Health information literacy: a library case study.ABSTRACT
CONCERN ABOUT HEALTH LITERACY health literacy Health care A measure of a person's ability to understand health-related information and make informed decisions about that information; HL includes interpreting prescriptions and following self care insturctions. Cf Literacy. IS ONE FACTOR driving an international movement to develop and disseminate dis·sem·i·nate
v. dis·sem·i·nat·ed, dis·sem·i·nat·ing, dis·sem·i·nates
1. To scatter widely, as in sowing seed.
2. health information that is easy to understand and appropriate for people who have difficulty reading or whose first language is not English. Libraries can work with organizations in their communities to improve the accessibility of materials. Strategies for effective collaboration will be outlined in the context of health literacy promotion efforts. Finally, the role that librarians can play to help deliver appropriate health information, using the example of one patient resource center, will be discussed.
This article will discuss how libraries can participate in the dissemination dissemination Medtalk The spread of a pernicious process–eg, CA, acute infection Oncology Metastasis, see there of plain language and easy-to-read health information to the general public. People should have access to information that is appropriate for their needs and play an active role in their health and well-being. Understanding the information available with respect to health issues increasingly is the responsibility of the patient. Recent surveys evaluating the basic literacy skills of Americans, Canadians, and Europeans have turned up alarming results. Libraries and librarians can contribute to the health of their communities through their involvement with health literacy initiatives and by keeping literacy issues at the forefront.
This article will present a general framework of how illness, stress, fear, and cultural differences can impact the way in which people understand their health problems--not to mention the health care system itself. The example of one patient resource center will illustrate how libraries can collaborate with the communities they serve to increase understanding of health.
Using criteria familiar to many librarians for evaluating the appropriateness of printed materials, librarians can make management decisions that will benefit users and libraries alike. The concepts of purpose, scope, authority, currency, and audience help us understand who libraries are serving, which organizations are key targets for collaboration, and the purpose of library programs. Hopefully, this practical structure will help others get involved with issues of health literacy.
WHAT IS HEALTH LITERACY?
Literacy is used in many different contexts today. Libraries have long played a role in basic literacy education and are beginning to carve out to make or get by cutting, or as if by cutting; to cut out.
See also: Carve their place in the new arena of information literacy Several conceptions and definitions of information literacy have become prevalent. For example, one conception defines information literacy in terms of a set of competencies that an informed citizen of an information society ought to possess to participate intelligently and . Finding definitions for the terminology of literacy is controversial. It is useful to understand the scope of the issue in order to develop programs and communicate with the community. A few definitions inform our work as librarians.
Literacy is "using printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential" (National Center for Education Studies, n.d.). Health literacy is "the ability to read, understand, and act on health information" (Pfizer Clear Health Communication, n. d.), and "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979
Health and Human Services, HHS , 2000, p. 20). Information literacy is a set of abilities enabling individuals to "recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information" (American Library Association American Library Association, founded 1876, organization whose purpose is to increase the usefulness of books through the improvement and extension of library services. , 1989).
A working definition of health information literary is "the set of abilities needed to: recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyze, understand, and use the information to make good health decisions" (MLA MLA
Modern Language Association
MLA n abbr (BRIT POL) (= Member of the Legislative Assembly) → miembro de la asamblea legislativa
MLA (Brit Net, 2003).
WHAT IS KNOWN ABOUT BASIC ADULT LITERACY?
The National Adult Literacy Survey, conducted in 1992 and again in 2003, and the International Adult Literacy Survey, completed in 1994, gave North Americans North American
named after North America.
North American blastomycosis
see North American blastomycosis.
North American cattle tick
see boophilusannulatus. and Europeans some startling star·tle
v. star·tled, star·tling, star·tles
1. To cause to make a quick involuntary movement or start.
2. To alarm, frighten, or surprise suddenly. See Synonyms at frighten. news about the reading and writing abilities of those sixteen and over. Both surveys evaluated three types of literacy:
Prose literacy--the most common form of prose literacy used is the newspaper or magazine article
Document literacy--the questionnaire required participants to read information in table form or in lists, such as a bus schedule or a table of contents
Quantitative literacy--using a graph, chart, or performing an arithmetic operation, such as calculating a tip
Within each type of literacy, five levels were defined, with level one being the lowest and five the highest. In both surveys, so few respondents scored at level five (about 3 percent for both Canada and the United States The United States and Canada share a unique legal relationship. U.S. law looks northward with a mixture of optimism and cooperation, viewing Canada as an integral part of U.S. economic and environmental policy. ) (Clark, 1996) that the results were deemed statistically insignificant and the scores were combined with those at level four.
