Evaluation of the Single Leg Stance Test for an Annual Preventative Physical Therapy Visit and the Effect of Education on the Perceived Value of Test Results as a Health Indicator

BACKGROUND AND PURPOSE

A preventative model of physical therapy (PT) care to promote activity and minimize mobility loss with aging is not routine. Performance testing and patient education are recommended to increase the perceived value of results to inform health decision-making. This study evaluated (1) the Single Leg Stance (SLS) test for an annual visit based on a priori criteria and (2) the effect of education on the perceived value of SLS and walking speed test results as health indicators.

METHODS

In a cross-sectional study, ambulatory adults aged 55+ completed a pre-survey, performed SLS and walking speed tests, received education about their results, and completed a post-survey. The distribution of test results was displayed with histograms and analyzed for correlations. Participants used a Likert scale to rate how they perceived the value of their test results as health indicators before and after education and their satisfaction with the education received, including a novel pocket card.

RESULTS

On average, participants (n = 152) were 64 years old (age range 55-82), 91% white, and 61% female. Walking speed results were normally distributed, and SLS results demonstrated a ceiling effect. Participants were below published norms for SLS 33% of the time and 34% for walking speed. The SLS test took an average of 3.6 minutes to complete. Binarized results for the tests as at/above and below norms were correlated with χ2 (1, N = 152) = 10.48, P = .001. The test results were significantly more valued as health indicators after education. Seventy-two percent of participants agreed (median rating 4, range 1-5) that they would be interested in PT if their walking speed results were below the norm, and 76% agreed for SLS.

CONCLUSION

The ceiling effect disadvantages the SLS test with an annual PT visit. Education on test results and comparison to norms increased how older adults valued physical performance measures as health indicators.

Improving the Readability of Patient Education Materials in Physical Therapy

Introduction Printed patient educational materials (PEM) are often written above the recommended sixth- to eighth-grade reading levels, resulting in decreased client understanding and subsequent poor health literacy. Researchers have demonstrated that it is possible to improve readability to enhance clients' understanding and health literacy. The purpose of this study was to evaluate the readability of physical therapy (PT) PEM with and without modifications for improvement. Methods A convenience sample of 38 PT PEM of at least 10 sentences was obtained from a large suburban hospital system in the Midwestern region of the United States. Original and three modified versions (exclusion, revision, and combined exclusion/revision of words with >3 syllables) of the documents were assessed with the Simple Measure of "Gobbledygook" (SMOG). All document means were compared to the recommended reading levels, and the original document means were compared with modified conditions. Results A majority of the documents were above an eighth-grade reading level. All modified conditions resulted in statistically significant reading level decreases, but only the combined modified condition decreased to the eighth-grade level. Conclusion Even with modifications, most PEM were above the recommended reading levels. Additional methods for improving readability and increased education about health literacy for healthcare professionals may be necessary to improve client comprehension.

A radiation therapist's guide to health literacy: A narrative review

Radiation therapist (RT) communication plays an essential part of patient-centred care in achieving better patient outcomes within radiation oncology. Patients present from a range of social circumstances, education levels and cultural backgrounds, all of which may significantly impact their level of health literacy (HL). Using literature sourced from databases such as EMCare Nursing & Allied Health Database, MEDLINE(R) and APA PsycInfo, this narrative review explores HL definitions, international comparison rates and indications of individual low HL. It also reviews HL assessments as well as exploring enablers and barriers to HL from the RT perspective. Strategies from both the individual or organisational perspective are provided for RTs to begin or continue their HL interest. By educating the radiation therapy profession about health literacy and making small changes in interpersonal interactions, there is the opportunity to impact patients' experiences and outcomes significantly.

Das Konstrukt Gesundheitskompetenz in Ausbildung und Studium der Physiotherapie in Deutschland – Ergebnisse einer Dokumentenanalyse

Hintergrund Physiotherapeutinnen und -therapeuten stellen eine Schlüsselrolle in der Förderung der Gesundheitskompetenz von Patientinnen und Patienten dar. Der Wunsch von Physiotherapeutinnen und -therapeuten nach Informationen zum Thema Gesundheitskompetenz ist groß. Die Ausbildung wird u. a. als wichtiger Informationsweg für dieses Thema eingeschätzt.

Ziel Explorative Studie zur Beantwortung der Fragestellung: Welche Rolle spielt das Thema Gesundheitskompetenz und Förderung der Gesundheitskompetenz von Patientinnen und Patienten in der beruflichen Ausbildung bzw. im Studium der Physiotherapie in Deutschland?

Methode Dokumentenanalyse von relevanten Unterlagen zu Ausbildung und Studium (z. B. Ausbildungslehrpläne, Modulbeschreibungen) in der Physiotherapie. Im Rahmen vorbereitender Arbeiten wurde mittels Workshops mit Expertinnen die Grundlage des in den Analysen verwendeten Kodierleitfadens erarbeitet. Qualitative Auswertung der Daten anhand der strukturierenden Inhaltsanalyse nach Mayring.

Ergebnisse In 27 analysierten relevanten Unterlagen zu Ausbildung und Studium wurde der Begriff Gesundheitskompetenz nur in einem Dokument explizit erwähnt. Allerdings werden zukünftigen Physiotherapeutinnen und -therapeuten in der Ausbildung und im Studium wichtige Fähigkeiten und Fertigkeiten, z. B. Kommunikationskompetenz, vermittelt, die für die Förderung der Gesundheitskompetenz der Patientenschaft grundlegend sind.

