Shared Decision Making in the Emergency Department Among Patients With Limited Health Literacy: Beyond Slower and Louder

Griffey, Richard T.; McNaughton, Candace D.; McCarthy, Danielle M.; Shelton, Erica; Castañeda-Guarderas, Ana; Young‐Brinn, Angela; Fowler, D A; Grudszen, Corita

doi:10.1111/acem.13104

Cited by 14 publications

(9 citation statements)

References 67 publications

(61 reference statements)

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“…Given that most of these participants viewed themselves as having poor health literacy, they preferred not to be involved. This finding is consistent with the findings of previous research which shows that poor health literacy is a significant barrier to shared decision-making [55,56]. Therefore, it is proposed that Arabic-speaking immigrants' understanding regarding involvement could be rectified through workshops which could be conducted at Arabic community centres, mosques, and churches.…”

Section: Participation In Decision-makingsupporting

confidence: 91%

Exploring the Health Care Challenges and Health Care Needs of Arabic-Speaking Immigrants with Cardiovascular Disease in Australia

et al. 2019

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The Arabic-speaking immigrant group, which makes up the fourth largest language group in Australia, has a high prevalence of cardiovascular disease. The objective of this study was to explore the health care challenges and needs of Arabic-speaking immigrants with cardiovascular disease (CVD), using a comparative approach with English-speaking patients with CVD as the comparable group. Methods: Participants were recruited from community settings in Melbourne, Australia. Face-to-face semi-structured individual interviews were conducted at the recruitment sites. All interviews were audio-taped, transcribed, and coded thematically. Results: 29 participants with CVD were recruited; 15 Arabic-speaking and 14 English-speaking. Arabic-speaking immigrants, and to a lesser extent English-speaking patients with CVD may have specific health care challenges and needs. Arabic-speaking immigrants’ health care needs include: effective health care provider (HCP)-patient communication, accessible care, participation in decision-making, and empowerment. English-speaking participants viewed these needs as important for CVD management. However, only a few English-speaking participants cited these needs as unmet health care needs. Conclusion: This study suggests that Arabic-speaking immigrants with CVD may have unique needs including the need for privacy, effective HCP-patient communication that takes into account patients’ limited English proficiency, and pharmacist-physician collaboration. Therefore, there may be a need to identify a health care model that can address these patients’ health care challenges and needs. This, in turn, may improve their disease management and health outcomes.

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Section: Participation In Decision-makingsupporting

confidence: 91%

Exploring the Health Care Challenges and Health Care Needs of Arabic-Speaking Immigrants with Cardiovascular Disease in Australia

et al. 2019

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“…This compromises their ability to manage their disease [3]. Beyond reading and other communication skills and knowledge of relevant health topics, making sense of health information and the healthcare system also requires numerical skills, such as disease risk or the normal range of values such as blood pressure or cholesterol [16].…”

Section: Functional Health Literacymentioning

confidence: 99%

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Butto¹,

Mberia²,

Bosire³

2020

JBM

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“…An even smaller number of American adults, 9 percent, have adequate numeracy skills [3] to ensure that correct medication dosages are taken, for example [4]. In Canada, by contrast, 46 percent of adults between 16 and 65 years of age are considered to have adequate health literacy, but that number falls to 12 percent for those older than 65 [5].…”

Section: Health Literacy and Health Literacy Universal Precautionsmentioning

confidence: 99%

The Role of Universal Health Literacy Precautions in Minimizing “Medspeak” and Promoting Shared Decision Making

Killian

Coletti

2017

AMA Journal of Ethics

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Shared decision making (SDM), a collaborative process whereby patients and professionals make health care decisions together, is a cornerstone of ethical patient care. The patient-clinician communication necessary to achieve SDM depends on many factors, not the least of which is a shared language (sometimes with the aid of a medical interpreter). However, even when a patient and clinician are speaking the same mother tongue, the use of medical jargon can pose a large and unnecessary barrier. This article discusses how health care professionals can use "universal health literacy precautions" as a legal, practical, and ethical means to enhance SDM and improve health care outcomes. Case of Language Barrier's Impact on Patient AutonomyPatient X, a 56-year-old construction worker, visits the emergency department (ED) with pain and swelling in his right calf. He can walk on his leg with a limp and considers the pain to be bearable. He would prefer to just "power through" whatever is causing the discomfort. This is his first ED visit. He is here to placate his wife, who was alarmed at the progression of the swelling over the last 24 hours.A physical exam reveals a slightly elevated temperature of 99 degrees and blood pressure of 150/110. Blood cultures, a creatine phosphokinase (CPK) test, and a Creactive protein (CRP) test are ordered. When asked about any previous trauma to his leg, Patient X is confused. Has he had "trauma"? He considers himself a calm person, not easily alarmed or "traumatized." He asks the physician (Dr. Y) why they need his blood and is told that the cultures may reveal the agent or pathogen responsible for his condition. Patient X is becoming alarmed. To him, an "agent" sounds like a person. A "pathogen" sounds like a "psychopath" but it can't mean that, except the doctor said something about the "culture." Dr. Y is running behind; it will be at least two hours before she can return with the bloodwork results to confirm her diagnosis, prescribe appropriately, and either discharge or admit Patient X. This leaves Patient X with two hours to worry and try to explain the situation to his wife over the phone.

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Shared Decision Making in the Emergency Department Among Patients With Limited Health Literacy: Beyond Slower and Louder

Cited by 14 publications

References 67 publications

Exploring the Health Care Challenges and Health Care Needs of Arabic-Speaking Immigrants with Cardiovascular Disease in Australia

Exploring the Health Care Challenges and Health Care Needs of Arabic-Speaking Immigrants with Cardiovascular Disease in Australia

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

The Role of Universal Health Literacy Precautions in Minimizing “Medspeak” and Promoting Shared Decision Making

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