Patient‐Reported Outcomes in Rheumatology Patients With Limited English Proficiency and Limited Health Literacy

2020 ◽  
Vol 72 (S10) ◽  
pp. 738-749 ◽  
Author(s):  
Guiset Carvajal Bedoya ◽  
Lisa A. Davis ◽  
Joel M. Hirsh
2018 ◽  
Vol 25 (1) ◽  
pp. 204-212 ◽  
Author(s):  
Lauren K Tormey ◽  
Jason Reich ◽  
Yu Sarah Chen ◽  
Arush Singh ◽  
Zachary Lipkin-Moore ◽  
...  

2020 ◽  
Vol 73 (1) ◽  
pp. 110-119 ◽  
Author(s):  
Patricia Katz ◽  
Maria Dall’Era ◽  
Laura Trupin ◽  
Stephanie Rush ◽  
Louise B. Murphy ◽  
...  

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1176.2-1176
Author(s):  
E. Eraslan ◽  
R. Bilici Salman ◽  
H. Satiş ◽  
A. Avanoglu Guler ◽  
H. Karadeniz ◽  
...  

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology that can affect any organ of the body. SLE is associated with adverse effects on both health and non-health-related quality of life (HRQOL and non-HRQOL). Lupus PRO is a patient reported outcome measure that has been validated in many languages. It has 44 items that cover both HRQOL and non-HRQOL (1). Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Multiple studies indicate that people with limited health literacy have worse health status and higher rates of hospitalization (2).Objectives:We aimed to evaluate the relationship between the LLDAS (Lupus Low Disease Activity State) criteria and the Lupus PRO test, as well as the health literacy status of lupus patients.Methods:83 SLE patients (94% women) were included in the study. We performed Lupus PRO and the European Health Literacy Survey tests during the routine follow-up visits of lupus patients to our rheumatology outpatient clinic and admissions to rheumatology inpatient clinic. Available clinical data on medical records were obtained, physician global assessments (PGA) were recorded by the attending physician.Results:LLDAS criteria strongly and inversely correlated with the total score, as well as the mood subunit of the Lupus PRO. Similarly, it also significantly inversely correlated with the body appearence and goals subunits. Health literacy status of the patients did not correlate with their LLDAS scores, ie their disease activities.Conclusion:Our results suggest that lupus disease activity, assessed by LLDAS criteria, significantly correlates with measures of quality of life, spesicifically Lupus PRO test, but not with health literacy status. Further studies are needed to evaluate if health literacy is related with damage, hospitalization or mortality associated with lupus.References:[1]Jolly M, Pickard AS, Block JA, Kumar RB, Mikolaitis RA, Wilke CT, et al., editors. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Seminars in arthritis and rheumatism; 2012: Elsevier.[2]Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. Journal of general internal medicine. 2005;20(2):175-84.Disclosure of Interests:None declared


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7038-7038
Author(s):  
Nadine Jackson McCleary ◽  
Jessica Cleveland ◽  
Sunyi Zhang ◽  
Eva M. Lepisto ◽  
Sherry Lee ◽  
...  

7038 Background: Health literacy and numeracy are essential for patients to make informed cancer treatment decisions. Oncologists do not typically evaluate literacy and numeracy and vary in their ability to adapt health discussions to meet patients’ needs. Systematic ascertainment of literacy and numeracy may provide oncologists with useful information to help guide initial oncology consultations. Methods: We deploy an electronic new patient intake questionnaire (NPIQ) that includes health literacy and numeracy, basic demographics and cancer risk screening. Patients are considered to have limited health literacy and/or numeracy if they respond with either “somewhat”, “a little bit” or “not at all” to a single question: “How confident are you filling out medical forms?” or “How confident are you in understanding medical statistics?” respectively. Results: Between January 2018 and August 2019, 8418 (24.6%) of patients presenting for a new patient consultation responded to the NPIQ. Among respondents with non-missing data, limited health literacy was reported by 19.4% respondents with 13.9% reporting “not at all” and 33.1% reporting “not at all” or only “a little bit” of confidence completing medical forms. Limited health numeracy was reported by 33.2% respondents with 9.1% reporting “not at all”. Nearly 20% of respondents reported both limited health literacy and numeracy. Patients reporting lack of confidence completing medical forms or understanding medical statistics were older (20.3%, 30.7% ³ 70 years old), male (20.2%, 30.1%), and non-white (21.3%, 32.1%). Conclusions: A substantial proportion of cancer patients report lack of confidence in their ability to complete medical forms or understand medical statistics, potentially limiting the ability to actively engage in shared decision-making. Prospective identification of these social determinants of health prior to consultations may provide oncologists with information necessary to tailor health discussions and to provide materials that promote understanding and informed decision-making. [Table: see text]


2016 ◽  
Vol 24 (1) ◽  
pp. 106-112 ◽  
Author(s):  
Neda Ratanawongsa ◽  
Jennifer L Barton ◽  
Courtney R Lyles ◽  
Michael Wu ◽  
Edward H Yelin ◽  
...  

