Wolf Michael S, Davis Terry C, Tilson Hugh H, Bass Pat F, Parker Ruth M
Institute for Healthcare Studies, Northwestern University, Chicago, IL 60611, USA.
Am J Health Syst Pharm. 2006 Jun 1;63(11):1048-55. doi: 10.2146/ajhp050469.
The common causes for misunderstanding prescription drug warning labels (PWLs) among adults with low literacy were studied.
A total of 74 patients reading at or below the sixth-grade level and receiving care at the primary care clinic at the Louisiana State University Health Sciences Center in Shreveport were recruited to participate in structured interviews. Patients were asked to interpret and comment on eight commonly used warning labels found on prescription medications. Correct interpretation was determined by expert panel review of patients' verbatim responses. Qualitative methods were employed to code responses and generate themes regarding the misunderstanding of these PWLs.
Among this sample of patients with low literacy skills, rates of correct interpretation for the eight warning labels ranged from 0% to 78.7%. With the exception of the most basic label, less than half of all patients were able to provide adequate interpretations of the warning label messages. Five themes were derived to describe the common causes for misunderstanding the labels: single-step versus multiple-step instructions, reading difficulty of text, use of icons, use of color, and message clarity. Labels were at greater risk for being misunderstood if they included multiple instructions, had a greater reading difficulty, included unfamiliar terms, or used confusing icons that were discordant with text messages. Participants also frequently imposed an incorrect meaning on label colors, which led to further confusion.
Patients with low literacy skills demonstrated a lower rate of correct interpretation of the eight most commonly used PWLs than did those with higher literacy skills. Multiple-step instructions, reading difficulty of text, the use of icons, the use of color, and message clarity were the common causes of label misinterpretation.
研究识字能力较低的成年人误解处方药警示标签（PWLs）的常见原因。
招募了74名阅读水平在六年级及以下且在什里夫波特的路易斯安那州立大学健康科学中心初级保健诊所接受治疗的患者参与结构化访谈。要求患者对处方药上常见的八个警示标签进行解读并发表评论。通过专家小组对患者逐字回复的审查来确定正确解读。采用定性方法对回复进行编码，并生成关于这些PWLs误解的主题。
在这个识字能力较低的患者样本中，八个警示标签的正确解读率在0%至78.7%之间。除了最基本的标签外，不到一半的患者能够对警示标签信息做出充分解读。得出五个主题来描述误解标签的常见原因：单步与多步说明、文本阅读难度、图标使用、颜色使用和信息清晰度。如果标签包含多个说明、阅读难度较大、包含不熟悉的术语或使用与文本信息不一致的令人困惑的图标，则被误解的风险更大。参与者还经常对标签颜色赋予错误的含义，这导致了进一步的困惑。
识字能力较低的患者对八个最常用的PWLs的正确解读率低于识字能力较高的患者。多步说明、文本阅读难度、图标使用、颜色使用和信息清晰度是标签误解的常见原因。
