Assessing the Impact of Military Service on Patient Health Literacy in an Otolaryngology Clinic

Int Forum Allergy Rhinol

et al. 2023

ObjectiveTo assess for differences of intended meaning in the description of congestion‐related symptoms among otolaryngology patients and clinicians.Materials and MethodsBetween June 2020 and October 2022, a questionnaire consisting of 16 common descriptors of congestion‐related symptoms within four domains (obstructive‐related, pressure‐related, mucus‐related, and other symptoms) was completed by patients and otolaryngologists at five tertiary otolaryngology practices. The primary outcome was to assess differences in patient and clinician perceptions of congestion‐related symptoms. Differences based on geographic location was a secondary outcome.ResultsA total of 349 patients and 40 otolaryngologists participated. Patients selected a median of 6.8 (standard deviation [SD] 3.0) terms compared with 4.0 (SD 1.6) terms for otolaryngologists (p < 0.001). Otolaryngologists were more likely to select obstruction‐related symptoms (difference 6.3%; 95% confidence interval [CI] 3.8%, 8.9%). Patients were more likely to describe congestion using pressure‐related (−43.7%; −58.9%, −28.5%), mucus‐related (−43.5%; −59.3%, −27.8%), and other symptoms (−44.2; −51.3%, −37.1%) compared with otolaryngologists. There were no significant differences identified based on geographic location with regard to symptom domains on multivariate analysis.ConclusionsThere are differences between otolaryngologists and their patients in the interpretation of the symptoms of congestion. Clinicians tended to have a narrower interpretation of congestion that was limited to the obstruction‐related symptom domain, while patients defined congestion more broadly. This has important counseling and communication implications for the clinician.

Section: Introductionmentioning

confidence: 99%

Are you congested? A comparison of definitions between otolaryngologists and their patients

Fischer

Tolisano

Int Forum Allergy Rhinol

et al. 2023

“…Health literacy plays an important role in the understanding of disease processes, management of complex chronic diseases, and outcomes following medical and surgical interventions. [4][5][6] Otolaryngology patients in general, 7 and rhinologic patients specifically, 8 appear to have high levels of health literacy. However, semantic content in the interpretation and expectation of sinus infection symptoms may be variable.…”

Section: Introductionmentioning

confidence: 99%

What do we mean when we have a “sinus infection?”

Riley

Int Forum Allergy Rhinol

Trinh

et al. 2022

Introduction Sinus infections are a common reason patients seek medical care. However, the intended meaning of the term sinus infection among patients and otolaryngologists is incompletely understood. Methods In this multi‐institutional cross‐sectional study, a semantics‐based questionnaire was provided to consecutive patients presenting to otolaryngology clinics at six academic centers from June 2020 until May 2021. The primary outcome was respondent definitions for sinus infection from a list of 28 proposed terms covering six general categories. Secondary outcome measures included differences between geographic regions. Results Responses were obtained from 560 patients (54% female, mean age 48.9 years) and 29 otolaryngologists (42% female, mean age 37.4 years). Patients and otolaryngologists selected a median of 10 and 11 terms, respectively, to define a sinus infection. Among patients the most frequently selected symptom categories were mucus (500, 89.3%), pressure/pain (480, 85.7%), and airflow (468, 83.6%). Compared to patients, clinicians selected with greater frequency the symptom categories of pressure/pain (14.3% difference; 95% CI, 7.6% to 22.5%), mucus (10.7% difference; 95% CI, 4.7% to 18.3%) and airflow (13.0% difference; 95% CI, 4.8% to 21.7%). Multiple categories were selected by 96% of patients and 100% of providers. Conclusion The definition of sinus infection appears variable for both patients and otolaryngologists, though patients appear to apply a broader range of symptoms to the term sinus infection. There were no pronounced geographic differences in the description of a sinus infection in this US sample population. Patients commonly described sinus infection in the context of pain‐related symptoms. Appreciation of these semantic differences may enable more effective patient‐clinician communication.

“…As such, clinicians may define certain medical terms differently from patients, which can lead to communication barriers. This presents a problem in otolaryngology as well as all other specialties 5,6 . Patients may have a poor or incomplete understanding of sinus physiology and pathophysiology, such that those who present with symptoms attributed to the sinuses may actually have a nasal disorder such as allergic rhinitis or a nonsinonasal disorder such as migraine 7 .…”

mentioning

confidence: 99%

“…This presents a problem in otolaryngology as well as all other specialties. 5,6 Patients may have a poor or incomplete understanding of sinus physiology and pathophysiology, such that those who present with symptoms attributed to the sinuses may actually have a nasal disorder such as allergic rhinitis or a nonsinonasal disorder such as migraine. 7 A patient's beliefs are likely affected by prior personal experiences, previous medical encounters, and ubiquitous advertisement of many overthe-counter medications labeled as treatments for sinus disease.…”

mentioning

confidence: 99%

Layperson Perception of Symptoms Caused by the Sinuses

Riley

Soneru

Otolaryngol.--head neck surg.

et al. 2023

Objective To assess the perceived symptoms caused by the sinuses as defined by otolaryngology patients and clinicians. Study Design Multi‐institutional cross‐sectional study. Setting Six academic outpatient otolaryngology practices. Methods We performed a multi‐institutional, cross‐sectional study using a semantics‐based questionnaire. Consecutive patients were enrolled at 6 academic otolaryngology centers from June 2020 to May 2021. The primary outcome examined patient and provider definitions for the symptoms caused by the sinuses from a list of 28 proposed terms covering 6 general categories. These data were also collected from otolaryngology faculty at the same institutions. Results Responses were obtained from 451 patients (54% female, mean age 48.3 years) and 29 otolaryngologists (38% female, mean age 37.4 years). Patients selected a median of 12 terms, compared to 8.5 for otolaryngologists. Among patients, the most frequently selected symptom domains were mucus (419, 92.9%), airflow (412, 91.4%), and pain (389, 86.3%). Compared to clinicians, patients more frequently selected symptoms related to the ear (difference, 48.3%; 95% confidence interval [CI], 34.8%‐59.3%), throat (difference, 35.7%, 95% CI, 22.0%‐47.5%), systemic (difference, 34.4%, 95% CI, 21.2%‐46.0%), mucus (difference, 20.5%, 95% CI, 10.2%‐30.6%), and airflow domains (difference, 19.0%, 95% CI, 8.4%‐29.3%). Multiple domains were selected by 98% of patients and 79% of providers. Conclusion Semantic differences exist between patients and clinicians regarding the symptoms caused by the sinus with patients having a broader range of perceived symptoms. These differences may provide clues to improve communication between otolaryngologists and their patients.