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Patient Educ Couns. 2009 Apr;75(1):114-20. doi: 10.1016/j.pec.2008.09.026. Epub 2008 Nov 28.

Patients' perspectives of the doctor-patient relationship and information giving across a range of literacy levels.

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Institute of Primary Care and Public Health, London South Bank University, UK.



This study explored the patient's experience of the doctor-patient relationship and information giving in health care. The views of patients with a range of literacy levels were examined.


321 patients at an in-patient cardiology unit provided the sample. The Health Literacy (HL) of participants was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). All participants (low and adequate HL) were then asked open ended questions about their experiences of communication with healthcare professionals. The qualitative data underwent a thematic analysis.


22% of the patients interviewed were found to have a low level of literacy as indicated by the REALM. Many patients felt that health information should be given in simpler language. Patients frequently stated that they either did not read information leaflets or were confused or worried by them. They described the importance of the doctor-patient relationship and the need to build up trust. These views were expressed by patients with adequate HL as well as patients with low HL.


Many patients irrespective of their HL skills, feel unable to access, understand and utilize health information.


If patients are to be actively engaged in achieving and maintaining good health, healthcare professionals must improve their communication skills and ensure that health information is clear and easy to access.

[Indexed for MEDLINE]

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