This document summarizes a study conducted at the North Chicago VA Medical Center examining factors affecting functional literacy and patient-provider communication. Focus groups with VA patients and providers identified challenges with healthcare literacy. Patients preferred simple verbal and written explanations and struggled to understand medical terminology. Providers wanted to improve communication by learning patients' literacy levels and tailoring information appropriately. The study recommends further research on how low literacy impacts elderly veterans and implementing literacy screenings to help match patients with effective communication interventions.
Senior Citizens need to have comprehensive medical evaluations that are readily available to emergency providers. Electronic Medical Recording is ideal for having much needed information at the proper person's finger tips. The hesitancy of primary care physicians to employ EMR/EHR systems places a heavy burden on emergency departments in the United States. Senior citizens often have special needs that are not readily known by first responders and in a crisis situations, the care provided is based on standard of care and not special needs. Innovative alternatives to the current data taking, storage and retrieval process.
A Proposal for an Onondaga County International Medical Graduate Training Program Prepared by Matt Cortese, MD/MPH Candidate SUNY Upstate Medical University Office of Diversity & Inclusion For the Healthcare Initiatives for Community Inclusion Committee (HCIC) 3 June 2014
The lived experiences of pantawid pamilya beneficiaries pptAlma Sy-Patron
This study examined the lived experiences of Pantawid Pamilya beneficiaries in availing PhilHealth Indigent Program (PIP) with the intent of improving its implementation. Descriptive qualitative method using phenomenology is employed in this study with 33 program members as participants.
Senior Citizens need to have comprehensive medical evaluations that are readily available to emergency providers. Electronic Medical Recording is ideal for having much needed information at the proper person's finger tips. The hesitancy of primary care physicians to employ EMR/EHR systems places a heavy burden on emergency departments in the United States. Senior citizens often have special needs that are not readily known by first responders and in a crisis situations, the care provided is based on standard of care and not special needs. Innovative alternatives to the current data taking, storage and retrieval process.
A Proposal for an Onondaga County International Medical Graduate Training Program Prepared by Matt Cortese, MD/MPH Candidate SUNY Upstate Medical University Office of Diversity & Inclusion For the Healthcare Initiatives for Community Inclusion Committee (HCIC) 3 June 2014
The lived experiences of pantawid pamilya beneficiaries pptAlma Sy-Patron
This study examined the lived experiences of Pantawid Pamilya beneficiaries in availing PhilHealth Indigent Program (PIP) with the intent of improving its implementation. Descriptive qualitative method using phenomenology is employed in this study with 33 program members as participants.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
“Thinking Ahead - Conversations across California” is an undertaking to learn about end-of-life advance planning user-centered information and communication formats. BRC conducted a series of learning focus groups comprised of representatives from five California cities. Participants provided insight about their understanding of end-of-life advance planning, and made recommendations for user-friendly information and communication approaches. Key learning: individuals were worried about not having choices or being denied the right to decision making at the end of their lives. There was also confusion about end-of-life treatments, the authority of advance planning documents and the responsibility of healthcare agents.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
Low health literacy affects us all. Only 12% of Americans are proficient in health literacy skills and only half of patients take medications as directed. Take this short quiz from HealthEd to test your own skills. Includes statistics and links to helpful literacy Web sites.
Provider Based Patient Engagement - An Essential Strategy for Population HealthPhytel
As the healthcare industry starts to re-engineer care delivery to accommodate new reimbursement models, providers on the front lines of change recognize the need for population health management and for increasing patients’ engagement in their own care. These two approaches are inextricably bound together, because it is impossible to manage the health of a population without getting patients more involved in self-management and the modification of their own risk factors. This paper discusses the fundamentals of patient engagement and shows how automation tools and web-based care management can facilitate this key process.
This webinar provides resources and guidance on effective conversations with patients and families about their goals, wishes, and values for end-of-life care.
Why Emplyers care about Pimary care 2008Paul Grundy
Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising healthcare costs and uneven quality. Primary care faces a crisis as a growing number of U.S. medical graduates are avoiding primary care careers because of relatively low reimbursement and an unsatisfying work life. Yet a strong primary care sector has been associated with reduced health care costs and improved quality. Through the and other efforts, some large employers are engaged in initiatives tostrengthen primary care. [Health Affairs 27, no. 1 (2008): 151–158;
Home visits in internal medicine graduate medical educationTÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
“Thinking Ahead - Conversations across California” is an undertaking to learn about end-of-life advance planning user-centered information and communication formats. BRC conducted a series of learning focus groups comprised of representatives from five California cities. Participants provided insight about their understanding of end-of-life advance planning, and made recommendations for user-friendly information and communication approaches. Key learning: individuals were worried about not having choices or being denied the right to decision making at the end of their lives. There was also confusion about end-of-life treatments, the authority of advance planning documents and the responsibility of healthcare agents.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
Low health literacy affects us all. Only 12% of Americans are proficient in health literacy skills and only half of patients take medications as directed. Take this short quiz from HealthEd to test your own skills. Includes statistics and links to helpful literacy Web sites.
