The ability of an individual to write, read, understand and speak is known as literacy. Literacy is not only required in education or academic level but the need of literacy is immensely important in other fields of life. The literacy allows performing the job as it brings on the potential and knowledge in a person. Having some knowledge or information regarding a particular thing is also known as literacy. Like other areas, literacy is also equally important in the medical field. It is not only important for the physicians or professionals but it is also important for the patients as well. When a patient is admitted in the emergency department for some reason then after discharge his treatment is not over. He has to continue the treatment by following some sort of instructions given by the professionals. In short, the medical process of the emergency department patients is not complete after discharge as well. Along with the discharge, the patient is provided with a number of instructions. These instructions are about the clinical conditions, medications and follow up. Following these instructions is quite necessary for getting better. It is very important that the patient must understand all these instruction properly in order to avoid any other medical problem. If the patient does not get along with these instructions then it might result in ineffective care and sometimes health issues. Obviously, for this reason the literacy of patient is highly required otherwise he will not be able to follow these instruction properly. In this dissertation we have tried our best to emphasize over the importance of patient literacy regarding the emergency department discharge instructions. The topic is no doubt a very critical issue as it is related to the life of the patient. The low literacy rate is one of the biggest reason for which the patients do not follow up the instructions properly. (Clarke, Friedman, Shi, Arenovich, Monzon & Culligan, 2005)
1.1 Background Overview
In order to ensure that proper treatment has been given to the patient and also to ensure that quality health care is being provided, discharge instruction play a significant role. For sound health, it is necessary to comply with these instructions. In this topic domain a number of studies have been performed in the past. Few studies have discussed that the patients having fractures do need to follow up the discharge instructions for better results and quick healing. Also, a number of studies have been performed in order to find out that whether the patients in emergency department are provided with the follow up instructions or not? These studies tried to find out that what the quality level of the medical institutes is. It is necessary for every responsible medical institute to provide their patients with follow up instructions. If any institute is not doing this practice then it is not sincere with the health of the patients. These studies were also necessary to be performed in order to analyze the level of the medical institutes. These studies showed that the compliance rate of the patients was very poor. Even in some cases, it turned out to be 28%. These studies show that even if the patients are provided with the discharge instructions then still they do not comply with these. It was found that the demographics of the patients like age, status, education and so on are the reasons which make a difference. The demographic variables affect a lot over the receiving of discharge instruction and then following it up. Solutions have been recommended for these problems in the studies that have been performed. The most common solutions that existed in almost every study were to improve the methods and to improve the patient’s education. The studies in past have always been performed in non managed affiliated emergency departments. No studies have been performed that may given attention to the factors and features that can affect the emergency departments instruction compliance percentage. There are many features or variables regarding the emergency department patients’ compliance rate that have not been studies yet. These variables may include the referrals that are given by the emergency departments to the patients. It is very necessary to find out whether these referrals are provided or not. Many studies have showed that in many cases, the patients are not even able to have an appointment with the referrals for their follow up. Many articles and books have proved it to the major reason given by the patients for not following the instructions that are given after discharge. The major limitation of most of the studies that have been conducted in this regard is that these studies have not tried to find out whether the referrals are reliable or not. Hence, it can be said that a lot of work has been done in this regard but none of these studies have focused over the patients of emergency departments. The focus has to be made over finding out that whether emergency department patients do follow their discharge instructions or not. (Saroff, Dell & Brown, 2002)
1.2 Research Objectives
The research study is covering a very broad topic domain. This topic domain covers a wide range of issues. Health care is no doubt a very important issue to be discussed. The research study is said to be manifold as it is covering a number of objectives. Few of these objectives have presented below:
- To find out the importance of literacy for the health care.
- To explore the concept of patient literacy.
- To find out the need of literacy in health care and for patients.
- To find out the significance of literacy in the emergency department.
- To find out the relationship that exists between the literacy and the various health outcomes or disparities.
- To find out the interventions that may cause to the people that are having low rate of literacy.
- To find out the role of patient literacy in providing quality health care.
- To have an in depth information regarding the discharge instructions.
- To understand the different kinds of discharge instructions those are being provided by the emergency department to the patients.
- To understand and explore the different features of discharge instructions.
- To understand the need of literacy for understanding the emergency department discharge instructions.
- To understand the need of having a good and sound communication between the patient and the physician.
- To make the people realize that patient literacy is the biggest reason for misunderstanding the emergency department discharge instructions.
- To demonstrate the objectives of discharge instructions for the quality health care to the patients.
All these objectives are of equal importance and we have tried our best to cover all these objectives. These objectives have made this research study a very broad and useful one.
1.3 Problem Statement
By observing the above objectives of this research study we are now able to develop the problem statement for this dissertation. The problem statement that we have formulated for this research study is given below:
‘What is the need of patient literacy for emergency department discharge instructions?’
In order to find out the answer to this problem statement we have performed a great deal of research and analysis work. The collection of the relevant information has helped us to solve this problem statement.
