The Nook
 
Wednesday, May 21, 2008
Health Literacy— Faith Community Nurses Need to Know ——
 
by Glenda Bronson, RN
The Health Literacy Forum and Networking session was recently hosted at the Oklahoma City Community Foundation.
The information presented was eye opening as well as a reminder that medical terminology is very, very difficult to interpret and understand.
As advocates for our church members we need to be aware of health literacy levels, how to assess, and available resources.
What is health literacy?
Health literacy is the ability to read, understand and effectively use basic medical instructions and information. Low health literacy can affect anyone of any age, ethnicity, background, or education level.
Nearly half of all American adults (90 million people) have trouble understanding and using basic health information, according to a recent report from the Institute of Medicine.
Research has found that many health materials are written at the 10th grade level or higher. For most of the population, anything above the 8th grade level is difficult to read, especially when it comes to medical jargon.
A 5th –6th grade reading level can be understood by the majority of those using the health care system. This is the recommended level for education materials.
Low literacy is a hidden problem.
Many adults with low literacy have developed coping skills that enable them to function well in most situations.
Low literacy does not mean low intelligence. You cannot depend on appearances; in one study, physicians could identify only 20% of their patients who were at the lowest literacy level (less than 3rd grade).
Because of the shame and stigma attached 67% have never told their spouses. In the work place it is estimated that 85% have not told their co-workers they cannot read.
Why should we worry?
Literacy is the strongest predictor of health status— more than age, income, employment status, race or ethnicity, and educational level.”
How to identify clients with low literacy. Red flags to assess are:
  1. •Eyes wander over page
  2. •Shows lack of interest in written materials.
  3. •Expresses frustration, impatience.
  4. •Takes a long time filling out forms or fills them out incompletely.
  5. •Says, “I forgot my glasses (or my eyes are tired), can you read it to me?”
  6. •Says, “I’ll take this home and read it later (or discuss with my family).”
  7. •Looks at the pills instead of reading the label of a pill bottle.
Informally you can ask what do you like to read, how happy are you with the way you read, or how often do you read?
Two measures of health literacy have been validated– the REALM and the TOFHLA. These tests are most often used in research, but the REALM and the S-TOFHLA can be useful the primary care setting.
Tips to Improve Communication
Create a safe environment where patients feel comfortable talking.
Focus on 3 to 5 main points— “need to know”. Use plain language—ear ache not “otitis media”—pill instead of medication.
Talk slowly—allow time for questions. Be very specific and clear—take with food and water. Use teach back technique– “I want to be sure I have been clear could you repeat the instructions?”
More information and resources can be found at www.askme3.org.
Resources for this article— Jean Blackwell, UNC-CH Health Sciences Library & Ask Me 3.