Patient education: interpretation of medical terms as a key part of diabetes mellitus treatment
Abstract
Background: Only a little percent of chronically ill patients was found to follow physicians’ prescriptions. One of the reasons for this issue is misunderstanding of recommendations due to inappropriate interpretation of medical terms, contained in medical advice.
Aims: The study is aimed to evaluate the quality of patient interpretation of the most frequently used medical terms in diabetes mellitus field (DM) and to evaluate the impact of misunderstanding on diabetes control.
Materials and methods: 13 endocrinologists composed 2 lists of the most frequently used terms – one list for DM type 1 and one for DM type 2. We selected 10 terms for DM type 1 and 10 terms for DM type 2, mentioned by the most of participated doctors, and created 2 kinds of questionnaire for patients. Patients were to explain the terms in written if they were aware of terms’ meaning. Three independent researchers evaluated every answer according to a 0 to 10 scale, where 0 was for totally incorrect or no answer, and 10 was for a completely correct answer. Patients also filled in the forms about their social and demographic parameters. Statistical analysis was conducted with the use of Wilcoxon Test and linear regression model.
Results: 89 patients with DM type 1 (27% men, HbA1c (mean±SD) 7,95±1,77%) and 86 patients with DM type 2 (27% men, HbA1c (mean±SD) 8,11±1,91%) were included into the study. Patients with type 1 DM received a greater overall score for understanding the terms than those with type 2 DM (p <0.0001) – 57.84±22.66 and 39.33±22.02 from 100, respectively. 38 (42.7%) participants with DM type 1 reported that they know all 10 terms, but only 15 (16.8%) respondents understand terms correctly. In the group of type 2 DM patients 9 (10.5%) of all answered yes for all the terms, but really know terms only 2 (2.3%) participants. In both groups, the total score of the terms knowledge did not correlate with the HbA1c level (р=0.698 and р=0.319 for type 1 and type 2 DM groups, respectively).
Conclusion: The most of patients with DM do not understand relevant medical terms properly. Some patients are in the wrong belief that they have no misunderstandings with their consulting doctors. However, terms understanding does not influence on glycemic control (HbA1c level). During the medical consultation, endocrinologists should check if a patient understands their advice properly to improve understanding and compliance of patients.
About the Authors
Nataliya S. NovoselovaAlmazov National Medical Research Centre
Russian Federation
MD
Competing Interests:
отсутствует
Anna A. Mosikian
Almazov National Medical Research Centre
Russian Federation
MD
Olga Y. Martyanova
City Polyclinic №27
Russian Federation
MD
Evgenya M. Patrakeeva
First State Pavlov Medical University of Saint-Petersburg
Russian Federation
MD, associate professor
Alsu G. Zalevskaya
First State Pavlov Medical University of Saint-Petersburg
Russian Federation
MD, PhD, associate professor
References
1. Lacroix A, Assal J-Ph. Therapeutic Education of Patients. New Approaches to Chronic Illness. 2nd ed. Paris: Edition Maloine; 2003.
2. Bauer AM, Parker MM, Schillinger D, et al. Associations between antidepressant adherence and shared decision-making, patient-provider trust, and communication among adults with diabetes: diabetes study of Northern California (DISTANCE). J Gen Intern Med. 2014;29(8):1139-1147. doi: 10.1007/s11606-014-2845-6
3. Piette JD, Schillinger D, Potter MB, Heisler M. Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population. J Gen Intern Med. 2003;18(8):624-633. doi: 10.1046/j.1525-1497.2003.31968.x
4. White RO, Eden S, Wallston KA, et al. Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting. Patient Educ Couns. 2015;98(2):144-149. doi: 10.1016/j.pec.2014.10.019
5. White RO, Osborn CY, Gebretsadik T, et al. Health literacy, physician trust, and diabetes-related self-care activities in Hispanics with limited resources. J Health Care Poor Underserved. 2013;24(4):1756-1768. doi: 10.1353/hpu.2013.0177
6. Lucero ME, Bendeck S, Ramos-Ceballos F, Chen S. Language disparities between patients and dermatologists in describing acne lesions. J Am Acad Dermatol. 2004;50(3):P12. doi: 10.1016/j.jaad.2003.10.053
7. Chapman K, Abraham C, Jenkins V, Fallowfield L. Lay understanding of terms used in cancer consultations. Psychooncology. 2003;12(6):557-566. doi: 10.1002/pon.673
8. Alden PA, Gilbert P, Webb T. Patient perceptions in doctor-patient consultation: do patients understand their diagnosis from the words doctors use? Psychooncology. 2000;(9):358-359.
