Medical Jargon Research Articles

Jargon Be Gone - Patient Preference in Doctor Communication.

While it has been shown that healthcare providers often use medical jargon, less is known about how patients prefer their clinicians communicate. This mixed-methods study aimed to better understand the general public's preference in healthcare communication. A volunteer cohort of 205 adult attendees at the 2021 Minnesota State Fair was presented a survey with two scenarios at a doctor's office sharing the same information: one using medical terminology and one using simpler, jargon-free language. Survey participants were asked which doctor they preferred, to describe each doctor, and to explain why they believe that doctors may use medical terminology. Common descriptive themes for the jargon-using doctor included that this doctor caused confusion, was too technical, and was uncaring, while the doctor who spoke without jargon was perceived as a good communicator, caring/empathetic, and approachable. Respondents perceived a range of reasons why doctors use jargon, from not recognizing they are using words that are not understood to trying to make themselves feel more important. Overall, 91% of survey respondents preferred the doctor who communicated without medical jargon.

‘Death’ Rarely Used in Family Discussions About Critically Ill Infants

According to this study: In family meetings between clinicians and the parents of critically ill infants, medical jargon and other types of euphemisms are used more often than the words die, death, dying, or stillborn.

Feasibility and acceptability testing of CommSense: A novel communication technology to enhance health equity in clinician-patient interactions.

Quality patient-clinician communication is paramount to achieving safe and compassionate healthcare, but evaluating communication performance during real clinical encounters is challenging. Technology offers novel opportunities to provide clinicians with actionable feedback to enhance their communication skills. This pilot study evaluated the acceptability and feasibility of CommSense, a novel natural language processing (NLP) application designed to record and extract key metrics of communication performance and provide real-time feedback to clinicians. Metrics of communication performance were established from a review of the literature and technical feasibility verified. CommSense was deployed on a wearable (smartwatch), and participants were recruited from an academic medical center to test the technology. Participants completed a survey about their experience; results were exported to SPSS (v.28.0) for descriptive analysis. Forty (n = 40) healthcare participants (nursing students, medical students, nurses, and physicians) pilot tested CommSense. Over 90% of participants "strongly agreed" or "agreed" that CommSense could improve compassionate communication (n = 38, 95%) and help healthcare organizations deliver high-quality care (n = 39, 97.5%). Most participants (n = 37, 92.5%) "strongly agreed" or "agreed" they would be willing to use CommSense in the future; 100% (n = 40) "strongly agreed" or "agreed" they were interested in seeing information analyzed by CommSense about their communication performance. Metrics of most interest were medical jargon, interruptions, and speech dominance. Participants perceived significant benefits of CommSense to track and improve communication skills. Future work will deploy CommSense in the clinical setting with a more diverse group of participants, validate data fidelity, and explore optimal ways to share data analyzed by CommSense with end-users.

Patient-Friendly Information Giving in HIV Counselling through the Use of Metaphors

HIV counselling is a method of communication between patients and certified HIV nurse counsellors to discuss and help patients deal with HIV-related issues. Despite the training received by these nurses, communicating HIV-related issues remains a difficult task in Malaysia. Due to lack of research examining information giving in HIV counselling in Malaysia, this study investigated both the challenges and the strategies in providing information to HIV patients. Twenty-four audio recordings of actual HIV counselling sessions were gathered and six focus group discussions with HIV nurse counsellors from three government hospitals in Malaysia were recorded. The discourse analysis of revealed a prominent use of metaphors as part of information giving strategies to overcome the challenges faced by HIV nurse counsellors when communicating with HIV patients. The metaphors were embedded in HIV nurse counsellors’ information giving to HIV patients and their spouse/family as a way to represent some medical jargons pertaining to HIV. Since the HIV patients came from different educational background, it would be much easier for them to understand HIV-related information giving through the use of metaphors. Therefore, the acknowledgement and integration of metaphors can be an amazingly valuable tool for HIV nurse counsellors especially in managing the communication challenges during HIV counselling. It is hoped that the findings provided in this study will serve as a basis for integrating metaphors into counselling practices.

