Numeracy and Communication with Patients: They Are Counting on Us

Abstract

.Patient-centered interactive communication between physicians and patients is recommended to improve the quality of medical care. Numerical concepts are important components of such exchanges and include arithmetic and use of percentages, as well as higher level tasks like estimation, probability, problem-solving, and risk assessment -the basis of preventive medicine. Difficulty with numerical concepts may impede communication. The current evidence on prevalence, measurement, and outcomes related to numeracy is presented, along with a summary of best practices for communication of numerical information. This information is integrated into a hierarchical model of mathematical concepts and skills, which can guide clinicians toward numerical communication that is easier to use with patients.

Parental Numeracy and Asthma Exacerbations in Puerto Rican Children

“…8,9 The 2003 National Assessment of Adult Literacy found that 44% of adults in the United States have basic or below basic health literacy and that 22% possess no more than the most simple and concrete quantitative skills. 10,11 Findings from this national survey also indicate that members of Hispanic subgroups have, on average, the lowest health literacy level of all ethnic groups in this country.…”

“…15 The management of childhood asthma relies on a parent's ability to monitor his or her child's illness, and numeracy is likely required to accomplish complex tasks such as estimating the correct dose of a medication and understanding risks and benefi ts of asthma treatment. 8,30 Numeracy may also promote parental behavior change, infl uence information-seeking behaviors, and affect health-care system navigation skills. 30,31 In addition, numeracy is also closely related to other health literacy skills (ie, reading, writing, speech, speech comprehension, and cultural and conceptual knowledge) as well as self-effi cacy.…”

A Randomized Trial of a Prenatal Genetic Testing Interactive Computerized Information Aid

“…Experts in health literacy tailored language to ensure it was appropriate for women of low and high health literacy; best practices were used to convey numerical concepts. 20 Participants had the opportunity to demonstrate comprehension of seminal concepts by replying to questions and receiving immediate feedback. Participants could spend varying amounts of time using the tool depending on their degree of user involvement.…”

How Navigating Uncertainty Motivates Trust in Medicine

“…In all three cases, public anxiety has steadily grown as trust has declined, contributing to difficult encounters between patients and their caretakers. Although outright violence against physicians is rare, physicians' failures to communicate uncertainty effectively to patients and their families can result in tremendous disappointment and distrust [24].…”