Those adults at the lowest levels of literacy (levels one and two) are of greatest concern for literacy advocates. Between 20 and 23 percent of Americans scored at the lowest level of prose, document, and quantitative literacy, while closer to 15 percent of Canadians fell into this category (Clark, 1996). The numbers increased for level two, with over 25 percent of both Americans and Canadians scoring at this level (Reading the Future, 1996). These two levels combined represent close to half the adult population.
WHERE DOES IT END? BEGIN?
Quite apart from the alarmingly low basic literacy rates in North America North America, third largest continent (1990 est. pop. 365,000,000), c.9,400,000 sq mi (24,346,000 sq km), the northern of the two continents of the Western Hemisphere. and Europe, health issues are notoriously complex and bewildering be·wil·der
tr.v. be·wil·dered, be·wil·der·ing, be·wil·ders
1. To confuse or befuddle, especially with numerous conflicting situations, objects, or statements. See Synonyms at puzzle.
2. . The most educated person when confronting a major health crisis can have problems understanding the information presented. Emotional exhaustion Emotional exhaustion is a chronic state of physical and emotional depletion that results from excessive job demands and continuous hassles. it describes feeling of being emotionally overextended and exhausted by one's work. , medication side effects Side effects
Effects of a proposed project on other parts of the firm. , and general fatigue can all play a role in obscuring messages. In Quebec as elsewhere, issues of language confound con·found
tr.v. con·found·ed, con·found·ing, con·founds
1. To cause to become confused or perplexed. See Synonyms at puzzle.
2. comprehension every day. Problems navigating the health system exacerbate many problems. Cultural issues or lack of sensitivity to cultural issues can create problems of cooperation in health care and foster distrust and secrets between doctor and patient.
Much research is now being done on the impact of low literacy, language barriers, and cultural issues on health. Some studies focus on the cost of treatment, while others focus on the health outcomes associated with poor health communication. Cost analysis generally concludes that, while health outcomes may not be significantly different, those with low literacy require two to three times as many visits to understand the same information as those with excellent literacy skills. Other studies show that low literacy contributes to more hospitalizations, thus costing the health care system billions of dollars (Gordon, Hampson, Capell, & Madhok, 2002; Weiss & Palmer, 2004; Baker, Parker, Williams, Clark, & Nurss, 1997; Ad Hoc Committee ad hoc committee A committee formed with the purpose of addressing a specific issue or issues, which theoretically is disbanded once its raison d'etre is finished , 1999).
Healthy People 2010 recognizes health communication as an important focus area and leading health indicator toward more effective preventative health initiatives:
Closing the gap in health literacy is an issue of fundamental fairness and equity and is essential to reduce health disparities. Public and private efforts need to occur in two areas: the development of appropriate written materials and improvement in skills of those persons with limited literacy. The knowledge exists to create effective, culturally and linguistically appropriate, plain language health communications. (U.S. Department of Health and Human Services, 2000, p. 15)
CASE STUDY: A NEUROLOGICAL DISORDER Noun 1. neurological disorder - a disorder of the nervous system
nervous disorder, neurological disease
disorder, upset - a physical condition in which there is a disturbance of normal functioning; "the doctor prescribed some medicine for the disorder"; PATIENT RESOURCE CENTER
The Neuro-Patient Resource Centre began as an initiative of members of the Patient's Committee of the Montreal Neurological neurological, neurologic
pertaining to or emanating from the nervous system or from neurology.
evaluation of the health status of a patient with a nervous system disorder or dysfunction. Hospital, who saw a need for quality health information to be made available to all patients of the hospital. The mission and goals of the Resource Centre are as follows:
The mission of the Neuro-Patient Resource Centre is to provide health information in English and French to patients, their families and caregivers, and the general public. Our services are designed to help individuals become informed and active partners in their health care. Our goals are To provide patients, their families, and caregivers with easy access to a source of reliable consumer health information To create awareness among hospital staff regarding the health information needs of patients and their families To advocate and promote the individual's right to confidentiality and unrestricted access to medical and health information To work in partnership with hospital staff to create patient education materials To initiate and participate in research dealing with the impact of health information on human behaviour (Montreal Neurological Hospital, n.d. a).
