Self-care instructions: do patients understand educational materials?

As health care providers we are not in a position to teach reading. We do, however, have a legal and an ethical obligation to provide patients with self-care instructions they can understand. Because the methods presented for enhancing patient understanding of self-care instructions are relatively new, and because nurses are just beginning to be aware of the need for such interventions, it will be a while before the ideal situation exists. Ideally, each pamphlet or set of instructions would be coded with the reading grade level needed to understand it and each patient's reading level would be recorded in the chart. Under such "perfect" circumstances it would be easy for nurses to provide patients with instructions at the appropriate reading level. For now, any step that nurses take toward making self-care a reality for patients who read poorly is a step in the right direction. People with poor reading skills are less adept at formulating questions than good readers because they lack vocabulary and the ability to analyze written material. Rather than be regarded as stupid, many choose not to verbalize their lack of understanding. This phenomenon puts a large group of patients at risk for health complications related to inadequate understanding of self-care directions.