Provider Based Patient Engagement - An Essential Strategy for Population HealthPhytel
As the healthcare industry starts to re-engineer care delivery to accommodate new reimbursement models, providers on the front lines of change recognize the need for population health management and for increasing patients’ engagement in their own care. These two approaches are inextricably bound together, because it is impossible to manage the health of a population without getting patients more involved in self-management and the modification of their own risk factors. This paper discusses the fundamentals of patient engagement and shows how automation tools and web-based care management can facilitate this key process.
This webinar provides resources and guidance on effective conversations with patients and families about their goals, wishes, and values for end-of-life care.
Why Emplyers care about Pimary care 2008Paul Grundy
Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising healthcare costs and uneven quality. Primary care faces a crisis as a growing number of U.S. medical graduates are avoiding primary care careers because of relatively low reimbursement and an unsatisfying work life. Yet a strong primary care sector has been associated with reduced health care costs and improved quality. Through the and other efforts, some large employers are engaged in initiatives tostrengthen primary care. [Health Affairs 27, no. 1 (2008): 151–158;
Home visits in internal medicine graduate medical educationTÀI LIỆU NGÀNH MAY
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Inside Retail Academy: Managing Marketing in a Multi Channel Retail EnvironmentACRSMonash
The ACRS team attended Inside Retail Academy’s one day intensive workshop, 'Managing marketing in a multi channel retail environment'. The workshop focused on modern marketing in a fast paced, technology fueled, ever-evolving retail environment.
Where we explain how the concept of a crypto currency can lead to the creation of a new kind of autonomous corporation. This one part of a three part slide deck. For the full deck and the context please visit http://bit.ly/pm-bbc
Va Health Literacy Research Presentationguest169e62f
What is the Impact of Low VA Patient Literacy on VA Diabetes Patient Educational Initiatives?
Department of Veterans Affairs Medical Center, North Chicago, IL USA
VA Diabetes Education Research Study 2008David Donohue
What is the Impact of Low VA Patient Literacy on VA Diabetes Patient Educational Initiatives?
Department of Veterans Affairs Medical Center, North Chicago, IL USA
The Workforce of the Future - Ben Frasier.pdfBenFrasier
As a nation, we are faced with a critical health care worker shortage that needs both immediate and long-term solutions. Everyone is affected by healthcare: as citizens whose health and that of our loved ones is affected by how well our healthcare system is functioning; as healthcare staff who are facing increasing levels of burnout and lack of motivation to work within a broken system; as healthcare administrators whose job it is to optimize resources to ensure that patients receive comprehensive and equitable care and that healthcare workers receive the support they need to thrive in a safe working environment; to legislators whose job it is to create practices and policies that allow the healthcare system to achieve these goals.
The issue of medical aliteracy has drawn both scholars and medical practitioners’ attention in the recent years. The negative cost of medical aliteracy has continued to constitute major threats to health related issue which has resulted in high mortality rate, high medical expenditure and medical underperformance among others. On this premise the study examined the influence of medical aliteracy among senior medical personnel. The study employed descriptive research design and Chi-Square to test the research hypotheses. A total number of 50 questionnaires were designed to collect information from the sampled population through a random sampling. From the result of the analysis it was revealed that factors such as ineffective supervision of medical personnel, low patient literacy level, lack of personnel-patients engagement could lead to medical aliteracy among senior medical personnel. Senior medical personnel have the knowledge of medical aliteracy and its implications on for medical personnel and the public. Medical aliteracy has an implication on health sector performance which includes increase in mortality rate, increase health expenditure, widening of the gap between patients – medical personnel communication among others. Perception of medical aliteracy has significant influence on medical personnel performance. The study concluded that, medical aliteracy is prevalent among medical personnel and patients and is associated with many poor medical outcomes in the health sector. It was however recommended that medical literacy training, schemes and programmes should be designed according to the needs of the different medical personnel and should therefore be included in medical professional training programs.
Addressing health equity & the risk in providing careEvan Osborne
What Is Health Equity & Why Should It Be Addressed?
How Does Health Equity Impact Providers & Payors?
How Can Providers & Payors Be Rewarded For Addressing Health Equity?
How Can Health Equity Be Addressed Through Technology?
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
Introduction
The big business of health care is growing in a massive rate more now than ever according to The Center for Health Workforce Studies a non-profit organization located in Rensselaer, New York the organization report that, “While total U.S. employment dropped by over 2% between 2000 and 2010, health care employment grew by more than 25% during the same period. More than 13% of the U.S. labor force worked in the health sector or in a health occupation (19 million jobs out of 143 million jobs in U.S. labor force). The health care sector is projected to add over 4.2 million jobs between 2010 and 2020, with 63% of those in ambulatory settings (offices of health practitioners, home health, and other non-institutional settings” (2012, CHWS). Health care is booming in all areas of study and research from Holistic to Western Medicine which include purchasing and supply. Unfortunately this is based off the demand for more Physicians that are not available where there is a need. The health care industry believe it or not includes the food industry and health and fitness as well.
