Functional illiteracy among emergency department patients: A preliminary study

Jolly, Bani; Scott, James; Feied, Craig F.; Sanford, Sandra M

doi:10.1016/s0196-0644(05)81944-4

Cited by 91 publications

(41 citation statements)

References 11 publications

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“…Moreover, clinic intake surveys, and research self-report questionnaires are administered with the assumption that patients have sufficient health literacy skills to adequately understand the questions, handle the document format, and respond with accurate information. 17,[68][69][70][71][72][73] Until recently, most health materials, including advisory materials published by the National Cancer Institute (NCI), the American Cancer Society (ACS) and others, had an average reading level between tenth and eleventh grade. 20,63,[74][75][76][77][78][79] Although the average American adult has achieved at least a twelfth grade education, the average reading level for American adults is estimated to be at the eighth or ninth grade.…”

Section: Low Literacy and Written Materialsmentioning

confidence: 99%

Health Literacy and Cancer Communication

Davis

Williams

Marin

et al. 2002

CA: A Cancer Journal for Clinicians

569

492

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Health literacy is increasingly recognized as a critical factor affecting communication across the continuum of cancer care. We reviewed research on health literacy and examined its impact on cancer outcomes and communication. According to the National Adult Literacy Survey (NALS), considered the most accurate portrait of literacy in our society, about one in five American adults may lack the necessary literacy skills to function adequately in our society. As patients, such individuals are at a disadvantage in their capacity to obtain, process, and understand cancer information and services needed to make appropriate health care decisions. Patients with poor health literacy have a complex array of difficulties with written and oral communication that may limit their understanding of cancer screening and of symptoms of cancer, adversely affecting their stage at diagnosis. In addition, these barriers impair communication and discussion about risks and benefits of treatment options, and patient understanding of informed consent for routine procedures and clinical trials. More research is needed to identify successful methods for educating and communicating with patients who have limited health literacy. Based on our own experience, we offer practical communication aids that can help bridge the cancer communication gap.

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Section: Low Literacy and Written Materialsmentioning

confidence: 99%

Health Literacy and Cancer Communication

Davis

Williams

Marin

et al. 2002

CA: A Cancer Journal for Clinicians

569

492

View full text Add to dashboard Cite

show abstract

“…In addition, 43% of their patients were reading at least two grade levels below the stated highest grade completed in formal education. Jolly et al [6] requested emergency department patients to read a preprinted discharge instruction and answer five oral questions derived from the instruction information. Of those aged 18-39 years, 76.0% could answer 4 or 5 questions correctly, but only 63.8% of those aged more than 59 years could do so.…”

Section: Introductionmentioning

confidence: 99%

Comprehension of Written Health Care Information in an Affluent Geriatric Retirement Community: Use of the Test of Functional Health Literacy

Benson

Forman²

2002

Gerontology

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Background: The comprehension of written health care information, e.g. prescription bottle labels or an informed consent form, impacts on communication with patients and their ability to understand medical procedures, as well as goals of therapy. Objective: To determine if the problem of literacy was present in a population of affluent Albuquerque retirement community dwellers. Methods: We administered the Test of Functional Health Literacy in Adults (TOFHL) to 93 residents (71 women and 22 men), using a one-on-one directed examination conducted by one of the authors (J.G.B.). Results: The group studied had a mean age of >70 years, were not acutely ill, had no known loss of mental function, were better educated and had a high standard of living compared to national standards. However, 30% (95% confidence level) of our group were unable to adequately comprehend written information as measured by the TOFHL. The subgroup with poor comprehension (21 women and 7 men) had a mean age of 85 years (versus 82 years in the group with good comprehension) and a mean of 13 years (versus 15 years in the group with good comprehension) of formal education. Multivariate analysis was consistent with a negative effect of age (p = 0.04), a positive effect of years of formal education (p = 0.0005) and no effect of gender on the TOFHL score. Conclusion: Two recent studies, one in an emergency room setting and the other among Medicare enrollees, demonstrated similar results to ours. The high prevalence of poor comprehension in these groups should alert providers to the need to develop additional or different communication skills that can address the problem of poor reading comprehension across at least three diverse groups of people, with particular attention to those over the age of 65.

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“…15 Functional illiterates are likely to have signifi cant diffi culties with routine reading requirements, such as those in pill bottles, appointment slips, self-care instructions, and health education brochures. 8,12,13,22,24 This problem affects the health care system, because, by not managing health problems effectively, these individuals are prone to require more appointments and to have higher hospitalization rates, implying extra-costs for the system. There are several levels of functional literacy and many instruments have been especially designed with the purpose of identifying and measuring those levels.…”

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confidence: 99%

Performance of a Brazilian population on the test of functional health literacy in adults

et al. 2009

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Desempenho de uma população brasileira no teste de alfabetização funcional para adultos na área de saúde ABSTRACT OBJECTIVE:To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS:The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS:The mean age of the sample was 47.3 years (SD=16.8) and the mean education was 9.7 years (SD=5; range: 1 -17). A total of 32.4% of the sample showed literacy/numeracy defi cits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; p<0.01) and a negative correlation between age and the scores (r=-0.259; p<0.01). The correlation between the scores and age was not signifi cant when the effects of education were held constant (rp=-0.031, p=0.584). A signifi cant association (B=3.877, Beta=0.733; p<0.001) was found between schooling and scores. Age was not a signifi cant predictor in this model p=0.584). CONCLUSIONS:The short version of the Test of Functional Health Literacy in Adults was a suitable tool to assess health literacy in the study population. The high number of individuals classifi ed as functional illiterates in this test highlights the importance of special assistance to help them properly understand directions for healthcare.

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Functional illiteracy among emergency department patients: A preliminary study

Cited by 91 publications

References 11 publications

Health Literacy and Cancer Communication

Health Literacy and Cancer Communication

Comprehension of Written Health Care Information in an Affluent Geriatric Retirement Community: Use of the Test of Functional Health Literacy

Performance of a Brazilian population on the test of functional health literacy in adults

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