Evaluating Literacy of Vascular Terminology in the U.S. Veteran Population
Kelli L. Summers, MD, Claudie Sheahan, MD, Kathryn DiLosa, BS, MPH, Alison Grise, BS, Marie Unruh, MD, Nicolas Zea, MD, Tapash Palit, MD, Bruce Torrance, III, MD, Robert Batson, MD, Malachi Sheahan, MD.
Louisiana State University, New Orleans, LA, USA.
Essentially no evidence is available regarding the public’s knowledge of vascular disease and its treatments. Improved health literacy has been associated with increased screening, adherence with physician recommendations, compliance with medication regimens, and an improvement in overall health outcomes. This study aims to assess the level of vascular literacy among U.S. veterans and their significant others.
A random cohort of veterans and their significant others were surveyed during attendance at national veterans’ conferences in New Orleans, Louisiana between July and August of 2017. Significant others were only surveyed if they were meaningfully involved in the veteran’s care. Volunteers were asked to complete a demographic form and a 24 question survey with multiple-choice answers concerning their knowledge of common vascular related terminology. The terms tested were extracted from our ten most commonly used vascular surgery consent forms. Participants were encouraged to select choice "I do not know" when appropriate.
The 203 participants were 55.1% male, 85.2% Caucasian, 88.8% over 50 years old, and 43.3% without an education beyond high school. Based on previously validated medical literacy tests, a score of 19/24 or greater was deemed literate. Only 20.8% of participants achieved literacy. Mean score was 13.2 (S.D. 5.7). Of all the responses, 32.4% were "I do not know" (average 8.1 ±7.0) and 10.8% were incorrect (average 2.7± 2.4). The most frequently known terms were "stent", "aorta", and "dialysis" (92.1%, 90.6%, and 89.1% correct). The least frequently identified terms were "fistula," "claudication" and "ischemia," (15.7%, 17.2%, 18.7% correct). Among the terms participants indicated they knew, "aneurysm" was most likely to be misidentified (52.9% incorrect). Overall score was not significantly associated with gender (t(201)=1.7, P=.09), but was associated with education (t(201)= -4.06, P<.001). No linear correlation or predictive value of education was demonstrated (R2=.101, F-value=.002). The study has good reliability (Cronbachs α=.85) and power (N of 168 needed for a 5% margin of error with 95% confidence).
This is the first study of vascular literacy among veterans and their significant others. Although an association of literacy with education level is seen, results are poor throughout suggesting a widespread concern. This study provides a reliable method for evaluating literacy of vascular terminology, as well as a future platform for improving physician-patient communication and vascular outcomes.
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