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Efthymiou A, Kalaitzaki A, Kondilis B, Rovithis M. Health literacy continuing education courses and tools for healthcare professionals: A scoping review. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:212-247. [PMID: 36545846 DOI: 10.1080/02701960.2022.2156865] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults.
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Affiliation(s)
- Areti Efthymiou
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
| | - Argyroula Kalaitzaki
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- University Centre of Research and Innovation 'Institute of AgriFood and Life Sciences, HMU
| | - Barbara Kondilis
- Department of Art & Sciences, Hellenic American University, Nashua, Greece
| | - Michael Rovithis
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- Department of Business Administration and Tourism, Hellenic Mediterranean University, Heraklion, Crete
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Portela-Pino I, Brea-Castro M, Portela-Pino C, Pino-Juste M. Health literacy and pandemic coping in Leisure Time Monitors. Glob Health Promot 2024; 31:15-24. [PMID: 37609824 DOI: 10.1177/17579759231191501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Health literacy allows us to make appropriate decisions about our self-care and to use health services appropriately, therefore, it conditions people's health. OBJECTIVES The aim of this study was to describe the level of health literacy of leisure time monitors and the influence of self-perception of health in times of pandemic. STUDY DESIGN We used a cross-sectional observational design with non-probabilistic purposive sampling among leisure time monitors in the Autonomous Community of Galicia (Spain). METHOD For this purpose, the HLS-EU-Q47 questionnaire measuring health literacy and a questionnaire measuring perception of COVID-19 were used. RESULTS The results verify that the monitors consider that the pandemic affects their daily life, that it will be a situation that will last for a long time, and they are very worried. The low level of health literacy of the leisure time monitors is also confirmed. CONCLUSIONS Therefore, it seems urgent to evaluate the existing training programme and to include health education contents in this programme, given the involvement of leisure time monitors in the training of children and adolescents.
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Affiliation(s)
- Iago Portela-Pino
- Department of Health Sciences, Faculty of Health Sciences, Isabel I University, Burgos, Spain
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Millán Brea-Castro
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Psychoeducational Analysis and Intervention, Faculty of Education, University of Vigo, Ourense, Spain
| | - Clara Portela-Pino
- Internal Medicine Service, Complejo Hospitalario Universitario de Vigo, Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Margarita Pino-Juste
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Didactics, School Organization and Research Methods, Faculty of Education and Sport Sciences, University of Vigo, Spain
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Bulfone G, Bressan V, Zerilli I, Mazzotta R, Favara G, Magnano San Lio R, Barchitta M, Agodi A. Nursing students' Health Literacy skills: a scoping review protocol for driving research. BMJ Open 2024; 14:e075682. [PMID: 38382950 PMCID: PMC10882316 DOI: 10.1136/bmjopen-2023-075682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research. METHODS AND ANALYSIS This scoping review will be conducted following Arksey and O'Malley's framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit. ETHICS AND DISSEMINATION This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals. REGISTRATION DETAILS The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7).
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Affiliation(s)
- Giampiera Bulfone
- Department of Medical, Surgical Science and Advanced Technology "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Valentina Bressan
- Department of Specialistic Medicine, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Irene Zerilli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | - Rocco Mazzotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | - Giuliana Favara
- Department of Medical, Surgical Science and Advanced Technology "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Roberta Magnano San Lio
- Department of Medical, Surgical Science and Advanced Technology "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Martina Barchitta
- Department of Medical, Surgical Science and Advanced Technology "G. F. Ingrassia", University of Catania, Catania, Italy
| | - Antonella Agodi
- Department of Medical, Surgical Science and Advanced Technology "G. F. Ingrassia", University of Catania, Catania, Italy
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Chang MC, Yu JH, Hsieh JG, Wei MH, Wang YW. Effectiveness of the refined health literacy course on improving the health literacy competencies of undergraduate nursing students: quantitative and qualitative perspectives. MEDICAL EDUCATION ONLINE 2023; 28:2173042. [PMID: 36718508 PMCID: PMC9891155 DOI: 10.1080/10872981.2023.2173042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/05/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
People with limited health literacy comprise a high-risk group for adverse health outcomes. Nurses must be made aware of the importance of health literacy and communicate with patients in plain language, which will solve the obstacles for patients using health care services. Providing health literacy education for nurses is an important strategy for health literacy practices. This study aimed to develop a refined health literacy course for nursing students and evaluate its effectiveness. The study used a single-group pre- and post-test quasi-experimental design and conducted focus group interviews. The intervention was an eight-hour course and applied team-based learning combined with various teaching methods. The study enrolled second-year nursing students of a university in eastern Taiwan via convenient sampling. A self-reported structured questionnaire was used to compare the participants' familiarity with health literacy, attitude, confidence in oral communication, and ability in written communication before and after the course. To discuss the learning experience of the course, the study held two focus groups with 12 participants. A total of 81 participants completed the pre- and post-test questionnaires. The results showed that familiarity with health literacy (t=9.12, t<.001), attitude (t=4.89, t<.001), confidence in oral communication (t=4.12, t<.001), and ability in written communication (t=8.83, t<.001) showed improvement after the course. Data analysis of focus group interviews yielded two categories and seven themes for the learning experience, most of which showed participants' positive learning experiences in the health literacy course. The course effectively enhanced the nursing students' knowledge and attitude toward health literacy and the ability to communicate with patients using health literacy principles. The results can provide a reference for integrating health literacy education into the undergraduate nursing curriculum.