Objective: Patients with limited health literacy (LHL) and limited English proficiency (LEP) experience suboptimal communication and health outcomes. Electronic health record implementation in safety net clinics may affect communication with LHL and LEP patients. We investigated the associations between safety net clinician computer use and patient-provider communication for patients with LEP and LHL. Materials and Methods: We video-recorded encounters at 5 academically affiliated US public hospital clinics between English- and Spanish-speaking patients with chronic conditions and their primary and specialty care clinicians. We analyzed changes in communication behaviors (coded with the Roter Interaction Analysis System) with each additional point on a clinician computer use score, controlling for clinician type and visit length and stratified by English proficiency and health literacy status. Results: Greater clinician computer use was associated with more biomedical statements (+12.4, P = .03) and less positive affect (−0.6, P < .01) from LEP/LHL patients. In visits with patients with adequate English proficiency/health literacy, greater clinician computer use was associated with less positive patient affect (−0.9, P < .01), fewer clinician psychosocial statements (−3.5, P < .05), greater clinician verbal dominance (+0.09, P < .01), and lower ratings on quality of care and communication. Conclusion: Higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy. Discussion: Implementation research should explore interventions to enhance relationship-centered communication for diverse patient populations in the computer era.


2019 ◽  
Vol 27 (2) ◽  
pp. 212-224 ◽  
Author(s):  
Samantha Stonbraker ◽  
Tiffany Porras ◽  
Rebecca Schnall

Abstract Objective The study sought to design symptom reports of longitudinal patient-reported outcomes data that are understandable and meaningful to end users. Materials and Methods We completed a 2-phase iterative design and evaluation process. In phase I, we developed symptom reports and refined them according to expert input. End users then completed a survey containing demographics, a measure of health literacy, and items to assess visualization preferences and comprehension of reports. We then collected participants’ perspectives on reports through semistructured interviews and modified them accordingly. In phase II, refined reports were evaluated in a survey that included demographics, validated measures of health and graph literacy, and items to assess preferences and comprehension of reports. Surveys were administered using a think-aloud protocol. Results Fifty-five English- and Spanish-speaking end users, 89.1% of whom had limited health literacy, participated. In phase I, experts recommended improvements and 20 end users evaluated reports. From the feedback received, we added emojis, changed date and font formats, and simplified the y-axis scale of reports. In phase II, 35 end users evaluated refined designs, of whom 94.3% preferred reports with emojis, the favorite being a bar graph combined with emojis, which also promoted comprehension. In both phases, participants literally interpreted reports and provided suggestions for future visualizations. Conclusions A bar graph combined with emojis was participants’ preferred format and the one that promoted comprehension. Target end users must be included in visualization design to identify literal interpretations of images and ensure final products are meaningful.


Author(s):  
Norrafizah Jaafar ◽  
Komathi Perialathan ◽  
Manimaran Krishnan ◽  
Nurashma Juatan ◽  
Masitah Ahmad ◽  
...  

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel Boyer ◽  
Yannick Begin ◽  
Julie Dupont ◽  
Mathieu Rousseau-Gagnon ◽  
Nicolas Fernandez ◽  
...  

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 397-397
Author(s):  
Hee Yun Lee ◽  
Eun Young Choi ◽  
Jieun Song ◽  
Jamie Gajos ◽  
Yan Luo

Abstract Opioid overdose risk is particularly high in immigrant communities partly due to limited English proficiency (Guarino et al., 2015). Previous studies reported that social determinants of health (SDH) have been associated with risk for opioid overdose (Dasgupta et al., 2018). The current study examines the association between SDH and literacy of opioid overdose risk among the immigrant population living in a rural area. Specifically, we examine the association in various age groups including young adults (aged 20 to 34), middle-aged (aged 35 to 49), and older adults (ages 50 to 75). Data were drawn from a sample of Korean American immigrants residing in rural Alabama (N=225). The participants administered the Brief Opioid Knowledge (BOOK) Questionnaire (Dunn et al., 2016). Multiple regression analyses were conducted for three age groups to identify predictors of opioid literacy. Overall, older adults had lower levels of opioid literacy relative to their younger counterparts. Among young adults, low English proficiency, more chronic conditions, and greater depressive symptoms were significant predictors of limited opioid literacy. For the middle-aged adults, lower levels of health literacy and more pain symptoms were associated with limited opioid literacy. Among older adults, women, those with higher English proficiency, and lower health literacy had lower levels of opioid literacy. The findings demonstrated a greater vulnerability of older immigrants to limited opioid literacy. Different predictors based on SDH of limited opioid literacy across age groups have implications for tailored health promotion strategies to reduce opioid overdose risk.


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