Medical communication: Do our patients understand?

The objective of this study was to determine emergency department (ED) pati ent's understanding of common medical terms used by health care providers ( HCP), Consecutive patients over 18 years of age having nonurgent conditions were recruited from the EDs of an urban and a suburban hospital between th e hours of 7 a.m. and 11 p.m. Patients were asked whether six pairs of term s had the same or different meaning and scared on the number of correct ans wers (maximum score 6). Multiple linear regression analysis was used to ass ess possible relationships between test scores and age, sex, hospital site, highest education level, and predicted household income (determined from z ip code). Two hundred forty-nine patients (130 men/119 women) ranging in ag e from 18 to 87 years old (mean = 39.4, SD = 14.9) were enrolled on the stu dy, The mean number of correct responses was 2.8 (SD = 1.2). The percentage of patients that did not recognize analogous terms was 79% for bleeding ve rsus hemorrhage, 78% for broken versus fractured bone, 74% for heart attack versus myocardial infarction, and 38% for stitches versus sutures, The per centage that did not recognize nonanalogous terms was 37% for diarrhea vers us loose stools, and 10% for cast versus splint, Regression analysis (R-2 = .13) revealed a significant positive independent relationship between test score and age (P < .024), education (P < .001), and suburban hospital site (P < .004), Predicted income had a significant relationship with test scor e (P < .001); however, this was no longer significant when controlled for t he confounding influence of age, education and hospital site. Medical termi nology is often poorly understood, especially by young, urban, poorly educa ted patients. Emergency health care providers should remember that even com monly used medical terminology should be carefully explained to their patie nts. Copyright (C) 2000 by W.B. Saunders Company.