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Affiliation(s)
- Mei-Chuan Chang
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Jui-Hung Yu
- Department of Public Health, Tzu Chi University, Hualien City, Taiwan
| | - Jyh-Gang Hsieh
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien City, Taiwan
- Department of Medical Humanities, School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Mi-Hsiu Wei
- Department of Communication Studies, Tzu Chi University, Hualien City, Taiwan
| | - Ying-Wei Wang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien City, Taiwan
- Department of Medical Humanities, School of Medicine, Tzu Chi University, Hualien City, Taiwan
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Abrams MA, Crichton KG, Oberle EJ, Flowers S, Crawford TN, Perry MF, Mahan JD, Reed S. A Refined Teach-back Observation Tool: Validity Evidence in a Pediatric Setting. Health Lit Res Pract 2023; 7:e187-e196. [PMID: 37812909 PMCID: PMC10561624 DOI: 10.3928/24748307-20230919-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/25/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Teach Back (TB) is recommended to assess and ensure patient understanding, thereby promoting safety, quality, and equity. There are many TB trainings, typically lacking assessment tools with validity evidence. We used a pediatric resident competency-based communication curriculum to develop initial validity evidence and refinement recommendations for a Teach-back Observation Tool (T-BOT). OBJECTIVE This study aimed to develop initial validity evidence for a refined T-BOT and provide guidance for further enhancements to improve essential TB skills training among pediatric residents. METHODS After an interactive health literacy (HL) training, residents participated in recorded standardized patient (SP) encounters. Raters developed T-BOT scoring criteria, then scored a gold standard TB video and resident SP encounters. For agreement, Fleiss' Kappa was computed for >2 raters, and Cohen's Kappa for two raters. Percent agreement and intraclass correlation (ICC) were calculated. Statistics were calculated for gold standard (GS) and TB items overall for all six raters, and for five faculty raters. Agreement was based on Kappa: no agreement (≤0), none to slight (0.01-0.20), fair (0.21-0.40), moderate (0.41-0.60), substantial (0.61-0.80), almost perfect (0.81-1.00). KEY RESULTS For six raters, Kappa for the GS was 0.554 (moderate agreement) with 71.4% agreement; ICC = .597; for SP encounters, it was 0.637 (substantial) with 65.4% agreement; ICC = .647. Individual item agreement for SP encounters average was 0.605 (moderate), ranging from 0.142 (slight) to 1 (perfect). For five faculty raters, Kappa for the GS was 0.779 (substantial) with 85.7% agreement; ICC = .824; for resident SP encounters, it was 0.751 (substantial), with 76.9% agreement; ICC = .759. Individual item agreement on SP encounters average was 0.718 (substantial), ranging from 0.156 (slight) to 1 (perfect). CONCLUSION We provide initial validity evidence for a modified T-BOT and recommendations for improvement. With further refinements to increase validity evidence, accompanied by shared understanding of TB and rating criteria, the T-BOT may be useful in strengthening approaches to teaching and improving essential TB skills among health care team members, thereby increasing organizational HL and improving outcomes. [HLRP: Health Literacy Research and Practice. 2023;7(4):e187-e196.].
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Affiliation(s)
- Mary Ann Abrams
- Address correspondence to Mary Ann Abrams, MD, MPH, Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205;
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Papa R, Sixsmith J, Giammarchi C, Lippke S, McKenna V, Di Furia L, Ceravolo MG, De Winter A. Health literacy education at the time of COVID-19: development and piloting of an educational programme for university health professional students in 4 European countries. BMC MEDICAL EDUCATION 2023; 23:650. [PMID: 37684654 PMCID: PMC10492329 DOI: 10.1186/s12909-023-04608-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/23/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Health literacy has a strong influence on individual health outcomes and the sustainability of healthcare systems. Healthcare professionals often overestimate patients' health literacy levels and lack adequate competencies to address limited health literacy effectively. Therefore, promoting understanding through effective health communication between professionals and citizens is becoming increasingly important. Although health literacy has recently gained more attention, health literacy educational programmes targeting future healthcare professionals are still scarce, especially in Europe. This study describes the piloting process of a pan-European health literacy educational programme and shows how the educational material is being used during time of crisis such as the COVID-19 pandemic. METHODS The educational programme was developed through the definition of an educational philosophy and iterative co-creation processes consisting of stakeholders' consultations, material development and pilots with students. The evaluation was carried out in Italy through four pilot tests involving 107 students of health-related degrees. An evaluation questionnaire and a pre-post test were developed and used to collect students' and educators' feedback (quantitative and qualitative) and assess changes in health literacy awareness, respectively. Three additional pilots were organized in Italy and Germany mostly during the COVID-19 pandemic to evaluate the feasibility of the educational programme through online and hybrid learning, respectively. RESULTS The pilots received positive feedback from both students and educators. Students were highly satisfied with the courses, reported their relevance for their future profession and appreciated the interactive teaching methods. The pre-post test showed a significant improvement in health literacy awareness after the training. Educators reported the adequacy and flexibility of the training material, the ease of transferability of the content of the lessons into practice, and the validity of the tested options to integrate the educational programme into the curricula. CONCLUSIONS Our comprehensive, evidence-based educational programme contributes to addressing the existing challenges in Europe, and its flexibility allows for easy integration in the curricula, through different options, hence supporting a widespread uptake in the European Union and maybe beyond. Health literacy education is a useful tool to improve citizens' access to healthcare information and services, achieve better health outcomes and support healthcare systems' sustainability.
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Affiliation(s)
- Roberta Papa
- Regional Health Agency Marche Region, Palazzo Rossini - via Gentile da Fabriano n.3, Ancona, 60125, Italy.
- IRCCS INRCA, Ancona, Italy.
| | - Jane Sixsmith
- Health Promotion Research Centre, Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | | | | | - Verna McKenna
- Health Promotion Research Centre, Discipline of Health Promotion, National University of Ireland Galway, Galway, Ireland
| | - Lucia Di Furia
- Regional Health Agency Marche Region, Palazzo Rossini - via Gentile da Fabriano n.3, Ancona, 60125, Italy
| | - Maria Gabriella Ceravolo
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Andrea De Winter
- Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Ramón-Arbués E, Granada-López JM, Antón-Solanas I, Cobos-Rincón A, Rodríguez-Calvo A, Gea-Caballero V, Tejada-Garrido CI, Juárez-Vela R, Echániz-Serrano E. Factors related with nursing students' health literacy: a cross sectional study. Front Public Health 2023; 11:1053016. [PMID: 37275493 PMCID: PMC10234423 DOI: 10.3389/fpubh.2023.1053016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Abstract
Background Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals. Objective The objective of the study was to examine the health literacy of nursing students and its associated factors. Methods A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire. Results 6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone (p < 0.05). Conclusion A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students.
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Affiliation(s)
- Enrique Ramón-Arbués
- Faculty of Health Sciences, San Jorge University, Villanueva de Gállego, Spain
- SAPIENF Investigation Group, Zaragoza, Spain
| | - José Manuel Granada-López
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- GIISA021 Seguridad y Cuidados Investigation Group, Zaragoza, Spain
| | - Isabel Antón-Solanas
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Antonio Rodríguez-Calvo
- Department of Anesthesia, Complex University of Salamanca, Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Community Health and Care Research Group, SALCOM, Valencia, Spain
| | - Clara Isabel Tejada-Garrido
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Emmanuel Echániz-Serrano
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
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Yang HF, Chang CC, Tseng PL, Lai HR, Tasi JS, Huang WH, Fan YH, Weng CX, Tung CY. Effectiveness of innovative instructional module for professional competence in health literacy in medical students. BMC MEDICAL EDUCATION 2022; 22:210. [PMID: 35351115 PMCID: PMC8960696 DOI: 10.1186/s12909-022-03252-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 03/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Physicians should be equipped with professional competence in health literacy to communicate more effectively with patients with limited health literacy. However, the health literacy curriculum has not yet been refined globally, and is scarce in Taiwan's medical education. We implemented an innovative instructional module to attain professional competence in health literacy among medical students and investigated its effects. METHODS We adopted a quasi-experimental design and recruited 204 fifth-year Taiwanese medical students between December 2019 and May 2020. Participants who worked as clerks at the Department of Family Medicine of three medical schools in northern Taiwan were assigned to the experimental group through convenience sampling. A total of 98 students received a three-hour innovative instruction, including medical simulation videos, role-playing, and board games. Both the experimental and control groups completed the online pre-test and mail-in post-test. A generalized estimating equation was applied to measure the effects of the intervention. RESULTS There was a significant difference between the experimental and control groups in terms of professional competence in health literacy in all three aspects. In terms of knowledge, the experimental group improved 12% more than the control group (𝛽=0.12, 95% CI: 0.05 ~ 0.19, p = 0.001). In terms of attitude, the experimental group improved by an average of 0.27 more points per question than the control group (𝛽=0.27, 95% CI: 0.08 ~ 0.46, p = 0.007). As for skill, the experimental group improved by an average of 0.35 more points per question than the control group (𝛽=0.35, 95% CI: 0.14 ~ 0.55, p = 0.001). CONCLUSION The proposed innovative instructional module significantly improved fifth-year medical students' professional competence in health literacy, which is expected to benefit their future medical practices.
