Residents' ability to identify patients with poor literacy skills
Residents' ability to identify patients with poor literacy skills
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DOI：
10.1097/00001888-200210000-00021
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发表时间：
2002-10-01
影响因子：
7.4
通讯作者：
Barnett, DR
中科院分区：
文献类型：
--
作者：
Bass, PF;Wilson, JF;Barnett, DR
目的.确定住院医师是否可以根据连续性门诊访视期间的临床互动识别识字技能较差的患者。作者假设住院医师会高估患者的读写能力，并且无法识别出许多有读写能力差风险的患者。成人识字率快速评估修订版（REALM-R）的管理，以筛选潜在的识字问题的患者。居民被问到“你觉得这个病人有读写问题吗？并回答是或否。连续性调整卡方被用来测试居民的识字能力高估。REALM-R评分和居民对182名患者的识字率评估。居民认为10%的患者（18）有识字问题的基础上，他们的临床互动。只有三名通过识字筛查的患者被错误地认定为有识字风险。在90%的患者（164）的居民认为没有读写能力的问题，36%（59）的读写能力筛选失败。住院医师高估了患者的识字能力。这些住院医生的患者中有很大一部分可能没有与医疗保健系统有效互动的技能，并且不良后果的风险增加。
Purpose. To determine whether residents could identify patients with poor literacy skills based on clinical interactions during a continuity clinic visit. The authors hypothesized residents would overestimate patients' literacy abilities and fail to recognize many patients at risk for poor literacy.Method. The Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) was administered to screen patients for potential literacy problems. Residents were asked "Do you feel this patient has a literacy problem?" and answered yes or no. Continuity adjusted chi-square was used to test for overestimation of literacy abilities by residents.Results. REALM-R scores and residents' evaluations of literacy were available for 182 patients. The residents believed 10% of patients (18) had literacy problems based on their clinical interactions. Only three patients passing the literacy screen were incorrectly identified as at risk for literacy. Of the 90% of patients (164) the residents perceived to have no literacy problem, 36% (59) failed the literacy screen.Conclusion. Resident physicians overestimated the literacy abilities of their patients. A significant portion of these residents' patients may not have the skills to effectively interact with the health care system and are at increased risk for adverse outcomes.