Nursing Education and Health Literacy

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 Health Literacy and Nursing Education

Nursing Education and Health Literacy

What Is Health literacy,Implementation of Health literacy,Research and Health Literacy,Role of Faculty In Nursing Health Literacy.

What Is Health literacy

    In Healthy People 2010, health literacy is defined as, "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (US Department of Health and Human Services, 2000, Section 11. p. 20).

Implementation of Health literacy

    People with poor literacy skills have much higher medical costs and more hospitalization than literate people. Poor health literacy results in increased morbidity and mortality. more emergency department visits, less likelihood of the use of preventive services, and less likelihood that a person will take medication as instructed (Bastable, Meyers, & Poitevent , 2014).

    Nurses are in a unique position as patient advocates and educators to help their clients obtain, process, and understand health information to make appropriate health decisions (Bastable et al. 2014). Whether in hospitals, long-term facilities, clinics, or public health settings, nurses provide care to more than 90 million Americans who struggle to locate, understand, and appropriately use health information (Zarcadoolas, Pleasant, & Greer, 2006).

    The American Association of Colleges of Nursing (2008) in its Essentials of Baccalaureate Education for Professional Nursing Practice identifies health literacy as an important content area for all baccalaureate programs. "Nurse educators recognize the need for curriculum standards in the area of health literacy" (Smith & Zsohar, 2011, p. 48). 

Nursing education programs best prepare students by focusing on current health literacy topics including the definitions of literacy and health literacy, the scope of the problem, at risk populations, the relationship between health literacy and poor health outcomes, how to identify people with low literacy skills, e-health literacy (appraising information from electronic sources), and ways to optimize the readability of patient education materials.

    Plain language communication, interpersonal skills, cultural sensitivity, at-risk populations, and observed client behavior related to low literacy are often included in health literacy education programs (Smith & Zsohar, 2011). Nurse educators can use active teaching strategies to help students integrate health literacy skills into practice (Smith & Zsohar, 2011). Nursing students can view video vignettes and then demonstrate skills. Patient education materials can be tested for readability and then rewritten at more appropriate reading levels

Research and Health Literacy

    Research in health literacy has focused on the development of standardized tests nurses can use to measure reading and health literacy skills of patients. These tests include the Wide Range Achievement Test (WRAT), the Rapid Estimate of Adult Literacy in Medicine (REALM), the Test of Functional Health Literacy in Adults (TOFHLA), the Newest Vital Sign (NVS), the eHealth Learning Scale ( eHEALS ), and the Literacy Assessment of Diabetes (LAD; Bastable et al, 2014). The dental/medical health literacy screen (REALMD-20) is now available for adult dental and medical patients (Gironda, Der-Martirosian, Messadi, Holtzman, & Atchison, 2013).

    Administration of health literacy screening tests can be awkward for nurses to use in practice and the results can be hard to use. According to Chew, Bradley, and Boyko (2004), an easier way to identify inadequate health literacy skills is to ask three questions: 

(a) "How often do you have someone help you read hospital materials?" 

(b) "How confident are you filling out medical forms by yourself?" 

(c) "How often do you have problems learning about your medical condition because of difficulty understanding written information?"

    Bastable et al. (2014) summarize the literature and present practical strategies for nurses to use when in the role of an educator. These strategies include establishing a trusting relationship before starting the learning process, using the smallest amount of information to accomplish behavioral objectives, teaching one step at a time, using multiple methods and tools requiring fewer literacy skills, allowing patients the opportunity to restate information in their own words and demonstrating procedures, recognizing patient progress to keep motivation high, tailoring new regimens into daily schedules of clients, and utilizing repetition by saying the same thing in different ways.

    Nurses often rely on the classic work of Doak, Doak, and Root (1996) for ideas on preparing written materials, Bastable et al. (2014) consolidate the literature and provide a comprehensive list of 27 strategies to use in writing easy-to-read patient education materials. Suggestions include ideas on text and sentence construction, format, layout, and the use of graphics. 

    Specific writing ideas include the following: use conversational style, use short words, use headers, have sufficient white space, use short sentences, define technical words, use simple and realistic drawings, use simple type style at 14 to 16 font size, and aim at or less than the 6th grade reading level. In addition, all written materials should be read ability tested using a formula such as SMOG (estimate of the years of education a person needs to understand written material) or FRY (evaluates readability) and be pretested.

Role of Faculty In Nursing Health Literacy

    The role of an educator has always been an important part of nursing practice. Nurses are communicators and interpreters of health information. As stated by Bastable et al. (2014). "Nurse educators need to know how to identify clients with literacy problems, assess their needs, and choose appropriate interventions that create a supportive environment directed toward helping those with poor reading and comprehension skills to better and more safely care for themselves" (p. 303 ).

    Nurses are in the ideal position to improve the quality of care delivered to clients. As the health care system becomes increasingly diverse and populations more heterogeneous, it becomes critical for nurses to learn and implement health literacy concepts and skills to help clients with the many problems associated with poor health literacy.

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