Registered Nurses' Knowledge of and Experience with Health Literacy

The roles of nurses in supporting health literacy: a scoping review

Introduction

The importance of health literacy in achieving optimum health is highly significant, particularly in the nursing profession where it is an integral part of the roles and functions of nurses. Therefore, this scoping review aims to describe the roles of nurses in promoting patient health literacy and identify the determinant factors of health literacy in nursing practices.

Methods

An integrative search was conducted through four databases, namely, ScienceDirect, ProQuest, SAGE Journal, and PubMed, using various keyword combinations such as "health literacy," "health information," "patient health literacy," "patient literacy," and "nurses." Furthermore, the inclusion criteria employed were peer-reviewed articles focused on the nursing profession, explicitly discussing health literacy related to nursing, and including original studies, such as cross-sectional, quasi-experimental, and qualitative studies. The selected review articles were all published between 2017 and 2022.

Results

In total, 13 articles met the criteria and were applied in this scoping review. Most of these discuss health literacy related to nursing practice in clinical and community settings, as well as educational institutions. Health literacy is an essential aspect of professional nursing practice. Consequently, the supportive roles of nurses include acting as caregivers, facilitators, and educators to help patients overcome their literacy limitations and attain improved wellbeing.

Conclusion

Nurses can improve the health literacy skills of patients by making health information related to their illnesses easier to access, understand, evaluate, and use. They must also recognize various factors influencing health literacy and use the factors as opportunities to optimize health literacy improvement. A health literacy approach can be applied by nurses to solve health problems and improve the quality of care for patients.

Evaluation of Health Literacy and Associated Factors Among Adults Living in Saudi Arabia: A Cross-Sectional Study

In this westernized culture, maintaining a healthy lifestyle has become a major health concern internationally. Health literacy is an emerging concept and requires effective measures and reform to improve the health status and health of individuals at both national and international levels, and has become one of the important determinants of individual health and healthcare service. This study aimed to assess health literacy among adults in Saudi Arabia. A cross-sectional study was conducted among a randomly selected population using a structured validated questionnaire over 4 months in 2021. The questionnaires designed for the study included 26 items divided into 5 domains assessed on a five-point Likert scale. Data were analyzed using IBM SPSS Statistics 26 (IBM Inc., Chicago, IL, USA) and IBM SPSS 26 (IBM Inc.). The mean score for reading, access to information, understanding, appraisal, and decision-making was 12.01 ± 4.37, 20.16 ± 7.17, 24.84 ± 8.37, 11.85 ± 4.90, and 36.94 ± 10.41 respectively. The mean scores of reading and understanding domains were found to have significant differences concerning gender (P < .05). Additionally, participants' age was significantly associated with the mean score of reading and decision-making (P < .006 and P < .049). The findings reported a prevalence of inadequate HL in the population of Saudi Arabia was 54.4%, and the determinants associated with the scores of HL were age, gender, and education.

Förderung organisationaler Gesundheitskompetenz aus Sicht von Pflegefachpersonen. Ergebnisse einer qualitativen Studie

Hintergrund

Gesundheitseinrichtungen sind gefordert, Patient*innen in ihrer Gesundheitskompetenz zu unterstützen und zu fördern. Dabei kommt Pflegefachpersonen eine bedeutsame Rolle zu, auf die Informationsfähigkeiten und -bedarfe von Patient*innen einzugehen. Bislang ist jedoch kaum untersucht, inwieweit die Pflegepraxis auf diese Aufgabe vorbereitet ist.

Ziel

Ziel der Studie ist es, die Ausgangslage in pflegerischen Informations- und Beratungssituationen zu beschreiben, auf die die Bestrebungen der Förderung der organisationalen Gesundheitskompetenz treffen.

Methode

Es wurden 21 leitfadengestützte Interviews mit Pflegefachpersonen durchgeführt. Die Auswertung erfolgte thematisch kodierend.

Ergebnisse

Die Ergebnisse zeigen, dass sich Pflegefachpersonen auf eine Ad-hoc-Informationsvermittlung spezialisiert haben, in der Aufklärung und Wissensvermittlung im Vordergrund stehen. Beratende und schulende Ansätze finden sich kaum. Adressiert wird ein breites Feld an Informationsthemen, das von Gesundheitsförderung und Prävention bis zu Fragen der Behandlung, Koordination und des Selbstmanagements reicht. Hier zeigt sich eine direkte Passfähigkeit an Konzepte der organisationalen Gesundheitskompetenz. Deutlich wird jedoch, dass es nach dem Berufseinstieg an strukturierten Qualifikationsmöglichkeiten für Pflegefachpersonen zum Thema Kommunikation mangelt. Informationstechniken erarbeiten sie sich durch Erfahrungslernen mit zunehmender Berufserfahrung überwiegend selbst.

