Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons
Background In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2017-05, Vol.475 (5), p.1291-1297 |
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| creator | Menendez, Mariano E. van Hoorn, Bastiaan T. Mackert, Michael Donovan, Erin E. Chen, Neal C. Ring, David |
| description | Background
In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions and engaging actively in their own care. But little is known regarding the relationship between health literacy and question-asking behavior during outpatient office visits.
Questions/purposes
(1) Do patients with lower levels of health literacy ask fewer questions in general, and as stratified by types of questions? (2) What other patient characteristics are associated with the number of questions asked? (3) How often do surgeons prompt patients to ask questions during an office visit?
Methods
We audio-recorded office visits of 84 patients visiting one of three orthopaedic hand surgeons for the first time. Patient questions were counted and coded using an adaptation of the Roter Interaction Analysis System in 11 categories: (1) therapeutic regimen; (2) medical condition; (3) lifestyle; (4) requests for services or medications; (5) psychosocial/feelings; (6) nonmedical/procedural; (7) asks for understanding; (8) asks for reassurance; (9) paraphrase/checks for understanding; (10) bid for repetition; and (11) personal remarks/social conversation. Directly after the visit, patients completed the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey (including age, sex, race, work status, marital status, insurance status), and three Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity Function, Pain Interference, and Depression. The NVS scores were divided into limited (0–3) and adequate (4–6) health literacy as done by the tool’s creators. We also assessed whether the surgeons prompted patients to ask questions during the encounter.
Results
Patients with limited health literacy asked fewer questions than patients with adequate health literacy (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to −1; p = 0.002). More specifically, patients with limited health literacy asked fewer questions regarding medical-care issues such as their therapeutic regimen (1 ± 2 versus 3 ± 4; mean difference, −2; 95% CI, −4 to −1]; p < 0.001) and condition (2 ± 2 versus 3 ± 3; mean difference, −1; 95% CI, −3 to 0; p = 0.022). Nonwhite patients asked fewer questions than did white patients (5 ± 4 versus 9 ± 7; mean differenc |
| doi_str_mv | 10.1007/s11999-016-5140-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5384911</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1891876953</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-e4d6f7f87b6d9b9d526fff60ce69f2289e06c0a4517c947baf6694b2c66ed9d53</originalsourceid><addsrcrecordid>eNqNkV1rFDEUhoModl39Ad5IwJvejCaZfExuCqW2bmGhFvvhXchkTrapszNrMqP035vptqUKhV6FkCdP8p4XofeUfKKEqM-JUq11QagsBOWkEC_QjApWFZSW7CWaEUJ0oRn9sYPepHSdtyUX7DXaYUppWRE2Q_abHQJ0Q8KXYbjCy7AOAzR4Aba93Q4QrbvB--knPoI_EPHpCGkIfZfwlzGGboVPvA8O8EVI4d6ysF2Dv49xBZl7i1552yZ4d7fO0fnR4dnBoliefD0-2F8WTpByKIA30itfqVo2utaNYNJ7L4kDqT1jlQYiHbFcUOU0V7X1UmpeMyclNBkv52hv692M9Roal0NF25pNDGsbb0xvg_n3pAtXZtX_NqKsuM4Tm6PdO0Hsf00pzTokB21rO-jHZGilaaWkFuUz0JJrLZWYrB__Q6_7MXZ5EpmqRJYyrjJFt5SLfUoR_MO_KTFT12bbtcldm6lrMwX-8Djww437cjPAtkDaTE1BfPT0k9a_6Ey1Ag</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1885189247</pqid></control><display><type>article</type><title>Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Menendez, Mariano E. ; van Hoorn, Bastiaan T. ; Mackert, Michael ; Donovan, Erin E. ; Chen, Neal C. ; Ring, David</creator><creatorcontrib>Menendez, Mariano E. ; van Hoorn, Bastiaan T. ; Mackert, Michael ; Donovan, Erin E. ; Chen, Neal C. ; Ring, David</creatorcontrib><description>Background
In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions and engaging actively in their own care. But little is known regarding the relationship between health literacy and question-asking behavior during outpatient office visits.
