Re: [NIFL-HEALTH:2879] Patient interaction with health care instructions

From: harwo001@mc.duke.edu
Date: Thu Mar 01 2001 - 13:27:13 EST


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Subject: Re: [NIFL-HEALTH:2879] Patient interaction with health care instructions
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We are beginning to try and incorporate more interaction in our documents.  Our
first attempt is a booklet on stress management.  It is about 1/3 interactive.
Each topic has a page or two of introductory material.  Then, there is a
vignette that incorporates that content into a patient scenario.  That is
followed by an interactive component that gives the reader the opportunity to
personalize the information to them. This includes completing a  checklist of
signs of stress they are experiencing, answering questions in narrative form
about how they've coped before, making a plan for problem-solving, exploring
current conflicts in their lives and creating their own visualization, either in
words or pictures.

This completed, we are now working on decision-making support materials that
will promote patient - physician interaction.  These will actually include areas
the physician customizes for the patient during the interaction.

Kerry Harwood, RN, MSN
Director, Cancer Patient Education Program
Duke University Health System




Lendoak@aol.com on 03/01/2001 11:44:25 AM

Please respond to nifl-health@nifl.gov

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Subject:  [NIFL-HEALTH:2879] Patient interaction with health care instructions


Dear friends,

We thank you for the opportunity to spend the week with you as "Guest
Discussion Leaders". We would like to share ideas with you on building
interaction into patient instructions.

Have you noticed the first thing a telemarketer says when you answer the
phone? Isn't it invariably, "How are you today?" Why do they open with a
question rather than a sales pitch? Because when you interact to respond to
their question - they gain your attention. And to some small degree they have
established a relationship with you.

>From research and long experience, educators know that interaction stimulates
interest, memory and learning. Oral and written responses are standard
practice in the classroom. More recently, neurologists have shown that
interaction causes a protein change in the brain that stimulates retention
and memory. But few health care instructions - in any mode of communication -
ask for substantive feedback from the patient.

Some feedback examples: (written) "Check at least three foods that you will
eat more of to reduce your risk of cancer." (Oral), "You're going home now,
tell me (or show me) how you will clean your stoma...take your meds...etc."

A few years ago we analyzed 100 written health care instructions and found
that fewer than 20 percent included interaction of any kind. More recently a
similar analysis of med instruction from a pharmaceutical company showed a
similar percentage. For instructions on video or audio tapes, patient
feedback is requested even less frequently.

Would you share your experience in building in feedback for patients? What
has worked for you? Do your materials exceed the 20 percent average?

Patient feedback can bring huge gains in effectiveness. We look forward to
your experience with feedbck, and in the following days we will share ours.

Ceci and Len Doak
Patient Learning Associates



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