Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id f9TF7r023151; Mon, 29 Oct 2001 10:07:53 -0500 (EST) Date: Mon, 29 Oct 2001 10:07:53 -0500 (EST) Message-Id: <20011029150431.27409.qmail@web11206.mail.yahoo.com> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: Bertha Mo <bertiemo@yahoo.com> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:3437] Re: NIFL-HEALTH digest 1177 X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas Content-Type: text/plain; charset=us-ascii Status: O Content-Length: 7835 Lines: 225 Dear Jeri and others: Thank you for telling us your story and the excellent references. There is an interesting discussion going on regarding the political economy of primarly prevention and early detection that I thought some readers might be interested in on a Canadian women's list serve. Anyone who is interested should send an email to jkornelsen@cw.bc.ca requesting information about the Breast Cancer Site discussion. Bertie Mo, Ph.D., MPH nifl-health@nifl.gov wrote: > NIFL-HEALTH Digest 1177 > > Topics covered in this issue include: > > 1) Re: Providers assessing literacy level-- W > by Jeri Levesque <levesqjr@webster.edu> > 2) Re: Providers assessing literacy level-- W > by Jeri Levesque <levesqjr@webster.edu> > 3) Re: Providers assessing literacy level-- W > by "Mark V. Williams, MD" <mwillia@emory.edu> > 4) Graphics > by "KIRSTEN ASPENGREN" > <KASPENGR.CARE1.CFH@cfhnyc.org> > 5) HLMonth Web sites > by "Helen Osborne" <helen@healthliteracy.com> > 6) On the credibility of health literacy efforts > by Dwyoho@aol.com > > ---------------------------------------------------------------------- > > Date: Fri, 26 Oct 2001 12:10:13 -0500 > From: Jeri Levesque <levesqjr@webster.edu> > To: nifl-health@nifl.gov > Subject: Re: Providers assessing literacy level-- W > Message-ID: <3BD998F3.6DF9A7AB@webster.edu> > > > --------------F239B089FAA216C65000F1CC > Content-Type: text/plain; charset=us-ascii; > x-mac-type="54455854"; x-mac-creator="4D4F5353" > Content-Transfer-Encoding: 7bit > > Jan and Others: > > Assessing patient's literacy needs has always been > an interesting discussion. I > discovered an interesting situation regarding Breast > Cancer. As this is > National Breast Cancer month, please allow me to > broach the subject of patient > decision making. > > After my fourth biopsy in 7 years I was confronted > with choosing between > treatment options which included a prophylactic > bilateral mastectomy. The > current practice for surgeons is to give patients > information but not to direct > the patient toward a treatment option. My surgeon > told me that as an > intelligent, well educated woman, it was my > responsibility to research the > disease and treatment options and then to return to > him with questions and a > decision regarding treatment. > > I am a reading specialist who defines comprehension > as the process of creating > meaning from print by bridging prior knowledge of a > subject with new > information. As a tenured university professor I > have well honed research > skills. However, reviewing articles from Medline and > the gamut of cancer > related web sites I finally surrendered to > information overload. For every > point regarding prophylactic bilateral mastectomies > with TRAM flap > reconstruction there is a counterpoint. I do not > have adequate background > knowledge to discern an author's bias or previous > work in the field. > > I sought a second opinion and the practice of > "patient makes the decision > without particular surgeon guidance" held. Imagine > trying to decide how to > invest all of your retirement in the current stock > market with a financial > advisor who tells you to figure it out for yourself. > My conclusion to have > surgery was supported and I am now in my sixth week > of recovery. > > A couple of health literacy lessons. First, the > Internet based health issues > Chat rooms provide a good forum for emotional > support. The search engine allows > one to zero in on specific questions and issues > regarding cancer types, > treatments, and recoveries. They are succinct > discussions with relatively low > levels of readability. Second; Y Me, Susan Komen, > Sloan Kettering, Johns > Hopkings, Cancernet and others have straightforward > FAQ's that are handled by > physicians. These are clearly cataloged and linked > to other concerns. Most key > vocabulary is hot linked to definitions and further > explanations. The > readability is higher but the FAQ's allow a standard > paragraph per question. > Third; patients can access medical journal abstracts > and collect current > information regarding treatment options including > new studies such as the STAR > Trials. This information is not intended for > consumers but very informative to > well educated readers. > > Bottom line; after weeks of research on the Internet > I was most comfortable > with one on one conversations with my two surgeons. > I seriously question > however how Jane Doe, a woman with an eighth grade > reading ability could make a > rational decision through print materials alone. I > did find a health literacy > project that bridged the gap. The day before my > surgery I watched a video, Just > Between Friends produced by Washington University > funded by Susan Komen > Foundation. This was a health literacy project that > includes a small booklet on > breast cancer and a FAQ video about options and > recovery. I have to admit > between the video and the booklet all the basis were > covered to inform a woman > to the point of asking her doctor good questions and > choosing a treatment > option. As we all know, patients need high touch > human communication just as > much as high tech health information sources. > > A toast to all of the pink ribbons, > > Jeri Levesque, Ed.D. > Associate Professor, Webster University > Director; Webster University Literacy Center > St. Louis, MO > > --------------F239B089FAA216C65000F1CC > Content-Type: text/html; charset=us-ascii > Content-Transfer-Encoding: 7bit > > <!doctype html public "-//w3c//dtd html 4.0 > transitional//en"> > <html> > Jan and Others: > <p>Assessing patient's literacy needs has always > been an interesting discussion. > I discovered an interesting situation regarding > Breast Cancer. As this > is National Breast Cancer month, please allow me to > broach the subject > of patient decision making. > <p>After my fourth biopsy in 7 years I was > confronted with choosing between > treatment options which included a prophylactic > bilateral mastectomy. The > current practice for surgeons is to give patients > information but not to > direct the patient toward a treatment option. My > surgeon told me that as > an intelligent, well educated woman, it was my > responsibility to research > the disease and treatment options and then to return > to him with questions > and a decision regarding treatment. > <p>I am a reading specialist who defines > comprehension as the process of > creating meaning from print by bridging prior > knowledge of a subject with > new information. As a tenured university professor I > have well honed research > skills. However, reviewing articles from Medline and > the gamut of cancer > related web sites I finally surrendered to > information overload. For every > point regarding prophylactic bilateral mastectomies > with TRAM flap reconstruction > there is a counterpoint. I do not have adequate > background knowledge to > discern an author's bias or previous work in the > field. > <p>I sought a second opinion and the practice of > "patient makes the decision > without particular surgeon guidance" held. Imagine > trying to decide how > to invest all of your retirement in the current > stock market with a financial > advisor who tells you to figure it out for yourself. > My conclusion to have > surgery was supported and I am now in my sixth week > of recovery. > <p>A couple of health literacy lessons. First, the > Internet based > health issues Chat rooms provide a good forum for > emotional support. The > search engine allows one to zero in on specific > questions and issues regarding > === message truncated === __________________________________________________ Do You Yahoo!? Make a great connection at Yahoo! Personals. http://personals.yahoo.com
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