501
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Sutherland LA, Campbell M, Ornstein K, Wildemuth B, Lobach D. Development of an adaptive multimedia program to collect patient health data. Am J Prev Med 2001; 21:320-4. [PMID: 11701304 DOI: 10.1016/s0749-3797(01)00362-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Direct entry of personal health survey information into a computer by patients could streamline clinical data collection, improve completeness and accuracy of health information available to providers, and provide data for tailoring health education messages. Few computerized programs, however, have been developed to adapt the interface to diverse literacy levels, language, computer skills, and health literacy levels of the broad spectrum of patient populations. METHODS To develop such a program, we conducted cognitive response interviews with a diverse sample of 21 adult participants from two North Carolina health clinics. Participants were placed into one of three interview categories: (1) low reading skill level, low computer skills; (2) high reading skill level, low computer skills; and (3) high reading skill level, high computer skills. The "think-aloud" technique was employed to elicit feedback on a series of computer interface screens and health risk assessment questions. RESULTS Interface-related findings showed that preference for touchscreen versus keyboard data entry was not strongly related to computer skill level but was related to question type. Respondents with limited education indicated that they would not click on a "help" or hyperlink option to get more information and that frequent reminders of directions on the screen were needed. Content-related findings showed numerous misperceptions regarding meanings of common health questions and terminology (e.g., seat belt use and intravenous drugs). CONCLUSIONS These findings have implications for health literacy and may have an impact on the accuracy of information obtained. Study results will be incorporated into the development and testing of an innovative, adaptive multimedia program.
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Affiliation(s)
- L A Sutherland
- School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-7400, USA.
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502
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Dowse R, Ehlers MS. The evaluation of pharmaceutical pictograms in a low-literate South African population. PATIENT EDUCATION AND COUNSELING 2001; 45:87-99. [PMID: 11687321 DOI: 10.1016/s0738-3991(00)00197-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An inability to read and understand written medication instructions may be a major contributory factor to non-compliance in certain patient populations, particularly in countries with a high illiteracy rate such as South Africa. Twenty three pictograms from the USP-DI and a corresponding set of 23 locally developed, culturally sensitive pictograms for conveying medication instructions were evaluated in 46 Xhosa respondents who had attended school for a maximum of 7 years. Respondents were tested for their interpretation of all 46 pictograms at the first interview and again 3 weeks later. The correct meaning of each pictogram was explained at the end of the first interview. Preference for either the Local or USP pictograms was determined. At the follow-up interview, 20 of the Local pictograms complied with the ANSI criterion of >/=85% comprehension, compared with 11 of the USP pictograms. Respondents indicated an overwhelming preference for the Local pictograms.
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Affiliation(s)
- R Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown 6140, South Africa.
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503
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Siebens H, Weston H, Parry D, Cooke E, Knight R, Rosato E. The Patient Care Notebook: quality improvement on a rehabilitation unit. THE JOINT COMMISSION JOURNAL ON QUALITY IMPROVEMENT 2001; 27:555-67. [PMID: 11593889 DOI: 10.1016/s1070-3241(01)27049-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Shortened lengths of stay in acute and rehabilitation hospitals, continuing financial pressures on all postacute care services, and increasing out-of-pocket health care costs for patients and families challenge rehabilitation hospitals' patient education and discharge planning processes. Spaulding Rehabilitation Hospital (Boston) introduced a patient care notebook in a 15-bed satellite unit and pilot tested its contribution to the patient education and discharge planning process. DEVELOPING THE NOTEBOOK: The three-ring binder notebook included sections on medical appointments and phone numbers, understanding illness and medical care, coping with illness, physical activities, recommendations for the home, and community resources, with both standard and patient-specific information. RESULTS Most of the patients and caregivers who received the notebooks found them to be helpful, and most staff indicated that the notebook improved the teaching process. Telephone calls to the unit after home discharges decreased form 28 calls for 11 discharges to 6 calls for 21 discharges after the notebook began to be used regularly. DISCUSSION Staff felt that the process of using the notebook helped focus attention on teaching during the entire course of a patient's hospitalization rather than just a day or two before discharge. The patient care notebook process is being introduced to the entire hospital and to all patients, regardless of discharge location and the patient's literacy or proficiency with English. CONCLUSION In using the notebook, the QI team, and the entire unit staff, learned about the complexities of QI, patient education, and discharge planning. The notebook process was implemented throughout the hospital a little more than a year after the completion of the pilot project.
