A nurse has finished teaching a patient about self-management of a new disease just diagnosed. What statements by the patient indicate to the nurse that the patient's health literacy may be a barrier to learning? (Select all that apply.)
a. "Can you write down the instructions step by step?"
b. "I can't read this brochure you gave me yesterday."
c. "I got admitted because I didn't know which doctor to call."
d. "These instructions mix me up and frustrate me."
e. "This new medication is too expensive for me to take."
A, C, D
Health literacy includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems. Needing instructions written down step by step, not knowing what health care provider to call, and getting mixed up and frustrated over instructions demonstrate this patient's lack of the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Not being able to read well and not being able to afford medications are certainly barriers to explore, but they are not related to health literacy.
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