The matter of ethics within the health care industry always needs to be address along with the quality of care for patients. Within this working essay paper I will discuss the matter of; Care & Service Provider, Ethics (codes and values), Mal-Distribution Physician Labor Forces. Even though the health care industry is growing the mal-distribution of health care is still evident in some rural areas. This factor of not having proper care delivered to impoverish neighborhoods and communities is another issue that still plagues the United States. David Cutler the online journal reporter for PBS News Hour stated, “About 10, 15 percent. Just to give you one example, Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs. That’s not to say they’re better, but that’s just on one dimension that they clearly cost less. What a lot of those people are doing in America is they are figuring out how to bill different insurers for different systems, figuring out how to collect money from people, all of that sort of stuff” (2013). The need for health care workers is great, but the balance is off regarding where the needs are not being meet.
Running head: HEALTH LITERACY PAPER
1
HEALTH LITERACY PAPER
8
Health Literacy Paper
Student’s Name
Institution’s Name
Date
Health Literacy Paper
In order for the population to have knowledge regarding the state of health in the country, it is crucial to visit specific issues affecting the health sector thus the importance of the topic on access to health services. For people to come to the understanding of how access to healthcare has been spread out in the country, this excerpt will strive to explore three areas that directly determine the spectrum in the ability to access health services across the whole population; incorporating the different factors that create variations in people’s abilities. The essay will give the disparities that exist in our social constructs that constitute to a problem that has affected a large part of the population in terms of coverage, availability of services and timeliness in getting medical care; all of which result in a positive or negative effect on the overall achievement of a healthy status among people. Additional information on the changing/ emerging trends in the provision of health services and improvements in access will be discussed to show the growth that has been attained with changing times and the effects that can be achieved through the continual increase in knowledge and information in the population regarding the matter. The essay will conclude with a brief summary of the important points on the topic together with the provision of the necessary steps to take to tackle disparities that cause variations in access to health care throughout the population.
It is crucial to mark the seriousness of the matter that is access to health care considering that in 2007, only 76.3 percent of the population was covered with medical insurance ergo dictating the adverse problem that some of the members of the population faced. The numbers changed upwards by more than 20 million in 2010 with the introduction of Patient Protection and Affordable Care but the underlying problem is still in existence since millions of Americans still lack insurance coverage (National HealthCare Quality Report, 2013). The importance of taking a medical cover on a people’s health is a subject that has not been grasped by many leading to avoidable consequences such as high medical bills, high mortality and morbidity rates and late discovery of diseases due to lack of ability to access basic services. The lack of coverage in the field can be associated with a lack of knowledge and understanding of how the system works. This factor can be attributed to low literacy levels of persons due to low educational levels, lack of informative channels that directly instruct citizens on what to do and the lack of advice on how to get insurance deals that work with different levels in the affordability among the pop.
Defining a Culturally Competent Organization Culturally competent .docxvickeryr87
Defining a Culturally Competent Organization Culturally competent health care, broadly defined as services that are respectful of and responsive to the cultural and linguistic needs of patients, is increasingly viewed as essential in reducing racial and ethnic disparities, improving health care quality, and controlling costs. The U.S. government considers cultural competence as a method of increasing access to quality care for all patients. The aim should be to develop systems more responsive to diverse populations. Managed care organizations view cultural competence as driving both quality and business. By embedding cultural competence strategies into quality improvement initiatives to make care more efficient and effective, clinical outcomes are improved while costs are controlled. Those in academic settings agree that cultural competency education is crucial for preparing future health care workers, although appropriate education on the topic is provided in only half of the medical schools in the United States (Betancourt, Green, Carrillo, & Park, 2005). According to the Office of Minority Health, cultural competence refers to the ability of health care providers and organizations to understand and respond effectively to the cultural and linguistic needs of patients (Office of Minority Health, 2001). Cultural competence encompasses a wide range of activities and considerations. It includes providing respectful care that is consistent with cultural health beliefs of the clients and family members. Competent interpreter services and programs to promote staff diversity are other ways in which health care organizations can increase cultural competence (Clancy & Stryer, 2001). Because communication is a cornerstone of patient safety and quality care, every patient has the right to receive information in a manner he or she understands. Effective communication allows patients to participate more fully in their care. Communicating effectively with patients is also critical to the informed consent process and helps practitioners and hospitals give the best possible care. For communication to be effective, the information provided must be complete, accurate, timely, unambiguous, and understood by the patient. Many patients of varying circumstances require alternative communication methods: patients who speak and/or read languages other than English; patients who have limited literacy in any language; patients who have visual or hearing impairments; patients on ventilators; patients with cognitive impairments; and children. The hospital has many options available to assist in communication with these individuals, such as interpreters, translated written materials, pen and paper, communication boards, and speech therapy. It is up to the hospital to determine which method is the best for each patient. Various laws, regulations, and guidelines are relevant to the use of interpreters. These include Title VI of the Civil Rights Act, 1964; Executive Order .
the graying of america challenges and controversies spring 20.docxoreo10
the graying of america: challenges and controversies spring 2012 17
Can Health Care
Rationing Ever
Be Rational?
