title: Health Literacy in Orthopaedic Trauma Patients.
abstract: OBJECTIVE
  This study aimed to determine the level of health literacy in a postoperative orthopaedic trauma population and to evaluate the efficacy of a simple predischarge discussion strategy, targeted at improving health literacy.
  
  
  METHODS
  A pre-post intervention study was conducted from April 2014 to January 2015.
  
  
  METHODS
  Academic Level 1 trauma center.
  
  
  METHODS
  One hundred ninety consecutive orthopaedic trauma patients with operatively managed lower limb fractures were recruited. All eligible participants agreed to participate.
  
  
  METHODS
  The first ninety-nine patients received usual care (UC). The following 91 patients received a structured predischarge discussion, including x-rays, written and verbal information, from the orthopaedic staff (DG). Patients were then randomized into health literacy evaluation before first outpatient review or after first outpatient review.
  
  
  METHODS
  The primary outcome measure was a questionnaire determining health literacy.
  
  
  RESULTS
  Ninety-six (97%) of the UC patients and 87 (96%) of the discussion patients (DG) completed the interview. UC preoutpatient (n = 46) demonstrated a mean score of 4.67 of a maximum 8. UC postoutpatient (n = 50) demonstrated a mean score of 5.42. DG preoutpatient (n = 47) demonstrated a mean score of 6.70. DG postoutpatient (n = 40) demonstrated a mean score of 7.08.
  
  
  CONCLUSIONS
  Australian orthopaedic trauma patients demonstrate poor health literacy, with this not showing improvement after their first outpatient follow-up visit. The use of a time efficient, structured predischarge discussion improved patient health literacy.
  
  
  METHODS
  Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, The Alfred, Melbourne, Victoria, Australia; †Department of Physiotherapy, The Alfred, Melbourne, Victoria, Australia; and ‡Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Filip
authors.initials: F
authors.lastname: Cosic
authors.forename: Lara
authors.initials: L
authors.lastname: Kimmel
authors.forename: Elton
authors.initials: E
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D004521:Educational Measurement / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000601:surgery*; D057220:Health Literacy / Q000379:methods / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007258:Informed Consent / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000193:education*; D063886:Patient Discharge Summaries / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data*; D010361:Patients / Q000706:statistics & numerical data; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult