1
|
Hariri E, Al Hammoud M, Donovan E, Shah K, Kittleson MM. The Role of Informed Consent in Clinical and Research Settings. Med Clin North Am 2022; 106:663-674. [PMID: 35725232 DOI: 10.1016/j.mcna.2022.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Informed consent plays an integral role in governing the patient-physician relationship with origins traced back to ancient Greek philosophy. The main pillars of informed consent are autonomy, integrity, respect, and care. In the last century, these notions have been codified into legislation to promote healthy patient-physician relationships. Understanding the process of informed consent is critical for patients, researchers, and medical practitioners. In this article, the authors provide a brief historical narrative of informed consent, elaborate on the process of obtaining an ethically and legally valid informed consent, and present some of the future challenges in the field.
Collapse
Affiliation(s)
- Essa Hariri
- Department of Internal Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, G10 Clinic, Cleveland OH 44195, USA
| | - Mazen Al Hammoud
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, P.O. Box 36, Byblos, Lebanon
| | - Erin Donovan
- Department of Communication Studies, The University of Texas at Austin, 2504A Whitis Ave, Austin, TX 78712, USA
| | - Kevin Shah
- Department of Medicine, Division of Cardiology, University of Utah Hospital, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132, USA
| | - Michelle M Kittleson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai, Medical Center, 8670 Wilshire Blvd, 2nd floor, Beverly Hills, CA 90211, USA.
| |
Collapse
|
2
|
Peiris R, Cornell S, Greaves K, Bonner C. Do hospital consent forms for cardiology procedures meet health literacy standards? Evaluation of understandability and readability. PATIENT EDUCATION AND COUNSELING 2022; 105:1254-1260. [PMID: 34579996 DOI: 10.1016/j.pec.2021.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Consent forms that are difficult to understand may jeopardize informed consent. The aim of this study was to determine whether consent documents for cardiology-related procedures could be easily read and understood by patients with low health literacy. METHODS All 37 cardiology-related consent forms with patient information material were retrieved from a publicly available suite of documents from one state in Australia. Two raters independently assessed documents and resolved discrepancies through discussion. Understandability was assessed using the Patient Education Materials Assessment Tool for Printed materials (PEMAT-P). Readability was assessed using the Gunning Fog Index, SMOG and Flesch Reading Ease formulas. Images were assessed using the 5C Image checklist. Results were analyzed descriptively. RESULTS Only 1 of 37 forms met the general PEMAT-P threshold (70%) for being 'understandable'. The average readability score was high, requiring a grade 10-12 level of education to understand. Most images lacked useful captions, had low visual clarity, and were not purpose-designed for the material. CONCLUSIONS The current format for cardiology consent forms does not meet recommended standards for understandability and readability. PRACTICE IMPLICATIONS Development of consent forms would benefit from taking health literacy principles into account with patient input, and purpose-designed images should be included in all forms to reinforce text.
Collapse
Affiliation(s)
- Ruwani Peiris
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Samuel Cornell
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Kim Greaves
- Department of Cardiology, Sunshine Coast University Hospital, University of the Sunshine Coast, Birtinya, Australia
| | - Carissa Bonner
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| |
Collapse
|
3
|
Kasaye MD, Beshir MA, Endehabtu BF, Tilahun B, Guadie HA, Awol SM, Kalayou MH, Yilma TM. Medical documentation practice and associated factors among health workers at private hospitals in the Amhara region, Ethiopia 2021. BMC Health Serv Res 2022; 22:465. [PMID: 35397590 PMCID: PMC8994305 DOI: 10.1186/s12913-022-07809-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Medical documentation is an important part of the medical process as it is an essential way of communication within the health care system. However, medical documentation practice in the private sector is not well studied in Ethiopian context. The aim of this study was to assess the practice of medical documentation and its associated factors among health workers at private hospitals in the Amhara region, Ethiopia. Method An institution-based cross-sectional quantitative study supplemented with a qualitative design was conducted among 419 health workers at the private hospitals in the Amhara Region, Ethiopia from March 29 to April 29 /2021. Data were collected using both a self-administered questionnaire and interview guide for quantitative and qualitative respectively. Data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Descriptive statistics, Bi-variable, and multivariable logistic regression analysis were performed. In-depth interviews were conducted using semi-structured questionnaires with eight respondents to explore the challenges related to the practice of medical documentation. Respondent’s response were analyzed using OpenCode version 4.03 thematically. Results Four hundred seven study participants returned the questionnaire. Nearly 50 % (47.2%) health workers had of good medical documentation practice. Health workers who received in-service training on medical documentation AOR = 2.77(95% CI: [1.49,5.14]), good knowledge AOR = 2.28 (95% CI: [1.34,3.89]), favorable attitude AOR = 1.78 (95%CI: [1.06,2.97]), strong motivation AOR = 3.49 (95% CI: [2.10,5.80]), available guide line formats AOR = 3.12 (95% CI: [1.41,6.84]), eHealth literacy AOR = 1.73(95% CI: [1.02,2.96]), younger age AOR = 2.64 (95% CI:[1.27,5.46]) were statistically associated with medical documentation. Conclusion More than half of the medical services provided were not registered. Therefore, it is important to put extra efforts to improve documentation practice by providing planed trainings on standards of documentation to all health workers, creating positive attitudes and enhancing their knowledge by motivating them to develop a culture of information.
Collapse
|
4
|
Zhong F, Pengpeng L, Qianru Z. Grouping Together to Fight Cancer: The Role of WeChat Groups on the Social Support and Self-Efficacy. Front Public Health 2022; 10:792699. [PMID: 35359783 PMCID: PMC8963820 DOI: 10.3389/fpubh.2022.792699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/31/2022] [Indexed: 12/25/2022] Open
Abstract
With the increasing number of cancer survivors, the question of how to coexist with cancer has become more and more pressing. This research uses a mutual help WeChat group organized by cancer patients as the research field to observe the daily interactions of cancer patients, so as to improve understanding of how social media technology can help cancer patients in the treatment and recovery process. The study found that the WeChat group is the main source of health knowledge for the participating cancer patients, and that when compared to traditional web-based patient mutual aid communities, the WeChat group is a more timely, popular, continuous, and accurate source of information. Patients in the group can listen and respond to each other's questions and worries, providing both an outlet for patients to vent their emotions and concerns and a source of recognition and encouragement. In addition, this study found that the WeChat mutual aid group improves patients' self-efficacy of disease on four levels: successful experience in curing patients, imitating patients' behavior, verbal persuasion, and emotional support.
Collapse
Affiliation(s)
- Fangqi Zhong
- College of Communication, National Chengchi University, Taipei, Taiwan
| | - Li Pengpeng
- College of Communication, National Chengchi University, Taipei, Taiwan
| | | |
Collapse
|
5
|
Kelly B, O’Donoghue A, Parvanta S, Boudewyns V, Oguntimein O, Bann C, West S, Tzeng J, Chandler C, Madson G, McCormack L. Effects of additional context information in prescription drug information sheets on comprehension and risk and efficacy perceptions. J Pharm Policy Pract 2022; 15:15. [PMID: 35232474 PMCID: PMC8887124 DOI: 10.1186/s40545-021-00386-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 11/26/2021] [Indexed: 12/04/2022] Open
Abstract
Objective To determine how additional explanatory text (context) about drug side effects in a patient medication information handout affected comprehension and perceptions of risk and efficacy. Methods We conducted an online experiment with a national sample of 1,119 U.S. adults with rheumatoid arthritis and related conditions, sampled through random-digit dialing, address-based sampling, and online ads. We randomized participants to receive one of several versions of a patient information handout for a fictitious drug, either with or without additional context, then measured comprehension and other outcomes. Results Additional qualitative context about warnings and side effects resulted in lower comprehension of side effect information, but not information about uses of the drug or warnings. The effect of additional context on risk perceptions depended on whether the medication handout was delivered online or through the mail. Those who received a hardcopy of the handout with additional context had higher perceived risk of side effects than those who saw the version without additional context. Conclusion More clarifying information is not always better and may lead to cognitive overload, inhibiting comprehension. Practice implications Additional research should further explore effects of context in online vs. hard-copy formats before practice implications can be determined. Supplementary Information The online version contains supplementary material available at 10.1186/s40545-021-00386-9.
Collapse
|
6
|
Naeem I, Quan H, Singh S, Chowdhury N, Chowdhury M, Saini V, Tc T. Factors Associated With Willingness to Share Health Information: Rapid Review. JMIR Hum Factors 2022; 9:e20702. [PMID: 35138263 PMCID: PMC8867291 DOI: 10.2196/20702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/30/2020] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background To expand research and strategies to prevent disease, comprehensive and real-time data are essential. Health data are increasingly available from platforms such as pharmaceuticals, genomics, health care imaging, medical procedures, wearable devices, and internet activity. Further, health data are integrated with an individual’s sociodemographic information, medical conditions, genetics, treatments, and health care. Ultimately, health information generation and flow are controlled by the patient or participant; however, there is a lack of understanding about the factors that influence willingness to share health information. A synthesis of the current literature on the multifactorial nature of health information sharing preferences is required to understand health information exchange. Objective The objectives of this review are to identify peer-reviewed literature that reported factors associated with health information sharing and to organize factors into cohesive themes and present a narrative synthesis of factors related to willingness to share health information. Methods This review uses a rapid review methodology to gather literature regarding willingness to share health information within the context of eHealth, which includes electronic health records, personal health records, mobile health information, general health information, or information on social determinants of health. MEDLINE and Google Scholar were searched using keywords such as electronic health records AND data sharing OR sharing preference OR willingness to share. The search was limited to any population that excluded health care workers or practitioners, and the participants aged ≥18 years within the US or Canadian context. The data abstraction process using thematic analysis where any factors associated with sharing health information were highlighted and coded inductively within each article. On the basis of shared meaning, the coded factors were collated into major themes. Results A total of 26 research articles met our inclusion criteria and were included in the qualitative analysis. The inductive thematic coding process revealed multiple major themes related to sharing health information. Conclusions This review emphasized the importance of data generators’ viewpoints and the complex systems of factors that shape their decision to share health information. The themes explored in this study emphasize the importance of trust at multiple levels to develop effective information exchange partnerships. In the case of improving precision health care, addressing the factors presented here that influence willingness to share information can improve sharing capacity for individuals and allow researchers to reorient their methods to address hesitation in sharing health information.
Collapse
Affiliation(s)
- Iffat Naeem
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shaminder Singh
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | - Nashit Chowdhury
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mohammad Chowdhury
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Vineet Saini
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Research and Innovation - Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Turin Tc
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
7
|
Geier C, Adams RB, Mitchell KM, Holtz BE. Informed Consent for Online Research-Is Anybody Reading?: Assessing Comprehension and Individual Differences in Readings of Digital Consent Forms. J Empir Res Hum Res Ethics 2021; 16:154-164. [PMID: 34029168 DOI: 10.1177/15562646211020160] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Informed consent is an important part of the research process; however, some participants either do not read or skim the consent form. When participants do not read or comprehend informed consent, then they may not understand the potential benefits, risks, or details of the study before participating. This study used previous research to develop experimentally manipulated online consent forms utilizing various presentations of the consent form and interactive elements. Participants (n = 576) were randomly exposed to one of six form variations. Results found that the highly interactive condition was significantly better for comprehension than any of the other conditions. The highly interactive condition also performed better for readability, though not significantly. Further research should explore the effects of interactive elements to combat habituation and to engage participants with the parts of the consent form unique to the study.
