Health Literacy, Teach Back And Consent

Question 1

What is health literacy?

Answer 1

= a persons ability to engage with health information and services

Question 2

What are the two aspects of health literacy?

Answer 2

• Individual health literacy - Skills, knowledge, motivation and capacity of an individual to access, understand, understand and act on health information
  
  • Health literacy environment - infrastructure, policies, processed, materials, how effectively health professionals communicate

Question 3

What are the red flags of health literacy?

Answer 3

• Frequently missed appointments
  
  • Incomplete forms
  • Unable to name medications, explain purpose or dose
  • Identifies pills by looking at them not reading the label
  • Unable to give coherent sequential history
  • Ask for or no questions
  • Lack of follow through on tests, referrals or meds

Question 4

What is the health literacy stat?

Answer 4

60% of adults do not have the level of health literacy needed to understand and use day to day health information

Question 5

What can we do to improve health literacy for out patients?

Answer 5

• Do not assume –> take a health literacy universal precautions approach and give health information in a way that all people will understand
  
  • Encourage patients to ask questions
  • Use visual aids
  • Ask clients how they remember things
  • Make greater use of healthcare interpreters
  • Allow extra time for indigenous patients to respond
  • Confirm using teach back method

Question 6

Methods to improve health literacy and self management ?

Answer 6

• Motivational interviewing

- Teach back method

Question 7

What is the teach back method ?

Answer 7

• An interactive communication technique
  
  • A way to ensure health care providers have explained information clearly to the patient
  • Asking client or carer to explain in their own words what they need to know or do
  • A way to check for understanding and if needed, re-explain and check again
  • A researched-based literacy intervention that improves patient-provider communication and patient health outcomes
  • IT IS NOT –> a test or a quiz of the patient

Question 8

What are the 4 steps of Teach back method?

Answer 8

1. Explain the information
   - Use plain language, choose culturally familiar terms and examples, and focus on relevant actions steps
   - Demonstrate if you can
   
   2. Check understanding
      
      • Instead of asking “do you understand”
      • Ask people to explain what you told them in their own words
      • Emphasise that your’e not testing them but rather checking that you explained the information well
   3. Re-explain if needed
      
      • If your first explanation didn’t quite get the job done, explain again in a new way
      • Try writing info down and highlighting key parts
   4. Re-check understanding
      
      • Ask people again to explain in their own words
      • Focus on whatever they struggled with the first time
        If showed someone how to do something like an inhaler get them too demonstrate

Question 9

What are the stages of Readiness to change?

Answer 9

Precontemplation - not even considering change

Contemplation - Ambivalent about making a change

Preparation - taking steps toward implementing change

Maintenance - Sustaining the target behaviour

Question 10

What are ways to identify change readiness?

Answer 10

“I want to take my medication BUT I hate the way it makes me sleepy”

- Listen for the BUT 
- Everything after BUT reveals patients personal roadblocks to meeting their goals which needs to be taken into consideration when planning treatment to increase the likelihood of success   
- Listen for change talk that indicates a desire to change behaviour e.g. I want to, I have to, I can

Question 11

What is Motivational interviewing?

Answer 11

= a collaboration partnership between patients and nurses, where nurses can explore patients understanding, motivation, confidence and roadblocks to change

Question 12

What are the Motivational interviewing principles?

Answer 12

1. Express empathy through reflective listening
   
   2. Highlight discrepancies between patients goals or values and their current behaviour
   3. Avoid argument and direct confrontation, Accept their ambivalence
   4. Adjust to a patients resistance rather than opposing it directly
   5. Support self - efficacy, Encourage optimism that things can change

Question 13

What are the guiding principles of MI

Answer 13

• Resit the righting reflex
• understand the patients own motivation
• listen to the pt
• empower them

Question 14

ways to practice MI

Answer 14

OARS

• open questions
• Affirmations
• reflections
• Summaries

Question 15

What is the legal age of consent to medical intervention?

Answer 15

• Legal parameters of a minor are locally defined (<18 years)
  
  • Age of consent for non-urgent medical treatment in NSW
    
    • <14 parental consent required
    • 14-15 parental consent is prudent unless youth objects
    • > 16 own consent is sufficient