Questions/purposes
(1) Do patients with lower levels of health literacy ask fewer questions in general, and as stratified by types of questions? (2) What other patient characteristics are associated with the number of questions asked? (3) How often do surgeons prompt patients to ask questions during an office visit?
Methods
We audio-recorded office visits of 84 patients visiting one of three orthopaedic hand surgeons for the first time. Patient questions were counted and coded using an adaptation of the Roter Interaction Analysis System in 11 categories: (1) therapeutic regimen; (2) medical condition; (3) lifestyle; (4) requests for services or medications; (5) psychosocial/feelings; (6) nonmedical/procedural; (7) asks for understanding; (8) asks for reassurance; (9) paraphrase/checks for understanding; (10) bid for repetition; and (11) personal remarks/social conversation. Directly after the visit, patients completed the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey (including age, sex, race, work status, marital status, insurance status), and three Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity Function, Pain Interference, and Depression. The NVS scores were divided into limited (0–3) and adequate (4–6) health literacy as done by the tool’s creators. We also assessed whether the surgeons prompted patients to ask questions during the encounter.
Results
Patients with limited health literacy asked fewer questions than patients with adequate health literacy (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to −1; p = 0.002). More specifically, patients with limited health literacy asked fewer questions regarding medical-care issues such as their therapeutic regimen (1 ± 2 versus 3 ± 4; mean difference, −2; 95% CI, −4 to −1]; p < 0.001) and condition (2 ± 2 versus 3 ± 3; mean difference, −1; 95% CI, −3 to 0; p = 0.022). Nonwhite patients asked fewer questions than did white patients (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to 0; p = 0.032). No other patient characteristics were associated with the number of questions asked. Surgeons only occasionally (29%; 24/84) asked patients if they had questions during the encounter, but when they did, most patients (79%; 19/24) asked questions.
Conclusions
Limited health literacy is a barrier to effective patient engagement in hand surgery care. In the increasingly tangled health-information environment, it is important to actively involve patients with limited health literacy in the decision-making process by encouraging question-asking, particularly in practice settings where most decisions are preference-sensitive. Instead of assuming that patients understand what they are told, orthopaedic surgeons may take “universal precautions” by assuming that patients do not understand unless proved otherwise.
Level of Evidence
Level II, therapeutic study.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-016-5140-5</identifier><identifier>PMID: 27796802</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Clinical Research ; Communication ; Comprehension ; Conservative Orthopedics ; Cross-Sectional Studies ; Female ; Hand ; Hand - surgery ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Office Visits ; Orthopedic Surgeons ; Orthopedics ; Patient Participation ; Physician-Patient Relations ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Surveys and Questionnaires</subject><ispartof>Clinical orthopaedics and related research, 2017-05, Vol.475 (5), p.1291-1297</ispartof><rights>The Association of Bone and Joint Surgeons® 2016</rights><rights>Clinical Orthopaedics and Related Research is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-e4d6f7f87b6d9b9d526fff60ce69f2289e06c0a4517c947baf6694b2c66ed9d53</citedby><cites>FETCH-LOGICAL-c503t-e4d6f7f87b6d9b9d526fff60ce69f2289e06c0a4517c947baf6694b2c66ed9d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384911/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384911/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27796802$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Menendez, Mariano E.</creatorcontrib><creatorcontrib>van Hoorn, Bastiaan T.</creatorcontrib><creatorcontrib>Mackert, Michael</creatorcontrib><creatorcontrib>Donovan, Erin E.</creatorcontrib><creatorcontrib>Chen, Neal C.</creatorcontrib><creatorcontrib>Ring, David</creatorcontrib><title>Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions and engaging actively in their own care. But little is known regarding the relationship between health literacy and question-asking behavior during outpatient office visits.
Questions/purposes
(1) Do patients with lower levels of health literacy ask fewer questions in general, and as stratified by types of questions? (2) What other patient characteristics are associated with the number of questions asked? (3) How often do surgeons prompt patients to ask questions during an office visit?