UTILIZING BOOT CAMP TRANSLATION TO ENCOURAGE HISPANIC/LATINX PARTICIPATION IN ALZHEIMER’S RESEARCH

Abstract Hispanic/Latinx (H/L) individuals are 50% more likely to develop Alzheimer’s disease (AD), relative to non-Hispanic whites. Despite higher prevalence rates and earlier age of onset, H/L individuals are underrepresented in aging and AD research. The Engaging Communities of Hispanics for Aging Research (ECHAR) Network is an interdisciplinary, multi-site project that aims to address these disparities. ECHAR uses Boot Camp Translation (BCT), a community-based participatory research (CBPR) approach that partners research faculty and medical experts with community stakeholders to translate medical jargon into action-based, locally-relevant messages. Researchers at University of Nevada, Las Vegas recruited 14 community members to participate in an AD-specific BCT. The process was completed between June 2021 through January 2022 to identify: 1) key messages, 2) target audience(s), and 3) dissemination strategies. BCT members identified three messages to reflect community concerns and highlight values: 1) “Amar es saber” (“To love is to know”), which acknowledges the importance of family and addresses cultural norms that may discourage disease conversations; 2) “The community cares. Let’s talk.”; and 3) "Podemos afrontar el Alzheimer juntos." (”We can face Alzheimer’s disease together.”). Target audiences include younger and middle-age adults who may be or become caregivers and local non-profit and community organizations. Members identified social media, community education events, community influencers, and educational products as dissemination strategies. BCT is an effective tool for engaging local communities and exploring Hispanic/Latinx beliefs and attitudes toward AD. It leverages community member expertise to create meaningful, tailored, and culturally-relevant messages that address health disparities and encourage action.

ADHD and reification: Four ways a psychiatric construct is portrayed as a disease.

The descriptive classification Attention-Deficit/Hyperactivity Disorder (ADHD) is often mistaken for a disease entity that explains the causes of inattentive and hyperactive behaviors, rather than merely describing the existence of such behaviors. The present study examines discourse on ADHD to analyze how authors passively and actively contribute to reification-a fallacy in which a concept is represented as a thing existing on its own. Critical Discourse Analysis and Qualitative Content Analysis of academic textbooks, scientific articles, websites and videos were used to analyze how ADHD is reified. The analyses reveal four ways in which inattentive and restless behaviors are presented as an entity by means of the ADHD classification: language choice, logical fallacies, genetic reductionism, and textual silence. First, language choice, such as medical jargon and metaphors aid in representing ADHD as a disease entity. Second, several logical fallacies do the same, including the relatively unknown "ecological fallacy" that refers to the erroneous belief that average group findings, such as average brain size of groups of those with an ADHD classification, can be applied on an individual level. Third, genetic reductionism is often achieved by overstating the results of twin studies and being silent about the disappointing molecular genetic research. Such textual silence is the last identified mechanism of reification and includes instances in which societal factors that affect the ADHD construct are often omitted from texts, thereby obscuring the extent to which ADHD is a limited heuristic. It is essential that discourse communities do not repeat these four ways of reifying behavior and social relations into an alleged entity with the acronym ADHD. The errors and habits of writing may be epistemologically violent by influencing how laypeople and professionals see children and ultimately how children may come to see themselves in a negative way. Beyond that, if the institutional world shaped to help children is based on misguided assumptions, it may cause them harm and help perpetuate the misguided narrative. To counter the dominant, reifying and medicalizing view, guidelines such as the recently published "Dutch ADHD Psychoeducation Guidelines" might be helpful.

Improving the quality of inpatient discharge summaries.

Discharge summaries (DCS) are vital in facilitating handover to community colleagues. Unfortunately, at Whittington Health, General Practitioners (GPs) found it difficult to identify relevant information in DCS, and use of medical jargon meant patients did not understand details of their admission. With this quality improvement project, the team aimed to improve DCS to enhance patient-centered care. The aim of this quality improvement project (QIP) was to improve the quality of DCS by critiquing the ones produced within our trust and implementing various interventions. Multiple Plan-Do-Study-Act (PDSA) cycles were completed. A multi-disciplinary meeting was conducted to identify the needs of each party in a DCS. A new template was subsequently launched. Teaching was conducted and educational leaflets were disseminated hospital-wide. Quality of written communication was audited quarterly, and evaluated against quality indicators. Problems with DCS were identified via GP and patient feedback, and these became the focus of subsequent PDSA cycles. From March 2019 to February 2020, all the audited categories improved, with an overall improvement from 67% to 92%. We also received positive feedback from GPs. Quality of DCS can be improved with appropriate interventions, leading to improved patient care. A similar PDSA cycle could be utilized elsewhere to achieve similar results.

