Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.9.3/8.9.0.Beta5/980425bjb) with SMTP id GAA25859; Tue, 29 Feb 2000 06:12:09 -0500 (EST) Date: Tue, 29 Feb 2000 06:12:09 -0500 (EST) Message-Id: <Pine.SGI.3.95.1000229054534.9277E-100000@world.std.com> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: David J Rosen <DJRosen@world.std.com> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:2247] The Reading Brush Off X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas Content-Type: TEXT/PLAIN; charset=US-ASCII Status: OR NIFL-Health Colleagues, In her message below, CPGarzona sensibly puts this discussion about reading and health in context. So why, one might ask, aren't patients always treated this way? Perhaps because some caregivers aren't as enlightened as CPGarzona, perhaps because of financial or organizational constraints in the health care system. This raises for me an issue that I would like to name the Reading Brush Off. In situations where a caregiver should talk with a patient -- patiently -- in the patient's first language, using illustrations and examples, the patient is instead just given written material or a pamphlet and a lecture. Even if the material is written clearly, at the right level, and in the patient's first language, written information is often not enough to help the patient take good care of herself. CPGarzona is right to remind us that health care >communication< is the issue, and clear writing is only one important part of that communciation. The Reading Brush Off is also an issue in other important communciation contexts: social services, education, government services, technology technical assistance, and others. It's right up there with the Branching Voice Mail Brush-off. David J. Rosen On Mon, 28 Feb 2000 CPGarzona@AOL.COM wrote: > Dear friends, > > We are missing the boat when we only talk about "plain language." My thesis > work, which looked at written hospital discharge instructions, found that > college-educated, upper-middle class patients/families did not > understand/apply many of the CRITICAL written instructions they were given > after open-heart surgery. I was able to document the many > surprising/horrifying ways people coped with NOT having the information they > needed. > > These well-educated people could READ the instructions fine, but found that > the instructions were not RELEVANT. This is because the instructions were > written by health professionals who did not have a clue what people REALLY > need to know after discharge (e.g., how to take a shower when you're too weak > to stand up; how to sleep when your bed isn't an adjustable hospital bed; > what to do about pain when you're afraid of your pain pills; how to do light > walking when you live in hilly Seattle; what to do about chest pain if you're > afraid to "bother" the doctor). > > My solution to this was to interview patients/caregivers in their homes after > surgery, to listen to their STORIES, and to construct RELEVANT discharge > instructions based on these stories (see Paulo Freire's work). I let the > PATIENTS define the themes in their OWN way. I let the PATIENTS tell me what > they most needed to know. > > Also added to discharge instructions: emotional support and a sense of > empowerment from testimonials from former patients/caregivers -- neither of > which were provided by their doctors. > > "Readability" and "understandability" are nice -- but they ain't nothin' > without relevancy, as defined by the LEARNER! "The best way to understand a > journey is to ask the person coming back." > > cpgarzona > cpgarzona@aol.com > > > > > > >
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