Thursday, January 20, 2004
Patients, speak up if you don’t understand something

By Dr. Anthony Policastro Nanticoke Memorial Hospital

Learning is a complicated task. Most people take it for granted. However, we are all born with different strengths and weaknesses. Some of those weaknesses can affect the way we learn. Reading is a good example. We know that about 25 percent of the population does not read above the sixth-grade level. This can create problems in medical situations. There are a lot of forms related to medical care. Not all of them are written at a level that the average patient can understand. The best example of this is what we call a consent form. An individual has to consent to any kind of medical procedure. In order to do so, patients should understand the risks, benefits and alternatives to the procedure. However, those things are not always written at a level that people can understand. It is very important for patients who do not understand these medical documents to make that clear before they sign them. It then becomes our responsibility as medical professionals to explain things more clearly. This is also true for individuals who do not speak English very well. Forms are often not clear even if written at the correct level. For example, there is a sign in the hospital. It is written in both English and Spanish. It says that interpreters are available. Unfortunately, the people who would need an interpreter cannot read this sign. You might question how effective is such a sign. In addition to consent forms, there are patient information forms that are handed out. Some of these are related to patient instructions. Others are related to the particular medical problem that the patient has. There is often an assumption by the medical professionals handing these out that patients can read and understand them. There is not always true. It is up to the patient to speak up and let us know. One additional problem that occurs with medical forms and signs is the words that are used. As medical professionals, we use a complex series of medical terms every day. We get so used to them that we think everyone knows what they mean. That sometimes leads to including this medical terminology in various papers that we hand out. Most medical forms are written at well beyond the sixth-grade level. That means that at least 25 percent of the patients will not understand them. As the wording becomes more complex that percentage goes up. It is important for patients to feel comfortable in telling medical personnel that they do not understand something. It is our responsibility to make sure that any kind of written information is provided in an understandable form.
As cases of flu are reported, vaccines are still available

Delawareans should continue practicing good hygiene as reports of influenza-like illness increase. Delaware’s Division of Public Health has received an increasing number of reports of flu-like illnesses from hospitals. The division has also received 45 reports of laboratory-confirmed influenza cases since October, 22 of which were reported in January 2005. Influenza-like illness is defined as symptoms that include a temperature of more than 100 degrees F and either cough or sore throat in the absence of a known cause other than influenza. “Residents who qualify for influenza vaccination and have not received a flu shot are encouraged to get one,” said Paul Silverman, associate deputy for Health Information and Science. “Frequent hand washing and covering coughs and sneezes are effective ways to prevent the spread of influenza and other illnesses among those who have not been vaccinated. People who are sick should stay home from work, day care or school.” Flu vaccine remains available through community physicians. It is not too late to benefit from a flu shot. Influenza strains identified nationally and by the Delaware Public Health Laboratory since October 2004 are covered by this year’s vaccine.
Individuals eligible for flu vaccination include:
• Children age 6-23 months
• Adults 50 years and older
• Age 2-49 with chronic medical conditions
• Women who will be pregnant during flu season
• Residents of long-term care facilities
• Children age 6 months-18 years on chronic aspirin therapy
• Healthcare workers involved in direct patient care
• Out-of-home caregivers and household contacts of people in the other high-risk categories.