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Affiliation(s)
- H Siebens
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA.
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504
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Schillinger D. Improving the Quality of Chronic Disease Management for Populations with Low Functional Health Literacy: A Call to Action. ACTA ACUST UNITED AC 2001. [DOI: 10.1089/10935070152596025] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Dean Schillinger
- University of California San Francisco, Primary Care Research Center, Department of Medicine, San Francisco General Hospital, San Francisco, California
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505
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Eysenbach G, Jadad AR. Evidence-based patient choice and consumer health informatics in the Internet age. J Med Internet Res 2001; 3:E19. [PMID: 11720961 PMCID: PMC1761898 DOI: 10.2196/jmir.3.2.e19] [Citation(s) in RCA: 160] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this paper we explore current access to and barriers to health information for consumers. We discuss how computers and other developments in information technology are ushering in the era of consumer health informatics, and the potential that lies ahead. It is clear that we witness a period in which the public will have unprecedented ability to access information and to participate actively in evidence-based health care. We propose that consumer health informatics be regarded as a whole new academic discipline, one that should be devoted to the exploration of the new possibilities that informatics is creating for consumers in relation to health and health care issues.
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506
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Abstract
There has been a recent trend to gather and record more comprehensive and more detailed personal medical information in computerized databases. Retrieval and access are much easier from electronic records than from hard copies stored in the archives of care-providing institutions. The Institute of Medicine voiced concern that these developments raised numerous problematic issues, the most disturbing of which is a much more widespread and systematic violation of privacy via what they called 'authorized abuse', i.e. authorized users abusing their access privileges. Other worries stemmed from the sharing of patient information among different entities. Multitudes of organizations receive information about patients' health records, often without their knowledge or consent. These include care providers, insurers, pharmacists, employers, life insurance companies and marketing firms. This article addresses the issues of medical data ownership and some health data-recording problems to which we propose co-ownership and co-documentation as part of the solution. We believe that a cooperative approach will help to maintain greater accuracy of personal medical data, written in language that can be shared and understood by the consumers and not one couched in terminology understandable only to professional personnel and to delegate the power to the patient to decide when and to whom to give authorization for its use by a third party and for research.
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Affiliation(s)
- B Sadan
- Information Systems Division, Hadassah Medical Organization, P.O. Box 12000, Jerusalem 91120, Israel.
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507
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Houts PS, Witmer JT, Egeth HE, Loscalzo MJ, Zabora JR. Using pictographs to enhance recall of spoken medical instructions II. PATIENT EDUCATION AND COUNSELING 2001; 43:231-242. [PMID: 11384821 DOI: 10.1016/s0738-3991(00)00171-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The first study in this series [Houts PS, Bachrach R, Witmer JT, Tringali CA, Bucher JA, Localio RA. Patient Educ. Couns. 1998;35:83-8] found that recall of spoken medical instructions averaged 14% but that, when pictographs (drawings representing the instructions) accompanied the spoken instructions and were present during recall, 85% of medical instructions were remembered correctly. Those findings suggested that spoken instructions plus pictographs may be a way to give people with low literacy skills access to medical information that is normally available only in written form. However, there were three important limitations to that study: (1) the subjects were literate and perhaps literate people remember pictograph meanings better than people with low literacy skills; (2) only short term recall was tested and, for medical information to be useful clinically, it must be remembered for significant periods of time and (3) a maximum of 50 instructions were shown in pictographs, whereas managing complex illnesses may require remembering several hundred instructions. This study addresses those limitations by investigating 4-week recall of 236 medical instructions accompanied by pictographs by people with low literacy skills. Subjects were 21 adult clients of an inner city job training program who had less than fifth grade reading skills. Results showed 85% mean correct recall of pictograph meanings immediately after training (range from 63 to 99%) and 71% after 4 weeks (range from 33 to 94%). These results indicate that people with low literacy skills can, with the help of pictographs, recall large amounts of medical information for significant periods of time. The impact of pictographs on symptom management and patient quality of life remains to be studied.
