File
Toibin M.1,2, Cusack T.1, Pender M.1
1University College Dublin, School of Public Health, Physiotherapy and Population Science, Dublin, Ireland, 2Health Service Executive, Community Physiotherapy, Sligo, Ireland
Background: The European Health Literacy Survey conducted in 2012 reported possible limited health literacy in half of all Europeans. Patients are expected to self monitor and follow treatment regimes between health care visits. Healthcare professionals need a method of ensuring that patients understand what is expected of them. When healthcare professionals consider patients´ health literacy, they use simpler language during consultations. Bilateral healthcare communication interventions incorporating teach back, a technique where patients reiterate explanations in their own words have been shown to facilitate health literacy. Participation - with patients contributing to the selection of their treatment plan - is enhanced by health literacy and a clinic atmosphere that welcomes discussion. Patients right to participate in their own healthcare is enshrined in the European Patient Charter.
Ask Me 3 is a bilateral healthcare communication intervention. It encourages patients to question and seek clarity during consultation and asks healthcare professionals to explain in lay language, use teach back and welcome discussion.
Ask Me 3 is a bilateral healthcare communication intervention. It encourages patients to question and seek clarity during consultation and asks healthcare professionals to explain in lay language, use teach back and welcome discussion.
Purpose: To establish a baseline level of health literacy and participation in patients attending primary care physiotherapy and compare the impact of implementing Ask Me 3 on patients´ level of health literacy and participation.
Methods: Five physiotherapist and twenty patient participants completed a cluster control pilot intervention study in two primary care clinics over a five week period. All patients had attended ≥1 physiotherapy appointment(s) prior to the study. Participants allocated to the intervention clinic were trained to use the Ask Me 3 communication intervention during physiotherapy treatment sessions. Participants allocated to the control clinic made no change to usual physiotherapy treatment sessions. All patient participants completed the Newest Vital Sign questionnaire to measure health literacy and a bespoke mixed method questionnaire to measure participation during one to one interviews with the researcher before and after the intervention period. Physiotherapists were invited to complete a post study feedback questionnaire. The data collected was analysed for changes within and between groups using SPSS version 20. The qualitative data was interpreted using thematic analysis.
Results: Health literacy improved significantly (p ≤ 0.01) in both groups and elements of participation increased, most notably compliance with therapeutic exercise(p ≤ 0.01). No significant difference was found between the two groups´ changes in outcome measures for health literacy or participation. Patients in the intervention group received significantly less physiotherapy during the intervention period, which was a limitation of the study. The qualitative analysis observed changes in empowerment to participate in the intervention group only. Ask Me 3 was reported to be user friendly and a useful adjunct to physiotherapy treatment.
Conclusion(s): Health literacy is dynamic. Increasing physiotherapists´ health literacy awareness improves the health literacy of patients attending them. Ask Me 3 empowers patients to participate in their healthcare.
Implications: The Ask Me 3 intervention empowers patients to question and seek clarity on issues that concern them during healthcare consultations. These patient generated questions give healthcare professionals clues to patients understanding acceptance and insight of their condition, which in turn facilitates sensitive delivery of relevant information to meet gaps in understanding in timely fashion.
Funding acknowledgements: This work was unfunded.
Topic: Professional practice: other
Ethics approval: Ethics Approval was obtained from Research Ethics Committee, Sligo University Hospital, Sligo, Ireland
All authors, affiliations and abstracts have been published as submitted.
