Do you understand everything your doctor tells you?

November 26, 2007 (Montreal) – Whether in the hospital or the clinic, nearly 50% of people would not understand the doctor’s explanations. Among those over 65, this proportion would rise to 80%.

This misunderstanding is said to be attributable to a lack of health literacy, experts say. It is an inability – to varying degrees – to obtain and understand information in order to treat oneself or improve one’s health, in different contexts.

We can therefore imagine the gap that exists between a patient already suffering from difficulties in understanding basic information and a doctor who speaks in often technical terms …

“81% of physicians use jargon when talking to their patients,” said Irving Rootman¹, expert in literacy and health. According to him, health workers should pay particular attention to the more or less conscious signs that patients send them, when they do not understand.

Supported by Margot Kaszap, professor in the Faculty of Education at Laval University. “Patients with a literacy problem hide their disability because they feel diminished,” she explains. They pretend to understand because they are too embarrassed to say that they are illiterate. “

Beyond the attention that health professionals should pay to patient literacy issues, they must also find other words to communicate better. “Even if the doctor speaks more slowly, the patient does not necessarily understand better: whether we speak quickly or slowly, Chinese is Chinese,” said Margot Kaszap. Often people don’t even know they haven’t understood …

Why is health literacy important?

According to Irving Rootman, studies show that low literacy seems to be linked to inadequate medication use and great difficulty following doctor’s directions. It is also associated with lower use of prevention services. In addition, users who have a low level of literacy have difficulty using the health system adequately, in addition to having more difficulty in expressing their concerns about their state of health.

“Scientific evidence shows that poor reading skills are associated with increased hospital stay and higher rates of cervical cancer, diabetes and premature death,” said the Canadian researcher.

In addition, the less reading skills you have, the less able you are to heal yourself for chronic illnesses, adds Rootman. “In Canada, 62% of people are unable to manage their disease on their own due to a lack of understanding of the written language. “²

In Quebec, it is estimated that 41.1% of 16 to 65 year olds have a low level of understanding, and 19.8% have a very low level. In short, more than 60% of Quebecers would not have a sufficient level of literacy to understand and take charge of their health.

“These results show the need to support individual health care, which is a major challenge given the aging of the population,” noted Bertrand Perron, of the Institut de la statistique du Québec.

How to improve literacy?

Some activities appear to be related to better literacy in general. Education is, obviously, in first place: 40% of people without a high school diploma (DES) have a very low level of literacy, against 14% of those with a DES, according to Mr. Perron. .

Having a job also improves general health knowledge, as does volunteering in an organization.

At the institutional level, simplifying the content of leaflets or other printed formats would be a first step to take, according to several stakeholders. Either by adapting them according to the clientele, or by distributing the information in audio or video form on the Internet. “But beware: popularizing is not trivializing, underlines Margot Kaszap. Popularizing means explaining differently, more simply, in order to provide adequate information. “

According to her, teaching what the human body is should be put back on the agenda in the classroom, in order to avoid misrepresentation of its true nature.

“I have seen people with edema refuse to wear their compression stockings because they feared that the swelling would move elsewhere in their body, as if it were a balloon! “, She gave as an example.

Martin LaSalle – PasseportSanté.net

1. Irving Rootman, Ph.D., is Executive Director of the Health and Learning Knowledge Center at the University of Victoria and co-chair of the Canadian Public Health Association’s Expert Panel on Health Literacy.
2. On this subject, see also: Murray S, et al, Health Literacy in Canada: Initial Findings from the 2007 International Adult Literacy and Life Skills Survey, Canadian Council on Learning, September 2007 [document PDF consulté le 26 novembre 2007].