Informational stories: a complementary strategy for patients and caregivers with brain metastases

OBJECTIVE We compared the efficacy of a story-based writing style with that of a fact-based writing style for educational material on brain metastases. METHODS Identical informational content on four topics-radiation therapy, side effects, steroid tapering, and palliative care-was constructed into equivalent story-based and fact-based materials. The content and reader preference for style were evaluated using a questionnaire of 20 + 1 items. Cancer patients and caregivers were invited to evaluate the materials. RESULTS A total of 47 participants completed the questionnaire. The recorded preferences for facts, stories, or both were 42%, 7%, and 51% respectively (p = 0.0004). The fact-based materials were rated superior in providing factual information (for example, discussion of treatment, side effects) and selected general characteristics (clarity of information, for instance). A rating trend suggested that story-based materials were superior in describing "how it feels to have brain metastases" (21/40 fact-based vs. 26/43 story-based) and "how brain metastases affected a spouse" (17/41 fact-based vs. 21/47 story-based), and in being "sensitive to the frustrations of a patient with brain metastases" (25/40 fact-based vs. 30/44 story-based). CONCLUSIONS Half the participants preferred to read both fact-based and story-based materials. A combined story-based and fact-based educational resource may be more effective in conveying sensitive information and should be further investigated.