Collapse
Affiliation(s)
- Caitlin Geier
- Department of Media & Information, 3078Michigan State University, East Lansing, MI, USA
| | - Robyn B Adams
- Department of Advertising & Public Relations, 3078Michigan State University, East Lansing, MI, USA
| | - Katharine M Mitchell
- Department of Advertising & Public Relations, 3078Michigan State University, East Lansing, MI, USA
| | - Bree E Holtz
- Department of Advertising & Public Relations, 3078Michigan State University, East Lansing, MI, USA
| |
Collapse
|
8
|
Zhong B, Chen J. Health information helps mitigate adolescent depression: A multivariate analysis of the links between health information use and depression management. Child Care Health Dev 2021; 47:201-207. [PMID: 33238070 DOI: 10.1111/cch.12831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/22/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression has brought a range of detrimental effects on adolescents. Despite the identified adverse outcomes, it is unclear what mechanisms contribute to the onset of adolescent depression. The limitation calls for innovative ways of managing the mental disorder, including embedding the methods and concepts from the humanities and social sciences into caring depressed teens. This study analyses how adolescents' health information use helps mitigate depressive symptoms. METHODS Guided by the information processing theories, this study proposes the health information processing model and uses it to analyse the impact of health information use on self-management of depressive symptoms among Chinese urban adolescents aged 10-18. A total of 310 urban teens were recruited from elementary, middle and high schools in Changchun in North China. The data collection was part of a project conducted jointly by China's National Health Commission and the United Nations Children's Fund. RESULTS Chinese teens' health knowledge and health literacy helped alleviate depressive symptoms. More health knowledge and self-efficacy predicted positive health behaviour changes, leading to better depression management. Older teens were more depressive and had more health knowledge than younger ones. Depressive symptoms were also associated with gender, school performance, family income and parents' education. Both parents' education levels significantly affected their children's depression, but in different ways. The more urban adolescents trusted health information from parents or teachers, the less they felt depressive, while the health information from peers did not have the same effect. CONCLUSION The study indicates that health information use may represent a unique form of intervention that could help mitigate the mental health issues Chinese youth experience. The findings add new insights to the knowledge of adolescents' depression management and health decision-making.
Collapse
Affiliation(s)
- Bu Zhong
- Donald P. Bellisario College of Communications, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Juan Chen
- School of Journalism and Communication, South China University of Technology, Guangzhou Higher Education Mega Center, Guangzhou, China
| |
Collapse
|
9
|
Rafferty KA, Beck G, McGuire M. When Facing Hopeful and Hopeless Experiences: Using Snyder's Hope Theory to Understand Parents' Caregiving Experiences for Their Medically Complex Child. J Pediatr Health Care 2020; 34:542-549. [PMID: 32771340 DOI: 10.1016/j.pedhc.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/01/2020] [Accepted: 06/06/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION An emerging subpopulation within pediatric chronic illness is children living with complex chronic conditions. Managing a child's complex chronic conditions can be emotionally taxing for parents. Many parents regard hope as a "life-sustaining and essential" process for them. METHOD We used the central concepts within Snyder's hope theory to guide our directed content analysis of parents' interviews about their hopeful and hopeless experiences. Our sample consisted of primarily Christian married mothers. RESULTS We found themes within each concept of Snyder's hope theory that clarifies the social and communicative processes that facilitate more hopeful thinking for parents. DISCUSSION Understanding how individuals communicate or enact hopeful thinking is an important contributor to performing hope in social settings like hospitals and nonprofit organizations (Ronald McDonald House) that support parents with medically complex children. Our findings indicate that messages should help parents identify care solutions, offer words of encouragement, and help parents create life goals that maintain a child's quality of life.
Collapse
|
10
|
Diemer FS, Snijder MB, Agyemang C, Haan YC, Karamat FA, van Montfrans GA, Oehlers GP, Peters RJG, Brewster LM, Stronks K. Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies. Intern Emerg Med 2020; 15:1041-1049. [PMID: 31950398 DOI: 10.1007/s11739-019-02269-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/21/2019] [Indexed: 01/14/2023]
Abstract
We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18-70 years), respectively. Groups were formed based on country and self-defined ethnicity, and stratified by sex. Age-adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated for hypertension prevalence, awareness, treatment, and control. Subsequently, we focused on hypertension prevalence and adjusted for risk factors for hypertension: BMI and waist circumference (model 2), educational level, physical activity, and smoking (model 3). After adjustment for age, no significant differences in hypertension prevalence, awareness, treatment, and control between countries were seen in men. However, women in Suriname were more often hypertensive with lower levels of awareness and control than those in The Netherlands (African: OR 1.54 [95% CI 1.19, 2.00]; South-Asian: 1.90 [1.35, 2.67]; awareness: 0.62 [0.43, 0.88] in African women; control: 0.48 [0.28, 0.84] in South-Asian women). Higher hypertension prevalence was explained by differences in BMI and waist circumference in African women (adjusted OR 1.26 [0.96, 1.65]) and by education, physical activity, and smoking in South-Asian women (adjusted OR 1.29 [0.87, 1.89]). Particularly, women in Suriname bear a relatively high hypertension burden with lower levels of awareness and control. As the higher hypertension prevalence was mainly explained by lifestyle-related risk factors, health promotion interventions may reduce the hypertension burden in Suriname.
Collapse
Affiliation(s)
- Frederieke Sophie Diemer
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
- Department of Cardiology, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Marieke Brigitte Snijder
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Yentl Christina Haan
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Fares Aziz Karamat
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | | | - Glenn Paul Oehlers
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | | | - Lizzy Maritza Brewster
- The Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
- Creatine Kinase Foundation, Amsterdam, The Netherlands
- Department of Public Health, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Karien Stronks
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
11
|
Tong A, Levey AS, Eckardt KU, Anumudu S, Arce CM, Baumgart A, Dunn L, Gutman T, Harris T, Lightstone L, Scholes-Robertson N, Shen JI, Wheeler DC, White DM, Wilkie M, Craig JC, Jadoul M, Winkelmayer WC. Patient and Caregiver Perspectives on Terms Used to Describe Kidney Health. Clin J Am Soc Nephrol 2020; 15:937-948. [PMID: 32586923 PMCID: PMC7341768 DOI: 10.2215/cjn.00900120] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/16/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The language used to communicate important aspects of kidney health is inconsistent and may be conceptualized differently by patients and health professionals. These problems may impair the quality of communication, care, and patient outcomes. We aimed to describe the perspectives of patients on terms used to describe kidney health. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Patients with CKD (n=54) and caregivers (n=13) from the United States, United Kingdom, and Australia participated in ten focus groups to discuss terms for kidney health (including kidney, renal, CKD, ESKD, kidney failure, and descriptors for kidney function). We analyzed the data using thematic analysis. RESULTS We identified four themes: provoking and exacerbating undue trauma (fear of the unknown, denoting impending death, despair in having incurable or untreatable disease, premature labeling and assumptions, judgment, stigma, and failure of self); frustrated by ambiguity (confused by medicalized language, lacking personal relevance, baffled by imprecision in meaning, and/or opposed to obsolete terms); making sense of the prognostic enigma (conceptualizing level of kidney function, correlating with symptoms and effect on life, predicting progression, and need for intervention); and mobilizing self-management (confronting reality, enabling planning and preparation, taking ownership for change, learning medical terms for self-advocacy, and educating others). CONCLUSIONS The obscurity and imprecision of terms in CKD can be unduly distressing and traumatizing for patients, which can impair decision making and self-management. Consistent and meaningful patient-centered terminology may improve patient autonomy, satisfaction, and outcomes.
Collapse
Affiliation(s)
- Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia .,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Andrew S Levey
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts
| | - Kai-Uwe Eckardt
- Medical Department, Division of Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Samaya Anumudu
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas
| | | | - Amanda Baumgart
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louese Dunn
- Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Talia Gutman
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Tess Harris
- Polycystic Kidney Disease International, London, UK
| | - Liz Lightstone
- Centre for Inflammatory Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Jenny I Shen
- Division of Nephrology and Hypertension, Harbor-UCLA Medical Center, Torrance, California
| | - David C Wheeler
- Centre for Nephrology, University College London, London, UK.,George Institute for Global Health, Sydney, New South Wales, Australia
| | - David M White
- Center for Health Action and Policy, The Rogosin Institute, New York, New York
| | - Martin Wilkie
- Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Michel Jadoul
- Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Wolfgang C Winkelmayer
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
12
|
Bute JJ, Brann M. Tensions and Contradictions in Interns' Communication about Unexpected Pregnancy Loss. HEALTH COMMUNICATION 2020; 35:529-537. [PMID: 30719939 DOI: 10.1080/10410236.2019.1570429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Early miscarriage is an unexpected pregnancy complication that affects up to 25% of pregnant women. Physicians are often tasked with delivering the bad news of a pregnancy loss to asymptomatic women while also helping them make an informed decision about managing the miscarriage. Assessing the communicative responses, particularly the discursive tensions embedded within providers' speech, offers insight into the (in)effective communication used in the delivery of bad news and the management of a potentially traumatic medical event. We observed and analyzed transcripts from 40 standardized patient encounters using Baxter's relational dialectics theory 2.0. Results indicated that interns invoked two primary distal already-spoken discourses: discourses of medicalization of miscarriage and discourses of rationality and informed consent. We contend that tensions and contradictions could affect how women respond to the news of an impending miscarriage and offer practical implications for communication skills training.
Collapse
Affiliation(s)
- Jennifer J Bute
- Department of Communication Studies, Indiana University-Purdue University Indianapolis
| | - Maria Brann
- Department of Communication Studies, Indiana University-Purdue University Indianapolis
| |
Collapse
|
13
|
Magsamen-Conrad K, Dillon JM, Billotte Verhoff C, Faulkner SL. Online Health-Information Seeking Among Older Populations: Family Influences and the Role of the Medical Professional. HEALTH COMMUNICATION 2019; 34:859-871. [PMID: 29474125 PMCID: PMC6230499 DOI: 10.1080/10410236.2018.1439265] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There are myriad technological devices, computer programs, and online information sources available for people to manage their health and the health of others. However, people must be technologically and health literate and capable of accessing, analyzing, and sharing the information they encounter. The authors interviewed middle-aged and older adults about their online health information seeking behavior and discovered that technology and health literacy are influenced by a collective ability to manage the health and technological needs of a family. We used information management theory to frame participants' experiences of their self-efficacy using technology to manage the health of loved ones. Findings suggest that health can be co-managed if at least one person in a family unit is technologically "savvy" and able to effectively share health information. However, individuals' confidence in their own literacy often depends on others, usually family members who tend to "do" instead of "teach."
Collapse
|
14
|
Palumbo R, Annarumma C, Manna R, Musella M, Adinolfi P. Improving quality by involving patient. The role of health literacy in influencing patients’ behaviors. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1620458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rocco Palumbo
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Carmela Annarumma
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Rosalba Manna
- Department of Business and Quantitative Studies, University of Naples ‘Parthenope’, Naples, Italy
| | - Marco Musella
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| | - Paola Adinolfi
- Department of Management & Innovation Systems, University of Salerno, Salerno, Italy
| |
Collapse
|
15
|
Thalén L, Heimann Mühlenbock K, Almkvist O, Eriksdotter M, Sundström E, Tallberg IM. Do adapted vignettes improve medical decision-making capacity for individuals with Alzheimer's disease? Scand J Psychol 2018; 58:497-503. [PMID: 29105128 DOI: 10.1111/sjop.12401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/19/2017] [Indexed: 11/29/2022]
Abstract
Medical decision-making capacity (MDC) is known to decline in individuals with Alzheimer's disease (AD). The vignette method uses hypothetical information as a prerequisite for measuring the capacity to make well-informed decisions to clinical trials. Our aim was to investigate if adapted vignettes can help individuals with mild AD to assimilate information, make decisions and express them in an understandable way, compared to corresponding decisions based on linguistically more demanding vignettes, as measured by the Swedish Linguistic Instrument for Medical Decision-making (LIMD). Two vignettes from LIMD were altered linguistically with the aim to facilitate understanding for individuals with AD. An experimental within-subject design was used to study the influence on MDC of readability (original/adapted vignettes) and content (two different clinical trials). We included 24 patients with mild AD in this prospective study, which read all four vignettes along with a few other tests. This allowed us to investigate the association between MDC and cognitive function. Adapted vignettes did not yield significant differences regarding MDC as compared with original vignettes using a two-way repeated measures analysis of variance. A difference was found between the two clinical trials where LIMD score was significantly higher for Kidney disease than hypertension vignettes. Our results indicate that adapted vignettes may not improve MDC for individuals with mild AD. MDC was affected by which clinical trial the vignettes regarded, which implies that other factors affecting MDC need to be investigated, like length of text and vocabulary used.