David A. Gruenewald
Case Study
Mr. M. was a 77-year-old decisionally incapacitated
long-term nursing home resident with chronic schizo-
phrenia who was admitted to the hospital with a
bacterial pneumonia. His past medical history was
notable for deteriorating functional status over the
past 2-3 years, urinary retention requiring chronic
indwelling bladder catheterization, and two recent
hospitalizations for urinary tract infections leading
to sepsis. He developed respiratory failure soon after
admission and was intubated and placed on mechani-
cal ventilation. Follow-up studies suggested worsen-
ing pneumonia and acute respiratory distress syn-
drome (ARDS), as well as worsening kidney function.
The patient was unable to participate in any decision
making. His guardian requested that cardiopulmo-
nary resuscitation and all other intensive care be pro-
vided if necessary, including dialysis should Mr. M.’s
kidney failure continue to worsen. After five days of
mechanical ventilation, the patient was weaned from
the ventilator and extubated. The palliative care ser-
vice was consulted following the extubation; his criti-
cal care team questioned whether it would be appro-
priate to re-intubate the patient if he again developed
respiratory failure. The palliative care team contacted
Mr. M.’s brother, his only living relative, who felt the
patient’s quality of life was poor and believed the
patient would not want aggressive medical care. The
staff at his nursing home was contacted, as well as
the patient’s mental health case manager, who had all
known Mr. M. for many years. All concurred with his
brother’s assessment. Additionally, the nursing home
staff said that Mr. M. would not be able to return there
if the plan was to continue more intensive medical
management of his worsening health conditions. Hos-
pice care was discussed with these parties, and it was
thought that choosing hospice would best represent
the patient’s wishes under the circumstances. The pal-
liative care team contacted his guardian and explained
the patient’s medical situation and its implications
for his ongoing care (including the need for physical
restraints, loss of stable nursing home placement, and
confinement to the acute care hospital environment
for the duration of his acute illness). Based on this new
David A. Gruenewald, M.D., is an Associate Professor of
Medicine at the University of Washington School of Medi-
cine in Seattle, Washington, and the Associate Director of the
Palliative Medicine Fellowship at the University of Wash-
ington. He is the Medical Director of the Palliative Care and
Hospice Service at VA Puget Sound Health Care System in
Seattle, Washington. He received his Bachelor of Arts (B. A.)
degree from Reed College in Portland, Oregon, and his Medical
Doctor (M.D.) degree from the University of C ...
Educating Patients: Understanding Barriers,
Learning Styles, and Teaching Techniques
Linda Beagley, MS, BSN, RN, CPAN
Health care delivery and education has become a challenge for providers.
Linda Beagley, M
cator, Swedish Cov
Conflict of intere
Address corresp
nant Hospital, 51
e-mail address: lbe
� 2011 by Ame
1089-9472/$36.
doi:10.1016/j.jo
Journal of PeriAnesth
Nurses and other professionals are challenged daily to assure that the
patient has the necessary information to make informed decisions.
Patients and their families are given a multitude of information about
their health and commonly must make important decisions from these
facts. Obstacles that prevent easy delivery of health care information
include literacy, culture, language, and physiological barriers. It is up
to the nurse to assess and evaluate the patient’s learning needs and read-
iness to learn because everyone learns differently. This article will
examine how each of these barriers impact care delivery along with
teaching and learning strategies will be examined.
Keywords: patient education, barriers, culture, literacy, perianesthesia
nursing.
� 2011 by American Society of PeriAnesthesia Nurses
EDUCATING PATIENTS HAS become a challenge
for health care providers because the patient
length of stay has decreased and the need to deliver
complex information has increased. A new version
of the melting pot society requires special efforts
by health care professionals to ensure that the pa-
tient understands the information given to him or
her. Barriers that inhibit patient education are liter-
acy, language, culture, and physiological obstacles.
Assessing and evaluating the learning needs of
the patient are essential before planning and im-
plementation of an educational plan. Presenting
a well-formulated plan will increase the likelihood
of a successful recovery for the patient. In this
article, barriers will be dissected and strategies
examined to determine what will best suit the edu-
cational needs of the patient.
S, BSN, RN, CPAN, is a PACU Clinical Edu-
enant Hospital, Chicago, IL.
st: None to report.
ondence to Linda Beagley, Swedish Cove-
40 N. California Ave, Chicago, IL 60625;
[email protected]
rican Society of PeriAnesthesia Nurses
00
pan.2011.06.002
esia Nursing, Vol 26, No 5 (October), 2011: pp 331-337
Adult Learning
To effectively educate patients, health care pro-
viders must have an understanding of the princi-
ples of adult learning. Malcolm Knowles, who
began to study adult learners in the 1960s, is
known as the father of adult learning principles be-
cause of his extensive writing on adult education.
The term andragogy, the art and science of teach-
ing adults, is synonymous with that of Knowles.
He deduced that adults learn differently than chil-
dren. His studies determined five assumptions on
learning: self-concept, experience, readiness to
learn, orientation to learning, and motivation to
learn.
1
Acco ...
Educating Patients: Understanding Barriers,
Learning Styles, and Teaching Techniques
Linda Beagley, MS, BSN, RN, CPAN
Health care delivery and education has become a challenge for providers.
