Lecutre 2 Flashcards
What are responsible for when it comes to patient care? What is a joint commission?
APTA Guide to Physical Therapy Practice: “Physical therapists are responsible for patient/client related instruction across all settings for all patients/clients.”
Joint Commission – provides standards for accreditation of hospitals and other health care organizations: “patient-centered” communications to optimize quality of care delivered and ensure patient understanding and safety
11 objectives related to health communication and health information technology
Improve health literacy of the population
Increase the proportion of persons who report that their health care provider always gave them easy-to-understand instructions about what to do to take care of their illness or health condition
Increase the proportion of persons who report that their health care provider always asked them to describe how they will follow the instructions
Increase the proportion of persons who report that their health care provider’s office always offered help in filling out a form
have satisfactory communication skills
always listened carefully to them
always explained things so that they could understand them
always showed respect for what they had to say
always spent enough time with them
always involved them in decisions about their health care as much as they wanted
recommends personalized health information resources to help them manage their health
What is the NAAL stand for what did they study?
National Adult Literacy Survey (NALS)
Conducted in 1992
10-year follow-up survey in 2003, National Assessment of Adult Literacy (NAAL)
NAAL
High prevalence of illiteracy and low literacy
Literacy = “using printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential”
How many people at prone task were only between the 5 and 8th grade levels what about for documenting tasks and quantitative tasks
Sample population n=20,000, 16 years of age or older 3 functional tasks Prose tasks 43% at basic or below basic Document tasks 34% at basic or below basic Quantitative tasks 55% at basic or below basic
What is health literacy? and what percent is basic level or lower and what percent is intermediate
What percent is proficient
Tasks specific to health literacy assessed for the first time
Clinical care
Prevention services and information
Navigation of health care system
Health literacy – “degree to which individuals have the capacity to obtain, process, and understand basic health decisions”
36% adults – basic or below basic levels of health literacy
53% - intermediate level
12% - proficient
So what is the NAAL going to do about this decline in health literacy
Increased attention to addressing health literacy problem
Rapid solutions not just within large health care organizations and systems, but at level of individual provider
Who are at people with disadvantages
Low income (adults below the poverty line), Older adults people less than the age of 65 due to vision and cognitive changes minorities such as Mexicans and nig nogs non native english speaker male gender more so than females not to sure about this one. people on medicare or medicaid and people with diseases
Assessing Health Literacy make sure you do what? and ID what type of red flags. Don’t be afraid to ask the patient what questions during the initial evaluation.
Observation and interviewing skills Be sure to take an adequate social history Review intake forms and medical chart Identify “red flags” At-risk populations Reading behaviors Self-care behaviors Communication behaviors
Shame-free questions
“How often do you have somebody help you read hospital materials?”
“How often do you have problems learning about your medical condition because of difficulty understanding written communication?”
“How confident are you filling out medical forms by yourself?”
Medication review
Do not rely on highest educational level completed
2-5 year discrepancy between grade level attained a patient’s true reading abilities
Strategies To Enhance Learning and Understanding
8
Create a shame-free environment Use private area of clinic when gathering/providing information Reassurance Sit with patient at their level, face them when speaking Be attentive, invite questions < 3 key points at a time Plain language Teach-back method Provide easy-to-read materials
Plain Language how to enhance that they understand like use simple words yes but what if they still don’t understand.
Information presented is clear, simple, precise, and directed toward the target audience
Do not use jargon
Repeat/rephrase as necessary
Use alternate types of information delivery
Allow time for questions
Whats the teach back method
Assess or verify a patient’s understanding of instructions or information you have provided
“Can you tell me in your own words…?”
“Can you demonstrate…?”
Recall and reinforcement increases possibility for adherence to therapist’s recommendations
Assess attributes of written materials: what to look for?
Organization
Writing style
Appearance
Appeal and suitability
What lifestyle choices can lead to a death and which disease are highly prevalent in the world
Can contribute to morbidity and mortality Diet Physical activity Tobacco use 2007 - >60% of deaths in the U.S. related to chronic illnesses Heart disease CVA Diabetes Cancer Chronic lower respiratory dise
Is a HEP better than an watched program by the therapist.
Home exercise program adherence significantly less compared to supervised exercise programs
Patient does less than what is prescribed
Patient does not initiate behaviors
Patient quits prematurely
Threatens patient’s recovery and level of function
Factors Affecting Adherence
Personal characteristics
Variable associated with disease or injury
Intervention variables
Patient/practitioner relationship
