Over the past thirty years, patient-provider relationships have undergone a transformation. These findings suggest that speaking and listening skills and support for such skills may be important factors to consider when developing patient activation and advocacy skills. While all literacy skills were significantly associated with advocacy when examined in isolation, greater speaking and listening skills remained significantly associated with better patient advocacy when all four skills were examined simultaneously. This study examined whether four literacy skills (reading, numeracy, speaking, and listening) were associated with patient self-advocacy, a component of health literacy itself, when faced with a hypothetical barrier to scheduling a medical appointment. increasingly requires a proactive stance. However, the complex nature of health care in the U.S. Less frequently examined is the advocacy role expected of patients. Contributions of the structural environment, of interpersonal dynamics, and of a variety of psychological and sociological factors in the relationship between patients and providers have long been under study. So too are studies of either structural or personal factors that inhibit or support a patient's ability to navigate health services and systems and to advocate for their own needs within a service delivery system. The results of this study do not support editorial guidelines that favor active voice over passive voice.Ĭhiropractic Education Education Linguistics Literacy Publishing Reading.Attention to the effect of a patient's literacy skills on health care interactions is relatively new. The texts written in the active voice were not more comprehensible than texts written in the passive voice. Students rated sentences written in the passive voice as marginally more comprehensible than sentences written in the active voice ( p =. There were no significant differences in the difficulties or sensitivities of questions pertaining to the 2 original texts written in the passive voice versus the active voice ( p >. Differences in comprehensibility between the 2 texts were assessed with a dependent t test. Comprehensibility was obtained by asking students to rate the comprehensibility of authentic sentences from biomedical manuscripts and matched manipulated form in which the voice of the main verb had been changed. The difficulties and sensitivities of questions were compared for the 2 forms of each text. Objectively rated comprehensibility was obtained by presenting 161 2nd-year chiropractic students with questions pertaining to 2 methods sections of biomedical articles, each presented in its original form with high prevalence of the passive voice, and in a manipulated form with all main verbs in the active voice. Hence, the purpose of this study was to compare objectively measured and subjectively perceived comprehensibility of texts in which one voice or the other was highly prevalent. Authors in the health sciences are encouraged to write in the active voice in the belief that this enhances comprehensibility.
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