Collapse
Affiliation(s)
- Liv Thalén
- Functional Area Speech and Language Pathology, Karolinska University Hospital, Huddinge, and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ove Almkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, University of Stockholm, Stockholm, Sweden
| | - Maria Eriksdotter
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Sundström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Stiftelsen Stockholms Sjukhem, Stockholm, Sweden
| | - Ing-Mari Tallberg
- Functional Area Speech and Language Pathology, Karolinska University Hospital, Huddinge, and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
16
|
Champlin S, Hoover DS, Mackert M. Health Literacy in Adult Education Centers: Exploring Educator and Staff Needs. Health Promot Pract 2018; 21:198-208. [PMID: 30070148 DOI: 10.1177/1524839918789690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective. Incorporating health content into adult education courses is promising for increasing health literacy skills among "hard-to-reach" populations. The purpose of this study was to gain previously untapped knowledge of adult education personnel (i.e., educators, staff) about the strategies and programs that would be beneficial for helping students learn about health. Method. Personnel (N = 53) from three literacy coalitions completed an online survey that assessed interest and preferences for developing a health literacy curriculum. Results. Personnel indicated general concepts such as health services and insurance as those of greatest priority. Additionally, tools designed for general use (completion of forms) were favored. Personnel preferred programs that focused on general skills over those designed to address specific health topics, χ2(1) = 11.52, p = .001. Conclusions. Adult education personnel find greatest value in health literacy programs aimed at increasing general skills rather than disease-/topic-specific content. There were several mismatches in topics noted as a "priority" and those for which personnel felt comfortable teaching. A focus on fostering general health skills will help all students-not just those with specific health concerns such as diabetes and asthma. Teaching health literacy through general skill development could make health programs exciting, engaging, and accessible for students.
Collapse
|
17
|
Patel A, Bakina D, Kirk J, von Lutcken S, Donnelly T, Stone W, Ashley-Collins H, Tibbals K, Ricker L, Adler J, Ewing J, Blechman M, Fox S, Leopold W, Ryan D, Wray D, Turkoz H. Patient counseling materials: The effect of patient health literacy on the comprehension of printed prescription drug information. Res Social Adm Pharm 2018; 14:851-862. [PMID: 29887494 DOI: 10.1016/j.sapharm.2018.04.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/25/2018] [Accepted: 04/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. OBJECTIVES To explore the impact of reducing the health literacy demands of written patient health information. METHODS 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. RESULTS The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. CONCLUSIONS Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients.
Collapse
Affiliation(s)
- Amit Patel
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA.
| | - Daria Bakina
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Jim Kirk
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Tom Donnelly
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - William Stone
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Karen Tibbals
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Lynn Ricker
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Jeffrey Adler
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - John Ewing
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | | | - Sherry Fox
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Will Leopold
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Daniel Ryan
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Donna Wray
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| | - Heather Turkoz
- Intellus Worldwide, PO Box 1449, Minneola, FL 34755, USA
| |
Collapse
|
18
|
Stone W, Faughnan JC. The Silent Majority: Limited Health Literacy Participants Missing from Market Research. Health Lit Res Pract 2018; 2:e88-e93. [PMID: 31294281 PMCID: PMC6607805 DOI: 10.3928/24748307-20180327-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/14/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- William Stone
- Address correspondence to William Stone, BA, Sommer Consulting, 408 Executive Drive, Langhorne, PA 19047;
| | | |
Collapse
|
19
|
Abstract
Introduction The final rule for the protection of human subjects requires that informed consent be “in language understandable to the subject” and mandates that “the informed consent must be organized in such a way that facilitates comprehension.” This study assessed the readability of Institutional Review Board-approved informed consent forms at our institution, implemented an intervention to improve the readability of consent forms, and measured the first year impact of the intervention. Methods Readability assessment was conducted on a sample of 217 Institutional Review Board-approved informed consents from 2013 to 2015. A plain language informed consent template was developed and implemented and readability was assessed again after 1 year. Results The mean readability of the baseline sample was 10th grade. The mean readability of the post-intervention sample (n=82) was seventh grade. Conclusions Providing investigators with a plain language informed consent template and training can promote improved readability of informed consents for research.
Collapse
|
20
|
Adding Health Literacy to the Health Belief Model: Effectiveness of an Educational Intervention on Smoking Preventive Behaviors Among University Students. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.13773] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
21
|
Drake BF, Brown KM, Gehlert S, Wolf LE, Seo J, Perkins H, Goodman MS, Kaphingst KA. Development of Plain Language Supplemental Materials for the Biobank Informed Consent Process. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:836-844. [PMID: 27037699 PMCID: PMC5047847 DOI: 10.1007/s13187-016-1029-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The US Department of Health and Human Services addresses clear communication in the informed consent process as part of the Notice of Proposed Rulemaking for revisions to the Common Rule. However, prior research has shown that participants may not fully comprehend research studies despite completion of an informed consent process. Our main goal was to provide plain language information about donation processes to a cancer biobank to supplement an informed consent form. We developed and conducted cognitive testing with supplemental brochures that clearly communicated information about three different models for consent (notice, broad and study-specific) to future use of biospecimens. During the brochure development process, we conducted qualitative, semi-structured, individual, in-person cognitive interviews among 14 women to examine participants' perceptions of the brochures. Each participant provided feedback regarding the understandability, graphics and layout, and cultural appropriateness of the brochures. Our findings demonstrate that these methods may be used to tailor consent form brochures, such as the ones developed here, to other populations. This study therefore adds to our understanding of how best to present content to help women from two different racial groups make informed decisions about participation in a cancer biobank.
Collapse
Affiliation(s)
- Bettina F Drake
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA.
- Alvin J. Siteman Cancer Center, St. Louis, MO, 63110, USA.
| | - Katherine M Brown
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Sarah Gehlert
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, 63110, USA
| | - Leslie E Wolf
- Center for Law Health and Society, Georgia State University College of Law, 85 Park Place NE, Atlanta, GA, 30303, USA
| | - Joann Seo
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Hannah Perkins
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Melody S Goodman
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, 63110, USA
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, 255 S. Central Campus Dr., Salt Lake City, UT, 84112-0491, USA
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| |
Collapse
|
22
|
Diemer FS, Haan YC, Nannan Panday RV, van Montfrans GA, Oehlers GP, Brewster LM. Health literacy in Suriname. SOCIAL WORK IN HEALTH CARE 2017; 56:283-293. [PMID: 28271964 DOI: 10.1080/00981389.2016.1277823] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Low health literacy is an independent predictor of cardiovascular mortality. However, data on health literacy in low- and middle-income countries are scarce. Therefore, we assessed the level of health literacy in Suriname, a middle-income country with a high cardiovascular mortality. METHODS We estimated health literacy in a convenience sample at an urban outpatient center in the capital and at a semirural health center, using the validated Rapid Estimate of Adult Literacy in Medicine adapted for the Dutch language (REALM-D) instrument. REALM-D scores vary from 0 to 66 (all correct). The primary outcome was the level of health literacy. Furthermore, we assessed the effect of age, sex, ethnicity, disease history, research location, and level of education on health literacy with multivariable linear regression. RESULTS We included 99 volunteers (52% men; 51% urban research location) with a mean age of 44.9 years (SD 13.4). The mean REALM-D score was moderate: 48.6 (SD 8.1). Greater health literacy was associated with male sex, an urban research location, and a higher educational level. CONCLUSION Health literacy was moderate in these Surinamese participants. Health care workers should take health literacy into account, and targeted interventions should be developed to improve health literacy in Suriname.
