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Patients with limited English proficiency have increased healthcare challenges. Providing patient education in the patient's language has the potential to improve health outcomes, reduce system costs, and improve patient satisfaction. Healthcare providers remain apprehensive regarding the contextual accuracy of neural machine translation to assist the efforts of human translators and interpreters. Google Translate (GT) now uses deep learning techniques to translate whole sentences, which is more sensitive to context and grammar. The purpose of this research was to investigate the feasibility and utility of using machine translation (Google Translate) to translate radiation therapy patient education materials. Five Radiation Therapy patient education pamphlets were chosen for translation based on their high usage and importance at our institution. The pamphlets chosen for the study were: 1) Taking care of your skin during radiation therapy; 2) What to expect when getting radiation therapy for prostate cancer; 3) What to expect when getting radiation therapy to the abdomen and pelvis; 4) What to expect when getting radiation therapy to the head and neck; 5) What to expect when getting palliative radiation therapy to the lungs. Each pamphlet was translated from English into the following five languages: Vietnamese, Punjabi, Simplified Chinese, Portuguese, and Spanish, using both GT and professional human translators. These languages were chosen based on data on the most common language needs in the local hospital network. An additional group of professional human translators (3 per language) conducted an independent, blinded review of the translated pamphlets, evaluating the domains of fluency, adequacy, meaning, and severity. When comparing human and machine-translated material scores, humans scored higher in every domain, with t-tests determining the differences to be significant (p=<0.001). Total scores for machine-translated materials ranged from 13.33-15.27 out of a possible 20 for GT and 14.5-17.28 for human-translated material. In the most sensitive domain of severity, which identifies the resultant risk to patient outcomes based on mistranslation, machine scores ranged from 3.27-4.40 out of a possible 5 compared to 3.60-4.93 for human translations. Analysis of variance (ANOVA) found significant differences in scores between languages with Spanish and Vietnamese regularly scoring better in both human and machine translated versions. This research suggests that using machine translation tools such as Google Translate to translate whole sentences in radiation therapy pamphlets from English to 5 common languages is feasible. While there remain significant differences in quality between human and machine translation, it appears that the latter does not pose a significant risk of adversely affecting patient health outcomes, potentially opening the path for its limited use in patient education. [ABSTRACT FROM AUTHOR]

A prospective clinical trial (PERSON study) was conducted to compare anxiety and satisfaction between standard care and a 'person-centered' model of care to meet the informational and supportive needs of patients with breast cancer receiving radiation therapy. The aim of this research was to qualitatively evaluate patients' experiences from optional interviews, acquired as a secondary trial outcome, to gain further insights on the person-centered aspects of their care. Patients receiving locoregional breast radiation therapy, in free-breathing or with an active breath-hold device, were randomized 1:1 to the intervention (person-centered model) or standard care. The intervention included a 45 minute face-to-face pre-CT education with a Radiation Therapist (RTT) and the same RTT performed CT-sim, planning and treatment delivery to maintain continuity of care. Standard care had no dedicated education session led by an RTT, and typically different RTTs were involved across procedures. Patients were offered the option to participate in a semi-structured interview within 2 weeks of completing treatment. These were conducted by a single facilitator and focused on their lived radiation therapy experiences and how it could be improved. Interviews were transcribed verbatim and coded using NVivo v.12 by a single observer, with coding reviewed by a second observer. Thematic analysis was conducted separately for each arm to identify themes. A total of 41 (21 intervention, 20 standard care) completed the optional interviews until data saturation was reached. The first theme that emerged focused on the importance of consistent RTTs. Patients in both arms reported a sense of belonging, familiarity and increase in confidence during their radiation therapy experience when cared for by a consistent RTT. Some patients noted that a small, consistent team of RTTs may also provide similar feelings of comfort. Participants in the intervention arm indicated particular value in having this consistency across specific transitions (e.g. between CT-sim and beginning of treatment) to provide a sense of continuity. The second theme identified by patients in both arms was uncertainty in the radiation therapy process as a source of nervousness, particularly for those requiring use of the active breath-hold device. The third theme emphasized by patients in the intervention arm was the importance of a RTT-led education session and its impact on feelings of preparedness. The session provided opportunity for treatment specific questions and allowed for visualization of the process. The insights gained from patients' qualitative experiences with breast radiation therapy supports the role of RTTs in person-centered care. Patients specifically reported on both study arms needing to be well prepared for treatment procedures and familiar with their care team, two aspects of care that are more proactively addressed in the person-centered (intervention) model of care. [ABSTRACT FROM AUTHOR]

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