Linda Beagley, M
cator, Swedish Cov
Conflict of intere
Address corresp
nant Hospital, 51
e-mail address: lbe
� 2011 by Ame
1089-9472/$36.
doi:10.1016/j.jo
Journal of PeriAnesth
Nurses and other professionals are challenged daily to assure that the
patient has the necessary information to make informed decisions.
Patients and their families are given a multitude of information about
their health and commonly must make important decisions from these
facts. Obstacles that prevent easy delivery of health care information
include literacy, culture, language, and physiological barriers. It is up
to the nurse to assess and evaluate the patient’s learning needs and read-
iness to learn because everyone learns differently. This article will
examine how each of these barriers impact care delivery along with
teaching and learning strategies will be examined.
Keywords: patient education, barriers, culture, literacy, perianesthesia
nursing.
� 2011 by American Society of PeriAnesthesia Nurses
EDUCATING PATIENTS HAS become a challenge
for health care providers because the patient
length of stay has decreased and the need to deliver
complex information has increased. A new version
of the melting pot society requires special efforts
by health care professionals to ensure that the pa-
tient understands the information given to him or
her. Barriers that inhibit patient education are liter-
acy, language, culture, and physiological obstacles.
Assessing and evaluating the learning needs of
the patient are essential before planning and im-
plementation of an educational plan. Presenting
a well-formulated plan will increase the likelihood
of a successful recovery for the patient. In this
article, barriers will be dissected and strategies
examined to determine what will best suit the edu-
cational needs of the patient.
S, BSN, RN, CPAN, is a PACU Clinical Edu-
enant Hospital, Chicago, IL.
st: None to report.
ondence to Linda Beagley, Swedish Cove-
40 N. California Ave, Chicago, IL 60625;
[email protected]
rican Society of PeriAnesthesia Nurses
00
pan.2011.06.002
esia Nursing, Vol 26, No 5 (October), 2011: pp 331-337
Adult Learning
To effectively educate patients, health care pro-
viders must have an understanding of the princi-
ples of adult learning. Malcolm Knowles, who
began to study adult learners in the 1960s, is
known as the father of adult learning principles be-
cause of his extensive writing on adult education.
The term andragogy, the art and science of teach-
ing adults, is synonymous with that of Knowles.
He deduced that adults learn differently than chil-
dren. His studies determined five assumptions on
learning: self-concept, experience, readiness to
learn, orientation to learning, and motivation to
learn.
1
Acco.
Similar to VA Medical Health Literacy Study 2007 (20)
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Department of Veterans Affairs
Medical Center
3001 Green Bay Road, North Chicago, IL 60031
“Analyzing Factors Affecting Functional Literacy in the
Context of Primary Care Patient/Provider Communication”
Dr. Tariq Hassan, M.D., Veterans Affairs Medical Center, North Chicago, IL
Dr. George Lutz, Ph.D, Veterans Affairs Medical Center, North Chicago, IL
Dr. Tom Muscarello, Ph.D, DePaul University, Chicago, IL
David R. Donohue. M.A., Qualitative Technologies Inc., Northwestern University
ABSTRACT
PURPOSE: North Chicago VA medical staff instituted a one-page primary care medical appointment
information sheet to help patients navigate through their primary care appointment environment, but
discovered 65% of patients discarded the information sheet. Healthcare providers wanted to know why
the information sheet was not effective.
METHOD: Data gathered in this study used 3 patient and 2 VA doctor/clinician focus groups. Each
group contained 10-15 participants. Focus groups were 60-75 minutes in length. Participants were
asked five to six questions focusing on health care communications.
RESULT: Group discussion is particularly appropriate when the interview(s) have a series of open
ended questions and wish to encourage research participants to explore the issues of importance to
them, in their own vocabulary, generating their own questions and pursuing their own priorities. This
helped our researchers to identify common ground, reveal health communication challenges and areas
of convergence and divergence.
CONCLUSION: Healthcare providers and patients acknowledge significant healthcare literacy
problems exist. We recommend additional research on the impact of low literacy on elderly VA patients
PURPOSE: Focusing regimens, a growing VA population most-at-risk. In addition, each primary care
and their medication On VA Patient and Provider Communication:
Dr. Tariq Hassan, M.D. given a health literacy Chicago Veterans Affairs Medicalliteracy said,
VA patient should be Chief-of-Staff, North screening test to establish a basic Center baseline where
“Goodcommunication interventions can be made available to match that patient’s literacy level.
new communications builds and maintains quality health care exchange and delivery. It can also,
facilitate and encourage patient participation in their care, reduces anxiety and help patient’s to become
active participants in their treatment/care plans.
As discussed in this paper, several factors play a key role in the communication process; however, literacy
and ability to utilize the tools of communication are the basic currency of communication, and unless
literacy issues are identified and properly addressed, it is unlikely that other interventions can be successful
utilized to improve provider–patient communication. (1) (2)
From the administration/organization standpoint, effective communication with the patient can further the
global drivers of health care, namely, access and timeliness of care, quality, patient satisfaction and cost
effectiveness. A well-informed and participatory patient will probably keep appointments, thereby reducing
costly no-shows and unnecessary ER visits. Patients can realize a greater overall satisfaction and level of
care with improved patient/physician interaction. (3)
Increasing patient participation in their care plan and their compliance level will likely increase the
effectiveness of the care itself, improve quality and reduce unnecessary utilization of resources. This can
translate into improving overall cost effectiveness and utilization of human resources within the health care
organization.”
