scholarly journals Evaluation of A Newly Designed Patient-Friendly Discharge Letter – A Randomized, Controlled Participant-Blind Trial

2020 ◽  
Author(s):  
Christian Smolle ◽  
Christine Schwarz ◽  
Magdalena Hoffmann ◽  
Lars-Peter Kamolz ◽  
Gerald Sendlhofer ◽  
...  
Keyword(s):  
Health Literacy ◽  
Medical Information ◽  
Healthcare Services ◽  
Poor Health Outcome ◽  
Patient Comprehension ◽  
Low Health Literacy ◽  
Discharge Letter ◽  
Medical Undergraduates ◽  
The Impact ◽  
Better Than

Abstract Introduction Low health literacy has been associated with poor health outcome and impaired use of healthcare services. The hospital discharge letter represents a key source of medical information for patients and can be used to address the problem of low health literacy. The aim of this project was to develop and evaluate a new, patient-directed, version of the discharge letter.Methods Based upon two conventional discharge letters (CDL; one surgical and one medical letter), two new, patient-friendly discharge letters (PFDL) were designed following 5 key principles: short sentences, few abbreviations, large font size, avoidance of technical terms and no more than 4 pages length. Medical undergraduates were randomized into two blinded groups (CDL, PFDL) and asked to assess the assigned letter for the 3 domains structure, content and patient-friendliness. Subsections were rated on a 6-point Likert scale (1=completely agree, 6=completely disagree), the results of the survey were compared using the Mann-Whitney-U-Test with a p < 0.05 being the level of significance.Results In total, 74 undergraduates participated in the study. PFDL (35 participants) were rated significantly better than CDL (39 participants) regarding structure (median 1 vs. 2, p=0.005), content (1 vs. 3, p<0.001) and patient-friendliness (2 vs. 6, p<0.001). Of all 17 subsections, PFDL were rated significantly better in 12 cases, and never worse than CDL.Conclusion PFDL were rated significantly better than their CDL counterparts. Medical undergraduates were considered the ideal cohort, not being medical lays and yet unbiased regarding everyday clinical practice procedures. Further tests evaluating the impact of the PFDL on patient comprehension and health literacy are necessary.

scholarly journals Design and preliminary evaluation of a newly designed patient-friendly discharge letter – a randomized, controlled participant-blind trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Smolle ◽  
Christine Maria Schwarz ◽  
Magdalena Hoffmann ◽  
Lars-Peter Kamolz ◽  
Gerald Sendlhofer ◽  
...  
Keyword(s):  
Health Literacy ◽  
Medical Information ◽  
Healthcare Services ◽  
Preliminary Evaluation ◽  
Patient Comprehension ◽  
Low Health Literacy ◽  
Discharge Letter ◽  
Medical Undergraduates ◽  
The Impact ◽  
Better Than

Abstract Background Low health literacy has been associated with poor health outcome and impaired use of healthcare services. The hospital discharge letter represents a key source of medical information for patients and can be used to address the problem of low health literacy. The aim of this project was to develop and evaluate a new, patient-directed, version of the discharge letter. Methods Based upon two conventional discharge letters (CDL; one surgical and one medical letter), two new, patient-friendly discharge letters (PFDL) were designed following 5 key principles: short sentences, few abbreviations, large font size, avoidance of technical terms and no more than 4 pages length. Medical undergraduates were randomized into two blinded groups (CDL, PFDL) and asked to assess the assigned letter for the 3 domains structure, content and patient-friendliness. Subsections were rated on a 6-point Likert scale (1 = completely agree, 6 = completely disagree), the results of the survey were compared using the Mann-Whitney-U-Test with a p < 0.05 being the level of significance. Results In total, 74 undergraduates participated in this study. PFDL (35 participants) were rated significantly better than CDL (39 participants) regarding structure (median 1 vs. 2, p = 0.005), content (1 vs. 3, p < 0.001) and patient-friendliness (2 vs. 6, p < 0.001). Of all 17 subsections, PFDL were rated significantly better in 12 cases, and never worse than CDL. Conclusions PFDL were rated significantly better than their CDL counterparts. Medical undergraduates were considered the ideal cohort, not being medical lays and yet unbiased regarding everyday clinical practice procedures. Further tests evaluating the impact of the PFDL on patient comprehension and health literacy are necessary.