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Affiliation(s)
- Hui-Fang Yang
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chen Chang
- Department of Senior Citizen Service Business, College of Human Ecology and Design, St. John's University, New Taipei, Taiwan
| | - Pei-Ling Tseng
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
| | - Hsiang-Ru Lai
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan
| | - Jaw-Shiun Tasi
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Hsin Huang
- Community Health Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yu-Hao Fan
- Department of General Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ci-Xiang Weng
- Department of General Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chen-Yin Tung
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei City, 106, Taiwan.
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Voigt-Barbarowicz M, Dietz G, Renken N, Schmöger R, Brütt AL. Patients' Health Literacy in Rehabilitation: Comparison between the Estimation of Patients and Health Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3522. [PMID: 35329219 PMCID: PMC8953381 DOI: 10.3390/ijerph19063522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 02/06/2023]
Abstract
The term health literacy (HL) comprises the handling of health information and disease-specific and generic self-management skills, especially relevant for patients with chronic conditions. Health care professionals (HCPs) should correctly identify patients' communication needs and their HL levels. Therefore, the aims of the study were (1) to determine inpatient medical rehabilitation patients' HL based on self-assessment, (2) to evaluate changes from admission to discharge, (3) to identify HCPs estimation of patients' HL, and (4) to compare the estimated patient HL by patients and HCPs. A combined cross-sectional and longitudinal study was conducted in an orthopedic rehabilitation center in Germany. The multidimensional Health Literacy Questionnaire (HLQ) was filled in by patients (admission, discharge). An adapted version was administered to HCPs (n = 32) in order to assess HL of individual patients. Data from 287 patients were used for the longitudinal analysis, and comparison was based on n = 278 cases with at least two HL estimations. The results showed a significant increase in HL in five of nine scales with small effect sizes. Moreover, HCPs mostly provided higher scores than patients, and agreement was poor to fair. Differences between the HL estimation might lead to communication problems, and communication training could be useful.
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Affiliation(s)
- Mona Voigt-Barbarowicz
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
| | - Günter Dietz
- Clinic for Orthopedic and Rheumatological Rehabilitation, Rehabilitation Centre Bad Zwischenahn, 26160 Bad Zwischenahn, Germany; (G.D.); (N.R.)
| | - Nicole Renken
- Clinic for Orthopedic and Rheumatological Rehabilitation, Rehabilitation Centre Bad Zwischenahn, 26160 Bad Zwischenahn, Germany; (G.D.); (N.R.)
| | - Ruben Schmöger
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
| | - Anna Levke Brütt
- Junior Research Group for Rehabilitation Sciences, Department of Health Services Research, University of Oldenburg, 26129 Oldenburg, Germany; (R.S.); (A.L.B.)
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Sriyanah N, Kadar KS, Efendi S. Knowledge, attitude and barriers towards health literacy among health professionals working in hospital. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anderson KM, Leister S, De Rego R. The 5Ts for Teach Back: An Operational Definition for Teach-Back Training. Health Lit Res Pract 2021; 4:e94-e103. [PMID: 32293689 PMCID: PMC7156258 DOI: 10.3928/24748307-20200318-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/22/2019] [Indexed: 01/02/2023] Open
Abstract
Background: Teach Back is a health communication strategy used to confirm patient understanding in a non-shaming way. Although Teach Back is widely recommended as a best practice strategy for improving patient outcomes and organizational health literacy, there is lack of consensus in the literature on the definition of Teach Back and the best methods for training health care workers (HCWs). Our experience suggests that if you teach specific, observable skills, these can be identified in practice and potentially measured in research. Brief description of activity: We created a training program, the 5Ts for Teach Back, based on a standardized operational definition of Teach Back and five specific, observable components. Participants use a Teach-Back Observation Tool to identify the 5Ts in practice and during peer evaluation. The program incorporates lecture, observation, practice, and videos with good and bad examples of Teach Back. Implementation: The training was offered to HCWs in a large academic health care system. Flexible training options ranged from a single 4-hour training to a more comprehensive program that included clinic-specific scenarios, peer coaching, and refresher activities over a 6-month period. Results: The 5Ts for Teach Back operationalizes the definition of Teach Back and provides a model for training HCWs in the use of Teach Back. The 5Ts for Teach Back can be used to train any HCW. A single training session does not guarantee proficiency in practice. Through coaching and refresher activities, competence in Teach Back increases. Lessons learned: Teaching entire clinical units may increase effectiveness, because Teach Back becomes embedded in the unit culture. The Observation Tool can be used for training, coaching, and evaluation. The standardized method and Observation Tool are potentially useful when evaluating Teach Back during outcomes and patient satisfaction research. [HLRP: Health Literacy Research and Practice. 2020;4(2):94–103.] Plain Language Summary: Health care workers may be clearer when giving information to patients if they use Teach Back. Studies do not show what methods are best for training health care workers how to do Teach Back. The 5Ts method breaks Teach Back into five skills that help health care workers do it well. The 5Ts can also confirm use and may be helpful for research.
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Affiliation(s)
- Kathryn M. Anderson
- Address correspondence to Kathryn M. Anderson, MA, University of New Mexico Hospitals, 2211 Lomas NE, Albuquerque, NM 87131;
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Mak V, Sandhu AK, Krishnan S. Using Simulation to Teach Methods for Improving Patient Literacy about Medicines. PHARMACY 2020; 8:E192. [PMID: 33081062 PMCID: PMC7720145 DOI: 10.3390/pharmacy8040192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023] Open
Abstract
Pharmacists have a role in educating patients on the self-management of their medications, using accurate medicines lists. Thus, pharmacy students need to be adequately trained and assessed in health-literacy skills to be competent for future patient-education consultations using medicines lists. Performance-based assessments using patient simulation are often utilized to examine students' competence in clinical knowledge and communication skills. Due to COVID-19, education systems changed to remote online delivery utilizing video conferencing platforms (i.e., ZoomTM), which proved challenging for performance-based assessments. These challenges include difficulty in observing non-verbal cues over ZoomTM and not having adequate internet access. Adaptations to reduce reliance on internet access were made where students submitted a video-recording task wherein they educated a simulated patient on a medicines list, under lockdown restrictions during the pandemic. A total of 304 submissions were received where students performed the role-play with a simulated patient, such as their family members, housemates or peers either at home in person or via ZoomTM. Although it was not an original goal of the task, the collaborative effort between pharmacy instructors, students and the public helped increase awareness of medicines lists through this task.
