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Health Literacy
A Summary for Respiratory Care
Students
The Problem—our side
• Our health care education,
– Varied, for some, as much as 20 years
• Common talk is filled is jargon and
acronyms—COPD, CVA, CABG, etc.
• Technological advances—ventilators, IV
pumps, monitoring equipment, etc.
• Proliferation of tests
The Problem-the patients’ side
• Approx. 90 million Americans or about half
the population has trouble or difficulty
using and understanding medical and
health care information
• “health literacy”--Obtain, process and
understand information to make decisions
about health care
Literacy and Health
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Poorer overall health
Less likely to make use of screening
Present in later stages of disease
More likely to be hospitalized
Poorer understanding of treatment
Less likely to stick to medical regimens
Why at Risk?
• Patient instruction is based on written
words
• Health care system is now more complex
– More medications (e.g., asthma medications)
– More tests and procedures
– More specialists
– More emphasis on self-care
Poor Reading Skills Correlate
with Less Knowledge of Asthma
• Best predictor of health status
• Better than
– employment status
– Age
– Income
– Racial or ethnic group
– Education level
Levels of Illiteracy
• Level 1
– Can sign name
– Cannot read bus schedule
– Cannot enter information on a government
application
• Level 2
– Can find location on a map, e.g., intersection
of two streets
– Can determine difference on price on tickets
– Cannot read bus schedule consistently
– Cannot identify information on a bar graph
– Cannot write a letter of complaint
GNINAELC – Ot erussa hgih ecnamrofrep,
yllacidoirep naelc eht epat sdaeh dna
natspac revenehw uoy eciton na
noitalumucca fo tsud dna nworb-red edixo
selcitrap. Esu a nottoc baws denetsiom
htiw lyporposi lohocla. Eb erus on lohocla
sehcuot eht rebbur strap, sa ti sdnet ot yrd
dna yllautneve kcarc eht rebbur. Esu a
pmad tholc ro egnops ot naelc eht tenibac.
A dlim paos, ekil gnihsawhsid tnegreted,
lliw pleh evomer esaerg ro lio.
• How do you clean the capstan?
Major Problems
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Medications
Appointments
Informed consents
Discharge instructions
Health education materials
Insurance applications and forms
Changes in System
Acute MI Tx
35 yrs ago
Today
4-6 wks rest
2-4 days
Available Rx drugs 650
10,000+
Aging and Literacy
• 44% had inadequate literacy levels
• Were not able to understand:
– Take medications q 6 hours
– Identify next appointment
– Take on an empty stomach
48%
27%
54%
What Works?
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Teach back
Shame free
Use common words
Simple, specific, direct sentences
Sequence ideas clearly and logically
Attentive to culture
Attentive to age, especially seniors
• Therapeutic Communication