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Patient Educ Couns. 2009 Jun;75(3):398-402. doi: 10.1016/j.pec.2009.02.019. Epub 2009 May 12.

Unraveling the relationship between literacy, language proficiency, and patient-physician communication.

Author information

1
San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA. rsucsf@yahoo.com

Abstract

OBJECTIVE:

To examine whether the effect of health literacy (HL) on patient-physician communication varies with patient-physician language concordance and communication type.

METHODS:

771 outpatients rated three types of patient-physician communication: receptive communication (physician to patient); proactive communication (patient to physician); and interactive, bidirectional communication. We assessed HL and language categories including: English-speakers, Spanish-speakers with Spanish-speaking physicians (Spanish-concordant), and Spanish-speakers without Spanish-speaking physicians (Spanish-discordant).

RESULTS:

Overall, the mean age of participants was 56 years, 58% were women, 53% were English-speakers, 23% Spanish-concordant, 24% Spanish-discordant, and 51% had limited HL. Thirty percent reported poor receptive, 28% poor proactive, and 56% poor interactive communication. In multivariable analyses, limited HL was associated with poor receptive and proactive communication. Spanish-concordance and discordance was associated with poor interactive communication. In stratified analyses, among English-speakers, limited HL was associated with poor receptive and proactive, but not interactive communication. Among Spanish-concordant participants, limited HL was associated with poor proactive and interactive, but not receptive communication. Spanish-discordant participants reported the worst communication for all types, independent of HL.

CONCLUSION:

Limited health literacy impedes patient-physician communication, but its effects vary with language concordance and communication type. For language discordant dyads, language barriers may supersede limited HL in impeding interactive communication.

PRACTICE IMPLICATIONS:

Patient-physician communication interventions for diverse populations need to consider HL, language concordance, and communication type.

PMID:
19442478
PMCID:
PMC4068007
DOI:
10.1016/j.pec.2009.02.019
[Indexed for MEDLINE]
Free PMC Article

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