Relationship between Perceived Quality of Prenatal Care and Maternal/Infant Health Outcomes.

Studies have shown that quality of care affects patient health outcomes and well-being. In this study, we examine the relationship between perceived quality of prenatal care, birth outcomes, and postpartum depression (PPD). We use data from the third wave of the Listening to Mothers dataset (2013). After removing missing data, the analytic sample size included 2168 women. Through linear and logistic regression analyses, we test the following hypotheses: higher perceived quality of prenatal care will have a positive association with a likelihood of vaginal delivery and normal birth weight outcomes, and a negative association with a likelihood of preterm birth; and higher perceived quality of prenatal care will have a negative association with a likelihood of PPD risk. Women who perceived higher quality of prenatal care were significantly less likely to have a preterm birth relative to women who reported lower quality care. Women who reported (any) medical jargon during their prenatal visits were less likely to have a normal birth weight baby. Women who reported provider use of medical jargon, lower perceived quality of interaction with a prenatal care provider, and lower perceived quality of US maternity care in general were more likely to be at risk for PPD. Negative prenatal care experiences may exacerbate adverse patient outcomes. Positive prenatal care experiences may buffer/improve adverse outcomes. Quality of care measures were most consistently predictive of PPD outcomes. Providers should focus on improving the quality of prenatal care as one of the means to improve maternal and infant health and well-being.

Accuracy in Patient Understanding of Common Medical Phrases

Despite acknowledging that medical jargon should be avoided, health care practitioners frequently use it when communicating with patients. To characterize the understanding of common medical jargon terms by surveying a cross section of the general public and studying phrases that have established meanings in regular usage but different meanings in a medical context (eg, negative and positive test results). In this cross-sectional study, participants indicated their understanding of phrases that may have different meanings in medicine than in colloquial English via a mix of short answer and multiple choice questions. Several questions included paired phrases to assess for differences in understanding with or without jargon. Volunteers were recruited at the 2021 Minnesota State Fair near St Paul, Minnesota. An electronic survey was given to a volunteer sample of 215 adults (>18 years) who did not work or train to work in the medical field and spoke and read English. Completing a written or verbal survey. The main outcome was an accurate understanding of the medical terminology. Free-text responses were coded by 2 researchers for comprehension. Secondary outcomes looked for associations between volunteer demographics and understanding. The 215 respondents (135 [63%] female; mean [SD] age, 42 [17] years) demonstrated a varied ability to interpret medical jargon phrases. For example, most participants (207 [96%]) knew that negative cancer screening results meant they did not have cancer, but fewer participants (143 [79%]) knew that the phrase "your tumor is progressing" was bad news, or that positive lymph nodes meant the cancer had spread (170 [67%]). While most (171 [80%]) recognized that an unremarkable chest radiography was good news, only 44 participants (21%) correctly understood that a clinician saying their radiography was impressive was generally bad news. In each of the paired phrases comparing jargon vs nonjargon approaches, the nonjargon phrase was understood significantly better (P < .001). These findings suggest that several common phrases are misunderstood when used in a medical setting, with the interpreted meaning frequently the exact opposite of what is intended.

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

“Am I Going to Die?”: Delivering Serious News to Patients With Liver Disease

Exploring community pharmacists' use of health literacy interventions in their everyday practice.