1
2. In addition, comparatively little attention has been devoted to enabling patients to comprehend their
condition and treatment, to make the best decision for their care and to take the right medications at the
right time in the intended dose. The result is many patients lack the confidence to ask questions concerning
their healthcare. (4)
The modern VA healthcare system began during World War I
with establishment of hospitals to treat and rehabilitate veterans
with service-connected disabilities. A second role was added in
1924 with the addition of hospital care for lower-income
veterans. Although the veteran population is projected to
decline over the next 10 years, the demand for VA health care
services continues to increase due to the aging of veterans
(average age is 62-years) and the comprehensive health care
services offered to veterans, including favorable pharmacy
benefits; the national reputation of VA as a leader in the
delivery of quality healthcare; long-term care services; and
improved access to healthcare with the opening of additional
community-based outpatient clinics. The VA is continuing to
focus on meeting the needs of its core population, especially
those with disabilities that are the result of military service. In
2005 the VA’s appropriation were $30.7 billion and with the
continuing War in the Middle East is proposing to continue
focusing health care on service-connected disabled veterans, as
well as, veterans with lower incomes and those who have special healthcare needs. (4)
A Diverse VA Patient Population—2006
The VA patient population is a vast heterogeneous group—over 5.7 million enrolled veterans, and over 25
million eligible vets. VA Medical Services represents the largest healthcare provider within the United
States today, and will be faced with providing ongoing service to new military veterans, but also to an
aging overall population with special healthcare needs. The VA population spans all races, numerous
cultures, all levels of education, all socioeconomic strata, and both genders, with approximately 85 percent
male. The VA patient population also shows a wide age range of 18 years and up, with two basic spikes 20
to 30 year old veterans with short military stints, and those over 50 years, representing retired military. This
heterogeneity of the population points to the need for greater awareness of differences in attitudes,
perception, and level of technological adeptness. Disabilities in the veteran population (includes blindness,
deafness, multiple chronic disease states, and mental disorders) also present barriers to quality healthcare.
(5)
Healthcare Literacy North Chicago VA Medical Center
Poor Literacy is a marker for an array of problems within the healthcare system that go far beyond a
persons reading ability or comprehension level. According to a major health literacy study (1), uncovered
major misconceptions involving low literacy skills describing several such widely held misconceptions:
people with low literacy skills are intellectually impaired and slow learners.
In fact, most people with low literacy skills are of average intelligence and function reasonably well by
compensating for their lack of reading skills. In absolute terms, the majorities of those in low literacy
populations are white, native-born Americans and hold a high school diploma. Among patients who did
admit trouble reading, 40% felt shame and more than 50% had never told their spouses or children about
their reading problem. (6)
METHOD:
North Chicago V.A Medical Center One-Page Primary Care Patient Information Sheet
Primary Care Appointment Procedural Policy within the North Chicago V.A. Medical Center used a single-
page patient informational handout to help patient’s understand appointment scheduling, medication
routines, treatment protocols and other pertinent information critical to maximizing the quality of their
2
3. healthcare experience. However, North Chicago V.A. staff discovered in 2004, 65% of the primary care
patient population did not use the information handout. Clearly, answers were needed to why this patient
information sheet was discarded.
Using Focus Groups
Data from this VA study used 3 patient focus groups and 2 VA medical provider staff focus groups, of
between 10 to 15 participants, lasting between 60 to 75 minutes. Gaining access to such a variety of
communication is useful because knowledge and attitudes are not entirely encapsulated in reasoned
responses to direct questions. Everyday forms of communication may tell us as much, if not more, about
what people know or experience, as to gather a wide concourse including developing an array of opinions
and attitudes on issues impacting healthcare literacy, while helping to identify common ground.
Doctor/Clinician Focus Group Discussion Questions
1. Do your patients have problems comprehending and using healthcare information?
2. How do you communicate medical information to patients?
3. How do you know if patients understand information you give them?
4. How confident are you that your patient’s understand the steps they need to take in maintaining
and improving their health?
5. How can you improve communications with your patient’s?
6. Where are the strengths and weaknesses in healthcare communication at the VA?
Patient Focus Group Discussion Questions
1. Do you have problems comprehending and using healthcare information?
2. How does your doctor communicate medical information to you?
3. How do you tell your doctor about medical issues that you need to know more about?
4. How confident are you that you understand the steps you need to take in maintaining and
improving your health?
5. How can communications with your clinician be improved?
6. Where are strengths and weaknesses in healthcare communications at the VA?
Discussion Group Results
Doctor/Clinicians and Patients-Array of Opinions and Attitudes
KEY COMMUNICATION RESEARCH FINDINGS - DOCTORS/CLINICIANS SIDE
♦Patient’s hide their literacy level
♦Need to ask patients about their literacy ability
♦Need easy wording in layman terms of diagnostics and medicines
♦Patients have challenges with understanding their multiple medications and treatment routines
♦Write things down, letters, explain things in greater detail
♦Patient’s wants oral communications and simple instructions
KEY COMMUNICATION RESEARCH FINDINGS - PATIENT SIDE
♦Patients prefer verbal explanations and simple written instructions
♦Patients need to ask more questions.
