Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Background: Medical terminology is often complex and confusing to lay people. Even common terms used by health care professionals often have other meanings and can easily be misinterpreted. Objective: This study aimed to identify patient comprehension of common orthopedic terminology across multiple hospital settings. Methods: A cross-sectional study was conducted from September 2016 until November 2016 at an Academic Level 1 trauma center. One hundred and fifty emergency department patients and 150 orthopedic inpatients with isolated orthopedic injuries were included. Participants completed a questionnaire consisting of 12 multiple-choice questions determining patient comprehension of common orthopedic terminology. Key Results: Total comprehension scores on the questionnaire were scored as number correct out of 11. In the emergency department, the mean total score was 5.01 compared to 5.45 in orthopedic inpatients ( p = .046). Patients in both groups demonstrated poor understanding of medical terms (including fracture, ruptured tendon) and anatomical terms. In contrast, nonmedical terminology such as broken bone was better understood. Fifty-seven percent of participants stated that they understood their orthopedic condition completely. Notably, there was no correlation ( r = .15) between comprehension and participants describing that they completely understood their orthopedic condition. Conclusions: Emergency department patients and orthopedic inpatients demonstrate poor comprehension of orthopedic terminology. Health care professionals should assume a poor level of comprehension during their interactions with orthopedic patients and ensure that patient communication is clear, concise, and informative to facilitate better patient comprehension, informed consent, and an improved doctor-patient relationship. [ HLRP: Health Literacy Research and Practice . 2019;3(3):e187–e193.] Plain Language Summary: This study evaluated patient comprehension of common orthopedic terminology in orthopedic inpatients and patients presenting to the emergency department with orthopedic injuries. This study found that patients demonstrate poor understanding of terminology used commonly by health care professionals, and that patients demonstrated little insight into their lack of comprehension. These findings have implications for doctor-patient communication, informed consent, and patient satisfaction.
The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including increased mortality and chronic disease morbidity. It has also been associated with an increased rate of hospitalisation and use of healthcare resources. Previous work in the orthopaedic trauma setting has found poor levels of health literacy and poor understanding of diagnosis, management and prognosis in the Australian public health system. Promisingly, it has been shown that simple, targeted interventions can improve patient health literacy. This study further highlights that health literacy exhibited by orthopaedic patients is poor, particularly among patients in the public healthcare system. The present study is the first to have demonstrated that health literacy is poor among patients in both the public and private healthcare systems, despite these patients having distinctly different demographics. Promisingly, the present study shows that, unlike public orthopaedic out-patient review, private orthopaedic out-patient review appears to be effective in increasing patient health literacy regarding their orthopaedic condition and its management. Health literacy is essential for patients to effectively communicate wit...
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