Collapse
Affiliation(s)
- Frederieke S Diemer
- a Department of Cardiology , Academic Hospital of Paramaribo , Paramaribo , Suriname
- b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands
| | - Yentl C Haan
- b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands
| | - Rani V Nannan Panday
- b Department of Vascular Medicine , Academic Medical Center , Amsterdam , The Netherlands
| | - Gert A van Montfrans
- c Department of Internal Medicine , Academic Medical Center , Amsterdam , The Netherlands
| | - Glenn P Oehlers
- a Department of Cardiology , Academic Hospital of Paramaribo , Paramaribo , Suriname
| | - Lizzy M Brewster
- c Department of Internal Medicine , Academic Medical Center , Amsterdam , The Netherlands
- d The Amsterdam Institute for Global Health and Development (AIGHD) , Amsterdam , The Netherlands
- e Department of Public Health , Anton de Kom University of Suriname , Paramaribo , Suriname
| |
Collapse
|
23
|
Wozney L, Chorney J, Huguet A, Song JS, Boss EF, Hong P. Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations? Otolaryngol Head Neck Surg 2017; 156:844-852. [PMID: 28195825 DOI: 10.1177/0194599817692529] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Parents frequently refer to information on the Internet to confirm or broaden their understanding of surgical procedures and to research postoperative care practices. Our study evaluated the readability, comprehensiveness, and consistency around online recommendations directed at parents of children undergoing tonsillectomy. Study Design A cross-sectional study design was employed. Setting Thirty English-language Internet websites. Subjects and Methods Three validated measures of readability were applied and content analysis was employed to evaluate the comprehensiveness of information in domains of perioperative education. Frequency effect sizes and percentile ranks were calculated to measure dispersion of recommendations across sites. Results The mean readability level of all sites was above a grade 10 level with fewer than half of the sites (n = 14, 47%) scoring at or below the eight-grade level. Provided information was often incomplete with a noted lack of psychosocial support and skills-training recommendations. Content analysis showed 67 unique recommendations spanning the full perioperative period. Most recommendations had low consensus, being reported in 5 or fewer sites (frequency effect size <16%). Conclusion Many online parent-focused resources do not meet readability recommendations, portray incomplete education about perioperative care and expectations, and provide recommendations with low levels of consensus. Up-to-date mapping of the research evidence around recommendations is needed as well as improved efforts to make online information easier to read.
Collapse
Affiliation(s)
- Lori Wozney
- 1 Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jill Chorney
- 2 Pediatric Research in Perioperative Care Lab, IWK Health Centre, Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anna Huguet
- 1 Centre for Research in Family Health, IWK Health Centre, Halifax, Nova Scotia, Canada.,4 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jin Soo Song
- 3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Emily F Boss
- 5 Departments of Otolaryngology-Head and Neck Surgery and Health Policy and Management, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Paul Hong
- 2 Pediatric Research in Perioperative Care Lab, IWK Health Centre, Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,3 Department of Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
24
|
Aldoory L. The Status of Health Literacy Research in Health Communication and Opportunities for Future Scholarship. HEALTH COMMUNICATION 2017; 32:211-218. [PMID: 27196266 DOI: 10.1080/10410236.2015.1114065] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
While national concern is growing, the scholarly body of knowledge in health literacy is still relatively small in health communication literature. The field began to distinguish itself as an outgrowth of adult literacy that focused on patient understanding of health information. It grew out of medicine and public health science mostly, and still today the majority of research can be found in health professional journals. However, the links with health communication, particularly with provider-patient communication and with printed health information, have been established and documented over the last decade. This article is a conceptual review that highlights state-of-the-science literature that has made connections between health literacy and health communication. Evidence reveals the contribution that health literacy can have on the health communication body of knowledge. The article illuminates the gaps in research and possibilities for theory development and future studies.
Collapse
Affiliation(s)
- Linda Aldoory
- a Department of Communication , University of Maryland
| |
Collapse
|
25
|
Aldoory L, Macek MD, Atchison KA, Chen H. Comparing Well-Tested Health Literacy Measures for Oral Health: A Pilot Assessment. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1161-1169. [PMID: 27726518 PMCID: PMC5521007 DOI: 10.1080/10810730.2016.1233308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
There has been growing national concern over the low health literacy of Americans and, coinciding with this, a growing importance placed on measuring health literacy. Health literacy is the ability to access, understand, and use information to make health decisions. Health literacy in an oral health context means access to accurate information about oral health, understanding the risks of neglecting oral care, and calculating the chances of getting periodontal disease. This exploratory study compared the 3 most popular and well-tested health literacy measures in an oral health setting. Using a survey of dental patients from safety net dental clinics in two states, we explored differences and similarities between health literacy measures as they pertained to oral health perceptions and oral self-efficacy. Findings indicated that the three health literacy measures were not interchangeable and had differential effects on data collected, which suggested differential relationships with oral health perceptions and outcomes.
