “You trust this
doctor completely.” Internal consistency was high. Higher total scores (range
2
–
10) indicate higher overall trust.
Two hundred people agreed to take part. Data were available from
180 participants (two did not return the questionnaire; four answered less than
half of the questions). The various scales were completely completed by at least
95% of the participants. The average age was 38
.±13.1 years, 60.5% were men.
The majority (76.2%) had higher education, 15.1% had secondary education, and
4.2% had secondary education. One third (36.5%) indicated that they may have
more knowledge about cancer than average because they have had experiences
with cancer in their personal life (31.9%) or at school/work (13. 2%). Participants
in the two conditions did not differ significantly on any background
characteristics.
To our knowledge, this study is the first in the Uzbekistan to examine lay
people
’
s understanding of common cancer-related terms. The results indicate
that participants
’
understanding was suboptimal, that is, the scenarios were
misunderstood by a significant number of people, and the number of correctly
understood scenarios varied greatly between them. It can be argued that the laity
the understanding does not have to be perfect because they do not personally
suffer from cancer. However, most scenarios relate to situations that may arise
during or shortly after diagnostic consultations, such as "sprouts", "spots",
"positive" or "benign". Level of their understanding, especially in the early post-
diagnostic period.
In conclusion, these and other findings suggest that laypersons
’
understanding of commonly used terms in cancer consultations is suboptimal.
This study also shows that people
’
s confidence in the oncologist
’
s understanding
was associated with their perceptions of the effectiveness of participating in the
consultation. Clinicians should be aware that especially patients with newly
diagnosed cancer may have difficulty understanding their situation and options,
which may result in patients being less involved in their care than they would like.
Such participation is important because it can help clinicians tailor information as
well as decision making to the needs of the individual patient. Adaptation and
sharing solutions with patients has been shown to be associated with
favorable patient outcomes such as quality of life and adjustment. To reduce
unnecessary anxiety and promote active patient participation, clinicians should
regularly assess patients
’
understanding during consultations.
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va
o‘qitish metodikasi”
mavzusidagi xalqaro ilmiy-amaliy anjuman
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