Can Screening Items Identify Surgery Patients at Risk of Limited Health Literacy?

Lorraine S. Wallace, David C. Cassada, Edwin S. Rogers, Michael Freeman, Oscar Grandas, Scott Stevens, Mitchell Goldman

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background: Health literacy skills (HLS) have been shown to have a major impact on patient outcomes. To identify patients with limited or marginal HLS, the accuracy of three established screening items were examined. Materials and methods: We studied English-speaking adults (≥21 years) attending a university-based vascular surgery clinic. Structured interviews were conducted to assess sociodemographic characteristics, screening items, and HLS. Area under the receiver operating characteristic (AUROC) curves were plotted to assess the discriminatory capacity of each screening item in detecting patients with limited/marginal HLS. Results: One hundred patients agreed to enter the study and met inclusion criteria. The mean age was 62.0 ± 12.9; 65 were female; 96 were Caucasian; and 32 had not completed high school. The three screening items were effective in detecting patients with limited (n = 18) or marginal (n = 21) HLS. "How often do you have someone (like a family member, friend, or hospital worker) help you read hospital materials?" (AUROC of 0.83; 95% confidence interval [CI] = 0.73, 0.92), "How often do you have problems learning about your medical condition because of difficulty understanding written information?" (AUROC of 0.77; 95% CI = 0.67, 0.86), and "How confident are you filling out medical forms by yourself?" (AUROC of 0.76; 95% CI = 0.66, 0.86) were effective in detecting those with limited/marginal HLS skills. Conclusions: Our findings provide further evidence of the clinical usefulness of these screening items for detecting inadequate HLS in this patient population. Surgeons should consider administering these easy screening items to identify patients at greatest risk of limited or marginal HLS.

Original languageEnglish (US)
Pages (from-to)208-213
Number of pages6
JournalJournal of Surgical Research
Volume140
Issue number2
DOIs
StatePublished - May 15 2007

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Health Literacy
ROC Curve
Confidence Intervals
Blood Vessels
Learning
Interviews

All Science Journal Classification (ASJC) codes

  • Surgery

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Can Screening Items Identify Surgery Patients at Risk of Limited Health Literacy? / Wallace, Lorraine S.; Cassada, David C.; Rogers, Edwin S.; Freeman, Michael; Grandas, Oscar; Stevens, Scott; Goldman, Mitchell.

In: Journal of Surgical Research, Vol. 140, No. 2, 15.05.2007, p. 208-213.

Research output: Contribution to journalArticle

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abstract = "Background: Health literacy skills (HLS) have been shown to have a major impact on patient outcomes. To identify patients with limited or marginal HLS, the accuracy of three established screening items were examined. Materials and methods: We studied English-speaking adults (≥21 years) attending a university-based vascular surgery clinic. Structured interviews were conducted to assess sociodemographic characteristics, screening items, and HLS. Area under the receiver operating characteristic (AUROC) curves were plotted to assess the discriminatory capacity of each screening item in detecting patients with limited/marginal HLS. Results: One hundred patients agreed to enter the study and met inclusion criteria. The mean age was 62.0 ± 12.9; 65 were female; 96 were Caucasian; and 32 had not completed high school. The three screening items were effective in detecting patients with limited (n = 18) or marginal (n = 21) HLS. {"}How often do you have someone (like a family member, friend, or hospital worker) help you read hospital materials?{"} (AUROC of 0.83; 95{\%} confidence interval [CI] = 0.73, 0.92), {"}How often do you have problems learning about your medical condition because of difficulty understanding written information?{"} (AUROC of 0.77; 95{\%} CI = 0.67, 0.86), and {"}How confident are you filling out medical forms by yourself?{"} (AUROC of 0.76; 95{\%} CI = 0.66, 0.86) were effective in detecting those with limited/marginal HLS skills. Conclusions: Our findings provide further evidence of the clinical usefulness of these screening items for detecting inadequate HLS in this patient population. Surgeons should consider administering these easy screening items to identify patients at greatest risk of limited or marginal HLS.",
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