Building the case for health literacy in gastroenterology

2021 ◽  
Vol 19 (7) ◽  
pp. 26-30
Author(s):  
Graeme D Smith ◽  
Veronica Lai ◽  
Sara Poon
Keyword(s):  
Health Literacy ◽  
Healthcare Services ◽  
Chronic Illnesses ◽  
Low Health Literacy ◽  
Illness Prevention ◽  
Concept Of Health ◽  
Health Related ◽  
Potential Risks ◽  
Potential Factors ◽  
The Impact

Living with a chronic gastrointestinal (GI) disorder, such as inflammatory bowel disease, can be a very challenging for patients. A range of skills can be required to deal with some of the issues and uncertainties associated with living with a GI disease, including the ability to identify and find appropriate healthcare services for worsening symptoms; communicate concerns to health professionals; understand information pertaining to illness prevention and self-management; weigh up the potential risks and benefits of adherence to complex medication regimes; and comprehend the written instructions on prescribed medication. All of these activities represent important features of the concept of health literacy, involving the ability to read textual information, understand material in forms and documents, deal with issues of numeracy, engage in verbal communication and navigate healthcare services. Although the full impact of health literacy in chronic GI disease remains unknown, lower levels of health literacy have been identified as a potentially modifiable risk factor, related to communication barriers and poorer health-related outcomes in other chronic illnesses. In this clinical review, issues associated with health literacy in chronic GI disease are explored, highlighting the impact of low health literacy in gastroenterology; identifying potential factors of living with low levels of health literacy; and introducing approaches to measurement of health literacy and interventions that can be used by nurses to help improve health literacy in patients. Focus is placed on health literacy related to reading and comprehension of vital GI health-related materials.

scholarly journals 4020 Impact of Patients’ Health Literacy Level on Patients’ Health Outcomes

2020 ◽  
Vol 4 (s1) ◽  
pp. 137-137
Author(s):  
Dae Hyun Kim ◽  
Larry Hearld ◽  
William Opoku-Aygeman
Keyword(s):  
Health Literacy ◽  
Health Outcomes ◽  
Medical Information ◽  
Linear Regression Models ◽  
Negatively Associated ◽  
Surgical Department ◽  
Lengths Of Stay ◽  
Health Literacy Level ◽  
Literacy Level ◽  
The Impact

OBJECTIVES/GOALS: The objective of this study is to examine the relationship between gastro-intestinal (GI) patients’ health literacy levels and patients’ health outcomes (length of stay, readmission, complication). METHODS/STUDY POPULATION: A research team at the University of Alabama at Birmingham (UAB) ‘s Gastro-Intestinal (GI) surgical department collected inpatient GI patients’ health literacy data by distributing the Brief Health Literacy Screen (BRIEF) survey to patients are about to be discharged. Patients’ health outcomes data were gathered through Business Objects, an online platform that allows physicians and researchers to access and gather patients’ medical information with an IRB approval. After accounting for necessary control variables, logistic regression and multiple linear regression models will be run to assess whether there is a significant relationship between patients’ health literacy levels and patients’ health outcomes. RESULTS/ANTICIPATED RESULTS: Three specific hypotheses are proposed in this study. H1: GI patients’ health literacy levels will be negatively associated with their lengths of stay H2: GI patients’ health literacy levels will be negatively associated with their readmission status to the hospital H3: GI patients’ health literacy levels will be negatively associated with their complication status to the hospital DISCUSSION/SIGNIFICANCE OF IMPACT: This study allows us to further our understanding of patients’ health literacy level and its’ relationship with important health outcomes. By looking at a variety of diverse health outcomes, the impact of a patients’ health literacy level on that patients’ health outcomes will be observed more clearly.

scholarly journals Low-Level Evidence Suggests that Perceived Ability to Evaluate and Trust Online Health Information is Associated with Low Health Literacy

2016 ◽  
Vol 11 (2) ◽  
pp. 183
Author(s):  
Lindsay Alcock
Keyword(s):  
Health Literacy ◽  
Health Information ◽  
Evaluation Criteria ◽  
Positive Association ◽  
The Internet ◽  
Online Health Information ◽  
Low Level ◽  
Evaluative Criteria ◽  
Low Health Literacy ◽  
The Impact

Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1) the ability to evaluate online health information based on (2) perceived reliability and accuracy, (3) trust in the Internet as an information source, and (4) the application of established evaluation criteria. Design – Systematic review and narrative synthesis. Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method. Subjects – 38 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. The most prevalent outcome measure studied was trust in online health information, and the least prevalent was the use of evaluative criteria. The ability to trust online health information was assessed primarily through self-reporting, half of which utilized the eHealth Literacy scale, the majority of which indicated a positive correlation between education level or low health literacy and the perceived or actual ability to evaluate online health information. No studies on perceived information quality were found to utilize health literacy as an indicator. A positive association between educational level and trust in health information on the Internet was reported in ten studies, while two articles noted a similar correlation based on proxies for health literacy, including English language proficiency and comprehension comfort. In terms of the use of evaluation criteria, only one study focused on health literacy, indicating that those with low health literacy evaluate online health information based on search result placement, celebrity endorsement, image quality, and site authorship, and that they trust university researchers more than government or religious authorities to provide health information. No association was shown between readability or physician-provided online information and evaluation criteria while one study demonstrated that study participants with higher education tended to check author credentials more often when evaluating a website. Conclusion – Effective and informed evaluation of online health information is impacted by low health literacy.

