R10 · Trouble understanding health information
Actual Communication and relationships
Definition
Low reading ability or health literacy makes instructions hard to follow.- Low literacy
- complex language
- stress
- poor vision
- older age
- Cannot explain the plan
- misses doses
- avoids forms
📋 Scenario
A patient signs forms but cannot explain the medicine plan.
Subjective (S): "I'm fine, I understand." (cannot repeat the plan)
Objective (O): Signs forms but cannot explain medicines; low literacy; embarrassed.
Assessment tools for this scenario: CP-TALK Communication Check
Validated scales to consider: Communication barrier checklist
**CarePath diagnosis:** Trouble understanding health information related to low literacy, as evidenced by cannot explain the plan and misses doses.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Use plain words. | Everyday words are easier to understand than medical terms, so plain language makes sure he really understands the plan. |
| Short steps. | Small steps are easier to take in and remember than a long list, and avoid overwhelming him. |
| Teach-back. | Asking him to explain the plan in his own words checks real understanding without making him feel tested, since signing a form does not show that he understands. |
| Pictures. | Pictures show information in a way that does not depend on reading skill, and are easier to remember. |
| Simple written notes. | Simple notes give him something to look at at home, which helps him remember what to take and when. |
| Repeat. | Repeating key points over time helps move information into memory, especially when he is stressed or embarrassed. |
**Expected outcomes**
- Within 2 sessions: explains the plan in his own words by teach-back and takes medicines correctly.
**Linking the data to the diagnosis**
The patient says, "I'm fine, I understand," but cannot repeat the plan. He signs forms yet cannot explain his medicines, has low literacy, is embarrassed, and misses doses. These data show a gap between appearing to understand and truly understanding, so this actual diagnosis fits better than a general lack of knowledge, because the cause is low literacy and not lack of teaching. The plan aims for him, within 2 sessions, to explain the plan in his own words using teach-back and to take his medicines correctly.
CarePath diagnosis
Trouble understanding health information related to low literacy, as evidenced by cannot explain the plan and misses doses.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Use plain words. | Everyday words are easier to understand than medical terms, so plain language makes sure he really understands the plan. |
| 2. Short steps. | Small steps are easier to take in and remember than a long list, and avoid overwhelming him. |
| 3. Teach-back. | Asking him to explain the plan in his own words checks real understanding without making him feel tested, since signing a form does not show that he understands. |
| 4. Pictures. | Pictures show information in a way that does not depend on reading skill, and are easier to remember. |
| 5. Simple written notes. | Simple notes give him something to look at at home, which helps him remember what to take and when. |
| 6. Repeat. | Repeating key points over time helps move information into memory, especially when he is stressed or embarrassed. |
Expected outcomes
- Within 2 sessions: explains the plan in his own words by teach-back and takes medicines correctly.
Linking the data to the diagnosis
The patient says, "I'm fine, I understand," but cannot repeat the plan. He signs forms yet cannot explain his medicines, has low literacy, is embarrassed, and misses doses. These data show a gap between appearing to understand and truly understanding, so this actual diagnosis fits better than a general lack of knowledge, because the cause is low literacy and not lack of teaching. The plan aims for him, within 2 sessions, to explain the plan in his own words using teach-back and to take his medicines correctly.