Schlussfolgerungen

Die Ergebnisse liefern Hinweise auf die aktuelle Praxis der Vermittlung von gesundheitskompetenzfördernden Informationen durch Pflegefachpersonen. Sie bieten Ansatzpunkte für die zukünftige Konzeptentwicklung, etwa Pflegefachpersonen gezielter in ihrem Qualifikationsbedarf zu unterstützen.

Effects of health literacy competencies on patient-centered care among nurses

Background

This study aims to identify the relationship between health literacy competencies and patient-centered care by clinical nurses.

Methods

The participants were 180 nurses working at three university hospitals located in G City and J Province, South Korea. Self-evaluation questionnaires were used to collect data that were collected from June 1 to 30, 2021. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression with SPSS 26.0.

Results

The mean of health literacy competencies was 3.19 (4 point scale) and the mean of patient-centered care was 3.48 (5 point scale). There were significant positive relationships between health literacy competencies and patient-centered care by clinical nurses (r = .50, p < .001). Factors influencing the health literacy competencies of clinical nurses were identified as education level (university) (β = .82), education level (masters) (β = .74), prior health literacy knowledge (β = .52), and health literacy competencies (β = .44). The explanatory power of this regression model was 36%, which was statistically significant (F = 17.65, p < .001).

Conclusion

Clinical nurses’ health literacy competencies should be developed to improve patient-centered care. Nursing education programs should emphasize the integration of health literacy into the nursing school curriculum.

Health literacy training program for community healthcare providers using hybrid online team-based learning in Taiwan

BACKGROUND

Health literacy (HL) has proven to be a determining factor influencing the health of individuals. Community health providers (CHPs) work on the front line of improving public HL. Increasing their understanding of HL and their ability to incorporate HL into healthcare can reduce obstacles in healthcare services. This study evaluated the effectiveness of an HL training program for CHP by using the hybrid online team-based learning (TBL) model.

METHODS

A quasi-experimental study and focused group interviews were conducted. We developed a six weeks HL online course for CHPs. The program included teaching videos for pre-class preparation, a 90-min online TBL model, and a case discussion in the last two weeks. Team application activities were designed for each class to enhance knowledge application. A total of 81 CHPs from 20 public health centers took the course and provided complete data for analysis. Learning effectiveness was evaluated based on the familiarity, attitude, and confidence in implementing HL practices, course satisfaction, and participants' learning experiences.

RESULTS

The comparison showed that the participants' familiarity with HL (4.29 ± 1.76 vs 6.92 ± 1.52, p < .001), attitude (7.39 ± 1.88 vs 8.10 ± 1.44, p = .004), and confidence in implementing HL practices (6.22 ± 1.48 vs 7.61 ± 1.34, p < .001) increased after the course. The average satisfaction with the teaching strategies was 4.06 ± .53 points, the average helpfulness to practice was 4.13 ± .55 points, and the overall feedback on satisfaction with learning was 4.06 ± .58 points (the full score was 5 points). According to the learning experience of the 20 participants in the focus group discussion, the experiences of teaching strategies and the learning experiences of the HL course were summed up into two categories, seven themes, and 13 subthemes. The results showed a positive experience with the hybrid online TBL program.

CONCLUSION

The use of hybrid online TBL model is a feasible and valid approach for the HL training of CHPs. The result can serve as a reference for the on-the-job training of various healthcare workers.

An assessment of nurses' participation in Health Promotion: a knowledge, perception, and practice perspective

BACKGROUND

Health promotion (HP) at the population level serves to improve health inequalities, enhance the quality of life, and ensures the provision of healthcare and related services. Nurses at all levels are charged with the task of ensuring that patients receive HP services. However, their competence in addressing this challenge needs further exploration. This study assessed the influence of HP knowledge and perceptions in nurses' HP practice.

METHODS

The study was conducted using a self-administered questionnaire among 184 nurses randomly sampled from a tertiary hospital. Questions bordered on respondents' demographics, knowledge, perception, and practice of HP. Responses were retrieved and analysed using IBM SPSS Statistics, Version 26.0. Armonk, NY: IBM Corp, 2019.

RESULTS

Analysis showed a statistically significant relationship between participants demographics and possessing adequate knowledge to provide HP services. Statistically significant relationships were found amongst the following variables: 'A holistic knowledge of disease pathology and processes are vital for effective care of patients' and 'education of patients on medication' p = 0.001, 'awareness of importance of educating patients about their condition' and 'patients encouraged to engage in healthy lifestyle' p < 0.001.

