Patient Education for Patients Who Do Not Read

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Imagine a patient who has a language need AND who does not read fluently in any language. How to do patient education about self-care?

This could be a person born in a foreign country or a person born here who uses ASL to communicate. Imagine the patient being discharged from the hospital with a list of medications to take and a set of self-care instructions that she must follow, such as for managing a colostomy or a feeding tube. The patient’s safe recovery depends on her being able to remember the instructions and having the confidence to carry them out.

Speech is easy for a person to understand, be it spoken speech or signed speech. Written language is much harder to manage because it requires decoding. But though speech is powerful, it is ephemeral, lasting only for seconds. The solution is to capture the instructions using speech and demonstration.

Some hospitals have rules against visually recording staff, for staff protection and privacy. But by using the patient or family as the star of the recording, it is possible to record patient education. Also, use the patient’s phone for visual recording or audio recording, as this assures that the material is under the patient’s control and does not constitute a formal medical record element that the hospital must manage.

The clinical professional will describe the self-care to the patient in short chunks. These are not recorded. The patient then repeats in her own words what she is supposed to do, and this is recorded for her. The interpreter is interpreting in both directions but only the patient’s own words or signs need to be recorded, as she can understand herself when she views the recording at home.

For patient education in the clinic, the clinical professional can record instructions onto any sound or video medium, such as onto a PowerPoint slide to email to a patient, or in a voice message recorded on the patient’s phone. (Click here to see how easy it is to record a PowerPoint memo to a patient.) The interpreter’s voice will be recorded as well. The patient can listen to it at home, replay it many times, and share it with family members.

The surgical department can make a short PowerPoint presentation of pre-surgical preparation steps, with voice-over or ASL signing, and host this file on the public-facing web page for the department or on YouTube. The team provides the patient with the URL to access the instructions from home. Translated/interpreted versions of this short presentation can be prepared for the most needed languages, including for ASL. This option for patient education is non-patient-specific. The material is created and produced for ALL patients, using translators to prepare the written script and fluent foreign language and ASL speakers to present the message in different languages.

Some patients do not own a phone or a computer on which to play digital material. Another way to preserve speech, especially for very short updates in instructions, is to use an inexpensive keychain-style memo recorder or a recordable “button.” People buy these small note recorders for remembering grocery lists. They are designed to be recorded over many times, and they support a message of 20 seconds to several minutes. This format works best for insulin or medication instructions which change frequently. The clinic can purchase the items for less than $10 each, and then gift or sell the item to patients. The patient brings in the recorder each time he comes for a visit.

During each office visit, record the latest medication instructions, with the interpreter’s oral rendition into the patient’s language, and send the patient home with it. It is important to state each time the name of the patient, today’s date, the new instructions, and the name of the doctor or nurse recording.

Here are some brand names that may be available locally or on the internet. Key search words are button recorder, memo recorder, note recorder.

Have you addressed this need using other tools? Is there a recording device that you would recommend? Share your thoughts in the comment box below.

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