1.5 Significance of the Study
Having literacy in every field of life is very important for every individual. When it comes to emergency department, then the need of literacy gets more significant. In this study we have tried to emphasize over the need and importance of the literacy among patients for the understanding of discharge instructions. This is no doubt a very significant topic as it makes the patients as well as the physicians to realize that for improving the health care it is necessary that patients must have literacy. Good health is very essential for every individual. When a patient gets discharged from the emergency department then the treatment does not get over here. Instead, it starts from here as it is very necessary to take proper care after the discharge as well. This can be done when the patients are provided with the discharge instructions. Also, it is necessary for the patients to understand these instructions. Only getting the instructions is never enough. Understanding these instructions is the main part. The dissertation has focused over the same topic. It has tried to find out that to what extent patients do get the understanding of these instructions. The report is of much significance as it has focused over improving the literacy rate of the patients of emergency department so that the quality of health care may get improved. Improving the health care and quality of health is a major task to be performed. It is very essential that steps should be taken that may help the professionals to improve the health of their patients. Developing literacy among the patients is the biggest step that can be taken. The dissertation is very significant as it has emphasized over the need and importance of literacy in the health care. It was never considered that literacy may hold such value for the health care as well. Hence the significance of this research study cannot be ignored. It is equally important for the readers, physicians and the patients.
1.6 Limitations of the Study
Although the study is very significant and we have performed our best for performing this study but still there are some limitations of this study. The major limitation was the time limit. In this short time it was very difficult to get variety of information from the medical centers. It was difficult to practically visit the medical centers and to get the physician charts. The physician charts allow knowing that whether the physicians are properly giving discharge instructions to their patients or not. It was also desired that records can be monitored that may inform us whether the patients follow up the physicians after they are discharged. Another thing that was to be searched practically was that whether the referrals that are given to the patients at the time of discharge are valid or not. Because of time constraint we were not able to perform that huge amount of practical research. But we have tried our best to get the reliable and complete information by surveying the different sources. For this purpose we have made use of all kinds of sources and performed in depth observation. This in depth information has covered this limitation to the large extent. If there was no time limit then it was also possible to visit the patients and their family members in order to find out that to what extent they are devoted to improve their health care. Although we have developed the conclusions by gathering reliable information and performing surveys but still the practical research element is missing. We have tried our best to perform the research work in such a manner that this limitation is covered and the dissertation is not affected. We have no doubt succeeded in performing the research study effectively.
1.7 Organization of the Chapters
The research study is very broad and large. We have divided the research study in to different chapters for managing the dissertation properly. The organization of dissertation holds much importance for performing the research study in a much sequenced way. Following is the description that how we have organized the dissertation in to the different chapters.
The first chapter provides the introduction to this paper on the whole. It has discussed the various elements like the purpose and significance of this study. This chapter has made it clear that why this study is very important to be performed. Also, through this chapter we have defined the various objectives of this paper. The research methodology and the type of data collection that have been used in this paper are also define din this chapter. Finally, the scope of the study has also been presented. In short, this chapter has made it possible to define the basic infrastructure of this study.
- Chapter 2: Literature Review
The chapter is responsible to provide the readers with the collected literature or information that has been collected for achieving the objectives. A huge amount of information has been collected that is relevant to the research study. The information has been collected by performing a great deal of research work. This chapter has provided the readers with a great deal of information that will allow the readers to understand the concepts and meanings of the research study. The literature review also enables the readers to develop their own opinion. Hence all he relevant collected information that is necessary to develop the conclusion is presented in this chapter.
- Chapter 3: Research Methodology
The chapter of research methodology is basically aimed to develop the research design for the entire dissertation. The research design includes many elements like selection of research methodology, selection of data collection method and types of sources to be used and so on. This is also very significant chapter as it binds together all the elements of the dissertation together. The importance of this chapter cannot be ignored as creating the right design for any dissertation is the mandatory task to be performed. If the design developed is inappropriate then the entire dissertation might lead to the wrong results. The conclusion and research findings largely depend over this chapter. Also the chapter explains the aims and objectives of the research study as well. We have also defined the type of data that has been used in this dissertation along with the sources that we have used for collecting the information.
- Chapter 4: Research Findings
In this chapter the findings of the dissertation have been presented. For this purpose, all the gathered information is observed and analyzed. After deep observations the findings are developed. The research findings present in front of the readers that what we have gained from this research study. The results that have been developed are presented here. These findings are developed by working over the defined methodology that has been selected for this dissertation. By using this methodology the presented literature review is used for developing the research findings.
In this chapter we have concluded the entire study. We have tried our best to summarize all the chapters in to a single one. The conclusion also includes our own opinion regarding the study. The conclusion is very important for any study as it is going to present the results of the study. The conclusion is responsible to provide the summary of the entire dissertation. It should be developed in such a way that all the necessary elements of the dissertation should be discussed.