To commemorate Health Literacy Month I’m sharing the following story from a colleague of mine who is a nurse. Her experience demonstrates the huge impact poor health literacy can have on patient outcomes and underscores why it is so important to take the time to engage with patients.
“Yesterday, I had a patient who drove himself to the hospital the day before for chest pain. He lives alone. He is 84 years old. Two months ago, he underwent stent placement in one coronary artery and was discharged on aspirin and given a prescription for Plavix. He never took the aspirin. He did not fill the prescription for Plavix. The protocol recommends one year of anti-coagulant therapy to maintain the patency of the stent. The cardiologist suspects the new stent has re-occluded. When I asked the patient what happened to the prescription, he told me he still has it in case he needs it.
When I offered my patient the newspaper yesterday, he declined. When a patient does not want the newspaper, I see red flags. I began to assess his literacy level. He can write his name. He can write the dates. He recognized the name of the paper but could not read the headlines. I asked him how he keeps track of his medications. He told me one of the staff members at his primary care physician’s office puts his medication in a pill organizer so he knows which ones to take when. Our hospital cardiac nurse educator gave him a booklet (everyone gets the same booklet). It uses the following terms “angina, triglycerides, sodium”. It is printed in Times New Roman, in 11-point font and it uses pictures, but the pictures are not in any context. He handed the booklet back to me saying, “I can’t use this.” I’m sharing my story as a reminder that we need to adapt how we communicate with our patients.”
How can the health care community increase health literacy among patients to improve outcomes?
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2 comments:
This anecdote reflects on a real obstacle to patient empowerment: lack of good public education. Providers could do a much better job explaining medical problems and choices to patients than they typically do. But it would help, a lot, if everyone had at the minimum, a 10th grade-level education including reading, basic math skills (like fractions and percents) and some knowledge of science (cells, DNA, etc.)
See related ML post, on the story of Henrietta Lacks and Rebecca Skloot's excellent book that bears on this topic - http://bit.ly/bmRJbE
Hi Elaine,
Thanks for your comment. I agree that it is unfortunate that low literacy in general is so pervasive. One thing I wonder, though, is why more hospitals and clinicians don't utilize some of the free tools that are available, through groups like the AHRQ, to help patients become better health care consumers? While these tools wouldn't help people with very low literacy it seems they might help those who are semi-literate.
Thanks for the note about Rebecca Skloot's book. I have been meaning to read this!
Jamie
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