Pharm 1- Health Literacy

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

Health Literacy

Age 65 or older, minorities, english as a second language, less than a high school diploma, live at or below poverty line, rate their overall health as poor, have medicare/medicaid/uninsured

Groups with Limited Health Literacy

Less knowledge of their disease/management, impact of weight loss on HTN and CV risk, hypoglycemia sx in DM, HIV and HCV risk, hospital discharge instructions, understanding medication labels and instructions

Potential health impact of limited literacy

Reads slowly, fills out forms incorrectly, uses excuses like “I forgot”, brings a friend, fails to show up for appts, does not ask questions for clarification, has difficulty following instructions, nods in agreement but does not truly understand information

Signs of limited health literacy

Rapid Estimate of Adult Literacy in Medicine Short Form

determine health literacy

using an alternative term rather than a medical terms is

simplifications

changes in demographics in the US and health disparities, legal and regulatory issues, patients have different explanation of their illnesses than found in western biomedical model, many factors can influence cultural values and beliefs about health care

cultural competency

Agriculture and food production, education, work environment, living and working conditions, unemployment, water and sanitation, home care services, housing

social determinants of health

failing to appreciate cultural differences, making the medical model the only or dominant paradigm, stereotyping groups, bias and lack of personal awareness bias, using medical jargon that impedes communication, failing to check meaning and understanding, failing to inquire about patient preferences, failing to express empathy, lack of awareness of historical event that may shape a patients illness and beliefs

Common pitfalls in cross cultural communication

Introduce yourself by name, title and role, ask patient what they prefer to be called, do not appear rushed, ask personal questions, use plain language, listen to questions, hold patient information confidential, display genuine concern

Trust building behaviors

What do you think has caused your problem? Why do you think it started when it did? What do you think your sickness does to you? How severe is your illness? What kind of treatment do you think you should receive? What are the most important results you hope to receive? What are the chief problems your illness has caused? What do you fear most about your sickness?

Patient Explanatory Model

Call, Cause, Coping, Concerns. What do you call the illness? What do you think caused the disease or illness? How do you cope with the disease or illness? What concerns do you have about your disease or illness?

Modified PEM 4 “Cs”

Enhancing providers ability to care for a diverse population can help to create _____ and more _____ healthcare

safer, effective