HEALTH CARE
And/or:
“Based on what we just talked about, tell me what you will
do at home and how you will do it?”
The impact of health literacy
Some studies have outlined that patients with low literacy
skills are more likely to report being in fair or poor health.
Low health literacy can also delay diagnosis and affect:
• medication adherence
• return visits
• quality of life
• hospitalization
• mortality
Recognizing the importance of consent in healthcare delivery, the issue of health literacy takes on added importance.
The dialogue between physician and patient about the proposed treatment is an important element of the consent
process. A patient must have appropriate information to
make an informed decision before consenting to treatment;
otherwise consent is not considered valid. In addition to
verbal communication, consent is implied through behaviour or the circumstances under which treatment is given.
Verbal or written consent from the patient is required when
treatment:
• is likely to be more than mildly painful
• carries appreciable risk
• will result in surgery
Signing a consent form does not mean consent is given.
Rather, it serves as written confirmation that the patient
agreed to what has been proposed.
The physician should consider including a note about the
consent explanation in the patient’s record. This note can
later serve as confirmation that a patient was appropriately
informed, particularly if it includes any special points raised
during the discussion.
Improving patient health literacy
Given the link between low health literacy levels and negative health outcomes, it is important for physicians to select
and appropriately frame information they give to patients.
They must also take into consideration the characteristics
of their practice, which include cultural diversity, age and
income.
Research shows that patients forget up to 80% of what they
hear in a medical office or clinic. Of the information they do
remember, they recall about 50% incorrectly. Physicians can
implement strategies to improve patient comprehension
and retention. They can:
•
•
create a shame-free environment so that no one is
afraid to ask questions.
sensitize office staff members to health literacy so they
can help identify who may need additional healthcare
coaching.
Measures you may consider in your practice,
to address health literacy:
•
remain attentive to health literacy issues, and how
they may impact your patients
•
identify, to the extent possible, patients who may be
at risk of low health literacy
•
utilize communications measures that will enhance
patients’ understanding
•
assess if the patient appears to understand the information being provided – give them the opportunity to ask questions
•
consider the use of printed and visual material to