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Health Literacy: Understanding What Your Physiotherapist Tells You

Broadly speaking, health literacy is the combination of skills and motivation required to obtain, understand and use information to promote your own good health.1 All too often a lack of health literacy skills gets in the way of optimal health outcomes. Some statistics help to identify just how serious this problem is:

  • 55% of adults 16-65 years of age, and 88% of adults over 65 have low health literacy.2
  • 48-80% of the information people are told is immediately forgotten.3
  • 50% of the information retained is incorrectly remembered.3

Looking at these numbers, it becomes apparent that patients and health-care providers need to do a better job of fostering health literacy and not just for literacy’s sake. It is increasingly recognized that clear communication between health-care providers and patients is essential for safe and effective care. Some of the consequences of having low health literacy include:

  • A lack of knowledge about your condition.4
  • Decreased use of prevention strategies to prevent or slow the progression of disease.4
  • Less involvement in health decision making.4
  • Increased chance of some conditions (diabetes and high blood pressure).4
  • A lower quality of life, worse general function and increased mortality.4

Physiotherapists have a key responsibility to provide information in a format and language that clients can understand and use. They also need to take a universal precautions approach to health literacy by avoiding jargon, speaking to all patients in plain language, checking their client’s understanding and encouraging questions in a sincere, non-threatening way. But what can a health-care consumer do to increase both their health literacy and their health outcomes?

Ask!

Ask questions about the things that you don’t understand

  • What’s the problem? What caused it? How can we treat it? What am I supposed to do when I get home?

Ask about warning signs

  • What symptoms would suggest that that something is wrong and I need to come back to see my health-care provider right away?

Ask your provider

  • Are there any things about my condition that you think are normal or expected that I might find surprising?

Ask for information in writing

  • Having information in plain language that you can take home and review again will help to increase your understanding, spark further questions for you to discuss at your next appointment, and helps to serve as a reminder for what you are supposed to do and what you should be expecting from your treatment.5 (“How often should I be doing my exercises? How long do I leave the ice on? Is this discomfort normal? When will it go away?)
  • Written information is also a useful resource for explaining to friends and family why you are following a certain treatment path, instead of doing what cousin Jimmy did after his surgery.5
  • Ask where you can find credible information about your condition if your physiotherapist doesn’t have a brochure or other information that they have developed.6

Come to your appointment with your questions; don’t be shy!  It often helps to write your questions down as they come to you so you have a list ready when you get to your appointment and don’t forget anything important in the moment.

Sometimes information found online or elsewhere or comments from friends and family with similar problems can be different from the information you are receiving from your physiotherapist. When that happens, bring your information in and ask them to explain why your own research doesn’t apply to your circumstances. There may be important reasons for the differences. Asking helps to clear up the discrepancies and will give you greater confidence in your own treatment choices.

Tell

When physiotherapists are working with you it is important that they know what matters to you. An essential part of health literacy is your use of health-related information to make decisions about your life. Your physiotherapist needs to know what’s important to you and what you value to offer you treatment options that fit your needs and goals. Goals can include being pain free, being able to get back to work or being able to spend time with your family.

Teach Back

One of the best ways to know if someone has understood what you’ve told them is to get them to repeat the information back to you in their own words, referred to as the teach back method.7 Ideally your health-care provider would ask you to do this but if they don’t you may want to take the initiative. Tell your provider what you plan to tell your loved ones about your appointment and your treatment plan when you get home. This simple strategy gives you a way to check your understanding of what you have been told and gives your physiotherapist a chance to correct anything you may have misunderstood sooner rather than later.

Providing safe and effective care matters to physiotherapists. A key part of providing that care is having patients who ask questions and get the information they need to make informed decisions.

  1. WHO as cited by Pullen H. MBA C725 Managing Communications in Health Care: Lecture #5. McMaster University, 2015.
  2. Hamilton Health Sciences. Health Literacy Connection. Available at:  http://www.healthliteracyconnection.ca/significance.aspx  Accessed July 21, 2015.
  3. Wiizoski L, Harper T, Hutchings T. Writing health information for patients and families. (3rd Ed.). Hamilton: Hamilton Health Sciences, 2008.
  4. Glanz, Rimer & Viswanth, 2008 cited by Pullen H. MBA C725 Managing Communications in Health Care: Lecture #5. McMaster University, 2015. (lecture C725)
  5. Pullen H. MBA C725 Managing Communications in Health Care: Lecture #5. McMaster University, 2015.
  6. Manitoba Institute for Patient Safety. Patient Values. Available at: http://www.mbips.ca/assets/final-patient-values.pdf  Accessed on July 21, 2015.
  7. Picker Institute. Always use teach-back! Available at: http://www.teachbacktraining.org/  Accessed July 21, 2015.  
  8. Byrd J, Manitoba Institute for Patient Safety. It’s Safe to Ask: An initiative to improve health literacy in Manitoba. Available at: http://safetoask.ca/wp-content/uploads/2007/01/safe2ask_presentation.pdf  Accessed July 21, 2015.

Page updated: 20/04/2022