after going through this washington post article about unawareness in english speaking patients about health care and terminology, I am really baffled to imagine the horrible situation in non english nations like ours, because the tongue of medical treatment here is unfortunately english and the interface between patients and doctors is far from humane!
Rajesh ----- Original Message ----- From: "Justice For All Moderator" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, February 20, 2007 12:57 PM Subject: A Silent Epidemic >A Silent Epidemic > > By Sandra G. Boodman > [EMAIL PROTECTED] > Staff Writer > > Tuesday, February 20, 2007 > > Toni Cordell recalled feeling reassured when her gynecologist said > her problem could be fixed with an "easy repair" involving > surgery. She readily agreed, she said, barely glancing at the > consent forms because reading was difficult for her. She said she > didn't ask any questions because she didn't know what to say. > > During a routine postoperative checkup several weeks later, > Cordell vividly remembers, she was stunned when the nurse asked, > "How are you since your hysterectomy?" > > "All I could think of was how could I have been so stupid?" > Cordell said of that day 30 years ago. "I just wanted to scream. I > really didn't know I was surrendering part of my body." > > Similar events occur every day in every hospital around the > country, medical experts say, a consequence of the pervasive and > largely unrecognized problem known as low "health literacy." > Cordell, who lives in Charlotte and received remedial reading > instruction as an adult, said she believes her case was typical: > She graduated from high school reading at a fifth-grade level, a > deficiency she long sought to hide. She attributes her poor > reading skills to a combination of dyslexia and a childhood > medical condition. > > In a 2004 report, the Institute of Medicine defined health > literacy as the ability to obtain and understand basic health > information and services needed to make informed decisions. Low > health literacy, the institute noted, affects an estimated 90 > million Americans, who struggle to understand what a doctor has > told them or to comply with treatment recommendations as essential > as taking the proper dose of medication. A 1999 report by the > American Medical Association found that consent forms and other > medical forms are typically written at the graduate school level, > although the average American adult reads at the eighth-grade > level. > > Earlier this month a Chicago-based organization known as the Joint > Commission, which accredits the nation's hospitals and clinics, > unveiled a list of 35 recommendations to address the problem, > which is estimated to cost taxpayers $58 billion annually. Among > the recommendations developed by a panel of experts: adoption of > communication techniques proven to be effective with patients, > simplification of jargon-laden consent forms, and development of > patient-friendly navigation signs, which may include the use of > pictures or icons that are also recognizable to non-English > speakers. > > Low health literacy "is a silent epidemic that threatens the > quality of health care," said Dennis O'Leary, commission > president. Too many physicians and administrators, he said, fail > to grasp the dimensions of a problem that affects every aspect of > medical care and is a major impediment to patient safety. In some > cases, cultural and language differences are a barrier, but > experts emphasize that the majority of those with low health > literacy are native-born and white. > > Interest in health literacy comes at a time when Americans are > expected to assume ever-greater responsibility for their care and > are discharged from hospitals sicker and quicker, experts agree. > Many patients are expected to comply with sophisticated drug > regimens, to adjust or calculate medication doses or to manage > complicated equipment with little training and less supervision. A > comprehensive national assessment of adult literacy conducted in > 2003 by the U.S. Department of Education found that 43 percent of > adults have basic or below-basic reading skills -- they read at > roughly a fifth-grade level or lower -- and 5 percent are not > literate in English, in some cases because it is not their first > language. > > The picture is even more dismal when it comes to numerical skills: > Fifty-five percent of adults have basic or below-basic > quantitative abilities; many are unable to solve simple arithmetic > problems, including addition. > > The statistics don't differ much from the literacy assessment > conducted a decade earlier. That survey found that many Americans > could not determine the difference between two prices using a > calculator or were unable to write a brief letter explaining a > credit card billing error. Studies of health literacy have found > that a surprisingly large number of adults were perplexed by the > meaning of the term "orally," didn't know the difference between a > teaspoon and tablespoon and were unable to calculate the proper > dose of medicine. Low health literacy is more common among elderly > or low-income patients and those with a chronic illness, > researchers say. > > A study published in the Journal of the American Medical > Association in 1995 found that more than 80 percent of patients > treated at two of the nation's largest public hospitals could not > understand instructions written at the fourth-grade level for the > preparation of gastrointestinal X-rays known as an upper GI > series. A 1999 study of more than 3,200 Medicare recipients found > that one in three native-born patients could not answer a question > about normal blood sugar readings even after being given a paper > to read that listed the correct answer. And a study of 2,500 > elderly patients published last year in the Journal of General > Internal Medicine reported that patients with low health literacy > were twice as likely to die during a five-year period as those > with adequate skills, regardless of age, race or income. > > Sometimes language is a factor. In Spanish, for example, the word > "once" means 11, not "once" as is often written on prescription > labels. Patients have been treated for accidental overdoses of > blood pressure medication and other drugs as a result of such > linguistic confusion, said Ronald M. Davis, president-elect of the > American Medical Association, who chaired the Joint Commission > panel. > > "You still have physicians who use medical jargon too much," Davis > added, citing the use of "hypertension" instead of "high blood > pressure" and "febrile" rather than "fever." Because doctors are > rushed, he noted, they tend to lapse into medical jargon because > it is what they are used to. > > O'Leary said that the Joint Commission's interest in the issue > should serve as a signal to hospitals to ramp up their efforts to > communicate better with patients. Literacy improvements might be > included in future standards hospitals must meet, he said, because > they are inextricably linked to patient safety. At the Washington > Hospital Center, the largest hospital in the District and health- > care provider for many low-income and elderly patients, > spokeswoman Paula Faria said administrators are aware of the > problem and are examining admission forms and other documents to > see whether they are intelligible as well as culturally sensitive. > "We want to make sure that people understand what they're reading > and, if they can't read, what they're hearing," she said. > > Faria said that some departments are using a technique endorsed by > the Joint Commission known as "teach back." Instead of asking a > patient, "Do you have any questions?" -- which will probably > elicit little in the way of a useful response and puts the patient > on the spot -- doctors are taught to ask, "What is the most > important thing you learned from our visit today?" > > "You never want to put a patient in a situation where they feel > like they're dense," Davis said. > > Another effort regarded as promising, underwritten by drug > manufacturer Pfizer, is called Ask Me 3. Designed by the > Partnership for Clear Health Communication, a coalition of > national health and literacy groups, the program encourages > patients to ask three simple questions and to be sure they > understand the answers: What is my main problem? What do I need to > do? Why is that important? > > Cordell, who has worked with the Ask Me 3 program as a patient > advocate, said she also advises patients never to go to a doctor > or to a hospital alone. Having another person present makes it > more likely that necessary questions will be asked, she said. > > Anyone who doesn't understand what a doctor or other health-care > worker has said should speak up, Cordell said. "You can say, > 'Look, you're giving me stuff I can't manage,' " she advised. > > Source: Washington Post > ________________________________________________________________ > > For more healthcare news issues, see: > http://www.aapd.com/News/health/indexhealth.php > > # # # > > MODERATOR, Anne Sommers, JUSTICE FOR ALL -- A Service of the > American Association of People with Disabilities (AAPD). To > contact Anne, please email her at [EMAIL PROTECTED] To > respond to a JFA alert or to submit an article, please see > http://www.aapd.com/JFA/JFAcontent.html. > > DISCLAIMER: The JFA Listserv is designed to share information > of interest to people with disabilities and promote dialogue > in the disability community. 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