Precision communication: Physicians' linguistic adaptation to patients' health literacy.
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ABSTRACT:
SUBMITTER: Schillinger D
PROVIDER: S-EPMC8682984 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Improving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question. We aimed to examine the effectiveness of communication skills training for physicians on the hypertension outcomes and the health literacy skills, self-efficacy and medication adherence in patients with uncontrolled blood pressure (BP). METHODS:A randomized, controlled trial method was conducted on 240 hypertensive patients and 35 physicians presenting to healthcare clinics in the Mashhad, Iran, from 2013 to 2014. Using stratified blocking with block sizes of 4 and 6, eligible patients with uncontrolled blood pressure were randomly allocated to the intervention and control groups. Physicians in the intervention group received educational training over 3 sessions of Focus -Group Discussion and 2 workshops. The control group received the routine care. The primary outcome was a reduction in systolic and diastolic BP from baseline to 6?months. The secondary outcome was promoting HL skills in hypertensive patients. Data were analyzed using the regression model and bivariate tests. RESULTS:After the physician communication training, there was a significant improvement in physicians-patient communication skills, hypertension outcomes, medication adherence, and self-efficacy among the patients being managed by the physicians receiving training, compared to the control group. CONCLUSION:The educational intervention leads to better BP control; it may have been sufficient training of physicians change to impact counseling, HL and self-efficacy and adherence. The quality of physician-patient communication is an important modifiable element of medical communication that may influences health outcomes in hypertensive Iranian patients. TRIAL REGISTRATION:Iranian Registry of Clinical Trials (IRCT), IRCT20160710028863N24. Registered April 4, 2018 [retrospectively registered].
| S-EPMC6979365 | biostudies-literature
Project description:Introduction:Communication remains the backbone of patient-provider relationships, and many health outcomes have been directly attributed to both effective and ineffective communication. We developed an educational intervention to improve bedside communication and increase use of health literacy principles, in part as a response to suboptimal inpatient satisfaction scores. Methods:Our intervention consisted of a beside communication curriculum among 37 attending medicine physicians, 76 internal medicine residents, and 85 bedside nurses. The 1- to 1.5-hour curriculum included a didactic session to teach health literacy principles, video demonstrations, group discussion, and role-play. Attending physicians' health literacy knowledge, attitudes, and confidence were evaluated using pre- and postsurveys. Evaluation of the curriculum included Likert-type questions and free-text responses. Results:Attending physicians' knowledge and confidence improved (74% correct pre, 100% correct post, p < .001; 4.41 pre, 4.68 post, p = .002, respectively). Certain attitude domains also improved, including importance of team introductions and nurse contributions to bedside rounds (p < .001). Both residents and nurses found the curriculum valuable and planned to incorporate it into their bedside rounding. Discussion:A brief, low-cost curricular intervention focusing on clear communication skills and health literacy principles resulted in significant improvements in knowledge and attitudes of attending physicians and was readily incorporated by resident physicians and nurses. This curriculum can be easily implemented in a variety of settings to improve bedside patient-physician communication.
| S-EPMC6376895 | biostudies-other
Project description:BackgroundImproving informed consent to participate in randomized clinical trials (RCTs) is a key challenge in cancer communication. The current study examines strategies for enhancing randomization comprehension among patients with diverse levels of health literacy and identifies cognitive and affective predictors of intentions to participate in cancer RCTs.MethodsUsing a post-test-only experimental design, cancer patients (n?=?500) were randomly assigned to receive one of three message conditions for explaining randomization (ie, plain language condition, gambling metaphor, benign metaphor) or a control message. All statistical tests were two-sided.ResultsHealth literacy was a statistically significant moderator of randomization comprehension (P = .03). Among participants with the lowest levels of health literacy, the benign metaphor resulted in greater comprehension of randomization as compared with plain language (P = .04) and control (P = .004) messages. Among participants with the highest levels of health literacy, the gambling metaphor resulted in greater randomization comprehension as compared with the benign metaphor (P = .04). A serial mediation model showed a statistically significant negative indirect effect of comprehension on behavioral intention through personal relevance of RCTs and anxiety associated with participation in RCTs (P < .001).ConclusionsThe effectiveness of metaphors for explaining randomization depends on health literacy, with a benign metaphor being particularly effective for patients at the lower end of the health literacy spectrum. The theoretical model demonstrates the cognitive and affective predictors of behavioral intention to participate in cancer RCTs and offers guidance on how future research should employ communication strategies to improve the informed consent processes.