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Affiliation(s)
- P S Houts
- Johns Hopkins Oncology Center, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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508
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Davis TC, Dolan NC, Ferreira MR, Tomori C, Green KW, Sipler AM, Bennett CL. The role of inadequate health literacy skills in colorectal cancer screening. Cancer Invest 2001; 19:193-200. [PMID: 11296623 DOI: 10.1081/cnv-100000154] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Colorectal cancer is ideally suited for early detection strategies that are likely to improve survival rates. Screening with either a fecal occult blood test (FOBT) or flexible sigmoidoscopy has been shown to identify precancerous polyps or cancers in early stages. However, persons with limited education and of lower socioeconomic status infrequently participate in screening programs in general and have very low rates of colorectal screening. Low literacy, which is common among persons with limited education and low income, may be an overlooked factor in understanding patients' decision making about colorectal cancer screening. This article provides information from focus groups about colorectal cancer screening, which we examine in the context of relevant literature on cancer screening and literacy. Using the health belief model, we examine the association between inadequate health literacy skills and low rates of colorectal cancer screening. The theoretical model also provides insights into strategies for improving knowledge, attitudes, and beliefs and screening rates for this challenging patient population.
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Affiliation(s)
- T C Davis
- Department of Medicine, Louisiana State University Medical Center, Shreveport, Louisiana, USA
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509
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Abstract
Health sciences librarians will face many new challenges in the new millennium. Some we can predict and some we cannot. The Hospital Information Services columns will explore some of these challenges in this and subsequent issues.
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Affiliation(s)
- C M Gilbert
- Library Services, Helen L. DeRoy Medical Library, Providence Hospital and Health Centers, 16001 West Nine Mile Road, Southfield, MI 48037, USA.
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510
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Slavkin HC. The Surgeon General's Report and special-needs patients: a framework for action for children and their caregivers. SPECIAL CARE IN DENTISTRY 2001; 21:88-94. [PMID: 11507848 DOI: 10.1111/j.1754-4505.2001.tb00232.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Surgeon General's Report, Oral Health in America, is the first comprehensive assessment of oral, dental, and craniofacial health in the history of our nation. The intent of this first-ever Report is to alert Americans to the full meaning of oral health and its importance to general health and well-being across the lifespan. Moreover, the Report has been released at a time in human history of enormous changes as well as opportunities. The convergence of public health policies, "quality of life" expectations, global informatics, a new century of biotechnology, the completion of the Human Genome Project, changes in the management of health care, and the acknowledgment of enormous health disparities herald a call to action. These profound dynamics particularly affect children and their caregivers and the multitude of social, economic, and health issues associated with special patients and developmental disabilities. This paper will highlight the issues, provide recommendations, and suggest a call to action.
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Affiliation(s)
- H C Slavkin
- Office of the Dean, Room 203, School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089-0641, USA.