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Affiliation(s)
- Vivienne Mak
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Anisha Kaur Sandhu
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia; (A.K.S.); (S.K.)
| | - Sunanthiny Krishnan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia; (A.K.S.); (S.K.)
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Voigt-Barbarowicz M, Brütt AL. The Agreement between Patients' and Healthcare Professionals' Assessment of Patients' Health Literacy-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072372. [PMID: 32244459 PMCID: PMC7177784 DOI: 10.3390/ijerph17072372] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022]
Abstract
Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. This involves assisting patients to locate, comprehend and evaluate health information. HCPs should assess patients’ health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients’ and HCPs assessment of patients’ HL. A systematic literature search in PubMed, Scopus, PsycINFO, CINAHL and the Cochrane Library was performed in November 2019. The search yielded 6762 citations, seven studies met the inclusion criteria. The following HL measurement instruments were completed by the patients in the included studies: REALM (n = 2), REALM-R (n = 1), S-TOFHLA (n = 1), NVS (n = 1), SILS (n = 1), HLSI-SF (n = 1) and HLS-EU-Q16 (n = 1). The HCPs assessed patients’ HL by answering questions that reflect the content of standardized tools. Six studies reported that a high proportion of patients assigned to have HL needs based on their self-report were overestimated by their HCPs in terms of the HL level. The results demonstrated that HCPs had difficulty determining patients’ HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems.
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Balmer D, King A, Moloney W, Moselen E, Dixon R. Nursing students and health literacy: The effect of region and programme level. Nurse Educ Pract 2020; 42:102688. [DOI: 10.1016/j.nepr.2019.102688] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/23/2019] [Accepted: 12/06/2019] [Indexed: 11/25/2022]
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Kaper MS, Reijneveld SA, van Es FD, de Zeeuw J, Almansa J, Koot JA, de Winter AF. Effectiveness of a Comprehensive Health Literacy Consultation Skills Training for Undergraduate Medical Students: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010081. [PMID: 31861918 PMCID: PMC6982343 DOI: 10.3390/ijerph17010081] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/12/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022]
Abstract
Comprehensible communication by itself is not sufficient to overcome health literacy related problems. Future doctors need a larger scope of capacities in order to strengthen a patient’s autonomy, participation, and self-management abilities. To date, such comprehensive training-interventions are rarely embedded in curricula, nor systematically evaluated. We assessed whether comprehensive training increased these health literacy competencies, in a randomized controlled trial (RCT), with a waiting list condition. Participants were international undergraduate medical students of a Dutch medical faculty (intervention: 39; control: 40). The 11-h-training-intervention encompassed a health literacy lecture and five interactive small-group sessions to practise gathering information and providing comprehensible information, shared decision-making, and enabling of self-management using role-play and videotaped conversations. We assessed self-reported competencies (knowledge and awareness of health literacy, attitude, self-efficacy, and ability to use patient-centred communication techniques) at baseline, after a five and ten-week follow-up. We compared students’ competencies using multi-level analysis, adjusted for baseline. As validation, we evaluated demonstrated skills in videotaped consultations for a subsample. The group of students who received the training intervention reported significantly greater health literacy competencies, which persisted up to five weeks afterwards. Increase was greatest for providing comprehensible information (B: 1.50; 95% confidence interval, CI 1.15 to 1.84), shared decision-making (B: 1.08; 95% CI 0.60 to 1.55), and self-management (B: 1.21; 95% CI 0.61 to 1.80). Effects regarding demonstrated skills confirmed self-rated competency improvement. This training enhanced a larger scope of health literacy competences and was well received by medical students. Implementation and further evaluation of this training in education and clinical practice can support sustainable health literacy capacity building of future doctors and contribute to better patient empowerment and outcomes of consultations.
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Affiliation(s)
- Marise S. Kaper
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
- Correspondence:
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Frank D. van Es
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Janine de Zeeuw
- Faculty of Medical Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (F.D.v.E.); (J.d.Z.)
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Jaap A.R. Koot
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
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Nesari M, Olson JK, Nasrabadi AN, Norris C. Registered Nurses' Knowledge of and Experience with Health Literacy. Health Lit Res Pract 2019; 3:e268-e279. [PMID: 31893259 PMCID: PMC6901361 DOI: 10.3928/24748307-20191021-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/07/2019] [Indexed: 11/20/2022] Open
Abstract
Background Limited skill in health literacy is a global issue. Variation in health literacy skills within societies is a source of health inequality unless health care providers apply health literacy practices to effectively communicate with all clients. Objective This study examined Iranian registered nurses' knowledge of and experience with health literacy practices. Methods: This cross-sectional study provides a quantitative description of knowledge of and experience with health literacy practices. Using a rigorous process, we adapted the Health Literacy Knowledge and Experience Survey to collect data from the participants, who were 190 registered nurses working in Tehran, Iran. Key Results Findings identify gaps in participants' knowledge and experience with health literacy practices. Knowledge deficits are most noticeable in standards to create written materials, screening tools to identify limited health literacy, and the Teach-Back strategies to determine people's understanding. Limited experience is prominent in using health literacy screening tools, evaluating written health information, and applying technologies to provide health information. Our multivariate analysis suggests participants who reported more interaction with health care professionals for personal reasons scored higher in knowledge of health literacy practices. Conclusions This study indicated that registered nurses in Iran do not have adequate knowledge and experience regarding health literacy practices. Addressing this issue is fundamental to promoting health equity. Future investigations should identify both barriers and facilitators for nurses to apply health literacy practices. [HLRP: Health Literacy Research and Practice. 2019;3(4):e268-e279.]. Plain Language Summary Health literacy practices enable health care professionals to offer understandable health information to all people and contribute to health equity. We surveyed 190 registered nurses in Iran to assess their knowledge of and experience with health literacy practices. The findings will be a guide to create interventions to improve registered nurses' knowledge of these practices and to use them to communicate clearly with clients.
