; Health Literacy among Spanish-Speaking Patients in the Emergency Department
Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out

Health Literacy among Spanish-Speaking Patients in the Emergency Department

VIEWS: 24 PAGES: 8

STUDY OBJECTIVE: Health literacy influences a patient's ability to read and understand labels on medicine containers, appointment slips, informed-consent documents and medical instructions--all of which are considered basic health documents that a patient encounters in healthcare settings. Previous research suggests Spanish-speaking patients have low levels of health literacy. This study compares the functional health literacy (FHL) of Spanish- and English-speaking adult patients in a suburban emergency department (ED). METHODS: Through a prospective, matched cohort design, Spanish-speaking adult patients and pediatric guardians presenting to the ED were matched with English-speaking patients by age, gender and treatment area. Demographic information, including total years of school completed and self-assessed reading ability, was collected. The Test of Functional Health Literacy in Adults (TOFHLA) was administered in the subject's primary language. A score of 74 adequate literacy. RESULTS: Eighty-six matched pairs were enrolled. The median age was 30.5 years, and 56% were male. Spanish speakers averaged a TOFHLA score of 59.72, and English speakers 90.78. Only 7% of English speakers had less-than-adequate FHL compared to 74% of Spanish speakers. The average years of school completed were 10.59 (7.95 Spanish; 13.19 English), and 55% of English speakers reported "excellent" reading ability compared to 13% of Spanish speakers. Last grade completed (p=0.004) and self-assessed reading ability (p=0.0007) are predictors of TOFHLA scores. Those subjects who completed less than the eighth grade had inadequate FHL. CONCLUSIONS: The majority of Spanish-speaking subjects have less-than-adequate FHL. Self-reported reading ability and years of school completed appear to predict FHL and may be clinically useful. Due to the disproportionately low level of health literacy among Spanish-speaking patients demonstrated

More Info
  • pg 1
									o    r    i    g      i   n      a     l         c      o     m        m   u     n      i    c     a      t     i    o      n




Health Literacy among Spanish-Speaking
Patients in the Emergency Department
Jane H. Brice, MD, MPH; Debbie Travers, PhD, RN; Christopher S. Cowden, BS; Matthew D. Young, MD;
Antonio Sanhueza, PhD; and Yolanda Dunston, PhD




                                                                           © 2008. From the Department of Emergency Medicine (Brice, associate
 Financial support: This study was supported by an Emergen-                professor), School of Nursing (Travers, assistant professor), and Department
 cy Medicine Foundation (EMF)/Emergency Nurses Associa-                    of Health Policy and Administration, School of Public Health (Cowden),
 tion Foundation Team Grant from the EMF.                                  University of North Carolina, Chapel Hill, NC; The Urology Clinic, Athens,
                                                                           GA (Young); Department of Mathematics and Statistics, Universidad de
 Study Objective: Health literacy influences a patient’s abil-             La Frontera, Temuco, Chile (Sanhueza, associate professor); and School of
 ity to read and understand labels on medicine containers,                 Education, North Carolina Central University, Durham, NC (Dunston, assis-
 appointment slips, informed-consent documents and medi-                   tant professor). Send reprint requests for J Natl Med Assoc. 2008;100:1326–
                                                                           1332 to: Dr. Jane Brice, CB #7595, University of North Carolina, Chapel Hill,
 cal instructions—all of which are considered basic health
                                                                           NC, 27599; phone: (919) 966-6440; fax: (919) 966-4787; e-mail: brice@med.
 documents that a patient encounters in healthcare settings.               unc.edu. Correspondence to: Christopher S. Cowden, 1765 Kelton Ave,
 Previous research suggests Spanish-speaking patients have                 Los Angeles, CA 90024; phone: (404) 345-9874; fax: (919) 966-4787; e-mail:
 low levels of health literacy. This study compares the func-              christopherscowden@gmail.com, ccowden@ucla.edu
 tional health literacy (FHL) of Spanish- and English-speaking
 adult patients in a suburban emergency department (ED).
                                                                           IntroductIon

                                                                           N
 Methods: Through a prospective, matched cohort design, Span-                       early 1 in every 3 American adults—upwards of
 ish-speaking adult patients and pediatric guardians presenting                     45 million people—is functionally illiterate.1-3
 to the ED were matched with English-speaking patients by age,                      The term “functional literacy” refers to an indi-
 gender and treatment area. Demographic information, includ-               vidual’s capacity to sufficiently operate in all facets of
 ing total years of school completed and self-assessed reading             everyday life through the use of basic reading, writing
 ability, was collected. The Test of Functional Health Literacy in         and computational skills.1 Subsequently, a large num-
 Adults (TOFHLA) was administered in the subject’s primary lan-            ber of adults have difficulty reading signs, decipher-
 guage. A score of <60 indicated inadequate FHL, 60–74 mar-                ing transportation schedules and completing even the
 ginally adequate FHL, and >74 adequate literacy.                          most basic forms. Existing literature has established the
 Results: Eighty-six matched pairs were enrolled. The median               impact of poor literacy on the access to, and utilization
 age was 30.5 years, and 56% were male. Spanish speak-                     of, healthcare. A patient’s level of literacy influences
 ers averaged a TOFHLA score of 59.72, and English speakers                their ability to read and understand labels on medicine
 90.78. Only 7% of English speakers had less-than-adequate                 containers, appointment slips, informed-consent docu-
 FHL compared to 74% of Spanish speakers. The average years                ments and medical instructions—all of which are con-
 of school completed were 10.59 (7.95 Spanish; 13.19 English),             sidered basic health documents the patient encounters
 and 55% of English speakers reported “excellent” reading                  regularly in healthcare settings.1,4-7 Furthe
								
To top
;