Entries in Health Literacy (2)


What's Your Health IQ? Experts Seek Better Communication with Patients

Keith Brofsky/Thinkstock(BOSTON) -- For more than a decade, Helen Osborne drafted health education material, but when she was diagnosed with breast cancer in 2006 and her doctor gave her a printout that was supposed to help her understand her condition, she said she couldn't make heads or tails of it.

"I had no idea what I just read," said Osborne, who worked with a variety of medical centers and organizations, including the National Institutes of Health.

Osborne, 62, of Natick, Mass., reached out to her colleague at the National Cancer Institute to vent her frustration. She told her friend that she didn't understand why the printout recommended that she see numerous specialists, including a medical oncologist and a radiation oncologist.

"Who exactly are these folks anyway?" she recalled asking her colleague.

"Well, Helen," she recalled her colleague say, "you wrote a whole booklet about this topic already."

Although Helen is highly educated and considered extremely literate, she is one of many Americans who, regardless of their education level, at times struggle to understand health information.

Nearly half of American adults, including doctors themselves, have poor health literacy, according to a report by the Institute of Medicine. Many struggle to understand instructions on prescription drug bottles, doctors' notes, health insurance forms, and educational brochures.

And many studies suggest that understanding health information could mean the difference between life and death.

As ABC News Radio reported Tuesday, surveyed heart failure patients who had low health literacy were more likely to die outside of a hospital setting than those who were considered health literate, according to a study published in the Journal of American Medical Association.

But literacy and health literacy are not synonymous terms, said Osborne, who founded Health Literacy Consulting, LLC.

"If you're struggling to read, of course you'll have trouble with health information," she said

But health information is often hard to decipher on your own.

"The fact that I love Shakespeare does not mean I'll have good health," said Rima Rudd, senior lecturer on society, human development, and health at the Harvard School of Public Health. "The mistake in research has been to focus on skill level of patients rather than on the information presented to them."

The responsibility lies in large part with some health experts who don't effectively communicate health information with the patient, according to Rudd.

But it's also due in part to some patients who don't ask for clarification when they need it, Osborne said.

The hard-to-decipher medical information is also found on many pill bottles and medication boxes likely to be found in any medicine cabinet.

Words like "risk," "probability," "range," and "normal" are hardly ever defined -- even a simple line that asks you to take medication with "plenty" of water but doesn't specify what that means, or a line directing you to take a certain medication "four times daily" but doesn't specify when or how far to space out the dose can be a problem.

But many researchers, including Rudd, are implementing methods to help health experts better communicate with patients. One method, says Rudd, is to change the way experts ask questions. Simple questions like "Do you have any questions?" can turn to "How can I help answer your questions?"

"It's known as the teachback method -- actively creating an environment for questions and understanding," Rudd said.

Also, Rudd says health communicators should pilot test text material to see whether it's easily understandable among a test group.

"I think it's a criminal offense for anyone to write health information on managing your diabetes for example, not pilot test it and simply press the print button for all to have."

While researchers work to reform how health providers communicate, patients can take proactive steps to better understand medical information, Osborne said. It's a simple list of advice that she says she wish she'd known throughout her breast cancer diagnosis.

"Make sure you really understand what you're really supposed to do," she said. "Make sure you ask questions. Bring someone with you. Create a notebook."

Copyright 2011 ABC News Rado ´╗┐


Mortality Rates for Heart Failure Patients Higher if Health Literacy Is Low

Medioimages/Photodisc/Thinkstock(DENVER) -- A new study published in the Journal of the American Medical Association says lack of knowledge about basic health presents a higher risk of death for heart failure patients.

Nearly one in five heart failure patients have low health literacy, which makes them twice as likely to die from the condition, the study says.

The degree to which a person can obtain, process and understand basic health information and seek services that aid in making necessary health choices is what the Institute of Medicine regards as health literacy.

Heart failure often results in significant lifestyle changes, taking of various medications and sometimes surgery.  If the patient is unable to self-monitor on a consistent basis, managing the condition becomes quite difficult.

"Although patients with heart failure are frequently hospitalized, much care for heart failure is performed on a daily basis by individual patients outside of the hospital," the authors write in JAMA. "This self-care requires integration and application of knowledge and skills.  Therefore, an adequate level of health literacy is likely critical."

Over an eight-year period, researchers followed more than 1,500 heart failure patients for up to a year.  To determine each participant's level of health literacy, they asked three questions:

1.  How often do you have someone help you read hospital materials?
2.  How often do you have problems learning about your medical condition because of difficulty reading hospital materials?
3.  How confident are you filling out forms by yourself?

Low health literacy was apparent in 17.5 percent of the patients, according to the study's results.  Among those with low health literacy, the majority tended to be older adults of lower socioeconomic status.  According to the data, they were also less likely to have completed high school and had higher rates of other illness such as diabetes, stroke or high blood pressure.

Despite the more frequent cases of low health literacy among the elderly, researchers say even young, insured patients with access to health care services experience higher mortality rates when health literacy is low.

Copyright 2011 ABC News radio´╗┐

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