Assessing and addressing low health literacy among surgical outpatients

AORN Journal,  Sept, 2007  by Cindy L. Monachos

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Documents that patients are expected to learn from and understand need to be designed for ease of understanding, and the message should be clear. Medical jargon should be eliminated and replaced with common words that are used in daily language. Breaking up medical concepts into bite-size pieces will help patients understand difficult ideas. Active voice and a conversational tone are more familiar and easier for patients to understand. (19) Stories, checklists, and fill-in-the-blanks are memory aids that should be included in every teaching arsenal.

The layout of documents should help make them easy to read. Tips for making a document more readable include the following:

* Text should be in 12 point type.

* Text should not be in all capital letters or all italics because this type of text is difficult to read.

* Line length should be limited to no more than 5 inches with a lot of white space for the eye to rest on.

* Visuals should stand alone and be simple, realistic, familiar, and engaging.

* Visuals that show behavior should be realistically portrayed, and written text should be concise. (19)

STRATEGIES FOR CLINICAL PRACTICE

Incorporating basic strategies for improving patient comprehension of medical information into daily clinical practice habits can yield significant results for health care practitioners. Identifying individual habits while speaking with patients during routine encounters is crucial to care providers' self-improvement. Table 4 lists practice behaviors that can lead to better patient understanding and can be used for health care providers' self-assessment of effective communication.

Above all, perioperative nursing professionals should educate and raise awareness throughout their organization, educating other health care professionals and organization leaders about the necessity of assessing for health literacy. They should suggest and encourage implementing behavior changes, assessment procedures, checklists, and changes in documents and teaching tools and instituting guidelines that are beneficial in assessing and addressing the needs of patients with low health literacy. The American Medical Association Foundation offers a health literacy tool kit with a clinician manual that contains information on resources, communication techniques, and health system barriers. (21) This is an invaluable tool for use in educating staff members in medical offices and outpatient surgical centers and as a basis for formulating patient education materials.

ADDRESSING LOW HEALTH LITERACY

Low health literacy is a fact of American life and a public health crisis. It is an ethical and financial issue that affects all health care professionals. For moral and ethical reasons, it is important that people are able to understand and follow directions. (22) Using resources and ingenuity, today's health care leaders can use the available tools for assessing low health literacy to develop new programs and educational tools for assessing and addressing the needs of patients with low health literacy.