Lecture 5: Health literacy - trudi aspden

Question 1

What is literacy?

Answer 1

The written and oral language people use in their everyday life and work including reading, writing, speaking and listening

Question 2

What is health literacy?

Answer 2

the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions

Question 3

what is the relationship between literacy and health literacy?

Answer 3

they are closely associated, but not exactly the same,

we can have one without the other

Question 4

What is the proportion of NZers which have low health literacy levels?

Answer 4

56%

Question 5

What is the minimum required score for individuals to meet the complex demands of every day life and work in the emerging knowledge based economy?

Answer 5

275.

most NZers score less than 275 on average

Question 6

In NZ, which groups do you fall under as more likely to have low health literacy?

Answer 6

male, older, maori or pacifica, living in a rural area, have english as a second language, or a low level of educational qualification.

Question 7

Why is low health literacy a barrier to optimal health?

Answer 7

Things like 
health promotion, 
health protection, 
disease prevention, 
health system navigation/accessing services all depend on the general population having an adequate level of health literacy, if this is not the case, the above actions will not have effect

Question 8

What are people with poor health literacy LESS likely to do?

Answer 8

Use prevention services e.g. Screening
Be knowledgeable about their illness, treatment and medicines,
Manage their long term/chronic condition

Question 9

How is low health literacy an issue to screening programmes?

Answer 9

Screening programmes rely heavily on patients knowing

The purpose of the screening
The date and place
And the procedure involved

Otherwise the may not show up to the appointment, or refuse to go through with it

Question 10

What are people with poor health literacy more likely to do?

Answer 10

Be hospitalised due to chronic condition
Use emergency services
Suffer a workplace injury

Question 11

Why are people with low health literacy more likely to suffer a workplace injury?

Answer 11

because they do not understand safety precaution messages

Question 12

What is the ideal patient expected to do regarding their health?

Answer 12

Monitor and manage their own health
Manage their own medications
Read, and interpret spoken and written information,
Listen, understand and remember important health/medicine related explanations and directions
Give accurate info to pharmacy staff about medical problems, symptoms and health related issues

Question 13

What does monitoring and managing ones own health involve?

Answer 13

Notice and be able to accurately describe changes in symptoms
Seek appropriate help when needed
Use devices like BP monitors and BG meters, understand what the results mean and make dietary and sometimes insulin dose adjustments accordingly

Question 14

What does managing ones own medications involve?

Answer 14

Know what to do if a dose is missed
Be able to count pills and measure liquid doses
Be able to calculate how long medications will last,
Be able to organise a new prescription, collect a repeat when required,
Be able to use clocks and calenders to ensure that medications are taken correctly
Work out dose intervals e.g. 2 tablets every 4 hours

Question 15

What does reading and interpreting spoken and written information involve?

Answer 15

Being able to read and understand labels and information leaflets including different names (generic and brand names) of medicines

Being able to understand the dosage instructions

Question 16

Why is it hard for patients to accurately give medical professionals info about their medical problems, history, symptoms and other related issues?

Answer 16

The patient is often not medically trained so information is likely to be inaccurate

Question 17

What are the consequences of poor health literacy?

Answer 17

Noadherence to medication treatment plans including missed repeats, inappropriate dosing or timing of meds
Failure to recognise side effects or drug interactions.

Increased emergency department costs
Reduced ability to self manage conditions
Reduced engagement with care plan/ health care system

Question 18

Why is it difficult to recognise people who have a low level of health literacy?

Answer 18

Many patients with low health literacy

Feel ashamed of poor reading or understanding
Have strategies to hide their difficulties
Often avoid reading in public situations

Question 19

What can pharmacists do to help people with low health literacy?

Answer 19

By having an awareness of the barriers faced by people with low health literacy to navigating the NZ health system

Adopt an attitude of helpfulness - i.e. Be willing to adapt practices

Being an advocate for patients with low health literacy

By establishing rapport with customers and patients

Being aware of signs that may indicate low health literacy

Using the universal precautions approach with all patients

Question 20

What are some signs that may indicate low health literacy?

Answer 20

If patient claims they cant read because they have forgotten their glasses,
Or odd behaviour like bringing in repeats when they are not due.

Question 21

Why is the universal precautions approach used?

Answer 21

We dont really want to single out and embarrass patients or make assumptions so best to treat everyone the same at first

Question 22

What is the universal precautions approach?

Answer 22

Specific actions that minimise risk for everyone when it is unclear which patients may be affected

They are also communication practices which remove literacy related barriers

This is done by structuring patient interactions to minimise the risk that any patient will not understand the health information they are given

It allows patients to make informed decisions about their health care,

Question 23

What are some things that can be done to help with low health literacy patients?

Answer 23

Avoid jargon when counselling
Consider the content and font size of labels
Dont overload with information - focus on the need to know and need to do and limit this to 3-5 points
Repeat and summarise

Question 24

What kind of explanations can we use when dealing with low health literacy patients?

Answer 24

Use of specific examples that are relevant to the patient, i.e. Personalise

Use diagrams, models, analogies and demonstrations to explain concepts or complex instructions or techniques

Search useful resources to use, e,g, pharmac, asthma foundation, public health offices

Question 25

What sort of education materials are suitable for patients with low health literacy?

Answer 25

Do not assume that patients read the information given to them

Use written info together with spoken instruction
Use the written info to facilitate the discussion, not replace it

Personalise the written info by circling, highlighting important information. Discuss how it relates to the patient’s care

Question 26

What are the ask me three encouragement questions?

Answer 26

What is my main problem?
What do i need to do?
Why is it important for me to do this?

Question 27

What is the teach back technique?

Answer 27

Where, after you have explained information to the patient, you ask them to teach it back to you as if switching roles

Question 28

Why is the teach back technique important?

Answer 28

40-80% of medical information patients receive is immediately forgotton.
Nearly half of the medication info received is retained incorrectly

Teach back is a way of confirming your explanation was correct and effective. Can also correct patient as you go
This can be used with verbal and written material

Question 29

What are the main actions that can be used to simplify patient counselling?

Answer 29

Use plain language, not jargon
Limit info to 3-5 key points
Be specific and concrete, not general
Demonstrate, draw pictures, use models
Repeat and summarise,
Encourage questions
Use teach back to confirm understanding
Be positive and empowering