Browsing by Subject "Health Literacy"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Examination of the Informed Consent Process as Experienced by Patients Who Underwent a De Novo Transjugular Intrahepatic Portosystemic Shunt, Chemoembolization or Radioembolization Procedure
    (2019-08) Hughes-Gay, Marsha A.; Draucker, Claire; Belcher, Anne; Jones, Josette; Shieh, Carol
    The purpose of this study is to examine the informed consent (IC) procedure as it was experienced by patients who had undergone a de novo transjugular intrahepatic portosystemic shunt (TIPS), chemoembolization (TACE), or radioembolization (TARE) procedure in an Interventional Radiology (IR) Department. The three main study aims and a fourth exploratory aim are as follows: (1) Describe how patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department described the IC procedure; (2) Describe what information patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department recalled being told during the IC procedure; (3) Describe the satisfaction of patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department with the IC procedure; and (4) Explore how the IC experiences of patients who underwent a de novo TIPS, TACE, or TARE procedure in an IR Department differed according to their levels of health literacy. Using a qualitative descriptive design, participants were recruited from an IR department that performed these procedures. A total of 14 participants were interviewed about their IC experiences and the Newest Vital Sign (NVS) Health Literacy assessment was administered. The participants described the IC procedure by discussing the staff they encountered, their feelings during the visit, the support persons who accompanied them, and the decisions they made about the procedure. The participants recalled being told about how their procedure would be performed, the care they would need, and the benefits and risks of the procedure. Most were satisfied with the information received during the IC procedure and found the information consistent with how they experienced the procedure. A few participants would have liked more visual materials, addition details about the procedure, simpler language, or more explanation of the medical terminology. No apparent differences in the IC experience could be attributed to health literacy. These findings suggest that persons’ experiences during the IC process are multi-faceted and affected by their emotions and concerns and the nature of their encounters with their healthcare providers.
  • Thumbnail Image
    Item
    An Intercultural Study in Health Literacy and Adherence among Patients with Diabetes
    (Office of the Vice Chancellor for Research, 2010-04-09) Connor, U.; Antón, M.; Goering, E.; Lauten, K.; Roach, P.; Wolf, J.; Balunda, S.; Hayat, A.
    Health Literacy is believed to play an essential role in the ability of individuals to effectively manage their own health care. A report by the Institute of Medicine acknowledges that 90 million Americans with low literacy probably also have low health literacy, and that even individuals with adequate health literacy face challenges in the complex demands of health care contexts. This poster presents results of a 3-year study of an interdisciplinary project on health literacy and adherence at the Indiana Center for Intercultural Communication (ICIC) funded by the Eli Lilly & Co. Foundation. The purpose was to examine multiple dimensions of health literacy, based on patients’ perspectives (van Dulmen et al., 2008), with the goal of creating a new conceptualization and way of assessing health literacy in its broader sense that includes processing and acting on information in order to integrate those findings into interventions to improve health regimen adherence. Taking critical studies into account, we developed a model to identify the most important variables of adherence (Nutbeam, D., 2000; Levin-Zamir, D. and Peterburg, Y., 2001; Von Wagner, C., Steptoe, A., Wolf, M., and Wardle, J., 2008). The data consisted of video-taped interviews with 43 English-speakers and 21 Spanish-speakers, all of whom have diabetes. The interviews involved open-ended questions that elicited information about living with diabetes as well as questions on health beliefs, medication adherence, information sources and uses, literacy level and basic demographic information. These narratives were analyzed using grounded theory methodology of the patients’ own words. The quantitative data were analyzed using a multivariate analysis as well as an ordered probit analysis (Connor, U., et al., 2008, 2009, 2010; Lauten, K., et al., 2009, 2010; Lopez-Yunez, A., et al., 2009; Matthias, M.S. & Goering, E., 2008; Rozycki, W. & Connor, U., 2008; Wolf, M.S., et al, 2007). The model that ICIC has built provides practical interventions for patient-centered care. This poster presents examples of linguistic cues and phrases from the interviews, the results of the intercultural comparisons between which information sources were used in the English-speaking and Spanish-speaking subgroups, and the resultant model. Implications are discussed in terms of enhancing the patient-centered tailoring of health information and communication.  
  • Thumbnail Image
    Item
    Is Low Health Literacy Associated with Increased Emergency Department Utilization and Recidivism?
    (Wiley Online Library, 2014-10) Griffey, Richard T.; Kennedy, Sarah K.; McGownan, Lucy; Kaphingst, Kimberly A.; Department of Emergency Medicine, IU School of Medicine
    OBJECTIVES: The objective was to determine whether patients with low health literacy have higher emergency department (ED) utilization and higher ED recidivism than patients with adequate health literacy. METHODS: The study was conducted at an urban academic ED with more than 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross-sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (S-TOFHLA) and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis and retaining those significant at an alpha of 0.05 in the final model. RESULTS: Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score. During the study period, 118 unique patients each made at least one return ED visit within a 14-day period. The proportion of patients with inadequate health literacy making at least one return visit was higher than that of patients with adequate health literacy at 14 days, but was not significantly higher within 3 or 7 days. CONCLUSIONS: In this single-center study, higher utilization of the ED by patients with inadequate health literacy when compared to those with adequate health literacy was observed. Patients with inadequate health literacy made a higher number of return visits at 14 days but not at 3 or 7 days.
  • Thumbnail Image
    Item
    Memory and comprehension for health information among older adults: distinguishing the effects of domain-general and domain-specific knowledge
    (Informa UK (Taylor & Francis), 2015) Chin, Jessie; Payne, Brennan; Gao, Xuefei; Conner-Garcia, Thembi; Graumlich, James F.; Murray, Michael D.; Morrow, Daniel G.; Stine-Morrow, Elizabeth A. L.; Department of Medicine, IU School of Medicine
    While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60-88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.