Improving quality by involving patient. The role of health literacy in influencing patients’ behaviors

Introduction Health Literacy (HL) is an important determinant of individual health. Limited HL is an increasing problem affecting the general population. This study aims to assess the level of HL in patients attending outpatient medical facilities in general medicine located in Naples and Caserta and investigate the association of HL with health behaviours and health status. Materials and methods The study involved patients attending outpatient medical facilities in general medicine. The questionnaire had four sections-the sociodemographic information, the 16-items version of the European Health Literacy Survey questionnaire, the general self-efficacy scale (GSE) and the health status scale (EQ-VAS). Univariate and multivariate analyses were performed to investigate the sociodemographic determinants of HL. The Pearson correlation coefficients were determined to compare HL with health behaviours (GSE) and health status (EQ-VAS). Results The study showed that 61.6% of 503 patients had a low level of HL. After the multivariate analysis, HL was found to be higher among patients with higher education level and general self-efficacy score �30. There were no differences in HL between the age groups and people with or without chronic diseases. HL was stronger correlated with GSE than with EQ-VAS (0.53 vs 0.27). Conclusion This is the first study on HL for Southern Italy. It showed a low level of HL. As the sample was not representative of the reference population, we cannot derive a corresponding conclusion for the general population of Southern Italy. Therefore, more data in Italy are needed to plan actions for improving HL.

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“…Health behaviour measured by GSE and health status measured by EQ-VAS were positively correlated with HL as expected [ 2 , 53 , 54 ].…”

Section: Discussionsupporting

confidence: 74%

Measuring Health Literacy in Southern Italy: A cross-sectional study

Schiavone

Attena

2020

PLoS ONE

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“…Patients with HF also present with cognitive impairment, dementia, and low levels of HL [28][29][30][31]. This, in turn, reduces the person's self-care abilities, with increased use of emergency care, frequent hospitalizations, and a higher mortality rate [32][33][34][35][36][37].…”

Section: Co-producing Health and Care With Persons Living With Hfmentioning

confidence: 99%

Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

Suutari¹,

Thor²,

Nordin³

et al. 2021

J Particip Med

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Background Co-production of health and care involving patients, families of patients, and professionals in care processes can create joint learning about how to meet patients’ needs. Although barriers and facilitators to co-production have been examined previously in various health care contexts, the preconditions in Swedish chronic cardiac care contexts are yet to be explored. This study is set in the health system of the Swedish region of Jönköping County and is part of system-wide efforts to promote better health for persons with heart failure (HF). Objective The objective of this study was to test the usefulness of the Capability, Opportunity, and Motivation Behavior (COM-B) model when assessing the barriers to and facilitators of co-production of health and care perceived by patients with HF, family members of patients with HF, and professionals in a Swedish chronic cardiac care context as a guide for subsequent initiatives. Methods Data collection involved 1 focus group interview (FGI) with patients with HF (n=5), 1 FGI with family members of patients with HF (n=5), 1 FGI with professionals in primary care (n=7), and 1 FGI with professionals in cardiac care (n=4). In addition, patients with HF kept diaries of their thoughts regarding co-production. Using a deductive approach to content analysis, underpinned by the COM-B model, barriers and facilitators were categorized into capabilities, opportunities, and motivations to co-produce health and care. Results The participants showed limited understanding of co-production as a practice. They appeared to view it as a privilege to be offered to patients on top of traditional care and rarely as an approach for improving health care processes. The interviews revealed the limited health literacy among patients and the struggle of professionals to convey health information to these patients. Co-production was considered to be more resource-intensive than traditional care. Different expectations of stakeholders’ roles were revealed: professionals expected older patients not to want to co-produce health and care, and all participants expected professionals to be in charge of health care services. The family members’ position involved trying to balance their desire to support their relatives with understanding when, how, and with whom to co-produce. Presumed benefits motivated stakeholders: co-production was recognized to motivate patients to improve self-care. However, the participants recognized that motivation to get involved in health and care decisions varies over time among stakeholders. Conclusions Co-production can be facilitated by the stakeholders’ motivation. However, varying levels of understanding of co-production, patients’ limited health literacy, unease with power sharing between patients and professionals, and resource constraints are barriers that need to be managed to promote co-produced care and better health for persons living with HF. Further research is warranted to explore how to co-produce health care services with patients with HF and how leaders can facilitate the inevitable cultural change it requires and represents.

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“…Other studies have concluded that empowering patients by improving their HL could enhance their self-con dence in controlling disease symptoms and managing their disease condition, which could improve health outcomes [35,[82][83][84][85][86][87][88]. To empower an individual to have greater control over their own health, they must be con dent in their ability to take control of their disease management (e.g., self-e cacy) and have the necessary skills (e.g., empowerment) to do so while navigating the complexities of the healthcare system [50].…”

Section: Discussionmentioning

confidence: 99%

“…To empower an individual to have greater control over their own health, they must be con dent in their ability to take control of their disease management (e.g., self-e cacy) and have the necessary skills (e.g., empowerment) to do so while navigating the complexities of the healthcare system [50]. As evidenced by the literature, an empowered individual is more likely to comprehend their health issues and understand health instructions, seek proper care services, navigate successfully through the health care system, evaluate the usefulness of health information received, describe symptoms and triggers, and make informed decisions by applying the gained information and experiences to maintain their health [83][84][85][86][87]. Therefore, if the goal of improved HL is to empower an individual to properly manage their health condition, all the necessary factors that play crucial roles in this process should be identi ed and applied in the development of a HL intervention model to improve disease self-management.…”

Section: Discussionmentioning

confidence: 99%

A Conceptual Model of Functional Health Literacy to Improve Chronic Airway Disease Outcomes

Poureslami

FitzGerald

Tregobov

et al. 2020

Preprint

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Background: Current conceptual models of health literacy (HL) illustrate the link between HL skills and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into a comprehensive framework. This article summarizes the process of developing a Chronic Airway Disease Management and Health Literacy (CADMaHL) conceptual model.Methods: The proposed CADMaHL model is developed within the following six stages: (1) Systematic review of HL measurement tools. (2) Patient-oriented focus group sessions. (3) HL and health professions (key-informants) interviews. (4) Attain perspectives and feedback of respirologists. (5) Develop a HL measurement tool for chronic airway disease (CAD) patients (e.g., asthma and COPD), pilot test, and tool modification. (6) Tool validation with asthma and COPD patients. Results: Throughout the study process, patient population groups, an advisory panel of HL experts, clinician scientists, and researchers reviewed the information acquired. This review process enabled us to organize the CADMaHL model into 6 primary modules, including INPUT, consists of four HL core components (access, understand, communicate, evaluate) and numeracy skill; OUTPUT, includes use/application of the obtained information; OUTCOME, covers patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, comprises HL assessment tools and strategies; IMPACT, includes mediators between HL and health outcomes; and CROSSCUTTING FACTORS, consists of diverse socio-demographics and health-system factors with applicability across the HL domains.Conclusions: We developed and validated the proposed HL tool using the CADMaHL model. We anticipate that the model may inform development of interventions aiming to improve HL and disease management outcomes of CAD patients, by properly identifying and mitigating HL gaps among these patient population groups.

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Improving quality by involving patient. The role of health literacy in influencing patients’ behaviors

Cited by 20 publications

References 44 publications

Measuring Health Literacy in Southern Italy: A cross-sectional study

Measuring Health Literacy in Southern Italy: A cross-sectional study

Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

A Conceptual Model of Functional Health Literacy to Improve Chronic Airway Disease Outcomes

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