♦Patients want additional treatment and medication information
♦Talk in layman terms that I can understand
♦Keep instructions and medical explanations simple
♦Can I bring a friend along to help my healthcare outcome—having support is good.
♦Have additional medical information sources or health library available
♦Asking questions keeps communications open, making it a two way street.
♦They need to tell us in simple language what to do, but it must be useful and condensed.
♦Medical providers should listen more.
PATIENT ISSUES – PERSONAL ISSUES-DOCTOR/CLINICIAN SIDE RESPONSES
1. 3.
3
4. Patients can’t read
Patients hide their literacy level
VA patients getting older, sight, hearing, mental issues
Loss of memory, trouble with memory
Patient worry, patients are nervous during appointments
PATIENT ISSUES- PERSONAL ISSUES -PATIENT SIDE RESPONSES
1. Many VA patients have poor memory, can’t remember things
Patients rely on their doctor for the right information, as if it were the Gospel
Patients worry over test results and are stressed.
Patients don’t understand medical terms and meds
2.
Oral communications, followed by written communications
5.
Exam and test results need to be explained.
Have a patient appointment exit interview.
Keep information simple. Patients want directions; need test results and what they mean.
HEALTH INFORMATION MATERIAL ISSUES- DOCTOR/CLINICIAN SIDE
RESPONSES
1. Patient’s need medicine lists and what meds do
Use different forms of health education media.
3. Information is missing
We don’t know if patients understand information given them
5. Font size on medical documents too small
Directions need to be simple
Develop a patient notebook, a profile to carry around
Print patient charts (information) with pictures and symbols
HEALTH INFORMATION MATERIAL ISSUES- PATIIENT SIDE
RESPONSES
1. Talk in lay terms and tell me what’s going on
Don’t understand the meaning of what doctor is saying.
Keep the information simple. Patients want directions, need information on test results, meanings
Patient wants to know the side-effects of their medications.
2. Preprinted information
Personal medical information written out by doctor
Doctor calls me on phone
3. 5. Patients need to ask more questions in Primary Care appointment time.
Doctors spend too much time on their computer going over patient file information.
Usually I think before I go and make my own little notes on what to ask when I go in.
I use printed pamphlets, brochures, and internet
I use medical books and encyclopedia, journals
Doctors and Nurses tell me information, get opinions.
Main medical information is my doctor.
Patients prefer oral communications and written information.
6. It is probably more so that patients don’t start asking questions that they don’t have the time to answer.
I would be worried that if we could see the screen all the time, we’d try to ask about everything on the
screen. This would take up even more time.
PATIENT/CLINICIAN INTERACTION ISSUES-CLINICIAN SIDE
1. Type patient notes to give to them
Appointment time is limited; spend more time going over things
4
5. We need to use new healthcare educational tools and see what works with particular patients
2. Patients are afraid to ask questions
Have a family member or friend present, an advocate in the appointment
Have MD’s/clinicians read instructions to patient
3. Patients are afraid to ask questions
We don’t have a benchmark to measure patient understanding
5. Ask patient for a small list of problems to discuss
Expand one-to-one contact time with patients
Spend more face time with each patient
Show more compassion, explain things, information
6. Doctor’s don’t explain enough
Show more compassion, explain things, information
Patients are afraid to ask questions
PATIENT/CLINICIAN INTERACTION ISSUES-PATIENT SIDE
1. I need answers to my medications and what they do
Doctors need to explain things more
Healthcare provider needs to ask patient if they understand the instruction they have given, and go over
things. Doctor needs to ask nurse to go over things and explain to patient.
2. Doctor needs to review patient file the day before their appointment.
Need faster medical consultation and my healthcare status.
Give follow up written report after medical appointment, what’s happening to me?
3. Patient’s need to be honest, talk about their conditions openly.
Improvements, as far as patient honesty goes I need to bring things up. You need to be able to get questions
answered.
4. I need answers to my medications and what they do.
The pharmacist needs to explain my meds to me and what they do.
I don’t remember everything about my condition.
5. Where can I go for the right information on my prescriptions?
Try a BEEPER to alert patient on test results
Healthcare provider needs to ask patient if they understand their instructions.
6. Medical test follow-up, results need to be explained. This makes patients more responsible
Patients not informed, they need more information Doctors need to explain things more
Do more health screening, preventative medicine
Doctor’s should not scare patients
TREATMENT/ADMINISTRATIVE ISSUES-PROCEDURE-CLINICIAN SIDE
Document healthcare notes
Make phone procedures simpler (inbound/outbound)
Expand health clerk’s education
Nurses take the lead in patient information-check information for patients
Pharmacy denies medications
Set up exit interviews for each patient
Get patient coming out of the clinics for education, information
TREATMENT/ADMINISTRATIVE ISSUES-PATIENT SIDE
1. We need to update patient information (results) because people are waiting.
I can’t understand him (The Doctor). At Hines and West Side VA you go see 1 doctor for an hour. A
month later you have an appointment at the same clinic and see a different doctor.
