Comprehension of medical information in narrative and expository discourse: Implications for health literacy among the Filipino American elderly.

摘要

Health literacy pertains to how medical information and services are understood and utilized. This study addressed the health literacy of elderly Filipino Americans, with emphasis on the comprehension of medical information. The main goal of the study was to determine whether there were differences in the amount of medical information and the categories of medical information (symptoms, timeline, consequences, risk factors, treatment) recalled when individuals were presented with narrative as opposed to expository discourse. In this within-subjects design, participants were presented with four sudden-onset medical conditions (heart attack, stroke, gout, shingles) and four non-sudden onset medical conditions ( diabetes, glaucoma, macular degeneration, COPD), and asked to recall information immediately after reading them. Responses were analyzed according to the amount of information (propositions) and the categories of medical information recalled. Findings from this study indicated significantly better recall of propositions and categories of medical information when presented in narrative discourse.;This study suggests that structuring health information in the context of illness narratives may facilitate better comprehension of text as compared to expository discourse. Elderly adults may benefit from the inherent temporal-causal structure of narratives which provides more redundant contextual cues and facilitates better information recall. Narratives present a vivid account of the medical condition and as such enable individuals to place themselves in the shoes of the protagonist and better contextualize the illness. This study further suggests that illness narratives may be a more familiar and comfortable means of exchanging medical information, especially among individuals from collectivistic cultures who primarily exchange information among peers and family via illness narratives. In conclusion, this study underscores the important role of information structure in the comprehension of medical information. It also suggests how information structure may be considered as a means through which health literacy gaps among elderly individuals from ethnic groups may be addressed.