The Impact of Health Literacy Level on Inhaler Technique in Patients With Chronic Obstructive Pulmonary Disease

2016 ◽  
Vol 30 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Collin R. Beatty ◽  
Laura A. Flynn ◽  
Tracy J. Costello
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Literacy ◽  
Pulmonary Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Obstructive Pulmonary Disease ◽  
Low Health Literacy ◽  
The Mean ◽  
The Impact

Background: Inhaled medications are recommended as first-line treatment for chronic obstructive pulmonary disease (COPD) and can reduce exacerbations and hospitalizations. Low health literacy is associated with poor inhaler technique. Objective: This study examined whether handouts written specifically for patients with low health literacy are more effective in showing patients how to use their medications when compared to standard education materials. Methods: A prospective, experimental study was performed at a community-based hospital. Patients included in the study were admitted to the hospital with a diagnosis of COPD, taking at least 1 inhaled medication and identified as having low health literacy based on a Rapid Estimate of Adult Literacy in Medicine—Short Form. Low health literacy handouts were compared against the standard hospital educational materials for inhalers. Correct technique during each demonstration was evaluated using a standardized checklist. Results: Mean baseline scores for inhaler technique were 12.2 ± 2.2 steps correct for the control group and 13.4 ± 1.3 for the low health-literacy group of the 18 maximum points ( P = nonsignificant). The mean change in inhaler technique score for the control group was 1.0 ± 1.8, while the mean change in inhaler technique score for the low health-literacy group was 2.1 ± 2.7 ( P = .03).

The impact of low health literacy on surgical practice

2004 ◽  
Vol 188 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Lisa D. Chew ◽  
Katharine A. Bradley ◽  
David R. Flum ◽  
Paul B. Cornia ◽  
Thomas D. Koepsell
Keyword(s):  
Health Literacy ◽  
Surgical Practice ◽  
Low Health Literacy ◽  
The Impact

Development of the Mammography Beliefs and Attitudes Questionnaire for Low-Health-Literacy Mexican-American Women

2010 ◽  
Author(s):  
Gloria Lopez-McKee
Keyword(s):  
Health Literacy ◽  
Mammography Screening ◽  
Mexican American ◽  
Expert Committee ◽  
Mexican American Women ◽  
American Women ◽  
Screening Participation ◽  
Low Health Literacy ◽  
The Impact ◽  
Beliefs And Attitudes

Low-income, low-health-literacy Mexican-American women exhibit poor mammography screening participation and are being diagnosed at later stages of breast cancer than are non-Hispanic white women. No instrument has been available to measure the impact of cultural and psycho-social factors on the intent to seek mammography screening participation in this population. In this article the author describes the development process of the English Mammography Beliefs and Attitudes Questionnaire (MBAQ) and the Spanish Mammography Beliefs and Attitudes Questionnaire (SMBAQ). The Theory of Planned Behavior is the theoretical framework underlying these instruments designed to measure intent to seek mammography screening in low-health-literacy Mexican-American women. The process of developing the MBAQ utilized input from low-health-literacy Mexican-American women and an expert committee. The MBAQ was translated into Spanish and assessed for content validity and reading level. In the discussion, the author explains why the MBAQ and SMBAQ are appropriate tools for use with low-health-literacy Mexican-American women to measure their intentions to seek mammography screening. Limitations of the study and implications for practice and research are presented.

scholarly journals Unmet Information Needs Among Hispanic Women With Thyroid Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A873-A874
Author(s):  
Debbie W Chen ◽  
David Reyes-Gastelum ◽  
Sarah T Hawley ◽  
Lauren P Wallner ◽  
Ann S Hamilton ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Health Literacy ◽  
Information Needs ◽  
Medical Information ◽  
Hispanic Women ◽  
Internet Access ◽  
Information Resources ◽  
Low Health Literacy ◽  
Access Information ◽  
Level Of Acculturation