This mission and goals are based on ideas put forward in the hospital's Patient Services Steering Committee steer·ing committee
A committee that sets agendas and schedules of business, as for a legislative body or other assemblage.
Noun Report: "Individuals who are active in making decisions about their care generally do better than those who are not. For patients to take control of their health and well-being and make informed health care choices, they need both information and knowledge" (McGill University Health Centre The McGill University Health Centre (MUHC) (in French, Centre universitaire de santé McGill) is a network of five teaching hospitals in Montreal, Quebec, Canada, all of which are affiliated with McGill University. , 1997).
Structure and History
The Resource Centre is an independent patient and family information library. It was conceived as an initiative of members of the Patients' Committee, which is a government mandated patient advocacy Patient advocacy refers to speaking on behalf of a patient in order to protect their rights and help them obtain needed information and services. The role of patient advocate is frequently assumed by nurses, social workers, and other healthcare providers. group in the hospital. Instead of positioning the Resource Centre under the auspices of either the Nursing Department or the Medical Library, where patient libraries are often positioned, it was decided that it should collaborate with, but be independent of, these groups. This decision was made because of concerns that, if it was organized under the Nursing Department, the focus would likely be more on patient education than information. Within the Medical Library, it was felt that doctors, nurses, students, and patients in the same library would not be the best way to serve the needs of these groups. The environment of the Resource Centre needed to be more family friendly than scholar friendly. Ultimately, due to space limitations, the Patients' Committee moved in with the Resource Centre. This has been found to be an excellent partnership.
Use of the Resource Centre--Purpose
It did not take long, working within the context of a hospital, to begin to realize where the barriers preventing patient and family members' "access to health information" lay and in how many ways the Resource Centre could ameliorate a·mel·io·rate
tr. & intr.v. a·me·lio·rat·ed, a·me·lio·rat·ing, a·me·lio·rates
To make or become better; improve. See Synonyms at improve.
[Alteration of meliorate. the situation.
It is common for patients to arrive at the door of the Resource Centre looking for Looking for
In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. information on a condition of which the library staff has never heard. As the Resource Centre is in a specialized hospital the staff know that very rare diseases are diagnosed and treated here, and it is entirely possible that the patient has a condition that is, in fact, new to everyone. More often than not, however, the patient has misheard the diagnosis or heard only incomplete information. This can be attributed partially to the stressfulness of the medical appointment itself. The appointment is often hurried and patients are reluctant to take up too much of the doctor's time.
Sometimes the doctor has bad news to impart. Once a person has been told that they have a serious health problem like a brain tumor Brain Tumor Definition
A brain tumor is an abnormal growth of tissue in the brain. Unlike other tumors, brain tumors spread by local extension and rarely metastasize (spread) outside the brain. , cancer, or multiple sclerosis or a disorder with a name that is new to them, like chronic inflammatory demyelinating polyneuropathy Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated inflammatory disorder of the peripheral nervous system but often can have central nervous system involvement. The disorder is sometimes called chronic relapsing polyneuropathy. or syringomyelia syringomyelia
Disease characterized by the entrance of cerebrospinal fluid into the spinal cord, where it forms a cavity (syrinx). The syrinx can expand and elongate over time, destroying the centre of the spinal cord and causing symptoms that vary with the syrinx's size and , it is very difficult to hear anything else. The patient can easily forget to ask necessary questions like, What kind of brain tumor? What is this disease and what is the treatment for it? In addition, a diagnosis can be just as shocking and difficult to understand to a family member as the patients themselves.
There is also the problem that the language or jargon of medicine is unfamiliar to most people regardless of their level of education. One would like to believe that doctors and nurses have become more sensitive to this and have adjusted their language accordingly when dealing with patients. Unfortunately, based on our experience, this is often not the case. A related difficulty that people have in understanding what the doctor is saying is that many people do not know very much about anatomy and physiology. When the doctor says "you have a lesion LESION, contracts. In the civil law this term is used to signify the injury suffered, in consequence of inequality of situation, by one who does not receive a full equivalent for what he gives in a commutative contract.
2. in your occipital lobe occipital lobe
The posterior lobe of each cerebral hemisphere, having the shape of a three-sided pyramid and containing the visual center of the brain. " or "we are going to place this tube down to your duodenum duodenum: see intestine; pancreas.
First and shortest (9–11 in., or 23–28 cm) segment of the small intestine. It curves down and then up from the pylorus of the stomach, where chyme enters it. ," the patient may not know where on the body these parts are located.
