The health care experience of patients with low literacy
The health care experience of patients with low literacy
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DOI：
10.1001/archfami.5.6.329
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发表时间：
1996-06-01
期刊：
影响因子：
--
通讯作者：
Imara, M
中科院分区：
文献类型：
--
作者：
Baker, DW;Parker, RM;Imara, M
目的：了解阅读能力差的患者在与医疗保健系统互动时遇到的困难，并确定他们用于处理这些问题的应对机制。设计：对文盲和低识字率患者进行焦点小组和个人访谈。设置：两家大型城市公立医院。参与者：通过焦点小组或个人访谈，对60名通过成人医学素养快速评估（Rapid Estimate of Adult Literacy in Medicine）测量的阅读能力差的患者进行了访谈。文化程度低的病人有一种深深的羞耻感，当有人不能填写表格或阅读说明时，医院工作人员会感到沮丧或愤怒，这会加强这种羞耻感。对于文化程度低的病人来说，寻求医疗服务是一件令人生畏的事情，因为他们看不懂标志和登记表。许多患者叙述了由于无法阅读标签而导致的严重用药错误。为了科普这些问题，低识字率的患者在很大程度上依赖于口头解释，视觉线索和任务的演示来学习新材料。大多数还使用一个朋友或家庭成员作为代理reader.Conclusions：阅读能力差的患者有重要的问题，访问医疗保健系统，了解推荐的治疗方法，并按照指示提供者。由于他们的羞耻感，低识字率的患者可能不愿意向卫生保健提供者透露他们的问题，可能需要对阅读能力进行筛选测试，以确定哪些人需要特殊帮助。患者的应对机制提供了可能的干预措施，可以改善他们与医疗保健系统的互动洞察。
Objectives: To understand the difficulties that patients with poor reading ability have interacting with the health care system and to identify the coping mechanisms they use to deal with these problems.Design: Focus groups and individual interviews with patients who are illiterate and patients with low literacy.Setting: Two large, urban public hospitals.Participants: Sixty patients with marginal to poor reading abilities as measured by the Rapid Estimate of Adult Literacy in Medicine were interviewed in focus groups or individual interviews.Measurements and Main Results: Patients with low literacy harbor a deep sense of shame, which is reinforced by hospital staff who become frustrated or angry when someone cannot complete a form or read instructions. Seeking medical care is intimidating for patients with low literacy because they cannot understand signs and registration forms. Many patients recounted serious medication errors resulting from their inability to read labels. To cope with these problems, the patients with low literacy rely heavily on oral explanations, visual clues, and demonstrations of tasks to learn new material. Most also use a friend or family member as a surrogate reader.Conclusions: Patients with poor reading ability have important problems accessing the health care system, understanding recommended treatments, and following the instructions of providers. Because of their shame, patients with low literacy may be unwilling to disclose their problem to health care providers, and screening tests of reading ability may be necessary to identify those who need special assistance. Patients' coping mechanisms give insight into possible interventions that may improve their interactions with the health care system.