Unit 2 Week 7: Assessment Cont'd, Literacy, Teaching Preparation Flashcards
4 Steps to Providing Culturally Sensitive Patient Teaching
- Examine Personal Culture
* What and who has shaped us? What are our bias? - Familiarity with patient culture
* Be a generalist, and curious with our patient’s culture - Identify Adaptations made by patient
* How do they live out their culture? Do not prescribe what we believe about their culture on to them - Modify Patient teaching based on data from previous steps
What is cultural competence>
can be viewed as a process – never fully achieved
Deliberate cognitive process is which we become appreciative and sensitive. Must Involve and begin with assessment of one’s own bias.
- self awareness
- other awareness
- bridging skills
General Assessment and Teaching Interventions for Culturally Competent Care
- Identify client’s primary language
- Observe interactions between client and family members.
- Listen to the client.
- Consider communication abilities and patterns.
- Explore customs or taboos.
- Determine the notion of time.
- Be aware of cues for interaction
- Assess client’s religious practices.
What to avoid in cultural assessment
- Do not overgeneralize or stereotype patients based on their ethnic heritage
- Never assume a patient’s learning needs or preferences for health treatment will be alike simply based on ethnicity.
- We do not want to view all members of a cultural group homogenously or expect certain beliefs or practices presumably.
- ASSESSING & TAILORING with EACH PATIENT IS VITAL
Define literacy
the ability of adults to read, write, and comprehend information at the 8th-grade level or above
Define illiteracy
the ability of adults to read, write, and comprehend information at the fourth-grade level or below, or not at all
Define low literacy
(marginally literate or illiterate): the ability of adults to read, write, and comprehend information between the fifth to eighth-grade levels of difficulty
Define functional illiteracy
in adults, the lack of fundamental reading, writing, and comprehension skills needed to operate effectively in today’s society
Define health literacy
“the ability to access, understand, evaluate and communicate information as a way to promote, maintain, and improve health in a variety of settings across the life-course.”
What 4 things should a client with health literacy be able to do?
- Access?
- Understand?
- Process and evaluate?
- Communicate?
_________ + __________ = utilizatoin of health information
Context + Skills = Utilization of health information
* Ex) if taught about healthy eating habits, must consider context (poverty/financial stability) and skills (cooking) to be able to utilize the Information
Many people read at least __________ grade levels below their reported grade level of education.
2-4
At risk groups for health illiteracy
- Economically disadvantaged
- Older adults
- Immigrants
- English as second language
- Racial minorities
- High school dropouts
- Unemployed
- Prisoners
Ask me 3 for health literacy
- What is my problem?
- What do I need to do?
- Why do I need to do that?
7 Key Strategies to Combat Health LIteracy
- look for the cues – how would you know?
- use audiovisuals
- highlight/circle key points on handouts
- plain handouts
- teach back method
- partnerships for self-care
- use demonstration
List some telltale signs you should be concerned with literacy
- reacting to complex learning with withdrawal/avoidance
- Excuses: too busy, tired, not feeling well enough to participatie
- Lost/broken/forgot glasses
- Surrounding themselves with books to give impression they can read
- Insist on reading information later
- Asking someone to read for them
- Being nervous when asked to read
- Talking out of context about topic of conversation
How do individuals with poor literacy skils think?
in very concrete, specific, and literal terms
- Characteristics of thinking:
- Disorganization of thought
- Limited perception of ideas
- Slow rate of vocabulary and language development
- Poor problem-solving skills
- Difficulty analysing and synthesizing information
- Difficulty formulating questions
- Struggles when handling more than one piece of information at a time
Poor outcomes associated with decreased functional health literacy
- Increased morbidity and mortality
- Poorer adherence
- More medication errors
- Decreased ability to interpret labels and health messages
- Dependence (decreased autonomy and empowerment)
- Increased use of ERs or EMS
- Increase in re-admission
- Decrease in overall health status and wellness
- Decrease in use of preventative services
3 P’s of Health Literacy
Plain, Personal, Possible
What reading grade level should PEM be kept at?
4-5
7 Things to Consider when Evaluating Printed Materials
- Nature of the audience
- Literacy level required
- Linguistic variety available
- Brevity and clarity
- Layout and appearance
- Opportunity for repetition
- Concreteness and familiarity
PEM should use an _____ voice
active
PEM should write _____ to the reader ______
directly
reader
PEM should include ____ terms with no _______
simple
jargon
PEM should use _____ sentences/_______ points
short
bullet
PEM should ______ key information
highlight
PEM should write instructions in order of __________
enactment
Assessment of Instructional Material Understandability:
The material makes its _________ completely evident
The material does not include ______
The material uses _________ language
The material provides a _________
The visuals _____ rather than _________
purpose
information or content that distracts from its purpose
common, everyday language
summary
reinforce
distract
Assessment of Instructional Material Actionability
The material identifies:
The material breaks down action into:
The material provides a ______ whenever it could help the user act
At least one action the user can take
Manageable, explicit steps
tangible tool
Learners typically read at least _____ grade levels lower than their highest level schooling
two
Flesch-Kincaid Scale
Readability Formula
- appropriate for grade 5 to university levels
- uses average sentence length (in words) and average word length (in syllables)
Cloze Procedure
Comprehension Test
- does not provide grade level rating
- measures ability to comprehend written material
- administered to patients who demonstrate difficulty reading/comprehension at a grade 6 level
- every 5th word is removed and patient asked to fill in blank
- easier the material to comprehend = higher score
Listening Test
Comprehension Test
- measures ability to comprehend verbally delivered
- can be used for low literacy (below grade 6)
- choose a grade.5 level sample that takes around 3 minutes to read
- formulate 5-10 questions around key information
- Ask questions and grade as correct answers
< 75%: needs to be simplified
75-89: additional assistance in comprehension required
>90%: easily understood