Items in AFP with MESH term: Communication Barriers

Health Literacy: The Gap Between Physicians and Patients - Article

ABSTRACT: Health literacy is basic reading and numerical skills that allow a person to function in the health care environment. Even though most adults read at an eighth-grade level, and 20 percent of the population reads at or below a fifth-grade level, most health care materials are written at a 10th-grade level. Older patients are particularly affected because their reading and comprehension abilities are influenced by their cognition and their vision and hearing status. Inadequate health literacy can result in difficulty accessing health care, following instructions from a physician, and taking medication properly. Patients with inadequate health literacy are more likely to be hospitalized than patients with adequate skills. Patients understand medical information better when spoken to slowly, simple words are used, and a restricted amount of information is presented. For optimal comprehension and compliance, patient education material should be written at a sixth-grade or lower reading level, preferably including pictures and illustrations. All patients prefer reading medical information written in dear and concise language. Physicians should be alert to this problem because most patients are unwilling to admit that they have literacy problems.


Using Bilingual Staff Members as Interpreters - Feature


Dealing with Adolescent Latino Patients - Curbside Consultation


Using Medical Interpreters - Curbside Consultation


The Role of Literacy in Health and Health Care - Editorials


Do I Need an Interpreter? (Spanish version) - Patient Education


Implementing Advance Directives in Office Practice - Article

ABSTRACT: Patients prepare advance directives in an effort to maintain autonomy during periods of incapacity or at the end of life. Advance directive documents are specific to the state in which the patient lives, but an effective strategy in the family physician’s office involves more than filling out a form. Physician barriers to completing an advance directive include lack of time and discomfort with the topic. On the patient’s part, lack of knowledge, fear of burdening family, and a desire to have the physician initiate the discussion are common barriers. Once the advance directive is complete, barriers to implementation include vague language, issues with the proxy decision maker, and accessibility of the advance directive. Overcoming these barriers depends on effective communication at multiple visits, including allowing the patient the opportunity to ask questions. Involving the family or a proxy early and over time can help the process. It may be helpful to integrate advance directive discussions at selected stages of the patient’s life and as health status changes.


Caring for Older Patients Who Have Significant Hearing Loss - Curbside Consultation



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