Abstract Background: Despite thyroid cancer being the second most common cancer in Hispanic women, little is known about access to and utilization of medical information resources by Hispanic women with thyroid cancer. Methods: Hispanic women who had diagnoses of thyroid cancer reported to the Los Angeles Surveillance Epidemiology and End Results (SEER) registry in 2014-2015, and who had previously completed our thyroid cancer survey in 2017-2018, were offered follow-up surveys in both English and Spanish (N=273; 80% response rate). Acculturation, which is the process by which individuals adopt the language, values, attitudes, and behaviors of a different culture, was assessed with the Short Acculturation Scale for Hispanics (SASH). Health literacy was assessed with the validated single-item question of “How confident are you filling out medical forms by yourself?” with response categories based on a five-point Likert scale from “extremely” to “not at all”. Patients were also asked about their internet access, information resources used, and ability to access medical information about thyroid cancer in their preferred language. We generated descriptive statistics for all categorical variables and used Rao-Scott adjusted chi-square tests to test for a relationship between level of acculturation and the following variables: health literacy, internet access, information resources used, and ability to access information. Results: Participants’ median age at diagnosis was 47 years (range 20-79); 49% were low-acculturated, 25% had low health literacy, and 14% reported no internet access at home. Low-acculturated Hispanic women reported using information resources in both English and Spanish whereas high-acculturated women used resources in English only. Hispanic women were more likely to report the ability to access medical information about thyroid cancer all of the time if they preferred information in English compared to if they preferred it in Spanish (89% vs 37%, P&lt;0.001). Low-acculturated (vs high-acculturated) Hispanic women were more likely to have low health literacy (47% vs 5%, P&lt;0.001) and to report use of in-person support groups (42% vs 23%, P=0.006). Depending on their level of acculturation, Hispanic women accessed the internet differently (P&lt;0.001) such that low-acculturated women were more likely to use only a smartphone (34% vs 14%) or have no internet access (26% vs 1%), and less likely to use both a smartphone and home computer/tablet (28% vs 58%) or use only a home computer/tablet (10% vs 21%). Conclusion: Our findings demonstrate that low-acculturated Hispanic women with thyroid cancer have greater unmet information needs and access information differently compared to high-acculturated Hispanic women. This study emphasizes the importance of a patient-focused tailored approach to providing medical information to this understudied population.

scholarly journals Health Literacy, Language, and Cancer-Related Needs in the First 6 Months After a Breast Cancer Diagnosis

2020 ◽  
Vol 16 (8) ◽  
pp. e741-e750
Author(s):  
Christine M. Gunn ◽  
Michael K. Paasche-Orlow ◽  
Sharon Bak ◽  
Na Wang ◽  
Jennifer Pamphile ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Literacy ◽  
Cancer Diagnosis ◽  
Self Efficacy ◽  
Breast Cancer Diagnosis ◽  
Spoken Language ◽  
Haitian Creole ◽  
Low Health Literacy ◽  
Screening And Prevention ◽  
The Impact

PURPOSE: Low health literacy (HL) and language negatively affect cancer screening and prevention behaviors; less is known about how they affect the patient’s experience during cancer treatment. This study explores associations among HL, spoken language, and dimensions of cancer-related needs within 6 months of receiving a breast cancer diagnosis. METHODS: Women speaking English, Spanish, or Haitian Creole, enrolled in a patient navigation study at diagnosis, completed a survey in their primary spoken language at baseline and 6 months to characterize their cancer-related needs. HL was measured using the Brief Health Literacy Screening Tool. Outcomes included the Cancer Needs Distress Inventory (CaNDI; n = 38 items) and the Communication and Attitudinal Self-Efficacy scale (CASE-Cancer) for cancer (n = 12 items). Linear regressions measured the impact of HL and language on total CaNDI and CASE-Cancer scale for cancer scores and subscales, adjusted for demographics. RESULTS: At baseline, 262 women participated and 228 (87%) followed up at 6 months. Of these, 38% had adequate HL, 33% had marginal HL, and 29% had inadequate HL. Women with inadequate or marginal HL had higher median baseline CaNDI scores ( P = .02) and lower self-efficacy scores ( P = .008), relative to those with adequate HL. Haitian-Creole speakers had significantly lower CANDI scores at baseline ( P = .03). Adjusting for demographics, differences in CaNDI scores at baseline remained significant for those with lower HL and Haitian-Creole speakers. At 6 months, differences in self-efficacy persisted for Haitian-Creole speakers. CONCLUSION: Findings suggest that interventions oriented to mitigating HL and language barriers might reduce distress at the time of diagnosis and improve self-efficacy over the course of treatment.

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