Marra G. Katz|Terry A. Jacobson|Emir Veledar|Sunil Kripalani
Patient Literacy and Question-asking Behavior During the Medical Encounter: A Mixed-methods Analysis
Emory University|Emory University|Emory University|Emory University
although patient participation medical encounter confers significant benefits many patients reluctant ask questions physicians patients literacy level may affect level participation questionasking behaviorsto examine effect literacy number types questions asked patients primary care office visitsconvenience sample recruited april november 2004 physicianpatient visits audiotaped patient questions complete encounters n 57 coded using adaptation roter interaction analysis systemparticipants predominantly middleaged mean age 567 years female 754 african american 947 low literacy skills 6th grade reading level present 386we hypothesized prospectively lowliteracy patients would ask fewer total questions fewer questions key aspects medical carelowliteracy adults asked significantly fewer questions medical care issues median 4 vs 6 among patients higher literacy levels p 014 also tended ask fewer questions overall median 7 vs 10 p 070 lowliteracy patients likely ask physician repeat something p 013 indicating initial lack understanding less likely use medical terminology refer medications name request additional services seek new information questionasking behavior significantly related patient gender age years education physicianpatient gender concordanceliteracy level appears important determinant patients participation medical encounter lowliteracy patients ask fewer questions medical care may affect ability learn medical conditions treatments