Even before a diagnosis is given there are major communication problems between the health care professional and the patient. People are told they are scheduled for diagnostic tests and will undergo examinations that they do not really understand. What exactly is an MRI 1. (application) MRI - Magnetic Resonance Imaging.
2. MRI - Measurement Requirements and Interface. or a lumbar puncture lumbar puncture: see spinal puncture. ? Why does the doctor want to see me walk as part of a neurological exam? Often a doctor will not stop and explain. Sometimes a patient is too shy to ask or does not think of asking these questions until after the appointment is over.
After a diagnosis is made or after the medical team has determined an inability to make a comprehensive diagnosis, there may be a discussion of treatment options. Usually the patient comes to this appointment armed with nothing. Sometimes the doctor may have made a decision on the best treatment and may present this to the patient without discussing the rationale. The pros and cons pros and cons
the advantages and disadvantages of a situation [Latin pro for + con(tra) against] of other treatment options may not be presented at all. Side effects may or may not be discussed. The level of pain involved, for example, may not be brought up.
The result of these stresses and omissions is that crucial information is never given or, if it is given, it often gets lost. The health professional may believe that the information has been given and frequently is not sensitive to the fact that the communication is not complete. Although the information may have been presented, it has not been received. These common scenarios provide many opportunities for the Patient Resource Centre to participate in patient care by providing information that educates and empowers patients and their families.
From first contact, the Resource Centre may be involved with the patient. Many telephone calls and e-mails are received requesting information on how to get an appointment at the hospital. The Resource Centre provides the names and contact information of specialists and clinics that focus on specific disorders. The Resource Centre can provide information on whether or not a specific treatment or surgical operation is performed at the hospital.
Another point of first contact with patients is online. The Resource Centre maintains a Web site that includes information about the Resource Centre, about diagnostic tests, about some disorders and procedures, and about clinics at the hospital (Montreal Neurological Hospital, n.d. b). The Resource Centre provides links to quality Web sites both on neurological subjects and to more general health search engines, as well as links to information on evaluating health information. Judging by the calls and e-mails received by the Resource Centre, this is the first contact many patients have with the hospital.
The goals of improving health literacy and health information literacy inform almost all the activities of and services provided by the Neuro-Patient Resource Centre. The Resource Centre maintains an up-to-date bilingual (French and English) collection of monographs written in plain language on neurological and psychiatric psy·chi·at·ric
Of or relating to psychiatry.
psychiatric adjective Pertaining to psychiatry, mental disorders disorders, as well as books on coping with chronic illness, pain, and death for adults and children. The Resource Centre also has reference books on general anatomy general anatomy
The study of the structure and composition of the body as well as of its tissues and fluids. , neuro-anatomy, and physiology; medical dictionaries A medical dictionary is a lexicon for words used in medicine. The three major English language medical dictionaries are Stedman's, Taber's, and Dorland's medical dictionaries. and encyclopedias This article contains a list of encyclopedias, including projects to create new works. Because the number of works that can be considered encyclopedias is very large, this list does not attempt to be comprehensive. ; and guides to medical tests, as well as neurology neurology (nrŏl`əjē, ny–), study of the morphology, physiology, and pathology of the human nervous system. textbooks.
The Resource Centre buys, or is given for distribution, pamphlets, information sheets, and booklets for patients on neurological disorders This is a list of major and frequently observed neurological disorders (e.g. Alzheimer's disease), symptoms (e.g.back pain), signs (e.g. aphasia) and syndromes (e.g. Aicardi syndrome). and related health promotion topics. The staff of the Resource Centre considers these "give-aways" extremely valuable. They usually come from very authoritative, unbiased sources like national organizations for a particular disorder. They are almost invariably in·var·i·a·ble
Not changing or subject to change; constant.
in·vari·a·bil written in plain language (although with varying degrees of difficulty in the vocabulary), and sometimes are available in more than one language. The fact that the patient or family member can take the information home with them means they can read it over and over again and they can show it to other members of the family; if they have trouble with the language the patient can get help with it. They can bring it with them to their medical appointments to discuss with the doctor and nurse, and they do not need to know how to use a computer to get it.
