The Impact of Health Literacy on Patients Receiving Hematopoietice Stem Cell Transplant

Sunday, November 1, 2009

Debra Jenkins, RN, MSN1
Elizabeth D. Carlson, PhD, RN1
Amanda Krueger, RN, BSN2
Marlene Z. Cohen, RN, PhD3
1Mennonite College of Nursing, Illinois State University, Normal, IL
2St. Mary's Hospital, Mayo Clinic-Minnesota, Rochester, IL
3College of Nursing, University of Nebraska Medical Center, Omaha, NE

Learning Objective 1: The learner will be able to understand the concepts of health literacy and the impact to health communication in patients receiving hematopoietic stem cell transplant.

Learning Objective 2: The learner will be able to understand the concepts of reading level analysis of patient educational materials.

In 2004, the Institute of Medicine reported that 90 million U.S. adults had health literacy deficits that could translate into negative health outcomes. Health literacy requires that an individual possess a range of skills that allow them to seek out, comprehend, evaluate, and use health information to make informed choices, reduce health risks and increase quality of life. The purpose of this study was to identify health literacy issues within a larger study of patients undergoing hematopoietic stem cell transplantation (HSCT). Data included phenomenological interviews, quantitative measures of symptoms and quality of life indicators (PI, MZC). Participants were recruited from one NCCN institution. Sufficient samplings of persons from three ethnic groups were included to identify any potential cultural differences.  In-depth interviews were conducted with 20 Caucasian, 20 African-American, and 20 Latino patients each interviewed 5 times over the first 100 days of the HSCT experience. A content analysis approach was used to identify health literacy issues. Findings suggest that as many as 34% of these patient experienced health literacy concerns. While patients with limited education had greater difficulty understanding health care professionals, irrespective of educational levels, patients described signing informed consents without a clear understanding of the HSCT procedure or the chemotherapeutic agents and side effects involved. Further analysis of patient informational materials showed that it was written at a 10th or 12th grade level, far above the recommended reading level. This presentation will discuss these issues and offer suggestions for improving communication among this patient population.

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