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(HealthNewsDigest.com) – Literacy is the ability to read and write, but health literacy is the capacity to process information so that we can understand health facts and make health decisions. A person that is literate can have very low health literacy. It’s estimated that only 12% of US adults have a proficient health literacy level. In simple terms this means for every 100 people, 88 of us will have trouble navigating the health care system, understanding medical terms, and actively participating in disease management.
Complex health information can overwhelm a person, especially if it is given during a stressful or unfamiliar situation. As a registered dietitian who has worked in a health care setting most of my career, I feel comfortable discussing health issues, reviewing cases, and providing patients with instructions. I believed that my health literacy score was off the charts. Was I in for a surprise and a true learning experience.
A member of our family had to have emergency abdominal surgery. Thrown into deciphering rapid fire information in the emergency room about diagnosis, choice of surgeon, and type of surgery, while trying to provide a basic health history and patient information to help the doctors make decisions, my head was swimming. And, I understood what they were saying. A person with a lower health literacy would have been overwhelmed.
The patient was in a university teaching hospital, which meant residents in training were swarming around. Though well-intentioned, these young doctors often offered too much advice and too much information, most of it unneeded for the specific case. They were regurgitating back all they had recently learned. This put both the patient and family on information overload and made the decision making progress all the more complicated. Next comes the surgeon with a much shorter tale and a few simple decisions. You would think that would make things easier, but it doesn’t. Now you start to wonder which story to believe. I actually found myself Googling terms and procedures to sort out all the information.
Next came the hospital stay and recovery. You do not recover in a hospital. They treat you but do not let you rest. IV pumps beep, vital signs (temperature and blood pressure) are taken regularly, people come and go to check on your wound and pain level, medical personal make rounds – if you are lucky the patient rests in hourly spurts.
And, sadly, though most hospital staffs are competent, helpful and caring, they are woefully understaffed and responsible for too many patients. At our hospital, new IV pumps had just been installed and they were overly sensitive. All day and night they beeped endlessly. This interrupted peace and often made patients aggitated because they assumed something awful had gone wrong with their IV. With an overload of patients to care for, it often took up to 20 minutes for the nurse to attend to the beeping IV. I simply silenced the IV alarm and used the nurse call button instead, to afford our patient some peace. There are few caregivers who would know how to be this assertive.
Post abdominal surgery your digestive tract goes to sleep and may take a few days to kick back into gear. The patient is initially put on no food by mouth, then clear fluids, low fiber meals, and finally regular food. As a dietitian, I knew this routine well.
You can imagine my surpirse when some people told our patient to drink water and suck on ice when clearly that was only going to aggravate the abdominal distention already present. When clear fluid meals were ordered – broth, apple juice, tea, jello, ginger ale – a dietary aid offered a protein shake the consistency of a milk shake. This was clearly a mistake but if I had not intervened the patient may have eaten it, possibly creating a delay in recovery.
The doctors initally order low fiber meals when food can be tolerated. In this hospital, all meals were ordered by the patient from an a la carte menu. The person taking the order checks each item requested against the dietary orders for that patients. If you are on a low fiber diet, you cannot have whole wheat bread, beans, salad, or fiberous vegetables like broccoli. Our patient did not have a clue about which foods had fiber and which did not, so he happily ordered what appealed to him. The person taking the order did not check the items as carefully as they should have and our patient was not happy with me when I removed the incorrect items from the meal tray.
This personal experience demonstrated why it is important for everyone to improve their health literacy. You don’t have to be a health professional to understand what is going on.
You can improve your health literacy by asking 3 simple questions.
What is my main problem?
What do I need to do?
Why is it important for me to do this?
Ask these questions of any health professional you see. Get a pad and write everything down. It is hard to remember all the information you are told. Go slowly. If you don’t understand the answer, request that the person use simple language you do understand. Your health and recovery may depend on these 3 simple questions.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with 12 current titles and sales of more than 8.5 million books. The books are widely available at your local or on-line bookseller.
Current titles include:
The Diabetes Counter, 4th Ed., 2011
The Protein Counter, 3rd Ed., 2011
The Calorie Counter, 5th Ed., 2010
The Ultimate Carbohydrate Counter, 3rd Ed., 2010
The Complete Food Counter, 3rd ed., 2009
The Fat Counter, 7th ed., 2009
The Healthy Wholefoods Counter, 2008
The Cholesterol Counter, 7th Ed., 2008
For more information on Jo-Ann and her books, go to TheNutritionExperts
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