Department of Surgery, The University of Alabama at Birmingham, Division of Gastrointestinal Surgery, USA.
Departments of Medicine and Pediatrics, Louisiana State University Health, Shreveport, LA, USA.
Am J Surg. 2022 Sep;224(3):943-948. doi: 10.1016/j.amjsurg.2022.04.034. Epub 2022 Apr 30.
Patients with limited health literacy (HL) have difficulty understanding written/verbal information. The quality of verbal communication is not well understood. Therefore, our aim was to characterize patient-surgeon conversations and identify opportunities for improvement.
New colorectal patient-surgeon encounters were audio-recorded and transcribed. HL was measured. Primary outcomes were rates-of-speech, understandability of words, patient-reported understanding, and usage of medical jargon/statistics. Secondary outcomes included length-of-visit (LOV), conversation possession time, patient-surgeon exchanges, and speech interruptions.
Significant variations existed between surgeons in rates-of-speech and understandability of words (p < 0.05). Faster rates-of-speech were associated with significantly less understandable words (p < 0.05). Patient-reported understanding varied by HL and by surgeon. Conversation possession time and usage of medical jargon/statistics varied significantly by surgeon (p < 0.05) in addition to patient-surgeon exchanges and interruptions. Patients with limited HL had shorter LOV.
Significant variations exist in how surgeons talk to patients. Opportunities to improve verbal communication include slowing speech and using more understandable words.
健康素养有限的患者在理解书面/口头信息方面存在困难。口头交流的质量还没有得到很好的理解。因此，我们的目的是描述医患对话，并确定改进的机会。
新的结直肠患者与外科医生的会面被录音并转录。测量了健康素养。主要结果是语速、单词的可理解性、患者报告的理解程度以及医学术语/统计数据的使用。次要结果包括就诊时间（LOV）、对话占有时间、医患交流和言语中断。
外科医生的语速和单词的可理解性存在显著差异（p<0.05）。较快的语速与明显较难理解的单词相关（p<0.05）。患者报告的理解程度因健康素养和外科医生而异。此外，医患交流和言语中断也导致了谈话占有时间和医学术语/统计数据的使用在外科医生之间存在显著差异（p<0.05）。健康素养有限的患者 LOV 较短。
外科医生与患者交谈的方式存在显著差异。改进口头交流的机会包括放慢语速和使用更易懂的单词。
