Health care is complex and it is therefore not surprising that when assessed by the Australian Bureau of Statistics in 2006, only 41 per cent of Australian adults were assessed as having adequate (or better) health literacy skills. Health information models must change to embed appropriate literacy levels, cultural and linguistic considerations, and other cognitive capabilities that can be addressed through plain language or easy English strategies. It is common for many consumers to experience difficulties in accessing and understanding the vast range, and complexity of health information they may be provided with and required to act upon. There is often a gap between what health professionals intend to convey in written and verbal communication and what patients understand. Accessible, appropriate and high-quality written and visual health information is essential to effective health care communication. Improving the capacity of patients to access, obtain, understand and to actively participate in clinical decision making is fundamental to good health outcomes, improving quality and safety and reducing health inequalities.
In health service contexts in particular, where invasive procedures are performed, this issue is of paramount importance. Patients and consumers require clear, accessible, understandable information in order to ask questions, express opinions and make appropriate decisions about treatment options, including considering benefits, risks and alternatives. This decision making process is commonly termed ‘informed consent’ and is a core clinical procedural requirement and an ethical component of patient care.
A systematic review undertaken by Kinnersley (2013) suggests that the process of obtaining informed consent can be hampered by information and communication that is unclear, insufficient and insensitive to health literacy and cultural and linguistic requirements. Consequences can include: “misunderstanding, a worse treatment response, and even litigation”.
Enhancing patient knowledge can, however, be achieved through a range of interventions that seek to improve accessibility and delivery of information and provide patients with appropriate materials for consideration. The review found that “patients’ immediate, short term, long term knowledge and satisfaction with decision making was increased through interventions to improve informed consent for patients who were undergoing surgical and invasive procedures”.