5
6. A lot of them are students. You can’t understand them and they don’t understand you.
2. Doctors and Nurses tell me information, get opinions
Main source of information is my doctor.
5. Medical specialist—follow-up—what’s going on and have primary care doctor explain things.
we now get an appointment letter and phone call.
The medical tests don’t tell you a reading on your test and don’t explain things.
Doctors and Nurse seem to spend more time with patient explaining things, and see the patient understands.
Changes patient want to see on clinic procedures
1. Provider interaction
2. New procedures overall to help patients
3. More patient education, to explain things
PATIENT PSYCHO-SOCIAL ISSUES-CLINICIAN SIDE
Motivational issues
Control issues
Patients don’t want their medications
Passive VA patient’s (not actively involved)
PSYCHO-SOCIAL ISSUES-PATIENT SIDE
1. 4. 6.
N. Chicago VA Healthcare staff, friendly, professional and concerned about patients.
Don’t talk over my head
I’m confused by the high level medical talk
LITERACY ISSUES-PATIENT SIDE
Prefer verbal explanations and simple written instructions
Where can I go to get answers to my treatment or medications?
Talk in layman terms that I can understand
Keep things simple, instructions and medical explanations
Literacy levels change in patients due to diet, fatigue, lack of sleep and other factors
Use a 3” X 5” card to write questions down to ask doctors in appointments
Patient’s want to become more active in their treatment
CONCLUSION:
KEY RECOMMENDATIONS
1. Healthcare providers and patients acknowledged a healthcare literacy problem exists. Our
recommendation is to institute a patient healthcare literacy screening test at the Primary Care
Medical Appointment, as a benchmark to evaluating individual literacy level.
2. Additional research is needed to discover what healthcare educational media would be the most
effective and useful to a particular patient’s literacy level.
3. We recommend research focusing on older VA patient population, a group most-at-risk. The VA
needs to design new communication interventions helping patients with low literacy to manage
their medication regimens to reduce errors, and noncompliance level, resulting in increased
patient safety and quality of care of all stakeholders.
Establishing good communication practices between patient/clinicians help also to build strategies for
improving patient compliance including giving clear, concise, and logical instructions in familiar language,
adapting drug regimens to daily routines, eliciting patient participation through self-monitoring, and
providing useful and understandable educational materials that promote overall good health in connection
with medical treatment. (7) (8) (9)
Historically in medicine, there was a paternalistic approach to deciding what should be done for a patient:
the physician knew best and the patient accepted the recommendation without question. This era is
ending, being replaced with involving the patient directly in health care outcomes and the movement
6
7. toward shared decision-making. Patients are advising each other to quot;educate themselves and ask questionsquot;.
Patient satisfaction with their care rests heavily on how successfully this transition is accomplished. Ready
access to quality information and thoughtful patient-doctor discussions is at the fulcrum of this growing
healthcare communication revolution. (10) (11)
Reference:
(1) Nielsen-Bohlman LT, Panzer AM, Hamlin B, Kindig DA. , editors. Institute of Medicine.
Health Literacy: A Prescription to End Confusion.
(2) Davis TC, Wolf, MS. Health Literacy Implications for Family Medicine, Farm Med 2004
Sept; 36: 595-8.
(3) Shea JA, Guerra CE. Health Literacy Weakly but Consistently Predicts Primary Care Patient
Dissatisfaction. Int. J Qual. Health Care, 2006 Dec 18th
(4) Smith JL, Haggerty J. Literacy in Primary Care Population: Is It A Problem?” Can J Public
Health, 2003 Nov-Dec; 94 (6): 408-12.
(5) Kelly PA, Haidet P. Physicians Overestimation of Patient Literacy: A Potential Source of
Health Care Disparities. Patient Educ Couns, 2006 Nov 29
(6) Wallace L. Health Literacy Skills: The Missing Demographic
Variable in Primary Care Research. Ann Farm Med. 2006 Jan-Feb; 4 (1): 85-6.
(7) Persell SD, Heiman HL. Understanding of Drug Indication by Ambulatory Care Patients. Am
J Health Syst Pharm, 2004 Dec 1; (23) : 2503.
(8) Davis TC, Wolf MS. Low Literacy Impairs Comprehension of Prescription Drug Warning
Labels. J Gen Intern Med. 2006 Aug; 21 (8): 847-51.
(9) Weiss BD, Mays MZ. Quick Assessment of Literacy in Primary Care: The Newest Vital Sign.
Ann Farm Med. 2005 Nov – Dec; 3 (6): 514-22.
(10) Carty B, Kenney K. Consumer Informatics in Primary Care. Stud Health Technol Inform,
2006; 122: 36-37.
(11) Bailey P., Jones L. Family Physician/Nurse Practitioner: Stories of Collaboration. J Adv Nurs.
2006 Feb; 53 (4): 381-91.
Editor- David R. Donohue, M.A.
QTinc@alumni.northwestern.edu
Cell (847) 651-3891
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