Short Assessment of Health Literacy for Portuguese-speaking Adults

Abstract

OBJECTIVE:To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS:The Short Assessment of Health Literacy for Portuguesespeaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defi ned as failure to fully understand standard medical prescriptions. RESULTS:Moderate to high correlations were found in the assessment of construct validity (Spearman's coeffi cients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coeffi cient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS:The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy. Health literacy is defi ned as the ability to perform basic reading and numerical tasks required to function in the health care environment.1 There is increasing evidence that health literacy skills are related to important health outcomes, even after adjustments for confounding factors such as education, age, and gender. Inadequate health literacy has been independently associated with lower utilization of preventive services, poor self-management of chronic conditions, low medication adherence, increased hospitalization, and higher death rates. 4 Some population groups are at greater risk for inadequate health literacy including the socioeconomically disadvantaged, immigrants, and older adults. Inadequate health literacy may disproportionately affect the health of older people, not only as a result of generation gap in education, but also because the elderly have more medical conditions, use more health care services, and are more likely to require complex therapeutic regimens. 12Because years of formal schooling alone are not a reliable indicator of health literacy and individuals with lower health literacy skills may try to hide it, it is diffi cult to recognize those patients with inadequate health literacy during routine clinical care.15 Developing RESUMO OBJETIVO: Desenvolver e validar um instrumento breve para avaliação de alfabetismo em saúde na língua portuguesa. MÉTODOS:O instrumento desenvolvido consiste de 50 itens que avaliam a capacidade do indivíduo de pronunciar e compreender termos médicos comuns. As propriedades psicométricas foram avaliadas e...

Literacia em saúde: tradução e validação de instrumento para pesquisa em promoção da saúde no Brasil

“…As discussões foram pautadas com base em buscas na literatura sobre instrumentos disponíveis que avaliassem literacia em saúde na população brasileira, o que resultou num único instrumento para o contexto brasileiro. O referido instrumento foi utilizado em uma amostra de idosos (> 60 anos) 17 e não atendia aos objetivos dos pesquisadores.…”

“…No Brasil, foi encontrado um instrumento validado para avaliar a literacia em saúde. Entretanto, o instrumento foi avaliado na população idosa e apresentou algumas limitações no processo de validação 17 , o que aponta para a necessidade de novos instrumentos dentro da área e voltados para a população brasileira.…”

Instrumentos de avaliação do letramento em saúde: revisão de literatura

“…REALM, employed in the United States, Ireland and Brazil, was chosen in 8 articles (29.6%) (11,12,25,26,30,(32)(33)(34) . Five of these articles used the full version (18.6%) (11,25,(32)(33)(34) , 1 of them used the short version (3.7%) (12) , and 1 used the reviewed version (3.7%) (30) .…”

“…Five of these articles used the full version (18.6%) (11,25,(32)(33)(34) , 1 of them used the short version (3.7%) (12) , and 1 used the reviewed version (3.7%) (30) . Of these 8 studies, 1 (3.7%) used SAHLPA (Short Assessment of Health Literacy for Portuguese-speaking Adults) (26) , a version (13,21,29,36) in Japan and the Netherlands, and SBSQ (Set of Brief Screening Questions), in 2 articles (7.4%) (16,17) : a study that performed assessments in 15 European countries (16) and a study that involved countries in Europe, Oceania, North and South America (17) . Each one of the other 13 health literacy assessment instruments that were identified in the study was used by 1 article (3.7%).…”

Letramento funcional em saúde na perspectiva da Enfermagem Gerontológica: revisão integrativa da literatura

“…4 FHL has attracted the interest of researchers, health professionals and public policy creators, due to its complex, multi-dimensional and interdisciplinary nature, as well as the impact that poor literacy can exert on an individual, their family, the community and the health system. 8,[10][11][12] FHL is a functional condition that involves multiple dimensions, which are interwoven into a complex network of health determinants, including: sociodemographic characteristics (occupation, income, social support, culture and language); cognitive abilities (cognition and memory); and physical abilities (age, vision, audition and verbal fluency). These determinants interact among each other, although it is important to consider macro aspects from each country, such as the educational system, the health system, and the cultural and social aspects that transversely permeate these determinants.…”