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511
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Abstract
BACKGROUND Numeracy, how facile people are with basic probability and mathematical concepts, is associated with how people perceive health risks. Performance on simple numeracy problems has been poor among populations with little as well as more formal education. Here, we examine how highly educated participants performed on a general and an expanded numeracy scale. The latter was designed within the context of health risks. METHOD A total of 463 men and women aged 40 and older completed a 3-item general and an expanded 7-item numeracy scale. The expanded scale assessed how well people 1) differentiate and perform simple mathematical operations on risk magnitudes using percentages and proportions, 2) convert percentages to proportions, 3) convert proportions to percentages, and 4) convert probabilities to proportions. RESULTS On average, 18% and 32% of participants correctly answered all of the general and expanded numeracy scale items, respectively. Approximately 16% to 20% incorrectly answered the most straightforward questions pertaining to risk magnitudes (e.g., Which represents the larger risk: 1%, 5%, or 10%?). A factor analysis revealed that the general and expanded risk numeracy items tapped the construct of global numeracy. CONCLUSIONS These results suggest that even highly educated participants have difficulty with relatively simple numeracy questions, thus replicating in part earlier studies. The implication is that usual strategies for communicating numerical risk may be flawed. Methods and consequences of communicating health risk information tailored to a person's level of numeracy should be explored further.
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Affiliation(s)
- I M Lipkus
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27701, USA.
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512
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Estrada CA, Hryniewicz MM, Higgs VB, Collins C, Byrd JC. Anticoagulant patient information material is written at high readability levels. Stroke 2000; 31:2966-70. [PMID: 11108757 DOI: 10.1161/01.str.31.12.2966] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Warfarin therapy requires frequent monitoring and dose adjustment. Elderly patients with atrial fibrillation, prior stroke, and lower literacy skills may have difficulty reading brochures that explain dosing instructions, procedures to follow, and the risks and benefits of anticoagulants. In general, it is recommended that brochures be written at or below the 6th-grade level. We determined the readability of patient information material being offered to patients receiving anticoagulants. METHODS AND RESULTS We used the SMOG grade formula to measure readability of written patient materials. We obtained 50 brochures commonly used in anticoagulation management units from industry and health advocacy groups. Patient information was related to atrial fibrillation (16%, n=8), warfarin (44%, n=22), low-molecular-weight heparins (12%, n=6), or other related topics (28%, n=14). The mean readability was found to be grade 10.7 (95% CI 10.1 to 11.2); none had a readability score at the 6th-grade level or below, 12% of the brochures had readability scores at the 7th- to 8th-grade levels (n=6), 74% at the 9th- to 12th-grade levels (n=37), and 14% at higher than 12th-grade level (n=7). The readability grade level was similar for brochures produced by industry or health advocacy groups (P:=0.9) but higher for information obtained from the Internet (12.2+/-1.3 grades) compared with other sources (10.3+/-2.1 grades; P:=0.01). CONCLUSIONS Patient education materials related to the use of anticoagulants are written at grade levels beyond the comprehension of most patients. Low-literacy brochures are needed for patients on anticoagulants.
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Affiliation(s)
- C A Estrada
- East Carolina University Anticoagulation Clinic, Clinical Information Support Office, University Health Systems, Greenville, North Carolina, USA.
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513
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Kalichman SC, Rompa D. Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. J Acquir Immune Defic Syndr 2000; 25:337-44. [PMID: 11114834 DOI: 10.1097/00042560-200012010-00007] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Poor health literacy is a prevalent barrier to medical care and people with lower health literacy experience greater illness severity than people with higher health literacy. Health literacy may therefore be an important factor in the health and treatment of people living with HIV-AIDS. METHODS A community-recruited sample of 339 HIV-infected men and women completed surveys and interviews that assessed functional health literacy, health status, AIDS-related disease and treatment knowledge, and health care perceptions and experiences. Medical records were available for chart abstraction of health status for a subsample of participants. RESULTS About 1 of 4 people living with HIV-AIDS demonstrated difficulty comprehending simple medical instructions and therefore lower health literacy. HIV-infected people with lower health literacy had lower CD4 cell counts, higher viral loads, were less likely to be taking antiretroviral medications, reported a greater number of hospitalizations, and reported poorer health than those with higher health literacy. In addition, after adjusting for years of formal education, lower health literacy was associated with poorer knowledge of one's HIV-related health status, poorer AIDS-related disease and treatment knowledge, and more negative health care perceptions and experiences. CONCLUSIONS Health literacy is a significant factor in the health and treatment of persons living with HIV-AIDS. Interventions are needed to improve medical care and the health status of people with lower health literacy that are living with HIV-AIDS.