Limited health literacy often results in people inadequately understanding medicines-related information and subsequently not taking medicines as prescribed. Using health literacy interventions is important for community pharmacists, as they are increasingly managing long-term conditions. However, there appear to be no previous studies of community pharmacists' everyday use of health literacy interventions in the UK. To explore UK community pharmacists' perspectives on the usability of health literacy interventions in their everyday practice. Semi-structured interviews were conducted with participants, following attendance at health literacy training that included practicing the use of four health literacy interventions (Teach-Back, Chunk and Check, Simple Language and visual aids) and two months experience of attempting to use them in their everyday practice. Participants were pharmacists from community pharmacies in Staffordshire, England who were invited to participate by an email sent to the pharmacy. Interviews were audio-recorded, transcribed verbatim and analysed using the Framework Analysis technique. Four themes emerged from 11 interviews undertaken: intervention appeal, limitations, adaptations and continued use. Participants reported using all four health literacy interventions in their everyday practice but Teach-Back appeared to be favoured most. Most participants talked about practicing Teach-Back before using it with patients but described it as useable with patients of all ages, without being prohibitively time consuming. Chunk and Check seemed to be viewed as a type of Teach-Back, whilst visual aids were reported as being used in conjunction with Teach Back rather than as a standalone intervention. Participants reported that Simple Language was an easy concept but easily 'slipped back' into medical jargon and were challenged to use simple enough words. All participants said they would continue to use all four health literacy interventions. The findings suggest that with training, community pharmacists can successfully incorporate these four health literacy interventions into their everyday practice.

Role-playing in medical education: An experience from public role-players

ObjectiveWe aim to explore the lived experiences of public role-players from the aspects of benefits, barriers, and enablers of role-playing in a medical school in Malaysia. MethodsA mixed-method study was performed involving 15 community dwellers who been engaged as role-players with Newcastle University Medicine in Malaysia. Participants answered a brief questionnaire followed by taking part in semi-structured interview. The interviews were audio-recorded, transcribed verbatim, and analyzed using thematic approach. Results86.7% of the participants strongly agreed that they had better medical knowledge after participating. Seven themes emerged under the three categories of perceived benefits, challenges, and recommendations: understanding and medical knowledge, and practical application, other benefits of role-playing, emotional upheaval, understanding medical jargons, improving the role-playing quality, and translating the experience gained into the community setting. ConclusionThe public role-players acknowledged their role positively and recognized refinement in their interpretation of medical knowledge and health. The public role-players were enthusiastic in using their knowledge acquired by upskilling themselves for community health programs and initiatives.

Go the extra mile.

Go the extra mile.

Characterizing the Language Used to Discuss Death in Family Meetings for Critically Ill Infants

Communication during conversations about death is critical; however, little is known about the language clinicians and families use to discuss death. To characterize (1) the way death is discussed in family meetings between parents of critically ill infants and the clinical team and (2) how discussion of death differs between clinicians and family members. This longitudinal qualitative study took place at a single academic hospital in the southeast US. Patients were enrolled from September 2018 to September 2020, and infants were followed up longitudinally throughout their hospitalization. Participants included families of infants with neurologic conditions who were hospitalized in the intensive care unit and had a planned family meeting to discuss neurologic prognosis or starting, not starting, or discontinuing life-sustaining treatment. Family meetings were recorded, transcribed, and deidentified before being screened for discussion of death. The main outcome was the language used to reference death during family meetings between parents and clinicians. Conventional content analysis was used to analyze data. A total of 68 family meetings involving 36 parents of 24 infants were screened; 33 family meetings (49%) involving 20 parents (56%) and 13 infants (54%) included discussion of death. Most parents involved in discussion of death identified as the infant's mother (13 [65%]) and as Black (12 [60%]). Death was referenced 406 times throughout the family meetings (275 times by clinicians and 131 times by family members); the words die, death, dying, or stillborn were used 5% of the time by clinicians (13 of 275 references) and 15% of the time by family members (19 of 131 references). Four types of euphemisms used in place of die, death, dying, or stillborn were identified: (1) survival framing (eg, not live), (2) colloquialisms (eg, pass away), (3) medical jargon, including obscure technical terms (eg, code event) or talking around death with physiologic terms (eg, irrecoverable heart rate drop), and (4) pronouns without an antecedent (eg, it). The most common type of euphemism used by clinicians was medical jargon (118 of 275 references [43%]). The most common type of euphemism used by family members was colloquialism (44 of 131 references [34%]). In this qualitative study, the words die, death, dying, or stillborn were rarely used to refer to death in family meetings with clinicians. Families most often used colloquialisms to reference death, and clinicians most often used medical jargon. Future work should evaluate the effects of euphemisms on mutual understanding, shared decision-making, and clinician-family relationships.

Evaluation of quality and readability of over-the-counter medication package inserts.

