Opinion 3.1

Quick personal answers with only one reference:

Health Literacy -BOYA

While adult literacy in the United States has been classified as an epidemic, the need for increased health literacy has been an important goal for the last couple of decades.  Knowing the difference is important.  A person with high literacy can potentially have low health literacy.  As with most things healthcare, the definition for health literacy has evolved over the years.  The definition of health literacy began as the degree to which a person can read and understand health information to successfully navigate the health system and make appropriate health decisions for themselves (Bastable, S. B. 2019).  The US Health Resources & Services give the definition as “the degree to which individuals have the capacity to obtain, process, and understand the basic health information needed to make appropriate health decisions” (HRSA 2021).  The US Department of Health & Human Services created the Healthy People Initiative in 2000.  The Healthy People recently released the Healthy People 2030 plan which included 2 definitions: one for the individual which is similar to the HRSA definition and adds an organizational healthy literacy definition: the degree to which organizations equitably enable individuals to find, understand and use information to make informed decisions.  It is no longer the sole responsibility of the individual to acquire and understand health information (Santana, S., Brach, C., Harris, L., Ochiai, E., Blakey, C., Bevington, F., Kleinman, D., Pronk, N.  2021). 

Health care has long struggled with patient education.  Many tools have been developed, changed and intermittently used.  Currently most healthcare establishments have a means to print out, visit summaries, discharge instructions and last medications given.  The limit to these is that they are often difficult to manipulate to reflect an individual’s plan of care.  In recent years, the healthcare system has tried to adjust the reading level to a variety of grades, typically 5th thru 8th.  As a home hospice nurse, I have tried to read and understand the discharge instructions and plan of care with little success.  Mostly because of missing information and confusing abbreviations.  It is imperative that nurses take the time to not just review the nurse’s interpretation of what the discharge or other printed educational information but actually read the instructions to allow the patient or family to ask questions and take notes if wanted about the actual words on the paper.  This is especially important if English isn’t the patient’s first language and the instructions are not available in the first language.  Studies show that over 80% of health information received in a healthcare facility or doctor’s office is forgotten and what is recalled is incorrect. Patient education should begin the first day of contact.  The education should be built upon with every interaction.   Health literacy is complex and involves the patient completing multiple tasks.  These tasks include navigating the health system to access appropriate care, communicating personal information, managing chronic disease process (often more than one) and numeracy: the ability to understand and complete calculations of medications.  Increasing individual’s health literacy leads to lower cost, improved health and increased quality of life (Bass, P. F. 2018). 

The following are some ways to improve health literacy:

1. Good communication:  Clear communication allows for clarification of the patient’s understanding of the main concern the patient is being seen for, what activities the patient or family needs to do to achieve the main goals (this should include who the activities will be accomplished, and why doing these actions is important for meeting the goals.

2. Teach-back:  Ask the patient or family to demonstrate actions needed for treatments and summarize in their own words what the plan of care is.  This allows for identifying any confusion of words and processes.

3. Use plain language:  Use language that easily understood the first time it is said.  Printed information should use headlines placing the most important information first, break complex topics into smaller issues, use language most people use around the dinner table, ensure paragraphs are limited to less than 5 sentences with fewer than 20 words each, and include easy to understand pictures or tables.  Ensure the font size is easy to read.

4. Questions:  Allow time for questions and clarifications.  Don’t be in a hurry to get to the next task or patient.

Knowing the target audience is one of the key components of effective teaching.  If a large part of the population being seen speaks a language other than English, have the printed materials available in multiple languages.  Use an interpreter service to assist in teaching and clarifying questions. 

#2

HEALTH LITERACY -Post

Bindu

What is health literacy? It is defined as the ability to find, understand, evaluate, communicate, and use information is associated with health. In order to live a healthy life, people need to learn a wide range of skills in order to become more knowledgeable. These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction. (Coleman et. al 2008).All individuals and health systems should be aware of health literacy. An example would be:

By using the skills needed to find, understand, evaluate, communicate, and use information, an individual can become health literate.Health care professionals can ensure that people are health literate by communicating health information in ways that improve understanding.Health literacy means that health information and health care can be accessed and delivered in a fair, easy and shame-free way. There are different types of health literacy which are the following:

• Electronic health literacy (e-literacy)

• Numeracy

• Print Literacy

• Health Literacy for the Older Adult

Electronic health literacy (ehealth literacy) is defined as "the ability to search, locate, understand and use health information through electronic resources and use this knowledge to resolve health-related problems" . EHealth resources enable people to make informed decisions about their health, which can improve health outcomes and reduce health inequities. Health professionals should assess people's eHealth literacy before recommending the use of online health information (Valizadeh-Haghi & Rahmatizadeh, 2018). Technological advances have been made over time. As people become more computer literate, they tend to go to the internet to find information about health and advice. In my mind, I recall a story about e-health literacy pertaining to pregnancy. I am the mother of three children. My oldest child is 20 years old. I received advice on different aspects of my pregnancy, breastfeeding, and parenting during my pregnancy (back in early 2000). I am not only talking about my doctors or midwives here; I am also talking about my parents, my aunts, and my cousins. Those who have had children before me have given me advice as well. All advice was taken into consideration with a grateful heart. As soon as my younger brother and wife became pregnant (12 years after I had my first child), I would try to pass on the advice I received to them. In place of listening to me or any other older generation member, they would literally search for information on the internet. I believe the internet has a lot of information, but I think there is also a lack of quality. People who search the internet for information about their health need to also be educated at the same time. Many times, there are too many options on the internet that people are confused about what to do. Doctors and nurses must educate the public so they can understand their health and the treatment that is needed.