Educating Patients: Creating Teaching Moments in Practice
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an ability to correctly take the medication (AHRQ, 2020). Patients at risk Low levels of education and/or difficul - ties during school have a correlation with low health literacy (CDC, 2018). Although there is a relationship between literacy, numeracy, and health literacy, it is vital that healthcare professionals do not as- sume that a person who is well educated has a high level of health literacy. Medi - cal terminology, anatomy, and physiology knowledge is specialized and is not con- sidered common knowledge. Health con- ditions such as confusion, fear, pain, and those requiring complex self-care can also impact health literacy (CDC, 2022b). As- sessment of every individual’s health liter- acy prior to providing patient teaching is imperative, and tools for this assessment will be discussed further in Chapter 3. Some populations, such as those with a language barrier or the young, are at a higher risk for low health literacy. Age disparities show that those younger than age 16 and older than age 65 have the lowest health literacy. Multiple studies have examined race and health literacy. Although there are some variations, His- panics, Asians, Pacific Islanders, and Na - tive Hawaiians are at risk for low health literacy. Other risk factors associated with lower health literacy include inabil- ity to work, low income, visual impair- ment, male gender, English as a second language, chronic physical or behavioral health issues, and social isolation (CDC, 2018; Pacific University Oregon, 2022). Red flags for low health literacy As mentioned earlier, health literacy re- quires patient assessment prior to educa- tion. There are some indicators, or “red flags,” related to persons with low health literacy. These factors can include repeat-
edly missed appointments and lack of fol- lowing through with testing or referrals. Registration forms that are not complete, making excuses to avoid reading some- thing, and an inability to provide an ap- propriate logical history may also be red flags. Asking very few questions or asking many questions can also be an indicator. Low health literacy may also be shown in a failure to name or explain medications, noncompliance with medications, and recognizing medications visually rather than looking at their labels (AHRQ, 2020; Pacific University Oregon, 2022). Readiness to learn One potential barrier to effective pa- tient education is readiness to learn. Learning readiness is described as the ability of a person to acquire and com- prehend knowledge, as well as apply that knowledge successfully. For patients, readiness to learn can be affected by their physical, emotional, experiential, and knowledge states. If there are deficien - cies in the patient’s learning readiness, effective teaching will be highly unlike- ly. Physical readiness can include health status, task complexity, physical abilities, and impact of the environment. Consid- erations for emotional readiness are mo- tivation, stress and anxiety, developmen- tal level, social support, frame of mind, and risk-taking behaviors. Experiential readiness can include orientation, posi- tion of control, cultural considerations, past experiences and coping, and ambi- tions. Knowledge readiness involves the person’s present knowledge base, learn- ing disabilities, cognitive capability, and learning styles (Bastable, 2021). Patient limitations Patients may have limitations that can affect their ability to learn and retain in- formation. Low health literacy, discussed
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