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Affiliation(s)
- Maryam Nesari
- Address correspondence to Maryam Nesari, PhD, RN, Faculty of Medicine and Dentistry, University of Alberta, 4-284, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, Canada, T6G 1C9;
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Anwar M, El‐Dahiyat F, Shriki HA, Khaled MA, Rani A. An insight into the perception of community pharmacists on health literacy. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2019. [DOI: 10.1111/jphs.12323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mudassir Anwar
- School of Pharmacy University of Otago Dunedin New Zealand
| | - Faris El‐Dahiyat
- College of Pharmacy Al Ain University of Science and Technology Al Ain United Arab Emirates
| | - Humam A. Shriki
- College of Pharmacy Al Ain University of Science and Technology Al Ain United Arab Emirates
| | - Mohammad A. Khaled
- College of Pharmacy Al Ain University of Science and Technology Al Ain United Arab Emirates
| | - Afshan Rani
- Faculty of Education Virtual University of Pakistan Lahore Pakistan
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Kaper MS, Winter AFD, Bevilacqua R, Giammarchi C, McCusker A, Sixsmith J, Koot JAR, Reijneveld SA. Positive Outcomes of a Comprehensive Health Literacy Communication Training for Health Professionals in Three European Countries: A Multi-centre Pre-post Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203923. [PMID: 31619010 PMCID: PMC6843857 DOI: 10.3390/ijerph16203923] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/16/2022]
Abstract
Many professionals have limited knowledge of how to address health literacy; they need a wider range of health literacy competencies to enhance empowerment and person-centred prevention. We evaluated whether: (1) a comprehensive health literacy training increased self-rated competencies of health professionals to address health literacy related problems and support the development of people's autonomy and self-management abilities after training and 6-12 weeks later, (2) professionals were satisfied with the training, (3) outcomes differed for the three participating European countries. Health professionals (N = 106) participated in a multicentre pre-post intervention study in Italy, the Netherlands and Northern Ireland. The 8-hour training-intervention involved health literacy knowledge, the practice of comprehensible communication skills, shared decision-making, and enhancing self-management. Self-rated health literacy competencies and training satisfaction were assessed at baseline, immediately after training and 6-12 weeks later, and analysed by multi-level analysis. Professionals' self-rated health literacy competencies significantly improved following training in all three countries; this increase persisted at 6-12 weeks follow-up. The strongest increase regarded professional's skills to enhance shared-decision making and enabling self-management after training and follow-up respectively. Professionals perceived the training as relevant for practice. Competency increases seemed to be consistent across countries. In three countries, professionals' self-rated health literacy competencies increased following this comprehensive training. These promising findings should be confirmed in a further full effect study. Implementation of this training in European education and health care may improve person-centred communication by professionals and might help to tackle health literacy related problems and to strengthen people's abilities in achieving better health outcomes.
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Affiliation(s)
- Marise S Kaper
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands.
| | - Andrea F de Winter
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
| | - Roberta Bevilacqua
- IRCCS INRCA (the National Institute of Health and Science on Aging), 60124 Ancona, Italy
| | - Cinzia Giammarchi
- IRCCS INRCA (the National Institute of Health and Science on Aging), 60124 Ancona, Italy
- The Regional Agency for Health (ARS of the Marche region), 60125 Ancona, Italy
| | | | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Jaap A R Koot
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
| | - Sijmen A Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
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Pirialam H, Kazerani M, Shekofteh M, Razzaghi Z. The importance of public libraries in education for health literacy: A case study on diabetic patients. IFLA JOURNAL-INTERNATIONAL FEDERATION OF LIBRARY ASSOCIATIONS 2019. [DOI: 10.1177/0340035219857445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Public libraries can play a major role in improving health literacy of clients by offering special services. Educating diabetic patients through public libraries can improve the dissemination of health information. The objective of the study was to evaluate the effect of education on the level of health literacy among diabetic patients referring to a public library, and the relationship between health literacy level, age and gender of patients. This research is a quasi-experimental study with pre-test and post-test. The study population included 48 diabetic patients referring to the public library. The research tool is a nationalized adult health literacy questionnaire in Iran. Results showed that 14.5% of samples had the maximum access to the required information in terms of accessibility. In terms of reading skill, 20% of samples had the maximum skill needed to read the information resources. In terms of information comprehension, 27% of samples had a maximum comprehending of the information they needed. In terms of evaluation, 13.5% of samples had completely correct evaluation of the information they needed. In terms of decision making, 24.5% of the people made decisive decisions about their information demands. The mean health literacy of diabetic patients before and after education showed a significant difference. In addition, no significant relationship was found between the level of health literacy and the age of diabetic patients referring to the public library before and after education (r <0.05). The health literacy level of diabetic patients increased before and after education in both males and females. It was concluded that as one of the tasks of public libraries is teaching citizens, the use of educational capacities in public libraries in the health sector can improve community health.
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Affiliation(s)
- Hamed Pirialam
- Department of Medical library and Information Science, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Kazerani
- Department of Medical library and Information Science, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Shekofteh
- Department of Medical library and Information Science, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Razzaghi
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ozen N, Bal Ozkaptan B, Coskun S, Terzioglu F. Health literacy of nursing students and its effective factors. Nurs Forum 2019; 54:396-402. [PMID: 30997673 DOI: 10.1111/nuf.12346] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/18/2019] [Accepted: 03/27/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The insufficiency of health literacy negatively affects the national economy as it leads to increased health service expenditure. It is very important for individuals to have accurate health-related information to reduce these negative effects. AIM The aim of the study is to examine the health literacy of nursing students and its effective factors. METHODS This descriptive study was carried out with students from the nursing department of a vocational school of health sciences between September and October 2018 in Turkey. A semi-structured questionnaire regarding the descriptive features of the participants and the European Health Literacy Scale were used for data collection. RESULTS The study included 283 nursing students; 29.3% had a problematic-limited health literacy level. The study found a statically significant difference between student year, high school graduation and family's income level and the total mean score of the HLS-EU scale. CONCLUSION The subject of health literacy should be integrated into the educational program of nursing students. The nurses are the most important workforce in health services, and awareness about this subject should be raised.
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Affiliation(s)
- Nurten Ozen
- Department of Midwifery, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
| | | | - Sabahat Coskun
- Department of Training, Gulhane Education and Research Hospital, Ankara, Turkey
| | - Fusun Terzioglu
- Department of Nursing, Faculty of Health Sciences, Atılım University, Ankara, Turkey
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Parnell TA, Stichler JF, Barton AJ, Loan LA, Boyle DK, Allen PE. A concept analysis of health literacy. Nurs Forum 2019; 54:315-327. [PMID: 30793314 DOI: 10.1111/nuf.12331] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/10/2019] [Accepted: 01/27/2019] [Indexed: 01/04/2023]
Abstract
AIM To propose a conceptual definition of health literacy incorporating system demands, burdens, and complexities that are a critical part of patients' level of health literacy. BACKGROUND Health literacy is used frequently in health care and often is confused with patients' reading and comprehension levels. DESIGN Walker and Avant's concept analysis method was used. DATA SOURCE Cochrane Library, Cumulative Index of Nursing and Health Literature, OVID, PubMed, EBSCO Host databases, and Google Scholar. REVIEW METHOD The primary Search terms and MeSH terms used were health literacy, patient education, patient engagement, patient activation, health communication, health promotion, and nursing. Empirical and nonempirical articles published in English were reviewed. Ten systematic literature reviews were included. RESULTS A new definition of health literacy is provided based on four components that include: system demands, burdens, and complexities; measurable components, processes and outcomes; the dynamic nature of health literacy; and demonstration of the direct relationship of informed decisions to informed actions. Defining attributes, antecedents, and consequences are identified. Implications for nursing practice, education, and research are given. CONCLUSIONS Because health literacy is a dynamic and quickly changing concept, further exploration and evolution of the concept is warranted as empirical research and theoretical literature emerge.
