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According to the Centers for Disease Control and Prevention (CDC), nearly nine out of 10 adults "may lack many of the skills necessary to sufficiently manage their health." In response, the U.S. Department of Health and Human Services launched the National Action Plan to Improve Health Literacy to promote simplified health language. Health literacy is the ability to understand, communicate, process, and obtain basic health information, so keep that in mind as your end goal during patient communication.
It can be difficult to tell, however, which patients have limited health literacy, and simply asking a patient if they understand isn't always effective. Even people with high literacy, such as college graduates, can have difficulty understanding health information.
Indications that a patient has limited health literacy include frequently missed appointments or incomplete forms. Some patients with limited health literacy might even make excuses for not properly filling out paperwork. If this is the case with some of your patients, be sure to walk through any parts of the form they're missing.
Terms to Teach
We've already discussed some common medical terminology that may be confusing to patients in a previous post. Here are some additional terms that your patients may not understand:
- Chronic and acute. Many people think chronic pain means pain that is severe. While chronic pain can be severe, it actually refers to pain that is long-developing and ongoing, meaning it lasts a long time. One way to explain chronic pain is to use the root word "chron," which means "time" in Greek. Acute is the opposite of chronic and refers to pain that is sudden and severe, but does not last long.
- Unconscious. A study conducted by the Emergency Medicine Journal (formerly the Journal of Accident and Emergency Medicine) found that understanding of the term "unconscious" was poor or worse for patients for whom English is not a first language. The study defined unconscious as a "state of being insensible or without conscious experiences," but you don't need to be that literal; just speak about the term regarding how it applies to the specific health situation at hand.
- Stable. Because stable has several definitions (including a building for keeping horses), it can confuse patients. It may be helpful to use "the same" or "unchanged" instead.
- Screening. One doctor in Louisiana researched patient understanding of screening terminology and found that patients regularly fail to recognize and understand such important terms as screening, mammogram, tumor, and growth. Make sure your patient knows what these mean in relation to their specific condition.
The best way to ensure that your patients understand what you're telling them is to keep your language as simple as possible. You might also try using the teach-back method. After you've given your patient a diagnosis or instructions, ask her to explain it back to you in her own words. This will help you determine how much information she understands and recalls. If she has trouble explaining the information, you may need to repeat it, clarify it, or adjust it. It's possible you'll need to repeat this process a few times.
Another method you could try is Ask Me 3. This tool specifies three questions that patients should ask after a doctor's visit:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Using Ask Me 3 along with the teach-back method can help ensure that patients are leaving your office with the information they need to stay healthy.
You can't properly treat patients if they don't understand your information and instructions. Recognize when your patients aren't retaining what you're telling them, and be prepared to explain certain terms over again. Use the aforementioned teaching methods, as well; while one may work better than others, it all depends on the individual patient. This approach may take more time, but ideally you'll save on that time if patients leave your practice feeling confident in what they've learned from you.