Musculoskeletal Health Literacy in Patients With Foot and Ankle Injuries

Rosenbaum, Andrew J.; Tartaglione, Jason P.; Abousayed, Mostafa M.; Uhl, Richard L.; Mulligan, Michael T.; Alley, Maxwell C.; DiPreta, John A.

doi:10.1177/1938640015593078

Cited by 18 publications

(16 citation statements)

References 27 publications

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“…Previous research into the health literacy skills and abilities of traumatically injured people is limited. Rosenbaum et al conducted a survey of US patients presenting with foot and ankle injuries to an emergency department showed a high prevalence of low health literacy [ 41 ]. Shahan et al also found trauma patients surveyed in a US outpatient department to have poor recall and knowledge of their injury and operations [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Patient-identified information and communication needs in the context of major trauma

Braaf

Ameratunga

Nunn

et al. 2018

BMC Health Serv Res

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BackgroundNavigating complex health care systems during the multiple phases of recovery following major trauma entails many challenges for injured patients. Patients’ experiences communicating with health professionals are of particular importance in this context. The aim of this study was to explore seriously injured patients’ perceptions of communication with and information provided by health professionals in their first 3-years following injury.MethodsA qualitative study designed was used, nested within a population-based longitudinal cohort study. Semi-structured telephone interviews were undertaken with 65 major trauma patients, aged 17 years and older at the time of injury, identified through purposive sampling from the Victorian State Trauma Registry. A detailed thematic analysis was undertaken using a framework approach.ResultsMany seriously injured patients faced barriers to communication with health professionals in the hospital, rehabilitation and in the community settings. Key themes related to limited contact with health professionals, insufficient information provision, and challenges with information coordination. Communication difficulties were particularly apparent when many health professionals were involved in patient care, or when patients transitioned from hospital to rehabilitation or to the community. Difficulties in patient-health professional engagement compromised communication and exchange of information particularly at transitions of care, e.g., discharge from hospital. Conversely, positive attributes displayed by health professionals such as active discussion, clear language, listening and an empathetic manner, all facilitated effective communication. Most patients preferred communication consistent with patient-centred approaches, and the use of multiple modes to communicate information.ConclusionsThe communication and information needs of seriously injured patients were inconsistently met over the course of their recovery continuum. To assist patients along their recovery trajectories, patient-centred communication approaches and considerations for environmental and patients’ health literacy are recommended. Additionally, assistance with information coordination and comprehensive multimodal information provision should be available for injured patients.

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Section: Discussionmentioning

confidence: 99%

Patient-identified information and communication needs in the context of major trauma

Braaf

Ameratunga

Nunn

et al. 2018

BMC Health Serv Res

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“…1,5,8,9,11 Patient understanding of postoperative protocols and instructions is both crucial and particularly challenging in foot and ankle surgery. 12 Complex anatomy may be difficult for patients to comprehend, and postoperative restrictions (necessary to protect wounds, arthrodesis, tendon transfers, and soft tissue repairs) can be difficult to follow. This holds particularly true for the Lapidus procedure, which requires patients to protect their wounds, take medication to prevent deep vein thrombosis, remain nonweightbearing while allowing for bony healing, follow progressive weightbearing instructions, and perform range of motion exercises among other tasks required for a good recovery.…”

Section: Introductionmentioning

confidence: 99%

Health Literacy and Recall of Postoperative Instructions in Patients Undergoing the Lapidus Procedure