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Affiliation(s)
- Terri Ann Parnell
- Principal & Founder of Health Literacy Partners, LLC, Garden City, New York.,Stony Brook University, School of Health Technology and Management, Southampton, New York
| | | | - Amy J Barton
- College of Nursing, University of Colorado, Aurora, Colorado
| | - Lori A Loan
- Family, Community, & Health Systems, UAB School of Nursing, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Diane K Boyle
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming
| | - Patricia E Allen
- Texas Tech University Health Sciences Center School of Nursing, Lubbock, Texas
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Joseph G, Lee R, Pasick RJ, Guerra C, Schillinger D, Rubin S. Effective communication in the era of precision medicine: A pilot intervention with low health literacy patients to improve genetic counseling communication. Eur J Med Genet 2018; 62:357-367. [PMID: 30553023 DOI: 10.1016/j.ejmg.2018.12.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 01/19/2023]
Abstract
Effective communication, where all parties share a common understanding, is necessary to realize the promise of Genomic Medicine. It is especially salient given the imperative to increase the participation of diverse populations in genomics research and to expand the reach of clinical genomics. We have previously shown that cancer genetic counseling is suboptimal for patients with limited health literacy. To address this finding, we implemented a pilot study to improve verbal communication between genetic counselors and their patients of limited health literacy that consisted of: i) curriculum development and delivery of a Genetic Counselors (GC) communication workshop; ii) two-month post-workshop interviews with GC participants (n = 9); iii) observations/audio recordings of counseling sessions involving 24 patients and two GC workshop participants; iv) post-counseling interviews with patients (n = 9). The 4.5-h workshop presented evidenced-based principles and strategies for effective communication with limited health literacy patients (e.g. use of plain language and teach-back), and offered specific techniques and exercises to practice adoption of such practices in the genetic counseling context. GCs expressed appreciation for the opportunity to refine their skills; however, they reported that some strategies were challenging given their professional training and communication habits. For example, GCs were concerned that use of plain language could undermine efforts to obtain informed consent and provide scientifically accurate information. Observations and patient interviews after the workshop revealed that GCs were able to employ the communication strategies with positive effects, with patients indicating sufficient understanding of the genetic test and its implications as well as satisfaction with the counselors' communication. While derived from research on communication with those of limited health literacy, the communication approaches taught in the GC workshop could benefit most patients, given the high rates of low health literacy in many countries, and the many factors beyond health literacy that can contribute to reduced comprehension in health care environments.
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Affiliation(s)
- Galen Joseph
- Department of Anthropology, History & Social Medicine, University of California, San Francisco, United States; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States.
| | - Robin Lee
- Cancer Genetics & Prevention Program, University of California, San Francisco, United States
| | - Rena J Pasick
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States; Department of General Internal Medicine, University of California, San Francisco, United States
| | - Claudia Guerra
- Department of General Internal Medicine, University of California, San Francisco, United States
| | - Dean Schillinger
- Department of Medicine, University of California, San Francisco, United States
| | - Sara Rubin
- Department of Social & Behavioral Sciences, University of California, San Francisco, United States
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Hernes K, Ott V. Health Literacy Education for Undergraduate Health Professions Students: A Call to Action. Health Lit Res Pract 2018; 2:e163-e165. [PMID: 31294291 PMCID: PMC6607840 DOI: 10.3928/24748307-20180726-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Vivian Ott
- Address correspondence to Vivian Ott, PhD, RN, NE-BC, College of Nursing, Purdue University Northwest, T-374, 1401 S. U.S. Highway 421, Westville, IN 46391;
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van der Heide I, Poureslami I, Mitic W, Shum J, Rootman I, FitzGerald JM. Health literacy in chronic disease management: a matter of interaction. J Clin Epidemiol 2018; 102:134-138. [PMID: 29793001 DOI: 10.1016/j.jclinepi.2018.05.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 11/19/2022]
Abstract
Health literacy plays a crucial role in chronic disease management. To comprehensively manage chronic conditions on a daily basis, individuals must be able to assess, understand, evaluate, and use health information. Several key publications emphasize that health literacy is not merely a matter of individual skills but that it is highly dependent on the accessibility of health-care systems, the communication skills of health-care professionals, and the level of complexity of the health information. However, the literature indicates that health literacy is mainly framed and measured as an individual attribute in research. Focusing health literacy research solely on the individual, rather than also including the health-care context, limits our understanding of the type of actions that should be undertaken to facilitate a person's access to and understanding, evaluation and use of health information. This commentary highlights the importance of interpreting the concept of health literacy as a dynamic construct that emerges from the interaction between patients/citizens and health-care systems, organizations, and professionals. This approach has the potential to fill a gap in our understanding of the link between health literacy and chronic disease management. Such an understanding would facilitate the development of comprehensive health literacy measurement instruments and interventions to enhance health literacy.
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Affiliation(s)
- Iris van der Heide
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, Gordon and Leslie Diamond Health Care Centre, The University of British Columbia, 7th floor, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, 7th floor, 828 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9.
| | - Iraj Poureslami
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, Gordon and Leslie Diamond Health Care Centre, The University of British Columbia, 7th floor, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, 7th floor, 828 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9
| | - Wayne Mitic
- School of Child and Youth Care, University of Victoria, P.O. Box 1700, STN CSC, Victoria, BC, Canada V8W 2Y2
| | - Jessica Shum
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, Gordon and Leslie Diamond Health Care Centre, The University of British Columbia, 7th floor, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, 7th floor, 828 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9
| | - Irving Rootman
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, 7th floor, 828 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9; School of Public Health and Social Policy, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada V8W 2Y2
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Department of Medicine, Institute for Heart and Lung Health, Gordon and Leslie Diamond Health Care Centre, The University of British Columbia, 7th floor, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, The University of British Columbia, 7th floor, 828 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9
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Nursing students’ perceptions of preparation to engage in patient education. Nurse Educ Pract 2018; 28:1-6. [DOI: 10.1016/j.nepr.2017.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/13/2016] [Accepted: 09/08/2017] [Indexed: 11/20/2022]
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Kaper MS, Sixsmith J, Koot JAR, Meijering LB, van Twillert S, Giammarchi C, Bevilacqua R, Barry MM, Doyle P, Reijneveld SA, de Winter AF. Developing and pilot testing a comprehensive health literacy communication training for health professionals in three European countries. PATIENT EDUCATION AND COUNSELING 2018; 101:152-158. [PMID: 28823383 DOI: 10.1016/j.pec.2017.07.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/12/2017] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Skills to address different health literacy problems are lacking among health professionals. We sought to develop and pilot test a comprehensive health literacy communication training for various health professionals in Ireland, Italy and the Netherlands. METHODS Thirty health professionals participated in the study. A literature review focused on evidence-informed training-components. Focus group discussions (FGDs) explored perspectives from seventeen professionals on a prototype-program, and feedback from thirteen professionals following pilot-training. Pre-post questionnaires assessed self-rated health literacy communication skills. RESULTS The literature review yielded five training-components to address functional, interactive and critical health literacy: health literacy education, gathering and providing information, shared decision-making, enabling self-management, and supporting behaviour change. In FGDs, professionals endorsed the prototype-program and reported that the pilot-training increased knowledge and patient-centred communication skills in addressing health literacy, as shown by self-rated pre-post questionnaires. CONCLUSION A comprehensive training for health professionals in three European countries enhances perceived skills to address functional, interactive and critical health literacy. PRACTICE IMPLICATIONS This training has potential for wider application in education and practice in Europe.
