Health Literacy and Emergency Department Outcomes: A Systematic Review

Herndon, Jill Boylston; Chaney, Michelle; Carden, Donna L.

doi:10.1016/j.annemergmed.2010.08.035

Cited by 135 publications

(120 citation statements)

References 48 publications

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“…Patient engagement is a broader concept that combines patient activation with interventions designed to increase activation and promote positive patient behavior, such as obtaining preventive care [9]. On the basis of available evidence in other settings of healthcare delivery [13,16,20,22,26,27,29,32,36,40,41], it is likely that patients with low health literacy presenting to a hand surgeon are at greater risk for poor treatment adherence, suboptimal outcomes, and misuse of resources; future studies should confirm these assumptions in this patient population. To the extent that asking more questions yields more information for patients, the observed difference in question-asking may reveal a source of health-literacy disparities in access to health information.…”

Section: Discussionmentioning

confidence: 99%

Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons

Menendez

Hoorn

Mackert

et al. 2017

Clinical Orthopaedics &Amp; Related Research

110

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Background In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions and engaging actively in their own care. But little is known regarding the relationship between health literacy and question-asking behavior during outpatient office visits. Questions/purposes (1) Do patients with lower levels of health literacy ask fewer questions in general, and as stratified by types of questions? (2) What other patient characteristics are associated with the number of questions asked? (3) How often do surgeons prompt patients to ask questions during an office visit? Methods We audio-recorded office visits of 84 patients visiting one of three orthopaedic hand surgeons for the first time. Patient questions were counted and coded using an adaptation of the Roter Interaction Analysis System in 11 categories: (1) therapeutic regimen; (2) medical condition; (3) lifestyle; (4) requests for services or medications; (5) psychosocial/feelings; (6) nonmedical/procedural; (7) asks for understanding; (8) asks for reassurance; (9) paraphrase/ checks for understanding; (10) bid for repetition; and (11) personal remarks/social conversation. Directly after the visit, patients completed the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey (including age, sex, race, work status, marital status, insurance status), and three Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity Function, Pain Interference, and Depression. The NVS scores were divided into limited (0-3) and adequate (4-6) health literacy as done by the tool's creators. We also assessed whether the surgeons prompted patients to ask questions during the encounter. Results Patients with limited health literacy asked fewer questions than patients with adequate health literacy (5 ± 4 versus 9 ± 7; mean difference, À4; 95% CI, À7 to À1; p = 0.002). More specifically, patients with limited health literacy asked fewer questions regarding medical-care issues such as their therapeutic regimen (1 ± 2 versus 3 ± 4; Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at

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Section: Discussionmentioning

confidence: 99%

Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons

Menendez

Hoorn

Mackert

et al. 2017

Clinical Orthopaedics &Amp; Related Research

110

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“…Low health literacy is associated with lower health-related knowledge, suboptimal use of preventive health services, and poorer chronic illness control (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011;Herndon, Chaney, & Carden, 2011), but the effect of low health literacy on certain clinical outcomes remains incompletely elucidated (Berkman et al, 2011;Easton, Entwistle, & Williams, 2010;Keller, Wright, & Pace, 2008). Better understanding of the relation between health literacy and clinical outcomes is fundamental to the design of initiatives aimed at improving health care delivery to patients with low health literacy.…”

Section: H J Mosher Et Almentioning

confidence: 99%

Association of Health Literacy With Medication Knowledge, Adherence, and Adverse Drug Events Among Elderly Veterans

Mosher

Lund

Kripalani

et al. 2012

Journal of Health Communication

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“…[23] However, education may be used as a proxy as studies note limited education is associated with limited health literacy. [24,25] We also noted higher education to be associated with greater knowledge.…”

Section: Limitationsmentioning

confidence: 99%

Carbohydrate knowledge in diabetic emergency department patients at an academic institution

Dalawari

Sprowls

Moran

et al. 2017

JHA

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Background: Diabetes Mellitus (DM) affects 12.3% of the U.S. population and is responsible for $245 billion in annual costs. Knowledge about their disease is an important part of patients' self-management. Objective: The objective of this study was to describe the baseline level of knowledge of patients with diabetes in this emergency department (ED), including behaviors related to healthy eating such as carbohydrate counting (CC). Methods: This was a cross sectional interview survey conducted at an academic tertiary center. An 8-item survey was developed to assess areas of diabetes self-care and carbohydrate knowledge. Trained research assistants approached all medically stable, non-pregnant ED patients with a past medical history of diabetes for participation. Descriptive statistics and ANOVA analysis were used. Results: Of the 115 patients approached, 98 were willing to participate; 54% were using insulin and 68% were female. The average age was 55 (SD +/-14) years and diagnosed for an average of 12 (SD +/-10) years. Fifty three percent did not check their morning blood sugar. Only 20% could accurately state the target hemoglobin A1c. While 48% of participants could relate the importance of carbohydrates to blood sugar, only 5% could state the number of grams of carbohydrates in a slice of bread. Only 1 participant correctly answered all 4 of the carbohydrate questions. Higher education and more visits with a nutritionist were associated with carbohydrate knowledge. Conclusions: Carbohydrate knowledge among this ED population was poor. Opportunities exist for patient education.

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Health Literacy and Emergency Department Outcomes: A Systematic Review

Cited by 135 publications

References 48 publications

Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons

Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons

Association of Health Literacy With Medication Knowledge, Adherence, and Adverse Drug Events Among Elderly Veterans

Carbohydrate knowledge in diabetic emergency department patients at an academic institution

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