Schlussfolgerung Das Thema Gesundheitskompetenz ist in der Ausbildung und im Studium der Physiotherapie nicht explizit verankert. Durch die Aufnahme in die Curricula kann das explizite Wissen der Physiotherapeutinnen und -therapeuten vertieft werden und durch ihre Sensibilisierung für das Thema ihre Schlüsselrolle in der Förderung der Gesundheitskompetenz von Patientinnen und Patienten weiter ausgebaut werden.

George TE, Hopp J. A Strategy for Teaching Health Literacy to Physician Assistant Students

This brief report presents a model that incorporates an analogous “see-one,” “do-one,” “teach-one” pedagogical strategy and experiential learning for mastery of health literacy principles by first-year Master of Science in Physician Assistant Studies students. Students completed a series of health literacy activities including classroom-based lecture (see-one), hands-on application of health literacy activities (do-one), and application and peer-instruction of health literacy best practices with other health science students (teach-one) as part of a two-semester hands-on learning experience. A health literacy knowledge examination, qualitative student feedback, and faculty review of content application were used to assess for effectiveness. Students demonstrated a significant and sustained positive change in knowledge examination scores complemented by positive faculty poster review. Physician Assistant student health literacy knowledge is increased and sustained after application of see-one, do-one, teach-one strategy with students demonstrating health literacy considerations in real-client application during experiential learning. Education programs seeking to meet the call for health professionals prepared to address gaps in health literacy should consider a see-one, do-one, teach-one and experiential learning approach over multiple semesters. [HLRP: Health Literacy Research and Practice. 2021;5(1):e70–e77.]

Health-Related Quality of Life in Older Adults: Its Association with Health Literacy, Self-Efficacy, Social Support, and Health-Promoting Behavior

This cross-sectional study aimed to explore the relationships among sociodemographics, health literacy, self-efficacy, social support, health-promoting behavior, and health-related quality of life (HRQOL) in older adults. A total of 240 older adults aged >65 years were recruited from three community senior welfare centers in South Korea. Standardized self-administered questionnaires measuring sociodemographic characteristics, health literacy, social support, self-efficacy, health-promoting behavior, and health-related quality of life were distributed to older adults. Multiple regression analyses with stepwise selection was used to determine the factors affecting health-related quality of life. Factors affecting a higher physical component score of HRQOL were a higher comprehension level of and numeracy in health literacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. Factors affecting a higher mental component score of HRQOL were a higher comprehension level of and numeracy in health literacy, self-efficacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. To improve HRQOL among older adults, nursing interventions are required to measure health literacy, empower physical health-promoting behavior and self-efficacy, and enhance emotional-informational support from family or other resources.

The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study

OBJECTIVE

To establish if health literacy (HL) is linked to poorer outcomes and behaviours in patients with chronic pain.

DESIGN

A prospective cross-sectional observational study.

SETTING

Multidisciplinary out-patient pain clinics in three university teaching hospitals.

PATIENTS

New patients (n=131) referred to the pain clinic with a history of chronic pain (>12 weeks).

METHODS

A questionnaire was distributed to chronic pain patients attending their first appointment. Those eligible for inclusion were newly referred patients who had pain lasting longer than three months. The questionnaire comprised the following sections: demographics, chronic pain status and disease-related knowledge, quality of life (SF-36), beliefs (Beliefs About Pain Control Questionnaire), and a validated HL tool (Newest Vital Sign).

RESULTS

Of the 131 participants recruited, 54% had inadequate HL. The group was subsequently stratified according to HL level. In bivariate analysis, inadequate HL was associated with older age (p<0.001), being unemployed or retired (p=0.005), less education (p<0.001), lower income, increased comorbidities (p=0.038), being less likely to utilise allied health services (p=0.001), poorer disease-related knowledge (p=0.002), and poorer beliefs about pain (p<0.05). In multivariate analysis, disease-related knowledge (OR 2.5, 95%CI 1.0 to 6.3, p=0.05) and beliefs about pain (B=-2.3, S.E=0.9, p=0.01) remained independently associated with HL.

CONCLUSION

Inadequate HL is prevalent in chronic pain patients, and may impact on the development of certain characteristics necessary for effective self-management.

Supporting Radiation Therapy Patients with Limited Health Literacy

Health literacy is one of the most important determinants of patient outcome. Literacy levels are influenced by factors such as formal education status, socioeconomic circumstances, age, language, cultural background, and employment status. Few health professionals are aware of health literacy issues, and even fewer can accurately address them. The purpose of this review article was to bring attention to the issue of health literacy, to provide information on how to identify patients at risk of limited health literacy, and to develop communication strategies designed to support cancer patients and their families. This article also aimed to develop and identify specific tools for radiation therapists and the radiation medical science community based on literature, evidence, and educational material from nursing and other allied professions. Health care organizations and professionals need to be aware of their duty to ensure that patients fully comprehend both the complex and simple information presented. Improving comprehension related to health choices leads to better decision making by the patient, improves patient outcomes, reduces hospitalization rates, and cuts health care costs.