Collapse
Affiliation(s)
- Linda Aldoory
- Department of Communication, University of Maryland, College Park, Maryland, USA
| | - Mark D. Macek
- Department of Dental Public Health, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Kathryn A. Atchison
- Division of Public Health and Community Dentistry, School of Dentistry, University of California Los Angeles, Los Angeles, California, USA
| | - Hayan Chen
- Department of Dental Public Health, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| |
Collapse
|
26
|
Fage‐Butler AM, Nisbeth Jensen M. Medical terminology in online patient-patient communication: evidence of high health literacy? Health Expect 2016; 19:643-53. [PMID: 26287945 PMCID: PMC5042046 DOI: 10.1111/hex.12395] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Health communication research and guidelines often recommend that medical terminology be avoided when communicating with patients due to their limited understanding of medical terms. However, growing numbers of e-patients use the Internet to equip themselves with specialized biomedical knowledge that is couched in medical terms, which they then share on participatory media, such as online patient forums. OBJECTIVE Given possible discrepancies between preconceptions about the kind of language that patients can understand and the terms they may actually know and use, the purpose of this paper was to investigate medical terminology used by patients in online patient forums. DESIGN Using data from online patient-patient communication where patients communicate with each other without expert moderation or intervention, we coded two data samples from two online patient forums dedicated to thyroid issues. RESULTS Previous definitions of medical terms (dichotomized into technical and semi-technical) proved too rudimentary to encapsulate the types of medical terms the patients used. Therefore, using an inductive approach, we developed an analytical framework consisting of five categories of medical terms: dictionary-defined medical terms, co-text-defined medical terms, medical initialisms, medication brand names and colloquial technical terms. The patients in our data set used many medical terms from all of these categories. DISCUSSION AND CONCLUSIONS Our findings suggest the value of a situated, condition-specific approach to health literacy that recognizes the vertical kind of knowledge that patients with chronic diseases may have. We make cautious recommendations for clinical practice, arguing for an adaptive approach to medical terminology use with patients.
Collapse
|
27
|
Molina Y, Kim S, Berrios N, Calhoun EA. Medical mistrust and patient satisfaction with mammography: the mediating effects of perceived self-efficacy among navigated African American women. Health Expect 2015; 18:2941-50. [PMID: 25308749 PMCID: PMC4393336 DOI: 10.1111/hex.12278] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Medical mistrust is salient among African American women, given historic and contemporary racism within medical settings. Mistrust may influence satisfaction among navigated women by affecting women's perceptions of their health-care self-efficacy and their providers' roles in follow-up of abnormal test results. OBJECTIVES To (i) examine whether general medical mistrust and health-care self-efficacy predict satisfaction with mammography services and (ii) test the mediating effects of health-related self-efficacy. DESIGN The current study is a part of a randomized controlled patient navigation trial for medically underserved women who had received a physician referral to obtain a mammogram in three community hospitals in Chicago, IL. After consent, 671 African American women with no history of cancer completed questionnaires concerning medical mistrust and received navigation services. After their mammography appointment, women completed health-care self-efficacy and patient satisfaction questionnaires. RESULTS Women with lower medical mistrust and greater perceived self-efficacy reported greater satisfaction with care. Medical mistrust was directly and indirectly related to patient satisfaction through self-efficacy. CONCLUSIONS Preliminary findings suggest future programmes designed to increase health-care self-efficacy may improve patient satisfaction among African American women with high levels of medical mistrust. Our findings add to a growing body of literature indicating the importance of self-efficacy and active participation in health care, especially among the underserved.
Collapse
Affiliation(s)
- Yamile Molina
- School of Public HealthUniversity of WashingtonSeattleWAUSA
- Fred Hutchinson Cancer Research CenterSeattleWAUSA
- School of Public HealthUniversity of Illinois‐ChicagoChicagoILUSA
| | - Sage Kim
- School of Public HealthUniversity of Illinois‐ChicagoChicagoILUSA
| | - Nerida Berrios
- School of Public HealthUniversity of Illinois‐ChicagoChicagoILUSA
| | | |
Collapse
|
28
|
Leak C, Goggins K, Schildcrout JS, Theobald C, Donato KM, Bell SP, Schnelle J, Kripalani S. Effect of Health Literacy on Research Follow-Up. JOURNAL OF HEALTH COMMUNICATION 2015; 20 Suppl 2:83-91. [PMID: 26513035 PMCID: PMC4706551 DOI: 10.1080/10810730.2015.1058442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Previous research has not examined the effect of health literacy on research subjects' completion of scheduled research follow-up. This article evaluates patient factors associated with incomplete research follow-up at three time points after enrollment in a large, hospital-based prospective cohort study. Predictor variables included health literacy, age, race, gender, education, employment status, difficulty paying bills, hospital diagnosis, length of stay, self-reported global health status, depression, perceived health competence, medication adherence, and health care system distrust. In a sample of 2,042 patients, multivariable models demonstrated that lower health literacy and younger age were significantly associated with a lower likelihood of completing research follow-up interviews at 2-3 days, 30 days, and 90 days after hospital discharge. In addition, patients who had less education, were currently employed, and had moderate financial stress were less likely to complete 90-day follow-up. This study is the first to demonstrate that lower health literacy is a significant predictor of incomplete research follow-up.
Collapse
Affiliation(s)
- Cardella Leak
- Institute for Medicine and Public Health, Vanderbilt University Medical Center
| | - Kathryn Goggins
- Center for Health Services Research, Vanderbilt University Medical Center
- Center for Effective Health Communication, Vanderbilt University Medical Center
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center
| | - Jonathan S. Schildcrout
- Department of Biostatistics, Vanderbilt University Medical Center
- Department of Anesthesiology, Vanderbilt University Medical Center
| | - Cecelia Theobald
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center
| | | | - Susan P. Bell
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center
- Center for Quality Aging, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center
| | - John Schnelle
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center
- Center for Quality Aging, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Sunil Kripalani
- Center for Health Services Research, Vanderbilt University Medical Center
- Center for Effective Health Communication, Vanderbilt University Medical Center
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center
| |
Collapse
|
29
|
Mackert M, Champlin S, Su Z, Guadagno M. The Many Health Literacies: Advancing Research or Fragmentation? HEALTH COMMUNICATION 2015; 30:1161-1165. [PMID: 26372026 DOI: 10.1080/10410236.2015.1037422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Health literacy is the degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions and is an important factor in patient health outcomes and resulting health care costs. Because of its importance across many areas of health, specific attention has been given to studying and measuring health literacy in recent years; however, the field lacks consensus on how health literacy should be defined and measured. As a result, numerous definitions and measures of health literacy exist. This fragmentation and inconsistency creates a barrier to conceptualizing, measuring, and understanding health literacy across health domains and fields. A directed literature search reveals a substantial body of work on health literacy; however, findings from studies often emphasize health literacy within specific health domains, populations, contexts, and languages, which makes the comparison of findings across studies difficult. While there is recognition that the measurement of health literacy should be improved, it is important to take into consideration what can be gained from a general health literacy focus and how this could be applied across domains.
