For patients with diabetes, learning about managing your disease is like learning a new language -- but often health professionals assume that what one might understand the other one will too.
Wrong! Diabetes affects people in all walks of life in different ways. Your diabetes team endeavors to work closely with them to manage these complex medical conditions. Often, (as noted by poor adherence to recommended treatment) there is a breakdown in communication between the patient and provider.
Communication is key factor in conveying disease management issues. However, a 1993 national adult literacy survey found that nearly one-third of people in the United States are unable to read and understand basic health-related materials because of various factors.
Another study found that among people with diabetes at a public hospital in the U.S., 38 percent had low health literacy. For people with low educational attainment, older people, and ethnic minorities, low health literacy is very common.
Due to the complexity of diabetes management and the reliance on self-management activities to control diabetes, this becomes a critical issue. Identifying and addressing the problem is key to better health for the person with diabetes.
How serious is the problem?
Studies have found low health literacy associated with poor diabetes knowledge, poor glucose control, and an increased risk of eye damage or retinopathy. One study measured the health literacy of 408 type 2 adults. It found that those with a low health literacy were less likely to reach optimal glucose control and more likely to report retinopathy than a group of people with higher health literacy.
Other studies have found that among people with low health literacy, the scores on diabetes knowledge tests were lower. Another study found that those with a low health literacy might have other limitations, not only with reading but with oral communication.
How do you identify low health literacy?
It is very difficult to identify people with low health literacy. Due to the embarrassment that is often associated with low literacy, people with this problem are often successful at hiding this problem from others. Instruments to assess health literacy have been developed and can be used to identify those with this problem. In some countries, due to low literacy rates, health education places use cartoons to convey their message.
What can be done?
For healthcare providers, it is important that communication be kept basic without any slang or jargon.
1. Provide three new concepts per visit.
2. Give the person a chance to tell their story or problem completely without interruption. Using pictures, real devices, and graphics to demonstrate work well.
3. Information should be provided orally with written information to be used for backup.
4. Asking questions that begin with "how" and "what" will ensure comprehension of the material.