Over-the-counter (OTC) medication package inserts are vital references for healthcare professionals to make drug recommendations and influential education materials that patients commonly refer to when self-caring. However, little is known about the quality and readability of the OTC medication package inserts in China. This study aimed at evaluating the quality and readability of OTC medication package inserts. Package inserts of OTC medication were selected based on the market share and pharmacological category. The quality of the package inserts was evaluated based on standards adapted separately from the Chinese National Medical Products Administration (NMPA) and European Medicines Agency's (EMA) Working Group. The readability was assessed using the Patient Education Materials Assessment Tool (PEMAT) in conjunction with the Chinese Readability Index Explorer (CRIE). A total of 29 OTC medication package inserts consisting of 12 Western Medicine (WM) and 17 Chinese Tradition Patent Medicine (CTPM) package inserts were included. Overall, the OTC package inserts met 92% of the NMPA standards and 54% of the EMA standards. In terms of readability assessment using PEMAT, the overall median (interquartile range) understandability score was 38% (38-45%) and for actionability score was 40% (40-55%). The overall text reading level of package inserts measured by the CRIE, after removing some medical jargon, is equivalent to the median reading level for the 12th (9.5-12th) grade reading level. The quality of OTC medication package inserts was satisfactory under internal standards but poor under international standards. Some OTC pharmacological information is not provided due to lack of research, especially for CTPM. A more informative and comprehensive package insert may be needed to guide drug use decisions. OTC medication package inserts are not appropriate patient education materials in terms of readability. Additional materials may be developed to supplement package inserts for patient education for OTC medications.

Linguistic tones in MRI reports correlate with severity of pathology for rotator cuff tendinopathy.

Written communication can convey one's emotions, personality, and sentiments. Radiology reports employ medical jargon and serve to document a patients' condition. Patients might misinterpret this medical jargon in a way that increases their anxiety and makes them feel unwell. We were interested whether linguistic tones in MRI reports vary between radiologists and correlate with the severity of pathology. (1) Is there variation in linguistic tones among different radiologists reporting MRI results for rotator cuff tendinopathy? (2) Is the retraction of the supraspinatus tendon in millimeters associated with linguistic tones? Two hundred twenty consecutive MRI reports of patients with full-thickness rotator cuff defects were collected. Supraspinatus retraction was measured on the MRI using viewer tools. Using Kruskal-Wallis H tests, we measured variation between 11 radiologists for the following tones: positive emotion, negative emotion, analytical thinking, cause, insight, tentativeness, certainty, and informal speech. We also measured the correlation of tones and the degree of tendon retraction. Multilevel mixed-effects linear regression models were constructed, seeking factors associated with the tone, accounting for retraction, the presence of prior imaging, and for the effects of each radiologist (nesting). There were statistically significant differences for all of the tones by radiologist. In bivariate analysis, greater retraction of the supraspinatus muscle in millimeters was associated with more negative emotion and certainty, and with less tentativeness. In multilevel mixed-effects linear regression, more negative tones were associated with greater retraction and absence of prior imaging. Greater tentativeness was associated with the absence of prior imaging, but not with retraction. Radiology reports have emotional content that is relatively negative, varies by radiologist and is affected by pathology. Strategies for more hopeful, positive, optimistic descriptions of pathology have the potential to help patients feel better without introducing inaccuracies even if unlikely. Level III, Diagnostic.

152 Assessment of Quality and Readability of Online Patient Education Materials Relating to Dog Bites

Abstract Aim Dog bites are common injuries which can result in significant morbidity and comprise a large workload for plastic surgery. We aimed to assess the quality and readability of online patient education resources related to dog bites. Method We entered the search term ‘dog bite’ into Google and assessed the top 50 results for quality and readability. Quality was measured using the DISCERN questionnaire, benchmark criteria published by the Journal of the American Medical Association (JAMA), and accreditation by the HONcode (Health On the Net code). Readability was measured with the Flesch-Kincaid reading grade (FKRG), Flesch reading ease score, Gunning's fog index, and the Coleman-Liau index (CLI). Results The mean JAMA and DISCERN scores were 2/4 and 35.7/80 respectively suggesting average quality. Only 3 sites were HONcode certified (7%). The mean Flesch reading ease score was 11.3 suggesting that the materials were very difficult to read and best understood by those with tertiary education. This corresponded with the high Gunning's fog score of 14.2. The FKRG and CLI indicated similar results. Conclusions Online materials relating to dog bites are of average quality and poor readability, especially in the context of the UK's reading age of 9. Avoidance of medical jargon and use of shorter words and sentences would improve readability. Timely review of websites, improved information on authorship and references could improve quality. Improved quality and readability would make it easier for patients to understand what to do following a dog bite, how to seek help if appropriate and what treatment to expect.

