OET リスニング パートC：Improving Health Literacy

Hello there.

My name is Carly Dugan.

I'm an emergency medicine physician and researcher.

I'd like to talk to you today about the importance of consumer engagement in health,

an area which has been widely acknowledged in recent years as playing a crucial role in achieving the best possible health outcomes for patients.

As health professionals, our clients or patients come to us with various levels of education or literacy,

and they may prefer to speak a different language,

and these issues can become barriers for them to understand health information.

This, essentially, is the issue of health literacy.

Which is defined as the capacity to obtain, process, and understand basic health information and services,

make appropriate health care decisions, or act on health information,

and the ability to access or navigate the health care system,

which we all know is extremely complicated.

Any client who does not read or write well, has trouble understanding verbal or written communication about health,

speaks a different language, or has trouble understanding or using numbers could have trouble with these areas.

Studies show that patients immediately forget 40% to 80% of medical information provided to them by health care providers.

And my own research clearly indicates that health literacy is a strong predictor of health status.

Patients with low health literacy have more difficulty recalling health information.

And inadequate health literacy can lead to numerous negative effects on an individual's health and well-being,

including poor self-care, increased utilization of health services,

worse outcomes, and decreased likelihood of receiving preventative care and services.

Poor communication by health professionals with patients also contributes to unnecessary readmissions.

In response to surveys that have indicated high rates of poor health literacy,

governments and national agencies in countries as diverse as the US, China, Australia,

and some European nations have now gone on to develop national strategies and targets

to improve health literacy in their populations.

Health information can be confusing, even for those with advanced literacy skills.

It's easy for those of us working in healthcare to forget that we speak our own language that patients can't always easily understand.

Most of us can recall times when we believed that we had shared information with a patient and family member or caregiver

and believed they understood our instructions,

only to later discover confusion or misunderstanding.

Communication breakdowns in the chain of care are also a leading factor in preventable disability and death.

I teach a session on health literacy at a local college and share examples from my own time and practice.

One example I like to share with my students is a study in which researchers asked patients what they know about diuretics,

better known to some of you as fluid pills.

52% of the respondents researchers interviewed believed that fluid pills caused fluid retention instead of alleviating it.

Another example I use is a story of a patient who is informed that she had Graves' disease and burst into tears because she thought the doctor was telling her she was about to die.

This kind of confusion is understandable but may also be avoidable if we take some extra care with our communication with patients and family caregivers.

Regardless of a patient's health literacy level,

it is important that as healthcare professionals, we ensure that patients understand the information they have been given.

The teach-back method is one way of checking understanding by asking patients to state in their own words what they need to know or do about their health.

It is a way to confirm that we have explained things in a manner our patients understand.

A pediatrician I recently did some work with told me, I decided to do teach-back on five patients.

With one mother and her child, I concluded the visit by saying, so tell me, what are you going to do when you get home?

She could not tell me what instructions I had just given her.

So I explained the instructions again, and then she was able to teach them back to me.

I had absolutely no idea she did not understand the first time.

I was so wrapped up in delivering the message that I did not even realize it wasn't being received.

Research clearly shows that consultations that include checking patients' recall and understanding do not take any longer than consultations that don't,

and they help prevent future unnecessary health service use.

It is therefore essential that as we continue to work on improving the safety and reliability of care,

we consider deficiencies that contribute to patient harm beyond the obvious focus on acute care and ambulatory settings,

to include how we communicate with patients about their treatment plans and their health.

Ensuring that we are communicating clearly and delivering information at the appropriate literacy level will be an important step.