Methods
We audio-recorded office visits of 84 patients visiting one of three orthopaedic hand surgeons for the first time. Patient questions were counted and coded using an adaptation of the Roter Interaction Analysis System in 11 categories: (1) therapeutic regimen; (2) medical condition; (3) lifestyle; (4) requests for services or medications; (5) psychosocial/feelings; (6) nonmedical/procedural; (7) asks for understanding; (8) asks for reassurance; (9) paraphrase/checks for understanding; (10) bid for repetition; and (11) personal remarks/social conversation. Directly after the visit, patients completed the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey (including age, sex, race, work status, marital status, insurance status), and three Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity Function, Pain Interference, and Depression. The NVS scores were divided into limited (0–3) and adequate (4–6) health literacy as done by the tool’s creators. We also assessed whether the surgeons prompted patients to ask questions during the encounter.
Results
Patients with limited health literacy asked fewer questions than patients with adequate health literacy (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to −1; p = 0.002). More specifically, patients with limited health literacy asked fewer questions regarding medical-care issues such as their therapeutic regimen (1 ± 2 versus 3 ± 4; mean difference, −2; 95% CI, −4 to −1]; p < 0.001) and condition (2 ± 2 versus 3 ± 3; mean difference, −1; 95% CI, −3 to 0; p = 0.022). Nonwhite patients asked fewer questions than did white patients (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to 0; p = 0.032). No other patient characteristics were associated with the number of questions asked. Surgeons only occasionally (29%; 24/84) asked patients if they had questions during the encounter, but when they did, most patients (79%; 19/24) asked questions.
Conclusions
Limited health literacy is a barrier to effective patient engagement in hand surgery care. In the increasingly tangled health-information environment, it is important to actively involve patients with limited health literacy in the decision-making process by encouraging question-asking, particularly in practice settings where most decisions are preference-sensitive. Instead of assuming that patients understand what they are told, orthopaedic surgeons may take “universal precautions” by assuming that patients do not understand unless proved otherwise.
Level of Evidence
Level II, therapeutic study.</description><subject>Adult</subject><subject>Aged</subject><subject>Clinical Research</subject><subject>Communication</subject><subject>Comprehension</subject><subject>Conservative Orthopedics</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Hand</subject><subject>Hand - surgery</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Literacy</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Office Visits</subject><subject>Orthopedic Surgeons</subject><subject>Orthopedics</subject><subject>Patient Participation</subject><subject>Physician-Patient Relations</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Surveys and Questionnaires</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkV1rFDEUhoModl39Ad5IwJvejCaZfExuCqW2bmGhFvvhXchkTrapszNrMqP035vptqUKhV6FkCdP8p4XofeUfKKEqM-JUq11QagsBOWkEC_QjApWFZSW7CWaEUJ0oRn9sYPepHSdtyUX7DXaYUppWRE2Q_abHQJ0Q8KXYbjCy7AOAzR4Aba93Q4QrbvB--knPoI_EPHpCGkIfZfwlzGGboVPvA8O8EVI4d6ysF2Dv49xBZl7i1552yZ4d7fO0fnR4dnBoliefD0-2F8WTpByKIA30itfqVo2utaNYNJ7L4kDqT1jlQYiHbFcUOU0V7X1UmpeMyclNBkv52hv692M9Roal0NF25pNDGsbb0xvg_n3pAtXZtX_NqKsuM4Tm6PdO0Hsf00pzTokB21rO-jHZGilaaWkFuUz0JJrLZWYrB__Q6_7MXZ5EpmqRJYyrjJFt5SLfUoR_MO_KTFT12bbtcldm6lrMwX-8Djww437cjPAtkDaTE1BfPT0k9a_6Ey1Ag</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Menendez, Mariano E.</creator><creator>van Hoorn, Bastiaan T.</creator><creator>Mackert, Michael</creator><creator>Donovan, Erin E.</creator><creator>Chen, Neal C.</creator><creator>Ring, David</creator><general>Springer US</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170501</creationdate><title>Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons</title><author>Menendez, Mariano E. ; van Hoorn, Bastiaan T. ; Mackert, Michael ; Donovan, Erin E. ; Chen, Neal C. ; Ring, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-e4d6f7f87b6d9b9d526fff60ce69f2289e06c0a4517c947baf6694b2c66ed9d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Clinical Research</topic><topic>Communication</topic><topic>Comprehension</topic><topic>Conservative Orthopedics</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Hand</topic><topic>Hand - surgery</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Literacy</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Office Visits</topic><topic>Orthopedic Surgeons</topic><topic>Orthopedics</topic><topic>Patient Participation</topic><topic>Physician-Patient Relations</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Menendez, Mariano E.</creatorcontrib><creatorcontrib>van Hoorn, Bastiaan T.</creatorcontrib><creatorcontrib>Mackert, Michael</creatorcontrib><creatorcontrib>Donovan, Erin E.</creatorcontrib><creatorcontrib>Chen, Neal C.</creatorcontrib><creatorcontrib>Ring, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Menendez, Mariano E.</au><au>van Hoorn, Bastiaan T.</au><au>Mackert, Michael</au><au>Donovan, Erin E.</au><au>Chen, Neal C.</au><au>Ring, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>475</volume><issue>5</issue><spage>1291</spage><epage>1297</epage><pages>1291-1297</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><abstract>Background
In the midst of rapid expansion of medical knowledge and decision-support tools intended to benefit diverse patients, patients with limited health literacy (the ability to obtain, process, and understand information and services to make health decisions) will benefit from asking questions and engaging actively in their own care. But little is known regarding the relationship between health literacy and question-asking behavior during outpatient office visits.
