Understanding health care instructions can be challenging

Findings from a survey and five focus groups conducted over the past two years by the Healthy Sheboygan County 2020 Health Literacy Committee indicate understanding health care instructions can be an especially daunting task for certain groups such as the elderly, young people new to the system, and individuals whose primary language is not English.

“We surveyed over 1,000 people in Sheboygan County and only 43 percent said they “always” understood their doctor’s instructions,” said committee co-chair Jean Beinemann, a registered nurse and Program Supervisor with Sheboygan County Health and Human Services. “When care was obtained at an emergency room, that percentage dropped to 14 percent.”

The survey also found that medications were often confusing, especially for those whose educational level was high school diploma or less. When asked how often they understood what their prescriptions were for, 60 percent of this group responded that they only “sometimes” or “never” understood. One-third of elderly respondents indicated they had similar difficulties.

At least one focus group member agreed. “A lot of times the doctor will say, ‘You’re on such-and such’ and I’ll be confused because he’s using one name and I’m only familiar with the drug’s generic name.”

Mary Paluchniak, committee co-chair and a registered nurse and program development specialist at St. Nicholas Hospital in Sheboygan, said input from the focus groups confirmed the survey results and added additional insights. “They felt that perhaps too much time was spent waiting for care, and not enough time was allocated for receiving care, listening to concerns and answering questions.”

“Sometimes so much is thrown at you during an appointment, especially with your kids, that it’s hard to remember it all,” said one focus group participant. “It’s great now that a summary of your visit is printed for you, but you still sometimes need to call back because what’s printed is different from what the doctor told you or there’s stuff missing.”

Several focus group members — even those who understand English well — noted that pictures and drawings helped them better understand their diagnosis and treatment. Many mentioned how impressed they were by physicians with a “personal touch,” who listened carefully and made an extra effort to treat them as individuals.

“Our pediatrician uses visual aids and experiences from her own life, her own kids, to explain things. The people in her office are happy and smiling, they take their time, and they seem excited about our children. There are also printouts and pamphlets to explain things, and you can login to find immunization records and other information about your past appointments online; they set it up for your family, and it’s easy to access.”

The findings from the survey and focus groups were shared recently at a meeting of about 30 health care representatives from a variety of Sheboygan County organizations. The committee’s next step is to work with these organizations as they continue to strive to make health care instructions clearer and easier to understand. Of course, whenever we seek health care we also have a responsibility as patients to listen carefully, ask questions, and follow through on the instructions we receive.

Persons interested in volunteer activities to improve the health of our community, or learning more about the HSC 2020 Coalition, are encouraged to visit www.healthysheboygancounty.org.

 —Kevin Struck is a senior lecturer with UW-Extension Sheboygan County and a member of the Healthy Sheboygan County 2020 Health Literacy Committee.