| S-EPMC5441300 | biostudies-literature
Project description:OBJECTIVE:To explore adult medical oncology outpatients' understanding of and preferences for the format of health risk information. METHODS:Two surveys, one assessing sociodemographic characteristics and a second survey examining perceptions of risk information. RESULTS:Of the 361 (74%) consenting patients, 210 completed at least one question on risk communication. 17% to 65% of patients understood numeric risk information, depending on the format of the information. More than 50% of people interpreted a "very good" chance of remission as greater than 80%, greater than 90% or 100%. The most preferred format of information was in both words and numbers (38% to 43%) followed by words alone (28% to 30%). CONCLUSION:Numeric risk information is understood by 17% to 65% of respondents, depending on the format. Interpretation of verbal risk information is highly variable, posing a risk of misunderstanding. Provision of information in both words and numbers may assist in aiding comprehension.
| S-EPMC6143261 | biostudies-other
Project description:BackgroundWeb-based health care has the potential to improve health care access and convenience for patients with limited mobility, but its success depends on active physician participation. The economic returns of internet-based health care initiatives are an important factor that can motivate physicians to continue their participation. Although several studies have examined the communication patterns and influences of web-based health consultations, the correlation between physicians' communication characteristics and their economic returns remains unexplored.ObjectiveThis study aims to investigate how the linguistic features of 2 modes of physician-patient communication, instrumental and affective, determine the physician's economic returns, measured by the honorarium their patients agree to pay per consultation. We also examined the moderating effects of communication media (web-based text messages and voice messages) and the compounding effects of different communication features on economic returns.MethodsWe collected 40,563 web-based consultations from 528 physicians across 4 disease specialties on a large, web-based health care platform in China. Communication features were extracted using linguistic inquiry and word count, and we used multivariable linear regression and K-means clustering to analyze the data.ResultsWe found that the use of cognitive processing language (ie, words related to insight, causation, tentativeness, and certainty) in instrumental communication and positive emotion-related words in affective communication were positively associated with the economic returns of physicians. However, the extensive use of discrepancy-related words could generate adverse effects. We also found that the use of voice messages for service delivery magnified the effects of cognitive processing language but did not moderate the effects of affective processing language. The highest economic returns were associated with consultations in which the physicians used few expressions related to negative emotion; used more terms associated with positive emotions; and later, used instrumental communication language.ConclusionsOur study provides empirical evidence about the relationship between physicians' communication characteristics and their economic returns. It contributes to a better understanding of patient-physician interactions from a professional-client perspective and has practical implications for physicians and web-based health care platform executives.
| S-EPMC10811595 | biostudies-literature
Project description:IntroductionHealth literacy and its associated communication practices are critical to patient-centered care and have been endorsed by various associations as important for health professional training. Unfortunately, there is little published literature on how to teach health literacy to medical students and health professionals.MethodsWe developed a two-part curriculum during a required module for medical students including an introductory session in their first year and a skill-building workshop in their second year. In the workshop, students studied, observed, and practiced three health literacy communication techniques: teach-back, avoiding jargon, and effective questioning.ResultsThe workshop was implemented with approximately 100 second-year medical students as part of a course in their required curriculum. Results of a Wilcoxon rank sum test of pre/post survey responses showed a statistically significant move towards conviction of importance and confidence in ability to use three health literacy techniques.DiscussionA skills-based workshop on health literacy skills can improve medical students' conviction and confidence in using health literacy communication practices.
