Assessing oral literacy demand in genetic counseling dialogue: preliminary test of a conceptual framework.

摘要: Health literacy deficits affect half the American patient population and are linked to poor health, ineffective disease management high rates of hospitalization. Restricted has also been with less satisfying medical visits communication difficulties, particularly in terms interpersonal informational aspects care. Despite growing attention these issues by researchers policy makers, few studies have attempted conceptualize assess those dialogue that challenge persons low skills, i.e., oral demand within encounters. The current study uses videotapes transcripts 152 prenatal cancer pretest genetic counseling sessions recorded simulated clients develop a conceptual framework explore its consequences for interaction related outcomes. Ninety-six 81 counselors-broadly representative US National Society Genetic Counselors-participated study. Key elements used define include: (1) use unfamiliar technical terms; (2) general language complexity, reflected application Microsoft Word grammar summary statistics session transcripts; and, (3) structural characteristics dialogue, including pacing, density, interactivity. counselor outcomes include self-ratings satisfaction, informativeness, development rapport. rated their satisfaction communication, counselor's effective nonverbal affective demeanor during session. Sessions greater overall term were longer more complex readability indices multi-syllabic vocabulary (measures averaging p<.05). proportionate characterized shorter visits, demand, slow speech speed, fewer dense speaking turns interactivity (p<.05). higher terms, interactive satisfied lower ratings counselors' effectiveness (all relationships Counselors' informativeness inversely Just as print material can be made reader-friendly following established guidelines, may patient-centered meaningful having providers monitor language, well interaction, thereby lowering routine dialogue. These important all patients but even so restricted literacy.