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Patient communication: How to use your words

Staff Development Weekly: Insight on Evidence-Based Practice in Education, August 30, 2007

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Do your patients understand what your physicians tell them? Maybe they do, maybe they don't. What is certain is that misunderstood medical information may compromise patients' health. A recent report found that nearly half of all American adults-90 million people-have difficulty understanding and using basic health information.

The impact is higher rates of hospitalization and use of emergency services. Patients who have difficulty reading and writing are at risk, but they aren't the only ones. Even an otherwise highly literate patient may have low health literacy.

Most healthcare workers know to avoid medical jargon when speaking with patients (e.g., using harmless versus benign, swelling versus edema). But some seemingly simple words, such as those fitting in the categories below, can create confusion:

• One phrase, two interpretations. Even commonly used words such as "may," "might," and "suggest" can be difficult to understand. For example, consider the phrase, "This treatment may help." To scientists, this is generally understood as meaning that there is no conclusive evidence. However, to patients, this same statement may be interpreted as "this treatment will help." Make sure to explain what phrases such as these really mean.
• Acronyms and other new "words." Acronyms are made-up terms that use the first letters from words in a phrase. Sometimes acronyms sound like familiar words, such as CAT for "computed/computerized axial tomography." Other times, acronyms form new "words" (which really aren't words), such as ADL, which stands for "activities of daily living." To help patients better understand, write out the entire term the first that time you use it and put the acronym in parentheses alongside it (e.g., "blood pressure [BP]").
• Common words used in uncommon ways. Sometimes health professionals use common words in unusual ways. For example, providers might tell patients that they are "unremarkable," which is likely good news. But when providers talk about "positive" test results, this is probably not good at all. To improve communication, confirm that others correctly understand the concept that you are trying to convey.
• Homonyms. These are words with different meanings that sound alike. The words may or may not be spelled the same way. Be sensitive to the fact that patients may not know what you are talking about when you use homonyms such as "stool," "gait," and "dressing." As with all communication, make sure to clarify what your words really mean.

To get more information, go to Private Practice Success (PPS). For the cost of just three stories, you can get the entire August issue of PPS. Click here to choose between the PDF and HTML versions for just $30. Subscribers to the online version of PPS have free access to this article. Subscribers to the print newsletter can find this article in their August issue.

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