Development of a Patient Activation Toolkit for Hepatitis C Virus Testing.

We evaluated the acceptability of a patient activation toolkit for hepatitis C virus (HCV) testing amidst universal adult guidelines. We developed a patient-facing toolkit that included a letter to the patient from their healthcare provider, HCV factsheet, and question prompt list, which contained questions for their provider about HCV infection and testing. We conducted qualitative interviews with patients ages 18-78 (n = 17), using a semi-structured interview guide based on learner verification. We assessed attraction, comprehension, cultural-linguistic acceptability, self-efficacy, and persuasiveness of toolkit materials using direct content analysis. Participants reported materials were attractive, offering suggestions to improve readability. They reported some understanding of materials but requested use of less medical jargon, particularly for the factsheet. Participants discussed cultural acceptability and suggested ways to improve language inclusiveness and comfort with content, given stigma surrounding HCV risk factors. Participants reported that including a letter, factsheet, and QPL improved the persuasiveness of materials, and they conveyed their motivation to be tested for HCV. Results indicate preliminary acceptability for use of the patient activation toolkit, which will be refined based on participants' recommendations. Overall, this patient activation toolkit holds promise for increasing HCV testing rates.

SEE-diabetes, a patient-centered diabetes self-management education and support for older adults: Findings and information needs from providers’ perspectives

Background and aimsDiabetes self-management education and support (DSMES) can improve clinical and health outcomes of people with diabetes. However, DSMES has been underutilized because of many barriers. We aimed to develop a patient-centered educational aid, SEE-Diabetes (Support-Engage-Empower-Diabetes), that facilitates shared decision-making about DSMES between patient and provider during the follow-up visit. We investigated the information needs to inform the design of the SEE-Diabetes from the providers’ perspective. MethodsWe conducted an online survey (N = 42) and three focus groups (N = 13) involving providers who have experience managing diabetes in older patients. Survey collected demographics and assessed knowledge of DSMES. During the subsequent focus groups, participants evaluated the Assessment and Plan section of three clinic notes of older people with diabetes. We also demonstrated the potential workflow of DSMES documentation using SEE-Diabetes during clinical practice. ResultsThe survey showed 60% of providers were familiar with DSMES. Focus group findings showed clinic notes should convey concise information at an appropriate reading level, numbered problems, and less medical jargon to improve the readability of clinic notes. Application of SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goals was suggested to deliver effective diabetes self-care information. ConclusionsProviders should consider adopting validated DSMES guidelines along with goal-setting strategies to provide patient-centered care. The research team will integrate the provider recommendations when we develop SEE-Diabetes.

Transforming unstructured digital clinical notes for improved health literacy

PurposeClinical notes typically contain medical jargons and specialized words and phrases that are complicated and technical to most people, which is one of the most challenging obstacles in health information dissemination to consumers by healthcare providers. The authors aim to investigate how to leverage machine learning techniques to transform clinical notes of interest into understandable expressions.Design/methodology/approachThe authors propose a natural language processing pipeline that is capable of extracting relevant information from long unstructured clinical notes and simplifying lexicons by replacing medical jargons and technical terms. Particularly, the authors develop an unsupervised keywords matching method to extract relevant information from clinical notes. To automatically evaluate completeness of the extracted information, the authors perform a multi-label classification task on the relevant texts. To simplify lexicons in the relevant text, the authors identify complex words using a sequence labeler and leverage transformer models to generate candidate words for substitution. The authors validate the proposed pipeline using 58,167 discharge summaries from critical care services.FindingsThe results show that the proposed pipeline can identify relevant information with high completeness and simplify complex expressions in clinical notes so that the converted notes have a high level of readability but a low degree of meaning change.Social implicationsThe proposed pipeline can help healthcare consumers well understand their medical information and therefore strengthen communications between healthcare providers and consumers for better care.Originality/valueAn innovative pipeline approach is developed to address the health literacy problem confronted by healthcare providers and consumers in the ongoing digital transformation process in the healthcare industry.