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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 • • • • • • 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 • • • • • • 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? • • • • • • • 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