| S-EPMC7842086 | biostudies-literature
Project description:Adherence to protective measures is a major component of COVID-19 epidemic control. COVID-19 health literacy is a major driver of this adherence, and the evaluation of health literacy levels is the basis for designing an effective communication strategy. We conducted a quantitative socio-anthropological study of the knowledge of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and perception of the prevention messages in Burkina Faso, Cabo Verde, Guinea-Bissau, Ivory Coast, and Sierra Leone. There are widespread erroneous ideas regarding the transmission of and the protection against COVID-19. The majority of people are unaware that asymptomatic individuals can transmit the virus. Knowledge of the risk factors for severe disease is not sufficient, and the majority of individuals fear contracting COVID-19 by visiting a health center. Our study also shows the achievements of communication campaigns on several aspects: almost everybody has heard of the virus and heard or read the messages on the protective measures and a large majority of people think that these measures are effective against COVID-19. Based on these results, we propose a communication strategy that will emphasize that asymptomatic individuals can transmit the virus, emphasize the risk factors, reassure individuals regarding the safety of frequenting health centers, and design specific messages targeting young populations.
| S-EPMC8592366 | biostudies-literature
Project description:PURPOSE: The aim of the study was to assess levels of health literacy and computer skills in Chinese patients with cataract, and their impact on the doctor-patient relationship. METHODS: We undertook a cross-sectional study of cataract patients scheduled for cataract extraction procedures in Guangdong Province, China. Generic health literacy was assessed using 3 established screening questions. Adequate computer skills was determined if patients had used a computer and routinely used search engines on the Internet. Socio-demographic measures (e.g., age, sex, education) were obtained from a standardized interview. Participants who indicated that they could not understand what their doctors mean were considered to have had poor patient-physician communications. RESULTS: Of the 211 participants, 92 (43.6%) had inadequate health literacy and 204 (96.7%) inadequate computer skills. In multivariate analysis, females were more likely to have inadequate health literacy (odds ratio = 2.5, 95% confidence intervals [CI]: 1.3 to 4.7). People with inadequately health literacy were more likely to have a poor patient-physician communication (odds ratio = 3.5, 95% CIs: 1.3 to 9.0). Similar associations were found for inadequate computer skills. CONCLUSION: Chinese elderly patients with cataract have inadequate health literacy and very limited computer skills, which place them at high risk of misunderstanding and mismanaging their ocular conditions. Patient education information other than online materials may improve the eye care and outcomes of these patients.
| S-EPMC4167241 | biostudies-other
Project description:Insights in the challenges that healthcare providers encounter in serving low health literate patients is lagging behind. This study explored challenges perceived by healthcare providers and provides strategies in communication with low health literate patients. Primary and secondary healthcare providers (N = 396) filled in an online survey. We assessed the frequency of challenges prior to, during and following a consultation, and which strategies were used and recommended. Survey outcomes were validated in in-depth interviews with healthcare providers (N = 7). Providers (76%) reported one or more challenges that were subscribed to patients' difficulties in comprehending or applying health-related information, in communicating with professionals, or in taking responsibility for their health. Providers (31%) perceived difficulties in recognizing low health literate patients, and 50% rarely used health literacy specific materials. Providers expressed needs for support to recognize and discuss low health literacy, to adapt communication and to assess patient's comprehension. Future research should focus on developing strategies for providers to ensure patients' understanding (e.g. applying teach-back method), to recognize low health literate patients, and to support patients' in taking responsibility for their health (e.g. motivational interviewing).
| S-EPMC9067671 | biostudies-literature
Project description:Understanding the short- and long-term impacts of a biomonitoring and exposure project and reporting personal results back to study participants is critical for guiding future efforts, especially in the context of environmental justice. The purpose of this study was to evaluate learning outcomes from environmental communication efforts and whether environmental health literacy goals were met in an environmental justice community. We conducted 14 interviews with parents who had participated in the University of Arizona's Metals Exposure Study in Homes and analyzed their responses using NVivo, a qualitative data management and analysis program. Key findings were that participants used the data to cope with their challenging circumstances, the majority of participants described changing their families' household behaviors, and participants reported specific interventions to reduce family exposures. The strength of this study is that it provides insight into what people learn and gain from such results communication efforts, what participants want to know, and what type of additional information participants need to advance their environmental health literacy. This information can help improve future report back efforts and advance environmental health and justice.
| S-EPMC4962231 | biostudies-literature