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Affiliation(s)
- S C Kalichman
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
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514
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Affiliation(s)
- S Vanderberg-Dent
- Rush Medical College, Rush-Illinois Masonic Family Practice Residency, Chicago, USA
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515
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Functional Health Literacy Is Associated With Health Status and Health-Related Knowledge in People Living With HIV-AIDS. J Acquir Immune Defic Syndr 2000. [DOI: 10.1097/00126334-200012010-00007] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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516
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Abstract
OBJECTIVE We examined the prevalence of access problems among public clinic patients after participating in trials of automated telephone disease management with nurse follow-up. DESIGN Randomized trial. SETTING General medicine clinics of a county health care system and a Veterans Affairs (VA) health care system. PARTICIPANTS Five hundred seventy adults with diabetes using hypoglycemic medication were enrolled and randomized; 520 (91%) provided outcome data at 12 months. INTERVENTION Biweekly automated telephone assessments with telephone follow-up by diabetes nurse educators. MEASUREMENTS AND MAIN RESULTS At follow-up, patients reported whether in the prior 6 months they had failed to obtain each of six types of health services because of a financial or nonfinancial access problem. Patients receiving the intervention were significantly less likely than patients receiving usual care to report access problems (adjusted odds ratio [AOR], 0.61; 95% confidence interval [CI], 0.43 to 0.97). The risk of reporting access problems was greater among county clinic patients than VA patients even when adjusting for their experimental condition, and socioeconomic and clinical risk factors (AOR, 1.61; 95% CI, 1.02 to 2.53). County patients were especially more likely to avoid seeking care because of a worry about the cost (AOR, 2.82; 95% CI, 1.48 to 5.37). CONCLUSIONS Many of these public sector patients with diabetes reported that they failed to obtain health services because they perceived financial and nonfinancial access problems. Automated telephone disease management calls with telephone nurse follow-up improved patients' access to care. Despite the impact of the intervention, county clinic patients were more likely than VA patients to report access problems in several areas.
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Affiliation(s)
- J D Piette
- Center for Health Care Evaluation/HSR&D Center of Excellence, VA Palo Alto Health Care System, Calif 94025, USA.
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517
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Baker DW, Gazmararian JA, Sudano J, Patterson M. The association between age and health literacy among elderly persons. J Gerontol B Psychol Sci Soc Sci 2000; 55:S368-74. [PMID: 11078114 DOI: 10.1093/geronb/55.6.s368] [Citation(s) in RCA: 282] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine why older age groups have worse functional health literacy. METHODS Home interviews were conducted with community-dwelling elderly persons (n = 2,774) to determine demographics, years of school completed, newspaper reading frequency, chronic diseases, and health status. Participants completed the Short Test of Functional Health Literacy in Adults (S-TOFHLA, range 0-100) and the Mini Mental State Examination (MMSE). RESULTS Mean S-TOFHLA scores declined 1.4 points (95% CI 1.3-1.5) for every year increase in age (p < .001). After adjusting for sex, race, ethnicity, and education, the S-TOFHLA score declined 1.3 points (95% CI 1.2-1.4) for every year increase in age. Even after adjustment for performance on the MMSE, the S-TOFHLA score declined 0.9 points (95% CI 0.8-1.0) for every year increase in age (p < .001). Differences in newspaper reading frequency, visual acuity, chronic medical conditions, and health status, did not explain the lower literacy of older participants. DISCUSSION Functional health literacy was markedly lower among older age groups even after adjusting for differences in MMSE performance, newspaper reading frequency, health status, and visual acuity. Future studies should prospectively examine whether functional literacy declines with age and whether this is explained by declines in cognitive function.
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Affiliation(s)
- D W Baker
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio USA.