Garfinkel

Hummel

Day

et al. 2020

Foot & Ankle Orthopaedics

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Background: Active participation in patients’ own care is essential for success after Lapidus procedure. Poor health literacy, comprehension, and retention of patient instructions may be correlated with patient participation. Currently, there is no objective measure of how well patients internalize and retain instructions before and after a Lapidus procedure. We performed this study to assess how much of the information given to patients preoperatively was able to be recalled at the first postoperative visit. Methods: All patients between ages 18 and 88 years undergoing a Lapidus procedure for hallux valgus by the senior author between June 2016 and July 2018 were considered eligible for inclusion. Patients were excluded if they had a history of previous bunion surgery or if the procedure was part of a flatfoot reconstruction. Patients were given written and verbal instructions at the preoperative visit. Demographic and comprehension surveys were administered at their first visit approximately 2 weeks postoperatively. A total of 50 patients, of which 42 (84%) were female and 43 (86%) had a bachelor’s degree or higher, were enrolled. Results: Mean overall score on the comprehension survey was 6.2/8 (±1.2), mean procedure subscore was 1.8/3 (±0.64), and mean postoperative protocol subscore was 4.4/5 (±0.8). The most frequently missed question asked patients to identify the joint fused in the procedure. Conclusion: Although comprehension and retention of instructions given preoperatively was quite high in our well-educated cohort, our findings highlight the importance of delivering clear instructions preoperatively and reinforcing these instructions often. Level of Evidence: Level II, prospective cohort study.

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“…LiMP scores below 6 are reported to indicate limited musculoskeletal HL and “…scores of ≥6 can effectively rule out both limited musculoskeletal literacy and general health literacy” (p. 191) [14]. The LiMP has been used to evaluate the musculoskeletal HL of those with carpal tunnel syndrome [15], foot and ankle complaints [16], those presenting to an emergency department [14, 17] and an orthopaedic outpatients clinic [18]. It has a Flesch-Kincaid grade level of 4.2 (able to be read by those with a 4th grade education or above) [17].…”

Section: Introductionmentioning

confidence: 99%

A Mokken analysis of the literacy in musculoskeletal problems questionnaire

Vaughan

Mulcahy

Coffey

et al. 2017

Health Qual Life Outcomes

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BackgroundLimited health literacy is known to impact on medication adherence, hospital readmission and potentially poorer health outcomes. The literature on the health literacy of those with musculoskeletal conditions suggests greater functional limitations and increased pain levels. There are a number of measures of health literacy. One that specifically relates to musculoskeletal complaints is the Literacy in Musculoskeletal Problems (LiMP) questionnaire. The LiMP contains 9 multiple choice items that cover anatomy, musculoskeletal conditions and the diagnosis of musculoskeletal complaints. The aim of the study was to evaluate the dimensionality and internal structure of the LiMP in patients attending for osteopathy care at a student-led clinic, as a potential measure of musculoskeletal health literacy.MethodThree hundred and sixty-one (n = 361) new patients attending the Victoria University Osteopathy Clinic completed the LiMP and a demographic and health information questionnaire prior to their initial consultation. Mokken scale analysis, a nonparametric item response theory approach, was used to evaluate the dimensionality and structure of the LiMP in this population, to ascertain whether the questionnaire was measuring a single latent construct – musculoskeletal health literacy. McDonald’s omega and Cronbach’s alpha were calculated as the reliability estimations. The relationship between the LiMP and a single item screen of health literacy was also undertaken.ResultsThe 9 items on the LiMP did not form a Mokken scale and the reliability estimations were below an acceptable level (alpha and omega <0.45). LiMP items 5 and 8 were more likely to be answered correctly by those with higher health literacy (p < 0.05), however the effect sizes were small (<0.20).ConclusionCalculation of a total score for the LiMP, as advocated by the original authors, is not supported based on data in the present study. Further research is required to explore the relationship of the LiMP items to demographic and clinical data, and to other broader measures of health literacy. Further research may also develop a health literacy measure that is specific to patients seeking manual therapy care for musculoskeletal complaints.

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Musculoskeletal Health Literacy in Patients With Foot and Ankle Injuries

Abstract: Prognostic, Level IV study.

Cited by 18 publications

References 27 publications

Patient-identified information and communication needs in the context of major trauma

Patient-identified information and communication needs in the context of major trauma

Health Literacy and Recall of Postoperative Instructions in Patients Undergoing the Lapidus Procedure

A Mokken analysis of the literacy in musculoskeletal problems questionnaire

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