As discussed in the MLA satellite conference Reading Between the Lines Between the lines can refer to:
For more in-depth medical research the Resource Centre uses its affiliation with McGill University McGill University, at Montreal, Que., Canada; coeducational; chartered 1821, opened 1829. It was named for James McGill, who left a bequest to establish it. Its real development dates from 1855 when John W. Dawson became principal. for electronic journal access, and the Resource Centre maintains a very close relationship with the hospital's medical library staff downstairs. The librarian at the Resource Centre will conduct a literature search for the patient and provide copies of journal articles for personal use only. The Medical Library provides an interlibrary in·ter·li·brar·y
Existing or occurring between or involving two or more libraries: an interlibrary loan; an interlibrary network. loan service for a small fee that is paid by the Resource Centre. If a patient wants to do his/her own research in the library, he/she is welcome to use the collection of the Medical Library on a consultation basis only.
Reference service is by phone, in person, and by e-mail. Consultations are made by patients and the general public in French and English from all over the world. Nurses from other hospitals call the Resource Centre to get patient information and community referrals.
Other McGill University Health Centre librarians call the Resource Centre for information and vice versa VICE VERSA. On the contrary; on opposite sides. . Since not all information requests are neurology or neurosurgery neurosurgery /neu·ro·sur·gery/ (noor´o-sur?jer-e) surgery of the nervous system.
Surgery on any part of the nervous system. related, the patient can easily be referred to another McGill University Heath Centre library better equipped to handle his/her particular information need.
As a library, the Neuro-Patient Resource Centre aims to provide resources to all types of patients and families. This is a continual challenge. The issue of language is a particularly acute one for the Resource Centre. The information available, in all formats, is overwhelmingly English. About one half of the user population is French speaking, and many of these patients and family members do not read English well enough to understand most health information--even if it is written in plain language. Some Canadian organizations and Web sites have information in both languages, but these are very few. European resources can be helpful, but there can be differences in the way medicine is practiced in Europe; anyone using information from other countries needs to understand the potential for these differences. The biggest obstacle is finding authoritative plain language material in French that is for a Quebec audience, not a European one.
When information in English or Spanish is needed, there is a great deal of patient information being made available, by very reliable sources, in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . However, there are some differences in the practice of medicine between Canada and the United States. A striking example is in medications: Canada and the United States often have different commercial names for the same drug; a medication may be approved for use in one country but not in the other, or it may have different indications for use.
LITERACY AND HEALTH INFORMATION LITERACY
The issues of literacy and health information literacy cut across a broad spectrum of patrons. At the Resource Centre there have been patrons who are very highly educated but simply lack the skills in the medical arena to find the information they need. In that case the Resource Centre helps them by providing more technical information and by providing training on the use of medical databases.
The Resource Centre participates in events that are organized by different groups in the hospital to promote awareness of health issues or to provide information about specific disorders such as stroke awareness days National or international Awareness days are dates usually set by major organisations or governments to commemorate a medical research or ethical cause of importance on a national or international level. , epilepsy epilepsy, a chronic disorder of cerebral function characterized by periodic convulsive seizures. There are many conditions that have epileptic seizures. Sudden discharge of excess electrical activity, which can be either generalized (involving many areas of cells in information days, and public lectures given by our doctors and researchers. The Resource Centre maintains patient information bulletin boards all over the hospital. These outreach efforts are particularly important. People do not expect to find a patient resource center in the hospital. That is why at the front door there is a large bulletin board full of information for patients and their families with a big welcome from the Neuro-Patient Resource Centre.
Authority of health information is critical in the environment of the Resource Centre. Numerous times the staff has experienced desperate people coming for information on unproven unproven Dubious, nonscientific, not proven, quack, questionable, unscientific adjective Relating to that which has not been validated by reproducible experiments or other scientific methods for determining effect or efficacy medications and treatments as well as doctors and clinics who practice a form of medicine that is not based on scientific evidence. The staff researches these practitioners and treatments and explains why the legitimate medical community would not endorse them.
There is also much "patient information" being produced by pharmaceutical companies that is really nothing more than thinly veiled advertising for one medication or another. The staff of the Resource Centre is vigilant in weeding out these marketing tools from its collection and making every effort to reduce its presence in the hospital.
The staff of the Resource Centre strives to keep an open dialogue with hospital staff; when the Resource Centre receives new materials on a topic, say, metastatic Metastatic
The term used to describe a secondary cancer, or one that has spread from one area of the body to another.