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Affiliation(s)
- Marise S Kaper
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Jane Sixsmith
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Jaap A R Koot
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Louise B Meijering
- University of Groningen, Urban and Regional Studies Institute, Population Research Center, PO Box 800, 9700 AV, Groningen, Netherlands.
| | - Sacha van Twillert
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, PO Box 30002, 9750 RA Haren, Netherlands.
| | - Cinzia Giammarchi
- The Regional Agency for Health (ARS of the Marche Region), Palazzo Rossini, Via Gentile da Fabriano 3, 60125, Ancona, Italy.
| | - Roberta Bevilacqua
- National Institute of Health and Science on Aging (INRCA),Via S. Margherita 5, 60124 Ancona, Italy.
| | - Margaret M Barry
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Priscilla Doyle
- Health Promotion Centre, National University of Ireland Galway, University Road, H91 TK33, Galway, Ireland.
| | - Sijmen A Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
| | - Andrea F de Winter
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, PO Box 30.001, FA10, 9700 RB Groningen, Netherlands.
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Coleman C, Peterson-Perry S, Sachdeva B, Kobus A, Garvin R. Long-term Effects of a Health Literacy Curriculum for Family Medicine Residents. PRIMER : PEER-REVIEW REPORTS IN MEDICAL EDUCATION RESEARCH 2017; 1:22. [PMID: 32944708 DOI: 10.22454/primer.2017.703541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction Improving education about health literacy for health care professionals has been recommended, and many US family medicine residency programs have developed such curricula. Few studies have evaluated the effectiveness of health literacy curricula for health care professionals. This pilot study aimed to determine whether a longitudinal health literacy curriculum for family medicine residents could achieve long-term sustained improvements in health literacy knowledge and clear communication practices. Methods Self-reported pre- and postassessments were conducted for a series of four health literacy didactic and experiential trainings over 11 months with a cohort of 12 first-year family medicine residents (study adequately powered for cohort of 10 or more). Results Five out of five health literacy knowledge items showed sustained significant improvement immediately after the initial didactic training. Two out of eight clear communication behaviors (eliciting patients' questions through an open-ended approach, and using a teach-back method to check for patients' understanding) showed sustained significant improvements in the 11-month follow-up period. The remaining six behaviors demonstrated a saw-tooth pattern, wherein each training session produced improvements in planned behaviors, which were, however, not maintained at subsequent follow-up assessments. Conclusions These data suggest that residents learned the cognitive material related to health literacy and clear communication easily, but had difficulty integrating many trained skills into clinical practice, despite the use of experiential learning techniques. Future studies should use an observational design to assess clear communication behaviors, and should include assessment of potential barriers to implementing clear communication skills in clinical practice.
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Affiliation(s)
- Cliff Coleman
- Oregon Health & Science University, Department of Family Medicine
| | | | - Bhavaya Sachdeva
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University
| | - Amy Kobus
- Department of Psychiatry, Oregon Health & Science University
| | - Roger Garvin
- Department of Family Medicine, Oregon Health & Science University
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Rajah R, Hassali MA, Lim CJ. Health Literacy-Related Knowledge, Attitude, and Perceived Barriers: A Cross-sectional Study among Physicians, Pharmacists, and Nurses in Public Hospitals of Penang, Malaysia. Front Public Health 2017; 5:281. [PMID: 29098146 PMCID: PMC5654106 DOI: 10.3389/fpubh.2017.00281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 10/02/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Patients’ health literacy (HL) has emerged as a critical determinant of health outcomes and becoming one of the core competencies of health-care providers. Therefore, this study aimed to assess among Malaysian physicians, pharmacists, and nurses, their HL-related knowledge, attitude, and perceived barriers, and also to determine the associated factors. Methods A cross-sectional study design was used to enroll 600 eligible respondents using stratified sampling from 6 public hospitals in Penang, Malaysia. A validated self-administered questionnaire was used for data collection. Descriptive and inferential analysis was performed with statistical significance defined as p < 0.05. Results The response rate was 87.6% with 526 questionnaires completed. Of these, 34.2% had poor knowledge, and more than half had negative attitude (51.9%) toward HL with no significant differences among physicians, pharmacists, and nurses. The majority of the respondents perceived time constraints and lack of human resources as major HL barriers. Respondents who had heard the term or concept of HL had significantly higher level of knowledge (p < 0.001) and more positive attitude (p < 0.001). While longer service years (≥11 years) significantly contribute to the higher level of HL knowledge among health-care providers (p = 0.028). Conclusion The study findings supported the concern on inadequate knowledge and substantially negative attitude toward HL among study health-care providers with highest cited barriers were time constraint and human resources. Thus, efforts to improve their perspective about HL to be effective patient educators are highly advocated.
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Affiliation(s)
- Retha Rajah
- Pharmacy Department, Hospital Seberang Jaya, Penang, Malaysia.,Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ching Jou Lim
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Howe CJ, Walker D, Watts J. Use of Recommended Communication Techniques by Diabetes Educators. Health Lit Res Pract 2017; 1:e145-e152. [PMID: 31294260 PMCID: PMC6607791 DOI: 10.3928/24748307-20170810-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/28/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Diabetes educators are challenged to teach diabetes self-management to patients, ensuring comprehension. Effectiveness with patients may be dependent on the communication skills of the diabetes educator. Objective: This study sought to determine diabetes educators' use of and perceived effectiveness of recommended communication techniques with patients to teach diabetes self-management and to determine differences in communication by educator characteristics. Methods: In this cross-sectional study, a convenience sample of 522 diabetes educators, comprised mostly of nurses, dieticians, and pharmacists, completed the American Medical Association (AMA) Communication Techniques Survey at a national conference. The AMA survey assessed diabetes educators' self-reported use of and perceived effectiveness of 14 communication techniques. Internal consistency for items reporting frequency of communication techniques was α = 0.83 and for items reporting perceived effectiveness was α = 0.87. Key Results: Simple language, written patient education materials, and using Teach-Back were the most frequently reported techniques. Follow-up phone calls and drawing pictures were the least reported. Educators of Hispanic ethnicity used significantly more communication techniques than Caucasian respondents (p < .05). Educators with more than 16 years in practice and those who provided more than 16 hours of diabetes education per week used significantly more techniques than those with less experience (p < .01). Nurses used significantly more techniques than dieticians (p < .01) and those who had health literacy or communication as part of their schooling used more techniques than those who did not (p < .05). No significant difference on the routine use of communication techniques was found by education level or diabetes educator certification status. Conclusions: The findings provide a baseline assessment of diabetes educator communication practice. Inclusion of health literacy and communication in health professional school curricula appears to support competency, suggesting opportunities for inter-professional health literacy and communication education and research. [Health Literacy Research and Practice. 2017;1(4):e145–e152.] Plain Language Summary: We did a survey asking diabetes educators how they communicate with their patients with diabetes. They mostly used simple language, gave out pamphlets, and used Teach-Back. They did not draw pictures to help explain things. Diabetes educators who were Hispanic, nurses, and had health literacy training in school used more communication techniques. Health literacy and communication should be included in training of health providers.
