Information - People who have trouble understanding information
For the target group
Information tools that you can use during the visit of the patient:
- Plates of the human body Understand your body www.begrijpjelichaam.nl
- Visual material on frequently occurring syndromes http://www.huisarts-migrant.nl/beeldmateriaal/
- Fifteen brochures in twelve languages about self-care in common complaints http://www.aof-amsterdam.nl/index.php/projecten/15-zelfzorgfolders/6-zelfzorgfolders
- Simple information about syndromes http://www.pharos.nl/nl/kenniscentrum/laaggeletterdheid-en-gezondheidheidsaardigheden/simplification-information material-in-de-zorg
- Use medicines icons http://www.bijsluiterinbeeld.nl/ and www.apo.nl
- Talking record book diabetes and manual I have diabetes. What can I do? Www.pharos.nl/diabetes
- Material and sites to which you can refer your patient
- Information about elderly care in the Netherlands http://nederlands.zorgvoorjeouders.nl/
- Videos on self-management http://www.hartenvaatgroep.nl/over-ons/nieuws/de-hartvaatgroep/artikel/bekijk/nieuw-filmpje-over-zelfmanagement.html
- Folder with plates of the human body Understand your body www.begrijpjelichaam.nl; a program to practice with (spoken text) http://oefenen.nl/programma/begrijp_je_lichaam;
- Simple information for low-literate people https://www.steffie.nl/
- Information about complaints and whether or not you should go to the doctor with them http://www.dokterenonderdedom.nl
There is material with which teams can improve the practical organization for people with low literacy. In addition, workshops and training courses are offered. With screening lists you can check to what extent the practice is easily accessible to low-literate people. The following materials can be useful:
- Low literacy toolkit (LHV) https://www.lhv.nl/service/toolkit-laaggeletterdheid
- Health communicator (for the GP) http://www.aof-amsterdam.nl/index.php/projecten
- Checklist practice set to low-literate people http://www.aof-amsterdam.nl/images/projecten/Checklist_Observaties_in_de_praktijk.pdf
- Practice folder low-literate people http://www.aof-amsterdam.nl/images/projecten/Praktijkfolder_uitleg_laaggeletterden.pdf
- Awareness of low literacy (videos of 1 to 2 minutes in which low-literate people explain what it is like to be low-literate http://www.pharos.nl/nl/kenniscentrum/laagliteracy-and-health/ex-layer-layers-telling-their-track- video
- Workshops and training courses for care providers on dealing with low literacy: Pharos (www.pharos.nl) and Reading and Writing Foundation (www.lezenenschrijven.nl)
- Tips and background information about communication with low-literate people in the pharmacy https://www.knmp.nl/patientenzorg/laaggeletterden-en-migranten
Everyone must be able to use general practice, dental practice and pharmacy. For low-literate people, however, care is not always accessible. To improve accessibility, a project has been set up: Is your practice ready for low-literate people? Where are you? In five steps, the practice and the care chain work on better accessible care.
Is your practice ready for low-literate people?
1. What you need to know about low literacy
In this step you work with your team on awareness of low literacy in practice and its consequences for health.
2. How do you recognize low-literate people
In this step your team works to recognize low literacy in your patients. You learn to recognize signs of low literacy. And if you notice or think that someone has trouble reading and writing, you can talk about that tactfully: 'Many people have trouble filling out forms. How is that for you? "It may be that you have to ask more often before someone trusts you enough to tell it. But then there is often relief, because it no longer needs to be hidden.
3. Training and tools for effective communication
In this step your team learns to have conversations at the level of the low-literate patient. This not only involves discussions at the desk, but also language use and the design of the site, leaflets and signposting of the practice. In addition, team members can use tools and materials that are geared to low-literate people.
If you see in the file the note of low literacy, or you know that a patient is low literate, then give extra explanation. Reserve more (consultation hour) time or invite the patient one or more times in the instruction room for explanation.
4. Collaboration with other healthcare professionals in the first line
This step involves collaboration between general practitioners, pharmacy teams and district nurses. The GP, POH, pharmacist's assistant or district nurse asks the patient if his file may include problems with reading and writing. This is possible in the GP Information System (HIS) via the ICPC (Z07.1 low literacy or Z04 problems with the English language). A patient who is low literate and also has difficulty with English, gets both codes. Pharmacists tick the low literacy point of attention in Pharmacom. In MIRA, low literacy can be indicated as a comment. If the patient thinks it is good, healthcare professionals can pass on low literacy to each other in the first line, for example by putting the ICPC or ETT (extra attention to therapy adherence) on the prescription.
In the pharmacotherapeutic consultation (FTO) between general practitioners and pharmacists, data from low-literate patients is exchanged. It also discusses how community nurses can be involved. District nurses can use the BEM questionnaire (self-medication review) to assess whether the patient is sufficiently skilled to manage his medication himself. This list also contains questions about low literacy. GPs, pharmacists and community nurses make agreements about the exchange of data on low literacy.
5. Safeguarding knowledge about low literacy and communication skills
In this step, the team ensures that everyone remains skilled and applies their skills in communication with low-literate people. This can be done by regularly putting the subject on the diary, by means of intervision, by discussing a case and by asking patients for feedback. It is also important that new team members are trained.