Collapse
Affiliation(s)
- Michael Mackert
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
- b Center for Health Communication , University of Texas at Austin
- c School of Public Health , University of Texas Health Science Center at Houston
| | - Sara Champlin
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| | - Zhaohui Su
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| | - Marie Guadagno
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| |
Collapse
|
30
|
Stephens KK, Pastorek A, Crook B, Mackert M, Donovan EE, Shalev H. Boosting healthy heart employer-sponsored health dissemination efforts: identification and information-sharing intentions. HEALTH COMMUNICATION 2014; 30:209-220. [PMID: 24580722 DOI: 10.1080/10410236.2013.836732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Health information dissemination options have expanded to include workplaces and employer-sponsored efforts. This study focuses on a core relational concept found in workplaces, organizational identification-the feeling of belongingness-and the impact of partnering with employers and health clinics in health information dissemination. We use social-identity theory and multiple identification to test our predictions from a sample of working adults representing more than 100 different employers. We found that when people strongly identify with their employer, they have increased health behavioral intentions and they intend to talk about the health information with coworkers. The significant models explain more than 50% and 30% of the variance in these two outcomes. The experimental results examining single and multiple organizational sources revealed no differences on any outcomes. These findings offer a contribution to health information dissemination research by articulating how identification with an employer functions to affect behavioral intentions.
Collapse
Affiliation(s)
- Keri K Stephens
- a Department of Communication Studies , University of Texas at Austin
| | | | | | | | | | | |
Collapse
|
31
|
Chen Y, Feeley TH. Numeracy, information seeking, and self-efficacy in managing health: an analysis using the 2007 Health Information National Trends Survey (HINTS). HEALTH COMMUNICATION 2014; 29:843-53. [PMID: 24266723 DOI: 10.1080/10410236.2013.807904] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study examined the unique effects of numeracy on self-efficacy in managing health and on information-seeking experience, and explored the mediating role of information-seeking experience. The proposed model was tested using a national random-digit-dial sample (n = 4,092) of adults participating in the 2007 Health Information National Trends Survey. Findings from multiple regression analyses revealed that higher numeracy was associated with higher self-efficacy in managing health and better (i.e., more positive) health information-seeking experience, and that better information-seeking experience partially mediated the association between higher numeracy and higher self-efficacy. Findings indicated that communication factors (e.g., information seeking) partially mediated the relationship between cognitive abilities (e.g., numeracy) and self-efficacy. Theoretical implications are discussed, along with practical implications for individuals, health care providers, and public health professionals.
Collapse
Affiliation(s)
- Yixin Chen
- a Department of Communication , University at Buffalo, The State University of New York
| | | |
Collapse
|
32
|
McFadden BL, Constantine ML, Hammil SL, Tarr ME, Abed HT, Kenton KS, Sung VW, Rogers RG. Patient recall 6 weeks after surgical consent for midurethral sling using mesh. Int Urogynecol J 2013; 24:2099-104. [PMID: 23818127 DOI: 10.1007/s00192-013-2136-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 05/14/2013] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We aimed to determine patient recall of specific surgical risks and benefits discussed during consent for midurethral sling (MUS) surgery immediately after consent and at 6 weeks follow-up. Specifically we sought to determine whether or not women recalled specific risks related to the placement of mesh. METHODS Surgeons consented patients for MUS in their usual fashion during audio recorded consent sessions. After consent and again at 6 weeks postoperatively, women completed a checklist of risks, benefits, alternatives, and general procedural items covered during consent. In addition, women completed the Decision Regret Scale for Pelvic Floor Disorders (DRS-PFD). Audio files were used to verify specific risks, benefits, alternatives, and procedural items discussed at consent. Recall of specific risks, benefits, and alternatives were correlated with DRS-PFD scores. RESULTS Sixty-three women completed checklists immediately post consent and at 6 weeks postoperatively. Six-week recall of benefits, alternatives, and description of the operation did not change. Surgical risk recall as measured by the patient checklist deteriorated from 92 % immediately post consent to 72 % at 6 weeks postoperatively (p < .001). Recall of the risk for mesh erosion declined from 91 to 64 % (p < .001). Recall that mesh was placed during the MUS procedure declined from 98 to 84 % (p = .01). DRS-PFD scores were correlated with poorer surgical risk recall and surgical complications (r = .31, p = .02). CONCLUSIONS Recall of MUS surgery risks deteriorated over time. Specifically, women forgot that mesh was placed or might erode. Further investigations into methods and measures of adequate consent that promote recall of long-term surgical risks are needed.
Collapse
Affiliation(s)
- Brook L McFadden
- Division of Urogynecology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA,
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Donovan-Kicken E, Mackert M, Guinn TD, Tollison AC, Breckinridge B. Sources of patient uncertainty when reviewing medical disclosure and consent documentation. PATIENT EDUCATION AND COUNSELING 2013; 90:254-260. [PMID: 23131417 DOI: 10.1016/j.pec.2012.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 10/04/2012] [Accepted: 10/08/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Despite evidence that medical disclosure and consent forms are ineffective at communicating the risks and hazards of treatment and diagnostic procedures, little is known about exactly why they are difficult for patients to understand. The objective of this research was to examine what features of the forms increase people's uncertainty. METHODS Interviews were conducted with 254 individuals. After reading a sample consent form, participants described what they found confusing in the document. With uncertainty management as a theoretical framework, interview responses were analyzed for prominent themes. RESULTS Four distinct sources of uncertainty emerged from participants' responses: (a) language, (b) risks and hazards, (c) the nature of the procedure, and (d) document composition and format. CONCLUSIONS Findings indicate the value of simplifying medico-legal jargon, signposting definitions of terms, removing language that addresses multiple readers simultaneously, reorganizing bulleted lists of risks, and adding section breaks or negative space. PRACTICE IMPLICATIONS These findings offer suggestions for providing more straightforward details about risks and hazards to patients, not necessarily through greater amounts of information but rather through more clear and sufficient material and better formatting.
Collapse
Affiliation(s)
- Erin Donovan-Kicken
- Department of Communication Studies, The University of Texas at Austin, Austin, TX, USA.
| | | | | | | | | |
Collapse
|