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Affiliation(s)
- Carol J. Howe
- Address correspondence to Carol J. Howe, PhD, RN, CDE, Harris College of Nursing and Health Sciences, Texas Christian University, 2800 W. Bowie Street, Fort Worth, TX 76129;
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Coleman C, Hudson S, Pederson B. Prioritized Health Literacy and Clear Communication Practices For Health Care Professionals. Health Lit Res Pract 2017; 1:e91-e99. [PMID: 31294254 PMCID: PMC6607795 DOI: 10.3928/24748307-20170503-01] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 05/02/2017] [Indexed: 11/20/2022] Open
Abstract
Background Health care professionals need more and better training about health literacy and clear communication to provide optimal care to populations with low health literacy. A large number of health literacy and clear communication practices have been identified in the literature, but health professions educators, administrators, and policymakers have lacked guidance regarding which practices should be prioritized among members of the health care workforce. Objective This study sought to prioritize recommended health literacy and clear communication practices for health care professionals. Methods A Q-sort consensus method was used among 25 health literacy experts to rank a previously identified list of 32 health literacy and clear communication practices for health care professionals. Mean ratings for each of the 32 practices were compared using t-tests. Key Results Mean ratings for the 32 practices fell along a spectrum from higher to lower importance. The eight top-rated practices formed a cluster, and seven of these items demonstrated clear consensus, whereas one item may have been influenced by one or more outlier rankings. Conclusions Although a large number of health literacy and clear communication practices have been recommended in the literature for health care professionals, this is the first known study to rank such practices in terms of importance. The top-rated items can be considered a core set of practices that all health care professionals should learn and routinely use in clinical settings. These consensus opinion results will help health professions educators, administrators, and policymakers to direct potentially limited resources toward improving training in patient-centered communication, and when designing curricula, practice standards, care delivery models, and policies for health care professionals and systems to improve patient outcomes. Future studies should empirically confirm the relative value of the ranked items in terms of patient-centered outcomes. [Health Literacy Research and Practice. 2017;1(3):e90-e99.]. Plain Language Summary This is the first study to rank the most important things that health care workers can do to communicate more clearly with patients. A group of 25 experts ranked 32 items in order of importance. The list can be used to improve training for health care workers.
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Affiliation(s)
- Cliff Coleman
- Address correspondence to Cliff Coleman, MD, MPH, Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239;
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Ernstmann N, Halbach S, Kowalski C, Pfaff H, Ansmann L. Measuring attributes of health literate health care organizations from the patients' perspective: Development and validation of a questionnaire to assess health literacy-sensitive communication (HL-COM). ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2017; 121:58-63. [PMID: 28545615 DOI: 10.1016/j.zefq.2016.12.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/28/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies addressing the organizational contexts of care that may help increase the patients' ability to cope with a disease and to navigate through the health care system are still rare. Especially instruments allowing the assessment of such organizational efforts from the patients' perspective are missing. The aim of our study was to develop a survey instrument assessing organizational health literacy (HL) from the patients' perspective, i. e., health care organizations' responsiveness to patients' individual needs. METHODS A pool of 30 items was developed by a group of experts based on a literature review. The items were developed, tested and prioritized according to their importance in 11 semi-structured interviews and cognitive think-aloud interviews with cancer patients. The resulting 16 items were rated in a standardized postal survey involving a total of N=453 colon and breast cancer patients treated in cancer centers in Germany. An exploratory factor analysis, a confirmatory factor analysis and structural equation modelling were conducted. Item properties were analyzed. RESULTS 83.2 % of the patients were diagnosed with breast cancer, 16.8 % had a diagnosis of colon cancer. The patients' mean age was 61 (26-88), 89.4 % were female. The most common comorbidities were hypertension (34.0 %) and cardiovascular disease (11.0 %). The final prediction model included nine items measuring the degree of health literacy-sensitivity of communication. The model showed an acceptable model fit. The nine items showed corrected item-total correlations between .622 and .762 and item difficulties between 0.77 and 0.87. Cronbach's α was .912. DISCUSSION In a comprehensive development process, the original item pool comprising several aspects of organizational HL was reduced to a one-dimensional scale. The instrument measures an important aspect of organizational HL; i.e., the degree of health literacy-sensitivity of communication (HL-COM). HL-COM was found to impact patient enablement, mediated through the support by physicians. Future research will have to test these associations in the context of other diseases or institutions.
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Affiliation(s)
- Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany; Center for Integrated Oncology Köln Bonn, Germany.
| | - Sarah Halbach
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | | | - Holger Pfaff
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
| | - Lena Ansmann
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
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Chang LC, Chen YC, Wu FL, Liao LL. Exploring health literacy competencies towards patient education programme for Chinese-speaking healthcare professionals: a Delphi study. BMJ Open 2017; 7:e011772. [PMID: 28093428 PMCID: PMC5253604 DOI: 10.1136/bmjopen-2016-011772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To achieve consensus on a set of competencies in health literacy practice based on a literature review and expert consultation. SETTING Hospitals and community health centres in Taiwan. METHOD A 2-stage modified Delphi study involving a literature review was conducted, followed by qualitative interviews and 3 rounds of email-based data collection over a 3-month period in 2011. PARTICIPANTS 15 Chinese healthcare practitioners with more than 6 months' experience in patient education were interviewed to collect data on health literacy practice. 24 experts (12 academic scholars in health literacy and 12 professionals with training related to health literacy practice) were invited to participate in the Delphi process. RESULTS Qualitative data from the interviews were analysed and summarised to form 99 competency items for health literacy practice, which were categorised into 5 domains of health literacy practice including those pertaining to knowledge and skills. Consensus was reached on 92 of 99 competencies, using a modified Delphi technique. CONCLUSIONS The 92 competencies in health literacy practice embraced core components of patient education in the Chinese healthcare profession.
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Affiliation(s)
- Li-Chun Chang
- School of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| | - Yu-Chi Chen
- Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Fei Ling Wu
- School of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung City, Taiwan
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Toronto CE. Health Literacy Competencies for Registered Nurses: An e-Delphi Study. J Contin Educ Nurs 2016; 47:558-565. [DOI: 10.3928/00220124-20161115-09] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 09/02/2016] [Indexed: 11/20/2022]
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