CONCLUSION

Data showed that nurses' knowledge regarding HP had a strong influence on their perception of HP. Their perception of HP in turn strongly influenced their practice of the same. Therefore, rigorous efforts must be made by governmental agencies, and organizations involved in healthcare worker training and nursing accreditation, to ensure the HP curriculum is well incorporated in nursing undergraduate training and sustained in service.

Familiarity, Attitude, and Confidence of Health Literacy Practice among Community Healthcare Providers in Taiwan

Health literacy (HL), which is a determinant of individuals’ health as well as a personal and public asset, can be improved by community healthcare providers (CHPs) with the capability of providing HL services. The purpose of this study was to explore CHPs’ familiarity with and attitudes toward HL and their confidence in implementing HL practices. A cross-sectional online survey was conducted involving a total of 104 CHPs from 20 public health centers in Taiwan. It was based on a structured questionnaire involving self-evaluation by participants. The scores for familiarity, attitudes, and confidence in implementing HL practices were mean = 4.36, SD = 1.99; mean = 7.45, SD = 1.93; and mean = 6.10, SD = 1.77 (out of 10 points), respectively. The results of the multiple regression analysis showed that the two independent variables of familiarity and attitude could predict confidence in implementing HL practices (R² = 0.57, F(2101) = 58.96, p < 0.001). The CHPs surveyed were not especially familiar with HL; thus, they recognized its importance, but they lacked confidence in implementing HL practices. Increasing practitioners’ familiarity with HL may therefore boost their confidence in implementation. The research results can serve as a reference when planning HL education and training.

A Comparative Analysis of Student and Practising Nurses' Health Literacy Knowledge in Ghana

This study examined student and practising nurses’ health literacy knowledge, and its correlates in Ghana. It was underpinned by an adapted version of the Institute of Medicine’s (IOM) conceptual framework of health literacy. We used convenience and snowball sampling techniques to collect data from 876 nurses (477 student nurses and 399 practising nurses) in a cross-sectional survey from February 2019 to June 2019. The respondents were drawn from all the former ten administrative regions of Ghana. Approximately 75.4% of the respondents had heard of health literacy. However, health literacy knowledge was generally low (average score of 6.6 out of 20) among both groups, with student nurses (average score of 5.8 out of 20) having significantly lower scores than practising nurses (average score of 7.4 out of 20). Factors associated with health literacy knowledge among student nurses included gender (male, B = −0.499, p < 0.01), trust in others (B = −0.874, p < 0.001), cultural values (B = 0.276, p < 0.001), year of study (B = 0.244, p < 0.05), and frequency of curative care use (B = −0.236, p < 0.05). For practising nurses, trust (B = −1.252, p < 0.01), cultural values (B = 0.357, p < 0.01), and working experience (B = 0.612, p < 0.01) were associated with their health literacy knowledge. Thus, responses targeted at gaps in health literacy knowledge of student and practising nurses must be sensitive to personal characteristics (e.g., gender), social values (e.g., issues of trust, and cultural beliefs and practices), as well as factors relating to nursing education and experience.

Health literacy knowledge and experience survey: Cross-cultural adaptation and the psychometric properties of the Iranian nurse version

BACKGROUND

Nurses' knowledge and Experience with Health Literacy can affect the treatment process, improving the quality of health care and effectively communicating with all clients. Evaluation of nurses' knowledge and experience requires a reliable instrument. This study aimed to translate cross-cultural adaptation and testing of Health Literacy Knowledge and Experience Survey (HL-KES).

MATERIALS AND METHODS

This cross-sectional methodological study was done during 2018-2019. The study was carried out in two stages: the first phase was designed to obtain a translation and cross-cultural equivalent of the (HL-KES), based on the World Health Organization (2018) and the Sousa and Rojjanasrirat (2011) Guidelines in six steps: preparation, forward translation, reconciliation, back translation, back translation review and pretesting and cognitive debriefing of the translated questionnaires. The second phase was conducted to evaluate the psychometric properties of the questionnaire.

RESULTS

The content validity index and content validity ratio values of all items were >0.62 and 0.79, respectively. Based on the Kuder-Richardson formula, the reliability of the knowledge dimension was reported as 0.7. Furthermore, split-half coefficient for inter-rather reliability and test-retest were 0.76 and 0.96, respectively. The reliability of their experiences with the HL-KES was measured using Cronbach's alpha, in which it was 0.82.

CONCLUSIONS

The Persian version of the instrument for assessing nurses' knowledge and experience with health literacy had good validity and reliability. It is recommended that it should be used in educational, clinical environments, and also in future research studies.