[NIFL-HEALTH:3444] Facilitating health communication

From: Dwyoho@aol.com
Date: Thu Nov 01 2001 - 15:10:25 EST


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Subject: [NIFL-HEALTH:3444] Facilitating health communication
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In a message dated 10/31/2001 12:31:38 AM Eastern Standard Time, 
levesqjr@webster.edu writes:


> Time is another factor to consider which also supports the need for a
> facilitator. At the major medical center, everyone I encountered was in
> a rush. After my initial diagnosis, I left my surgeon in a state of
> shock, not really sure about his message. I'd waited over an hour and a
> half for "my turn" and was on the street 15 minutes after he walked in
> 

Many years ago, I worked as a "director of information and education" in a 
Planned Parenthood center. After some training in family planning and human 
sexuality, my job was to work with the patients appointed to the clinic while 
they waited for the doctor.  Most had at least an hour and a half wait, 
sometimes longer, because the physicians came from the hospital to do the 
clinic and were often delayed in getting there.  

In effect, the waiting room was the education room.  I simply greeted the 
group when most had arrived, (others came in late or later)  and began a 
discussion/lecture about family planning options.  (Meanwhile the RN met with 
each person individually for the miedical history, "pulling" them out of the 
group one by one.)  I didn't know at the time that what I was doing would 
today be called "health literacy".   As a trained educator, it was simply 
natural for me to use a wide variety of communication methods.  I assumed 
most of the patients were poorly educated as this was a Title 10 clinic 
serving a specific socio-economic group.  I made no judgments one way or 
another as to their "ability" to understand.  But in this era of feminism, 
the entire atmosphere of everything that happened there was careful respect 
for each individual woman, and careful reservation to the patient of all 
decision-making.  Even today, the use of birth control simply will not be 
successful unless the woman understands all the pluses and minuses, is happy 
with her own choice, and especially in the case of the Pill,  understands a 
complicated regime of pill taking. In another setting, I later counseled 
women as they waited for an abortion procedure, making sure each one was 
fully informed and fully in charge of whether or not to go forward.

I stressed all options available, including tubal ligation and the rhythm 
method, and strived to present each option neutrally.  In retrospect, I know 
full well that 90% came to the clinic wanting the Pill and left with the 
same.  Some ignored the discussion, but the vast majority paid rapt 
attention, and asked many questions.  Even though they had already made their 
decision as to the desire to contracept and the method of doing so long 
before they met me,  most left understanding their own bodies much better.  
We even taught them breast self-exam.  Of course, how much information they 
left with depended on how late the doctor was.  " 

What I've described is routine in Planned Parenthood clinics and in many 
other places.  Is there anything from this experience that could be 
transferred to other settings, and applied to other health needs?    

Deborah W. Yoho
Co-moderator, NIFL Health Literacy Discussion Group
Chief Executive Officer
Greater Columbia Literacy Council
921 Woodrow Street  
Columbia, SC  29205
803/765-2555   dwyoho@aol.com



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