9. Redlich FC. The Patient's Language: An Investigation into the Use of Medical Terms. Yale J Biol Med. 1945;17(3):427-453.
10. McCormack D, Evoy D, Mulcahy D, Walsh M. An evaluation of patients comprehension of orthopaedic terminology: implications for informed consent. J R Coll Surg Edinb. 1997;42(1):33-35.
11. Roth HP. Patients' Beliefs about Peptic Ulcer and Its Treatment. Ann Intern Med. 1962;56(1):72. doi: 10.7326/0003-4819-56-1-72
12. Binyet S, Aufseesser M, Lacroix A, Assal JP. The diabetic foot: various interpretations by patients of some terms used by physicians in podiatric consultation. Diabete Metab. 1994;20(3):275-281.
13. Aufseesser M, Lacroix A, Binyet S, Assal JP. Diabetic retinopathy. Interpretation of medical terms by patients. J Fr Ophtalmol. 1995;18(1):27-32.
14. Бубнова М.Г. Понимание некоторых медицинских терминов мужчинами и женщинами с сердечно-сосудистыми заболеваниями // Проблемы женского здоровья. – 2016. – Т. 11. – №3 – С. 5-13. [Bubnova M.G. Understanding some of the medical terms men and women with cardiovascular diseases. Problemy zhenskogo zdorov'ya. 2016;11(3):5-13. (In Russ.)]
15. Дедов И.И., Шестакова М.В., Майоров А.Ю., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом / Под ред. Дедова И.И., Шестаковой М.В., Майорова А.Ю. 8-й выпуск // Сахарный диабет. – 2017. – Т. 20. – №1S. – С. 1-112. [Dedov II, Shestakova MV, Mayorov AY, et al. Dedov II, Shestakova MV, Mayorov AY, editors. Standards of specialized diabetes care. 8th ed. Diabetes mellitus. 2017;20(1S):1-112. (In Russ.)] doi: 10.14341/DM20171S8
16. American Diabetes A. Erratum. Diabetes Care in the Hospital. Sec. 14. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1);S120-S127. Diabetes Care. 2017;40(7):986. doi: 10.2337/dc17-er07d
17. Nice.org.uk [Internet]. Type 1 diabetes in adults: diagnosis and management [cited 2018 Dec 30]. Available from: https://www.nice.org.uk/guidance/ng17.
18. Richards J, McDonald P. Doctor-patient communication in surgery. J R Soc Med. 1985;78(11):922-924. doi: 10.1177/014107688507801109
19. Hadlow J, Pitts M. The understanding of common health terms by doctors, nurses and patients. Soc Sci Med. 1991;32(2):193-196. doi: 10.1016/0277-9536(91)90059-l
20. Kelly PA, Haidet P. Physician overestimation of patient literacy: a potential source of health care disparities. Patient Educ Couns. 2007;66(1):119-122. doi: 10.1016/j.pec.2006.10.007
21. Royal College of General Practitioners. Health Literacy. Report from an RCGP-led health literacy workshop. 2014.
22. Агаджанян С.А. Особенности использования специальных терминов в коммуникации врач-пациент (на материале английского языка) // Вестник Тверского государственного университета. Серия: Филология. – 2014. – №1 – C. 272-276. [Agadzhanyan SA. Characteristics of special terms use in doctor-patient communication (based on the material of the English language) Vestnik Tverskogo gosudarstvennogo universiteta. Seriya: Filologiya. 2014;(1):272-276. (In Russ.)]
23. Koch-Weser S, Dejong W, Rudd RE. Medical word use in clinical encounters. Health Expect. 2009;12(4):371-382. doi: 10.1111/j.1369-7625.2009.00555.x
Supplementary files
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1. Fig. 1. The percentage of patients with type 1 diabetes who answered that they know the meanings of all ten terms. | |
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2. Fig. 2. Dependence of understanding medical terminology on age. | |
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3. Fig. 3. Dependence of glycated hemoglobin on the duration of diabetes mellitus. | |
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Type | Исследовательские инструменты | |
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Review
For citations:
Novoselova N.S., Mosikian A.A., Martyanova O.Y., Patrakeeva E.M., Zalevskaya A.G. Patient education: interpretation of medical terms as a key part of diabetes mellitus treatment. Diabetes mellitus. 2018;21(6):472-479.