Questions/purposes
(1) Do patients with lower levels of health literacy ask fewer questions in general, and as stratified by types of questions? (2) What other patient characteristics are associated with the number of questions asked? (3) How often do surgeons prompt patients to ask questions during an office visit?
Methods
We audio-recorded office visits of 84 patients visiting one of three orthopaedic hand surgeons for the first time. Patient questions were counted and coded using an adaptation of the Roter Interaction Analysis System in 11 categories: (1) therapeutic regimen; (2) medical condition; (3) lifestyle; (4) requests for services or medications; (5) psychosocial/feelings; (6) nonmedical/procedural; (7) asks for understanding; (8) asks for reassurance; (9) paraphrase/checks for understanding; (10) bid for repetition; and (11) personal remarks/social conversation. Directly after the visit, patients completed the Newest Vital Sign (NVS) health literacy test, a sociodemographic survey (including age, sex, race, work status, marital status, insurance status), and three Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity Function, Pain Interference, and Depression. The NVS scores were divided into limited (0–3) and adequate (4–6) health literacy as done by the tool’s creators. We also assessed whether the surgeons prompted patients to ask questions during the encounter.
Results
Patients with limited health literacy asked fewer questions than patients with adequate health literacy (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to −1; p = 0.002). More specifically, patients with limited health literacy asked fewer questions regarding medical-care issues such as their therapeutic regimen (1 ± 2 versus 3 ± 4; mean difference, −2; 95% CI, −4 to −1]; p < 0.001) and condition (2 ± 2 versus 3 ± 3; mean difference, −1; 95% CI, −3 to 0; p = 0.022). Nonwhite patients asked fewer questions than did white patients (5 ± 4 versus 9 ± 7; mean difference, −4; 95% CI, −7 to 0; p = 0.032). No other patient characteristics were associated with the number of questions asked. Surgeons only occasionally (29%; 24/84) asked patients if they had questions during the encounter, but when they did, most patients (79%; 19/24) asked questions.
Conclusions
Limited health literacy is a barrier to effective patient engagement in hand surgery care. In the increasingly tangled health-information environment, it is important to actively involve patients with limited health literacy in the decision-making process by encouraging question-asking, particularly in practice settings where most decisions are preference-sensitive. Instead of assuming that patients understand what they are told, orthopaedic surgeons may take “universal precautions” by assuming that patients do not understand unless proved otherwise.
Level of Evidence
Level II, therapeutic study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27796802</pmid><doi>10.1007/s11999-016-5140-5</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical orthopaedics and related research, 2017-05, Vol.475 (5), p.1291-1297 |
| issn | 0009-921X 1528-1132 |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Clinical Research Communication Comprehension Conservative Orthopedics Cross-Sectional Studies Female Hand Hand - surgery Health Knowledge, Attitudes, Practice Health Literacy Humans Male Medicine Medicine & Public Health Middle Aged Office Visits Orthopedic Surgeons Orthopedics Patient Participation Physician-Patient Relations Sports Medicine Surgery Surgical Orthopedics Surveys and Questionnaires |
| title | Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons |
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