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Registered Nurses’ Experiences With Individuals With Low Health Literacy

A Qualitative Descriptive Study

Journal for Nurses in Professional Development: January/February 2016 - Volume 32 - Issue 1 - p E8
doi: 10.1097/NND.0000000000000242


  • Read the article on page 8.
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GENERAL PURPOSE: To provide information on what nurses experience when interacting with patients thought to possess low health literacy.

LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:

1. Identify issues related to identifying patients with low health literacy and addressing their educational needs.

2. Select registered nurses’ experiences with individuals thought to possess low health literacy.

  1. The Institute of Medicine (2004) defines health literacy as the degree to which individuals have the capacity to
    1. write out their medical history so that it can be used by healthcare providers.
    2. repeat hospital discharge instructions verbatim.
    3. obtain, process, and understand basic health information and services.
  2. According to Parnell (2015), the health literacy literature has placed minimal emphasis on the
    1. communication skills of healthcare professionals.
    2. culture and ethnic background of the patient.
    3. health knowledge and skills of the patient.
  3. What is one method that one participant in this study used to build trust?
    1. speaking to the patient in her own language
    2. involving the patient’s family in the decision-making process
    3. having the same patient assignment each day
  4. A participant suggested that, before providing education, healthcare providers should
    1. accept patients’ cultures and preferences.
    2. ask patients what they would like to learn.
    3. attend to patients’ needs for pain management.
  5. When did participants’ recognition of gaps in patient understanding occur most often?
    1. during team conferences
    2. when speaking to a family member
    3. during an assessment
  6. Two participants recognized a need for additional patient teaching during what patient encounter?
    1. dressing changes
    2. medication administration
    3. meal delivery
  7. What appeared to be the most prominent barrier to learning in this study?
    1. having the time for teaching/learning
    2. patients’ lack of acceptance of their illnesses
    3. perceptions of cultural differences
  8. Several participants reported which of the following barriers to patients’ understanding health-related information?
    1. multiple “teachers”
    2. limited resources
    3. short hospital stays
  9. System barriers to learning that were identified in this study included
    1. a lack of materials written in Spanish.
    2. patients’ unwillingness to learn.
    3. a lack of family participation.
  10. When providing written material to patients, several participants in this study mentioned the importance of using
    1. colorful papers.
    2. pictures.
    3. current statistics.
  11. The only participant to illustrate a clear method for evaluating learning explained that the nurse
    1. asked the patient if he understood what was taught.
    2. used the teach-back methodology.
    3. observed the patient nodding to acknowledge understanding.
  12. Paasche-Orlow and Wolf (2007) report that limited health literacy has been associated with all of the following except
    1. more mistrust of health providers.
    2. lower satisfaction in quality of care.
    3. greater likelihood of following instructions closely.
  13. Parnell (2015) noted that many patients with low health literacy
    1. are embarrassed that they cannot understand their health information.
    2. tend to have more comorbid medical conditions.
    3. are more prone to side effects from medications.
  14. In the United States, the persons at highest risk for low health literacy include those with
    1. low socioeconomic status.
    2. Asian/Pacific Islander ethnicity.
    3. male gender.
  15. When teaching non-English-speaking patients, participants reported
    1. frequent use of English-speaking family members.
    2. a limited availability of interpreters.
    3. the effectiveness of demonstrations and hand gestures.
  16. Which best practice for promoting health literacy was used in this study?
    1. speaking loudly and clearly
    2. limiting key concepts presented
    3. using specific medical terminology
  17. Kripalani and Weiss (2006) suggest that improving the care of patients with low health literacy should include
    1. the use of educational support group classes for patients.
    2. increased use of simplified, online patient teaching.
    3. training health professionals about basic health literacy.
  18. It is recommended that medical information for patients is written at the
    1. fifth-grade reading level.
    2. seventh-grade reading level.
    3. 10th-grade reading level.
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