Mentioned in: Coagulation Disorders
pertaining to or of the nature of a metastasis. brain tumors, the members of the brain tumor team are informed that this material has arrived. Recently a publication on amyotrophic lateral sclerosis amyotrophic lateral sclerosis (ALS) (ā'mīətrōf`ik, sklĭrō`sĭs) or motor neuron disease, in Chinese was put into the collection, and the members of the ALS Als (äls), Ger. Alsen, island, 121 sq mi (313 sq km), Sønderjylland co., S Denmark, in the Lille Bælt, separated from the mainland by the narrow Alensund. team were immediately informed. The result of these efforts is that many of the health professionals at the hospital refer their patients to the Resource Centre. In turn the Resource Centre welcomes suggestions from the health care staff for additions to the collection.
A critical concept in health information is that of currency. The field of medicine is a rapidly advancing one. A good example is treatment for multiple sclerosis. It used to be that there was nothing that could be done. When a patient was diagnosed with multiple sclerosis there was no proven treatment. Over the past few years studies have shown that, if certain disease modifying medications are initiated early, they can slow the progression of the disease over time. If a newly diagnosed patient is having a number of attacks per year, it will now be recommended that they follow a course of medications even though they may not be experiencing disability. This is an area of active research. For patients who have a condition called benign multiple sclerosis, there is an 80 percent chance that it will develop into a more progressive type of multiple sclerosis in the long term (about fifteen years). Under investigation is whether it is useful to give medication to these patients. There is also recent proof that certain types of chemotherapy, which had been used only for cancer patients, can reduce the number of attacks experienced by patients with certain types of multiple sclerosis. These therapies can have serious side effects, and patients who are deciding whether or not to take them need the best, most current information.
In addition, the hospital staff needs to know that when a patient has questions about his/her treatment they can send the patient to the Resource Centre for current, authoritative information. This has been one of the most important steps in establishing the Resource Centre as part of the heath care team. It has also motivated a number of doctors and nurses to make donations of quality materials to the Resource Centre.
PRODUCTION OF MATERIALS--AUDIENCE DRIVEN
One of the most important ways that the Resource Centre collaborates with the health professionals in the hospital is through our program of producing patient education and information materials. For example, information on diagnostic tests, clinic handbooks, caregiver care·giv·er
1. An individual, such as a physician, nurse, or social worker, who assists in the identification, prevention, or treatment of an illness or disability.
2. guides, and fact sheets on specific disorders and procedures have all been produced collaboratively with the Resource Centre. All of these projects require the involvement of doctors and advanced practice nurses. Sometimes the Resource Centre collaborates with physical, occupational, and speech therapists speech therapist Speech pathologist, speech/language therapist A health professional trained to evaluate and treat voice, speech, language, or swallowing disorders–eg, hearing impairment, that affect communication. See Speech pathology. ; social workers; and technicians. Part of the Resource Centre contribution to these publications is to edit the information and, when needed, change the language to something that can be understood by people who do not have a medical vocabulary. All publications are produced in both English and French. After editing is completed, two patients (without a university education) are recruited and asked to review the text. Resource Centre staff work with a graphic designer to make the information visually interesting and inviting. All the patient information produced follows plain language guidelines guidelines,
n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. , which include using the active voice, writing directly to the reader, using common words rather than technical jargon, and using short words and sentences. The materials are monitored for reading level, usually no more than grade eight. The Resource Centre has recently begun producing easy-to-read versions of some of these materials to reach people who may have difficulty reading in English or French. The challenge is that it can be difficult to translate complex concepts into very simple words. Using pictures can often help explain a procedure more clearly than words. Clear graphic design can also help people penetrate a "wall of words."
The response of the hospital staff to Resource Centre productions has been overwhelmingly positive. This, perhaps more than anything else, has influenced the Resource Centre's acceptance as part of the patient care team and has highlighted the need for better communication with patients by all members of the team as well as providing some strategies for achieving this.
WHAT ROLE DO LIBRARIES HAVE?
Libraries are recognized for their firm belief in the right to access information, and this naturally extends to the right to access and understand treatment and disease information. Libraries are often perceived as neutral territory and a welcoming environment for community members. Public libraries play important roles in basic literacy training and provide space for local organizations to meet and exchange ideas.
However, people with low literacy skills are not necessarily the same people who come into the library. Despite our belief that libraries are nonjudgmental non·judg·men·tal
Refraining from judgment, especially one based on personal ethical standards.