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518
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Ungvarski PJ. It's a shame. HOME HEALTHCARE NURSE 2000; 18:595. [PMID: 11951745 DOI: 10.1097/00004045-200010000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- P J Ungvarski
- AIDS Services, The Visiting Nurse Service of New York, USA
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519
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Osborne H, Hochhauser M. Readability and comprehension of the introduction to the Massachusetts Health Care Proxy. Hosp Top 2000; 77:4-6. [PMID: 11009943 DOI: 10.1080/00185869909596531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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520
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Abstract
There is little evidence of systematic negative bias against older patients in medical visits. The nature of the current narrative review, largely based on studies conducted after 1985, is consistent with the author's previous metaanalysis of over 40 studies published between 1965 and 1985. In that review, based on videotapes or audiotapes of medical visits, consistent relationships between patient age and physicians' interviewing skills were found. Older patients received more information, more total communication and questions concerning drugs, more courtesy, and perhaps more formality reflected in less laughter and joking than younger patients. Ultimately, the subtle ageism that may be present in medical visits with older patients is probably balanced somewhat by communication advantages afforded them challenging the negative views of older patients' care prevalent in the literature. This balance may help explain the ubiquitous finding that older patients are more satisfied with their health care, despite poorer health status, than younger patients. Nevertheless, other patients, especially those in the oldest cohorts, are at high risk for passive relationships and communication complications related to low literacy and poor health status and deserve the attention and special consideration of providers and health service researchers.
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Affiliation(s)
- D L Roter
- Department of Health Policy and Management, Faculty of Social and Behavioral Sciences, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
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521
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Morrow D, Carver LM, Leirer VO, Tanke ED. Medication schemas and memory for automated telephone messages. HUMAN FACTORS 2000; 42:523-540. [PMID: 11324848 DOI: 10.1518/001872000779698042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The present study investigated whether older and younger adults use a schema to organize and remember spoken reminder messages for taking medication. Previous research has shown that older and younger adults share preferences for organizing printed instructions for taking medication, suggesting a shared schema. Older and younger participants in Experiment 1 of the present study used a similar schema to organize medication reminder messages. This finding suggests that the medication schema generalizes across communication purpose (to remind or to instruct) as well as across patient age. Medication reminder messages were better understood and remembered when organized to match this schema, whether the reminders were presented as automated telephone messages (Experiment 2) or in printed form (Experiment 3). Schema-compatible organization especially helped people draw inferences from the messages, suggesting that organization helps older and younger adults construct a situation model of the medication-taking task from the messages. Potential applications of organized messages include increasing the impact of automated systems for delivering health services.
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Affiliation(s)
- D Morrow
- Department of Psychology, University of New Hampshire, Durham 03824, USA.
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522
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Sieving PC. Factors driving the increase in medical information on the web--one American perspective. J Med Internet Res 1999; 1:E3. [PMID: 11720912 PMCID: PMC1761702 DOI: 10.2196/jmir.1.1.e3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
From the perspective of an academic medical community in the United States, factors driving the increase in medical information on the Internet are examined. These factors are considered in two categories: those that create a demand for information, and those which respond to that demand or attempt to increase or profit by it. The factors explored include demographic, economic, and technological conditions on both sides of the information marketplace. The paper also addresses the responsibilities shared by providers of this information, and possible strategies to assure high-quality resources and informed use of them, both by health care professionals and by patients. The value of informed use is perhaps best conveyed with the following quote.
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Affiliation(s)
- P C Sieving
- Department of Ophthalmology & Visual Sciences, W.K. Kellogg Eye Center, Michigan 48105, USA.
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523
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524
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Stark F. History versus ideology: the Medicare reform debate. Health Aff (Millwood) 1999; 18:265-7. [PMID: 10388224 DOI: 10.1377/hlthaff.18.3.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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525
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Perhaps not everyone knows that…. Ann Oncol 1999. [DOI: 10.1093/oxfordjournals.annonc.a010368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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