Managing chronic conditions is a major process in every correctional setting. The chronic care visit is an ideal time for patient teaching and reinforcement. Correctional nurses often provide a large part of patient teaching in a collaborative chronic care clinic. Areas of teaching include
- The disease process
- Lifestyle adjustments
- Medication effects and side effects
- Self-care activities
Unfortunately, there are few ready-made patient educational materials that suit the correctional setting. Most materials must be adapted to the restrictions of a secure facility and the limitations of diet and exercise imposed on our patients. As described in an earlier post, many of our patients have learning disabilities or little formal education. For all these reasons, correctional nurses need to be sure written materials are adapted to our environment, easy to understand, and make sense to our patients.
Even the general population has trouble understanding most patient education materials, as this Institutes of Medicine paper indicates. Therefore, we need to improve the readability of any patient handout used in our setting. Fortunately, there are free resources available to help us – like this guide created by the Centers for Disease Control.
Back to Basics
Here are some basic principles for creating clear and understandable patient education materials for low literacy patients taken from the CDC guide:
- Include graphics and pictures to demonstrate important principles
- Limit text to need-to-know information that uses action terms to directly tell the patient what they need to do
- Use a positive, friendly, and conversational writing style
- Use simple words with limited use of medical and scientific jargon.
- Limit statistics and use general terms, such as many or few, instead.
- Format the teaching material for maximum understanding – font size of text should be as large as possible to improve readability – at least 12 points
Once materials are written and formatted, readability should be tested. The best test is to pilot with a sample of your patients; however, readability can also be factored using MSWord functions or online readability services. A very simple test of readability is the number of multiple-syllable words in the document. The Simple Measure of Gobbledygook (SMOG) is a quick online option. The test counts the multiple-syllable words in three strings of 10 sentences within the document and then comparing the count to a table to determine reading level.
Culture and Language
Once you have your basic material together, check it for cultural appropriateness. Are the visuals representative of your patient population? Are there any trigger words that might be offensive to members of your patient community? Are there familiar terms that need to be added for clarity? Again, you may want to pilot test with key members of your patient groups. Also consider whether translation is needed; for example some settings have a large Spanish-speaking population.
Start with a Good Foundation
As you can see, writing patient education materials that make sense is hard work. You may want to start with some foundational materials created by experts. In that case, there are plenty of materials from national associations and government sites that can be adapted for the criminal justice setting. Here are a few links to get you started:
- American Cancer Society
- American Heart Association
- CDC Patient Education – Tuberculosis, Hepatitis, High cholesterol
- Medline Plus
How do you teach patients in your setting? Share your thoughts in the comments section of this post.
Photo Credit: © Vladimir Voronin – Fotolia.com