Adj. 1. nonjudgmental places, open to everyone, many people may find libraries intimidating in·tim·i·date
tr.v. in·tim·i·dat·ed, in·tim·i·dat·ing, in·tim·i·dates
1. To make timid; fill with fear.
2. To coerce or inhibit by or as if by threats. and never come to us for the information they need. Public libraries are alive and well in Sweden. In the report Catching up with the Swedes This is a list of well known Swedes, ordered alphabetically within categories: Actors
Main article: List of Swedish actors
As illustrated above, the library can provide multiple functions within a broad context: welcome desk, information provider, information producer, referral agent, and authority controller. These efforts can only be successful through partnerships with nonlibrarians and librarians alike. As discussed elsewhere in this volume, librarians increasingly need to leave the confines con·fine
v. con·fined, con·fin·ing, con·fines
1. To keep within bounds; restrict: Please confine your remarks to the issues at hand. See Synonyms at limit. of their library buildings in order to reach the wider community. If not everyone considers the library a place for learning and information, then we need to expand our reach through a variety of partnerships.
We encourage every librarian, regardless of setting, to develop a good working relationship with a medical librarian. Health issues affect almost everyone over the course of a lifetime. Knowing someone you can turn to for document delivery, a good referral, and a specialized list of resources can be invaluable. With the right partnerships, our role as literacy brokers can span the wide range of basic adult literacy to health literacy, and using the principles of information literacy we can develop the concept of health information literacy.
Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association American Medical Association (AMA), professional physicians' organization (founded 1847). Its goals are to protect the interests of American physicians, advance public health, and support the growth of medical science. . (1999). Health literacy: Report of the Council on Scientific Affairs. Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 281, 552-557.
American Library Association Presidential Committee on Information Literacy. (1989). Final report [Electronic version]. Chicago, IL: American Library Association. Retrieved August 16, 2004, from http://www.infolit.org/documents/89Report.htm.
Baker, D. W., Parker, R. M., Williams, M. V., Clark, W. S., & Nurss, J. (1997). The relationship of patient reading ability to self-reported health and use of health services health services Managed care The benefits covered under a health contract . American Journal of Public Health The American Journal of Public Health (AJPH) is a peer reviewed monthly journal of the American Public Health Association (APHA). The Journal also regularly publishes authoritative editorials and commentaries and serves as a forum for the analysis of health policy. , 87, 1027-1030.
Clark, W. (1996). Adult literacy in Canada, the United States and Germany [Electronic version]. Canadian Social Trends, 43, 27-32. Retrieved August 16, 2004, from http://www.nald.ca/fulltext/pat/AL/page4.htm.
Gordon, M. M., Hampson, R., Capell, H. A., Madhok, R. (2002). Illiteracy illiteracy, inability to meet a certain minimum criterion of reading and writing skill. Definition of Illiteracy
The exact nature of the criterion varies, so that illiteracy must be defined in each case before the term can be used in a meaningful in rheumatoid arthritis rheumatoid arthritis
Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course. patients as determined by the Rapid Estimate of Adult Literacy in Medicine (REALM) score. Rheumatology rheumatology /rheu·ma·tol·o·gy/ (-tol´ah-je) the branch of medicine dealing with rheumatic disorders, their causes, pathology, diagnosis, treatment, etc.
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Weiss, B. D., & Palmer, R. (2004). Relationship between health care costs and very low literacy skills in a medically needy and indigent indigent 1) n. a person so poor and needy that he/she cannot provide the necessities of life (food, clothing, decent shelter) for himself/herself. 2) n. one without sufficient income to afford a lawyer for defense in a criminal case. Medicaid population. Journal of the American Board of Family Practitioners family practitioner
n. Abbr. FP
See family physician. , 17(1), 44-47.
Erica Burnham, Macdonald Campus The Macdonald Campus of McGill University (Mac Campus) houses its Faculty of Agricultural and Environmental Sciences, School of Dietetics and Human Nutrition, and the McGill School of Environment. Library, McGill University, 21,111 Lakeshore Road Lakeshore Road is the western extension of Toronto's Lake Shore Boulevard and is the southernmost major road in Mississauga and most of Peel Region and Halton Region. It generally follows the northern shore of Lake Ontario from the eastern border of Mississauga to near the , Ste-Anne-de-Bellevue, Quebec H9X 3V9, and Eileen Beany Peterson, Neuro-Patient Resource Centre, Montreal Neurological Hospital #354, 3801 University Street, Montreal, Quebec H3A 2B4